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PubMedDate not supplied

Changing life patterns of the resident in long-term care and the community-residing spouse.

Fundamental changes occur in the life patterns of a couple when one of them enters an extended care facility. Each of the life patterns influences each of the others, and changes that affect one member of the couple have a significant effect on the other. With time, situations fluctuate and dependency needs change. With preadmission planning and understanding of life patterns by the nurse, many of these issues can be explored and plans made to deal with them before placement. On-going assessments become the basis for interventions that can help the couple cope with additional changes. Emphasis needs to be placed on periodically revisiting the issues and having the nurse monitor, initiate, and facilitate cooperative, collaborative relationships within the health care team. Through careful planning, the nurse can assist in promoting more effective adjustments to residential life and can assist the married couple with maintaining a more satisfying relationship.

Aged↗
PubMed2003

Posttraumatic stress disorder in the spouse of a patient with sleep terrors.

A 27-year-old woman who developed posttraumatic stress disorder (PTSD) as a consequence of her husband's severe sleep terror episode is reported. A 29-year-old man suddenly aroused from sleep and jumped through the closed second-story window of the room he shared with his wife, sustaining major lacerations to his arms. He hung onto the roof as his wife screamed at him from the window, and eventually climbed back inside. He was evaluated with polysomnography and was given the diagnosis of sleep terrors, which was effectively treated with behavioral and pharmacologic interventions. During a routine follow-up visit with the patient, his wife's PTSD symptoms came to clinical attention and she was referred for treatment. She demonstrated marked improvement in her condition after an 8 week course of cognitive-behavioral therapy. We conclude that family members of patients with sleep disorders manifesting as violent behaviors during sleep can suffer psychological trauma even if they are not physically injured.

Adult↗
PubMed2003

Advanced prostate cancer patients' relationships with their spouses following hormonal therapy.

The paper analyses the adverse impact of the hormonal therapy's side-effects on advanced prostate cancer patients' capacity for maintaining their pre-treatment spousal relationships, the pros and cons of their ways of coping with the difficulties involved, and the implications of these issues for oncology nursing interventions. In-depth interviews were conducted with 15 Israeli prostate cancer patients, and the data were processed according to the constant comparative analysis method. The findings show that partners' supportive attitude and patients' attempts to stage resilience led to pre-treatment relationships' maintenance, and that, accordingly, patients' rejection by their partners and resignation to this difficulty resulted in spousal ties' disruption. However, whereas the relationships' maintenance came at the cost of burdensome constant pretence, their disruption was eventually reconstructed by the patients in positive terms. These findings are analysed against the backdrop of the constraints imposed by the hormonal therapy on patients' general coping competence and ability to enjoy non-sexual activities, which impair their capability to solve their marital problems more effectively. They would thus benefit from training oncology nurses who specialize in the unique difficulties facing them and their partners, and from oncology nursing interventions that focus on relevant information provision and counselling.

Adaptation, Psychological↗
PubMed2006

Concordance in the mental health of spouses: analysis of a large national household panel survey.

BACKGROUND: Spousal concordance for common mental disorders provides evidence of the relevance of social contextual factors. There are, however, limitations within the existing literature examining spousal similarity in mental health and little consensus as to the causes of spousal similarity. This study considers a large representative sample and examines an extensive range of risk factors using multilevel statistical methods to explore spousal similarity in common mental disorders. METHOD: Data were from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, a large nationally representative survey of Australian households. Analysis focused on 3808 mixed-sex couples in marriage and de facto relationships. Multilevel models assessed the mental health scale of the SF-36. Analyses considered risk factors at the individual, couple and area levels, examined the effects of relationship duration on concordance, and considered longitudinal data to assess the consistency with cross-sectional analysis. RESULTS: Significant spousal concordance on the mental health scale was demonstrated (r=0.25) and was independent of, and unexplained by mental health risk factors, including experience of multiple shared life events. Spousal similarity for mental health increased across the first 5 years of relationships. CONCLUSIONS: Evidence of spousal concordance for common mental disorders highlights the importance of the social context of marriage in the aetiology of mental illness and identifies an important direction for further research.

Adolescent↗
PubMed1989

Prevalence and stability of physical aggression between spouses: a longitudinal analysis.

Community couples (N = 272) were assessed in a longitudinal study of early marriage. More women than men reported physically aggressing against their partners at premarriage (44% vs. 31%) and 18 months (36% vs. 27%). At 30 months, men and women did not report significantly different rates of aggression (32% vs. 25%). However, using either the self-report or the partner's report, the prevalence of aggression was higher for women than men at each assessment period. Modal forms of physical aggression for both men and women were pushing, shoving, and slapping. Conditional probability analyses indicated that the likelihood of physically aggressing at 30 months given that one had engaged in such aggression before marriage and at 18 months after marriage was .72 for women and .59 for men. Furthermore, 25-30% of the recipients of physical aggression at all three assessment periods were seriously maritally discordant at 30 months.

Adult↗
PubMed2000

Therapeutic alliance: predicting continuance and success in group treatment for spouse abuse.

This study examined the role of the therapeutic alliance between client and therapist on group treatment outcome in 70 husband-to-wife violent couples. Strength of husbands' alliance assessed at Session 1 was positively associated with treatment outcome, as measured by decreased husband-to-wife mild and severe psychological and physical aggression. Strength of wives' alliance was unrelated to treatment outcome. Finally, although alliance was related to treatment outcome, it was unrelated to treatment completion.

Adult↗
PubMed1997

Estimating social adjustment following spinal trauma--I: Who is more realistic--patient or spouse? A statistical justification.

Whilst assessment of functional independence has been accomplished, to a greater extent, following spinal trauma, assessing social adjustment remains an area requiring considerable further investigation. Providing premorbid estimation of adjustment is an area which presents a number of methodological difficulties both in the collection and interpretational of longitudinal data. Such analyses tend to allow overall estimates of adjustment to be made but which lack individual specificity. Analyses are presented of over 250 individuals, and their closest relative's assessment, of social adjustment to their spinal cord injury. Using a modification of an established scale for assessing social adjustment it has been possible to establish the statistical level of agreement and address the hypothesis of differential perception of the extent of adjustment problems by the injured person and their closest relative. The study allows for the conclusion that an injured person's perception of adjustment is at least as reliable as their closest relative, and that there is further evidence to support the essential accuracy of their estimations of premorbid and current levels of adjustment. Both issues are of clinical importance, particularly in relation to any medico-legal compensation aspects.

Adult↗
PubMed1998

An exploration of anticipatory grief: the lived experience of people during their spouses' terminal illness and in bereavement.

Anticipatory grief has been the subject of much debate since Lindemann first coined the term to describe premature mourning. Much of the research in this area takes a positivist approach focusing on the effect of anticipatory grief on bereavement. In contrast, this study, explores anticipatory grief through a Heideggerian phenomenological approach to elicit the experience of anticipatory grief. Unstructured interviews were conducted with four participants. The resulting data were interpreted using hermeneutics and evaluated using the criteria identified by Madison. The themes arising from this interpretation identify the change the participants experienced. Although these findings are limited to four participants, they are offered to raise awareness of the impact of multiple role loss and the impact of diagnosis on supporting partners. The findings also raise ways in which nurses might support people experiencing loss.

Bereavement↗
PubMed2000

Counselling groups for spouses of elderly demented patients: a qualitative evaluation study.

Ten women and eight men who were caring for their demented husbands or wives participated in a closed-group counselling programme, developed and carried out by two district nurses at a local health centre. There were seven or eight participants in each group, which met 13-14 times over a period of 8 months. This study is based on semistructured interviews about the participants' situation just before entering the counselling group, the counselling programme itself, and their situation after the end of the programme. Their situations before the programmes were described as an exhausting, chaotic prison but after the programme they could cope with their situation and plan and manage their daily life. None of the participants needed further organised counselling; engagement in the local dementia association was sufficient for them. The counselling nurses' experience in and about caring for demented patients, their tactful authority, the closed groups and the long duration of the programme were judged to be crucial for the successful outcome of the programme.

Activities of Daily Living↗
PubMed1999

Group therapy for spouses of aphasic patients.

The setting, course, and results of a counseling and a therapeutic group for relatives of chronic aphasic patients are reviewed. Generally, providing and discussing information on the illness, its consequences, and medical and social services are greatly appreciated by group members. Counseling and group psychotherapy, as conducted by us, did not result in measurable improvements of relatives' perceptions of personal, social, and familial burdens. We assume, however, that group therapy does lead to more realistic attitudes toward burdensome and severely straining situations and may help with coping. Further research into psychotherapeutic strategies for relatives of disabled persons, who themselves suffer from psychological and social handicaps, is needed.

Adaptation, Psychological↗