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PubMed2003

Neuroticism and depressive symptoms among spouse caregivers: do health behaviors mediate this relationship?

This study examined the mediating role of health behaviors in the relationship between neuroticism and depressive symptoms among spouse caregivers. Path analysis was used to test a model of the caregiver stress process among 233 caregivers of people with dementia. Results indicate that neuroticism has a significant direct effect on depressive symptoms and also indirectly influences depressive symptoms through health behaviors and perceived stress. When individual health behaviors were examined in the path model, only physical activity served a significant mediating role. These findings suggest that neuroticism may lead to depressive symptoms among caregivers partly through declines in physical activity.

Adult↗
PubMed1998

The experiences of female spouses of survivors of acute myocardial infarction: a pilot study of Lebanese-born women in south-western Sydney, Australia.

Lebanese migrants form a significant proportion of the population in southwestern Sydney (SWS), and in New South Wales, Australia. This pilot study was undertaken in south-western Sydney, a rapidly expanding and socioeconomically disadvantaged region, to explore the experiences of English speaking women of Lebanese origin whose spouses had recently experienced an acute myocardial infarction (AMI). Semi-structured interviews were conducted with seven Lebanese-born women at 2- and 4-week intervals, following the discharge of their husbands from hospital. Qualitative analysis of narrative text revealed four distinct themes. These were: struggle to resolve distress; intensive monitoring of the AMI survivor; searching for avenues of support; and reflecting on the future. Study findings are discussed in relation to the literature. Implications for nursing practice and research are drawn from study findings.

Adaptation, Psychological↗
PubMed2002

Synergy towards health: a nursing intervention model for women living with fibromyalgia, and their spouses.

AIM: The purpose of this study was to develop a consensus-based nursing intervention model for women living with fibromyalgia, their spouses and nurses working in a community health centre in Québec, Canada. BACKGROUND: Fibromyalgia syndrome, a rheumatic disorder associated with severe chronic pain and fatigue, has a major impact on the lives of individuals and their family. To date, research results on effective interventions are somewhat limited and inconclusive. Few studies take into account the perspective of those who live with this health problem on a day-to-day basis. METHODS: Data were collected mainly in 1999, through in-depth interviews and through group meetings using a qualitative research design, along the lines of the constructivist paradigm. The analysis plan aims for movement between the global and the specific: synthesis and thematic analysis. Analysed data were submitted to all participants throughout the data-collection process, thus allowing for shared constructions. FINDINGS: Results present the general consensus stemming from shared construction in all three groups. The nature of the intervention involves two major elements, support and teaching along with the fundamental importance of believing in the person. The timing of the intervention and the health and social context in which the intervention occurs also emerge as integral parts of the model. Synergy towards health in fibromyalgia emerges as the constitutive pattern composed of the following three elements: personal growth, spousal and professional support. The discussion addresses the model's components and uses an ecological perspective, in order to consider all the contexts that greatly influence the intervention. Empowerment is embedded in this intervention model. CONCLUSIONS: This study shows that research based on partnership allows the integration of perspectives and skills of various actors so as to develop meaningful interventions for both those seeking care and health professionals.

Adaptation, Psychological↗
PubMed1990

Spouse abuse. Care goes beyond the office door.

Domestic violence is an underreported and underrecognized problem with immense medical, social, psychological, and emotional costs. Vigilance in recognizing the victim of spouse abuse and direct questioning of the patient about the possibility are the first steps in identification and treatment. Being alert to signs of abuse in the face of patient denial is also important. Treatment of the medical and surgical sequelae of abuse is just the initial stage of therapy. A concerned, knowledgeable team that can address the patient's individual psychological and emotional needs while providing a safe alternative living situation and referral resources is critical to success. Great caution should be used in prescribing psychotropic medication. Clear documentation of an abused patient's injuries serves both the victim and the physician well, but reporting the information to authorities should only be done when it is legally required or at the patient's request.

Female↗
PubMed2006

Mental health and sleep of older wife caregivers for spouses with Alzheimer's disease and related disorders.

This descriptive study examined sleep and mental health variables in 37 older wife caregivers for spouses with dementia compared to 37 age-matched controls. The relationships among selected caregiving variables (behavioral problems, caregiving hours, and years of caregiving), appraisal of burden, self-reported sleep efficiency for the past week, and mental health outcomes were examined. Lazarus and Folkman's stress and coping framework guided the study. Mental health and sleep were poorer for caregivers. Caregiving and appraisal of burden variables showed direct and indirect effects on mental health. However, caregiving and appraisal of burden variables were not significant for predicting sleep efficiency. Sleep efficiency was a good predictor of mental health in this sample of wife caregivers.

Aged↗
PubMed2006

Health responses of New York City firefighter spouses and their families post-September 11, 2001 terrorist attacks.

Much attention has been focused on New York City firefighters and their responses to the traumatic events of the September 11, 2001, terrorist attacks on the World Trade Center, given their extensive involvement in rescue efforts, and the overwhelming loss of life among the fire department employees. It quickly became evident that the impact of this horrendous event had resonated deeply not only on the families and children of the firefighters who gave their lives, but also on those who had survived. The goal of this study was to conduct semi-structured focus groups of women whose firefighter husbands were directly involved in rescue efforts at Ground Zero. We hoped to identify patterns in survivors' responses to the events as well as any coping mechanisms that the participants used to manage their exposure to the tragedy. An analysis of transcripts from interviews reveals the nature and extent of the impact of the trauma on these women, their husbands, and their children. There were two recurring themes that were apparent from the interview data. Women used patterns of connectedness to other spouses to cope with the emotional impact of the event. In addition, participants reported a constant need to be vigilant in helping their families cope. Issues related to the family's physical, mental, and spiritual health in the context of nursing practice are discussed.

Adaptation, Psychological↗
PubMed2003

Older women caring for spouses with Alzheimer's disease at home: making sense of the situation.

I combined phenomenological and feminist approaches to capture older women's own description of their Alzheimer's disease (AD) caregiving experience. Face-to-face interviews were conducted with 14 women who were 60 or older and cared at home for their spouses diagnosed with AD. Data were analyzed using a modified version of Colaizzi's method. Five major themes were found to define the fundamental structure of these women's experience. Here I address only findings pertaining to the fourth theme: making sense of the situation. These findings reveal aspects unique to older women's/wives' AD caregiving experience.

Adaptation, Psychological↗
PubMed2004

Inter-relationships of nutrient intakes for urban Chinese spouses in Taiwan.

This study was to examine dietary intakes and the inter-relationships in urban Chinese spouses in Taipei, Taiwan. We analyzed the dietary intakes and related household factors for 82 wives and their husbands by 24-h recalls and a Chinese food frequency questionnaire (CFFQ) designed with meal sequences in Taipei, Taiwan. The distributions of energy assessed from CFFQ by meals were similar for husbands and wives, with 16% for breakfast, 39% for lunch, 40% for dinner and 5% for snacks (afternoon and evening combined). Assessed by 24-h recalls, the means for total energy, the energy per kilogram body weight, and the percent energy from fat, protein, and carbohydrate were different: 2394 kcal, 34.4 kcal/kg, 31%, 15%, and 51% for husbands; and 1729 kcal, 32.0 kcal/kg, 34%, 16%, and 50% for wives, respectively. The P/M/S (polyunsaturated fat/monounsaturated fat/saturated fat) ratios were 1.5/1.2/1 for husbands and 1.3/1.2/1 for wives. A high eating-out frequency may account for the low correlations for most nutrient intakes between husbands and wives. Canonical correlation analysis for total energy, protein and carbohydrate reveals significant inter-relationships between husbands and wives. Carbohydrate is the consistent and important variable that weighted in an opposite direction with protein and energy intakes in both husbands and wives. These results support the observation that decreased rice consumption as a staple food, cooked at home, for urban Chinese couples, indicated by decreased carbohydrate intake in wives, may account for the increase of energy and protein intakes for husbands.

Adult↗
PubMed2001

"It was never that bad": biased recall of grief and long-term adjustment to the death of a spouse.

At 6 months following the death of their spouse, 37 participants reported their grief-related symptoms and thoughts, and then, approximately 4.5 years later, they attempted to recall how they felt at the time of the 6-month report. Although participants were far less distressed at recall than initially, they recalled their 6-month grief rather accurately. Participants did however overestimate prior grief-related intrusive ideation. Participant's current level of grief predicted what they recalled slightly better than the actual initial grief. Conversely, what they recalled predicted current levels of grief across various measures. Participants whose grief diminished relatively little over time tended to overestimate prior grief more. The retrospective reappraisal that one's past grief was not severe may indicate effective coping.

Adaptation, Psychological↗
PubMed2006

Bereavement after caregiving or unexpected death: effects on elderly spouses.

Responses to bereavement have been shown to vary depending on whether death is expected or unexpected, and on the nature of family caregiving experiences, but little previous research has examined these factors simultaneously. To address these issues, we utilized prospective data on bereavement from 193 participants in the Changing Lives of Older Couples (CLOC) study, who were assessed both before their loss and at six and 18 months after the death. Participants who experienced either unexpected loss, or expected loss without caregiving, with low-stress caregiving, or with high-stress caregiving completed measures of psychological, social, and health functioning on each occasion. Results showed that unexpected death was associated with marked increases in depression, while the nature of caregiving did not affect the trajectory of any of the psychological well-being measures. All groups except highly stressed caregivers showed improvements in social activity and support after bereavement, suggesting that highly stressed caregivers may be at an increased risk for social isolation during bereavement. Thus experiencing an unexpected death may put bereaved spouses at risk for depression, while high-stress caregiving may lead to problems with social isolation.

Adaptation, Psychological↗
PubMed2006

Depression and mental health among older Mexican American spouses.

Although the association between marriage and well-being is well established, few studies have focused on learning more about the context of marriage and mental health. Recent research studying the mechanisms of marriage and health has focused on contagion of well-being among spouses. This study examined the association of depression with self-esteem, social support, life satisfaction, concern for independence, and cognitive function using baseline data for 553 older, Mexican American couples. Overall, we found evidence to suggest an interdependent relationship between husbands' and wives' emotional states, but the association was not equal for couples. Husbands' depression was significantly associated with the well-being of their wife, but the wife's depression was rarely associated with the husband's well-being. The findings from this study add to the increasing literature on spousal contagion by focusing on an under studied minority group, examining how depression affects well-being, and highlighting unequal effects of marriage on spousal well-being.

Aged↗
PubMed2006

Spouse resemblance in body mass index: effects on adult obesity prevalence in the offspring generation.

Accruing evidence indicates that mate selection is promoted by similarity in body fatness. Assortative mating for obesity may contribute genetically to the obesity epidemic by increasing the risk in subsequent generations. To test this hypothesis, the authors analyzed measured and validated questionnaire data on family members, obtained between 1987 and 2000 from 7,834 obese probands and from 829 subjects randomly ascertained from the general Swedish population. Spouse correlations in body mass index were strongest among couples with the shortest duration of cohabitation. Obesity concordance in parents was associated with an obesity prevalence of 20.1% in adult offspring compared with 1.4% if parents were concordantly nonobese (odds ratio = 18.3, 95% confidence interval: 9.0, 37.4). The prevalence was 8.2% if parents were obesity discordant (odds ratio = 6.5, 95% confidence interval: 3.2, 13.2). No association was found between rearing parents' and nonbiologic offspring's body mass index. These results agree with the hypothesis that assortative mating for obesity confers a higher risk of obesity in the offspring generation and thus contributes to the obesity epidemic. Parental obesity concordance is a strong, easily identifiable genetic risk factor that should be considered in the complex network of risk factors for obesity in designing primary prevention programs.

Adult↗
PubMed1995

A comprehensive support program: effect on depression in spouse-caregivers of AD patients.

Caregivers of Alzheimer's disease patients often suffer from depression. Using a longitudinal treatment/control study, we examined the effects of a comprehensive support program on depression in spouse-caregivers. This psychosocial intervention program treats the primary caregiver and family members over the entire course of the disease through individual and family counseling, the continuous availability of ad hoc counseling, and support group participation. In the first year after intake, the control group became increasingly more depressed, whereas the treatment group remained stable. By the eighth month, treated caregivers were significantly less depressed than those in the control group. These results suggest that enhancing long-term social support can have a significant impact on depression in caregivers.

Activities of Daily Living↗
PubMed1999

The spouse as a kidney donor: ethically sound?

A shortage of cadaver donor organs requires transplant units to examine all possible alternatives. Transplantation from living donors accounts for only approximately 10% of kidney transplants in the UK. Recent studies have shown that the results of kidney transplantation between spouses are at least as good as those of well-matched cadaver organs, but very few transplants of this type have been performed in this country so far. As part of the assessment process, the proposed donor and recipient are required to provide written statements about the issues. We reproduce here the personal statements made by one of our patients and his wife: we believe that the statements support our contention that spousal transplantation is ethically justifiable and should be more widely available. We report our early experience in Bristol with seven kidney transplants from spousal donors and we encourage other renal units in this country and elsewhere to consider this method of improving the prospects of kidney transplantation for their patients.

Adult↗
PubMed2006

The lived experience of first-time expectant fathers whose spouses are tocolyzed in hospital.

The purpose of this study is to explore the experiences of first-time expectant fathers whose spouses undergo tocolysis in the hospital. The study was conducted by the descriptive phenomenological method. On the basis of the qualitative method, the data were subjected to Colaizzi's content analysis by means of the constant comparison method. Data were collected through one-on-one interviews with six expectant fathers. The findings revealed that the experiences of the fathers could be summarized under the following five themes: being confused and absent-minded in an awkward situation, facing difficulty and attempting to identify solutions, breaking through the dilemma, looking forward to being a father, and looking back with complicated feelings. The findings of this study should provide nursing staff in charge of family- centered maternity care with information about how tocolysis influences the families of first-born babies. They should also contribute to improvements in nursing quality.

Adaptation, Psychological↗
PubMed2006

Depression and pesticide exposures in female spouses of licensed pesticide applicators in the agricultural health study cohort.

OBJECTIVE: This nested case-control study evaluated the association between depression and pesticide exposure among women. METHODS: The study population included 29,074 female spouses of private pesticide applicators enrolled in the Agricultural Health Study between 1993 and 1997. Cases were women who had physician-diagnosed depression requiring medication. Lifetime pesticide use was categorized as never mixed/applied pesticides, low exposure (up to 225 days), high exposure (>225 days), and a history of diagnosed pesticide poisoning. RESULTS: After adjustment for state, age, race, off-farm work, alcohol, cigarette smoking, physician visits, and solvent exposure, depression was significantly associated with a history of pesticide poisoning (odds ratio [OR] = 3.26; 95% confidence interval [CI] = 1.72-6.19) but not low (OR = 1.09; CI = 0.91-1.31) or high (OR = 1.09; 95% CI = 0.91-1.31) cumulative pesticide exposure. CONCLUSION: Pesticide poisoning may contribute to risk of depression.

Adult↗
PubMed1995

Younger-onset Alzheimer's disease: learning from the experience of one spouse carer.

There are estimated to be 17,000 younger sufferers of dementia currently living in the UK. At present, individualized service and practice initiatives for younger sufferers and their carers remain fragmented and poorly developed. This is despite potential additional caregiving stressors caused by the age of onset, such as financial difficulties due to disruption in the work pattern, children still living at home, and the sufferer's decreased life expectancy. Drawing on an individual carer's personal case history, this article details a spouse carer's individual experience of her husband's decline through the stages of younger-onset Alzheimer's disease. Pointers for policy and practice for younger sufferers and their carers are drawn from this case history and a role for the community psychiatric nurse is outlined.

Adaptation, Psychological↗
PubMed2006

Couple similarity and marital satisfaction: are similar spouses happier?

This study examined the role of couple similarity in spouses' marital satisfaction and affect. The associations between spousal similarity and relationship measures were examined in a sample of 248 married couples. As hypothesized, greater similarity between partners was associated with higher levels of marital satisfaction and lower levels of negative affect. In particular, similarity on the gendered personality and values domains was more strongly associated with relationship measures, whereas similarity on the attitudes and religiosity domains showed weaker and inconsistent patterns of associations. Finally, profile-based similarity tended to be a stronger and more consistent correlate of relationship measures than difference score-based similarity. The implications of these findings for processes underlying intimate relationships are discussed.

Adult↗