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PubMed1995

Reactions to repeated STD infections: psychosocial aspects and gender issues in Zimbabwe.

This study explores psychosocial and gender issues related to multiple STD infections within the context of marriage. Thirty men and thirty women, currently married and attending a municipal clinic for treatment for repeated STD infections were interviewed. A semi-structured interview schedule was administered to explore themes of knowledge and beliefs about STDs, psychological reactions to repeated infections and power aspects of sexuality. It was found that men and women differed in how they interpreted and reacted to multiple STD infections. There was clear evidence of women's lack of power to negotiate safe sex within marriage and of the lack of social support networks for infected women.

Adolescent↗
PubMed2006

[Fraser syndrome. A case report].

Fraser syndrome is a rare autosomal recessive disorder; the most consistent features are cryptophthalmos, syndactyly of fingers and toes, laryngeal stenosis, and urogenital abnormalities. We report a newborn case at day 1 of life who had multiple abnormalities, born from a consanguineous marriage. Clinically, the newborn had an ankyloblepharon on the left side, a cryptophthalmos on the right side, a syndactyly, anorectal abnormalities with ambiguous genitalia, laryngeal stenosis, and ear malformations. TDM of the cranium and orbits and the transfontanel ultrasound were normal. The abdominal ultrasound showed renal abnormalities. Right eye surgery showed a reduced cornea to an opaque thin plate clinging to the iris without an anterior chamber and a nonindividualized eyeball. The authors discuss the morphological abnormalities, the clinical and paraclinical aspects of this syndrome, its multispecialized clinical management, and the importance of prenatal diagnosis.

Abnormalities, Multiple↗
PubMed1996

Determinants of stillbirth mortality in Greece.

A population-based case-control study of the determinants of stillbirths was conducted in Greece from 1989 to 1991. All reported stillbirths after 28 weeks of pregnancy (N = 2,006) during the three year study period comprised the case group. The control group derived from random sampling of 10% of all livebirths in Greece, during the same period (N = 30,705). The data were analysed by modelling through multiple logistic regression. The adjusted relative risk of stillbirth was significantly higher for males compared to females. A statistically significant monotonic increase in relative risk was observed with shorter gestational age, low maternal education, and older maternal age. Birthweight and parity showed a statistically significant U-shaped association with stillbirth risk, with a higher risk being observed among both low and high birthweight deliveries, as well as among primiparous or multiparous (4+) mothers. Positive associations of stillbirth with multiple births, out-of-wedlock marriage and non-Greek-orthodox maternal religion were noted in crude analyses, but these associations almost disappeared in logistic regression model. Maternal urban or rural residence showed no relation to risk. Overall, the prospective risk of stillbirth after the 24th week of gestation in Greece has been estimated to be higher than that in Japan (a more developed country) with more than 40% of stillbirths occurring after the 36th week of pregnancy.

Birth Weight↗
PubMed1995

Social support: gender differences in multiple sclerosis spousal caregivers.

The purpose of this study was to investigate gender differences in social support of spousal caregivers of persons with multiple sclerosis (MS). The sample consisted of 37 male and 28 female caregivers of individuals with MS. It was found that female caregivers scored significantly higher than males on the total number of resources available, perceived social support and the perceived availability of friends and self-help groups. There was a positive relationship between caregiver-perceived social support and the ability of the mate to perform intimate functions. Caregiver-perceived social support was also found to be positively correlated with the caregiver's level of commitment to the spousal relationship.

Adaptation, Psychological↗
PubMed1996

Occupational factors in multiple sclerosis: an analysis of occupational mortality statistics for men and married women in Great Britain.

This paper presents an exploratory study based on occupational mortality statistics for Great Britain. It examines disease concordance between marital partners for multiple sclerosis (MS). Previous studies have revealed that a married woman's life expectancy and her specific cause of death is reliably associated with the occupational mortality of her husband. This relationship exists across a wide range of occupations but is particularly marked in the case of MS. The present study examines the mortality rates for MS for a large number of occupations (taking into account possible sources of statistical bias) and considers the relationship of these findings with existing hypotheses about the aetiology of MS. It is suggested that there should be more consideration of occupational and psychological factors in multicausal explanations of the disease.

Adult↗
PubMed2001

Rehabilitation of intimacy and sexual dysfunction in couples with multiple sclerosis.

Sexual dysfunction is a highly prevalent symptom of multiple sclerosis (MS), with little published research on effective treatments. This pilot study tested the efficacy of a counseling intervention in nine couples utilizing a quasi-experimental research design. The intervention consisted of 12 counseling sessions, communication with the MS medical treatment team, education, and tailoring symptomatic treatments so they interfere less with sexual function. Repeated measures analysis of variance indicated significant improvements in affective and problem-solving communication, marital satisfaction, and sexual satisfaction during the treatment vs. the waiting list phase of the study (F=1.7, P<.001). MS patients and their spouses reported similar levels of improvement.

Adult↗
PubMedDate not supplied

Living with chronic illness: social support and the well spouse perspective.

Progressive neurologic disease has a significant impact on family members, particularly those living with and caring for a homebound adult. Focus groups were conducted with women who were the primary caregiver for their disabled husband. The women described themselves as being restricted to the home by caregiving requirements. Multiple sclerosis was a critical personal hardship for them, involving persistent struggle that often resulted in anger and frustration. Because of the social isolation created by their caregiving responsibilities, these women depended on their disabled husband for support. Yet, never having time away from the husband strained the marital relationship and threatened the supportive nature of the relationship. The women in this study found it necessary to have personal time and space away from their husband. They created space for themselves by setting apart a place in the home that was theirs or by declaring time out for themselves. These strategies helped them avoid or reduce negative outcomes of the social support received from their husband.

Adaptation, Psychological↗
PubMed1983

Multiple sclerosis and mobility restriction.

Examination of mobility restriction among multiple sclerosis (MS) patients and its relationship to selected disease and demographic characteristics was undertaken using data gathered in the National Multiple Sclerosis Survey. Whether and where an individual needed assistance and the types of assistance needed were the dependent variables. These data were crosstabulated with the following patient characteristics: sex, race, educational level, region of residence, age on prevalence day, marital status, awareness of diagnosis, diagnostic code, duration of disease and age at first diagnosis. More than half of the patients reported needing assistance both indoors and outdoors. Significant factors in increasing the percentage needing assistance were as follows: longer duration, older at the time of first diagnosis, admitted awareness of the diagnosis, currently unmarried, nonwhite, and a "probable" MS diagnostic code. Most patients relied on a wheelchair or a person's assistance for help while few relied on crutches or leg braces.

Adult↗
PubMed1993

Multiple sclerosis: stressors and coping strategies in spousal caregivers.

Community health nurses, who have frequent and prolonged contact with patients afflicted with chronic disease, play a central role in the assessment and care of patients and their families who must deal with the many ramifications of long-term disease. The importance of multiple sclerosis in health care is a result of its worldwide prevalence rate of 57.9 per 100,000 population, its tendency to occur in the young adult, and its chronicity. This exploratory study was designed to describe the stressors of caregivers of individuals with multiple sclerosis, to identify coping behaviors used by caregivers, and to explore the relation between caregiver stress and caregiver coping behavior. The study sample included 20 caregiving spouses of individuals with multiple sclerosis. The data were collected through a semistructured interview of caregiving spouses. Caregiver coping behavior was measured with the Ways of Coping Checklist (Folkman & Lazarus, 1980), and caregiver stress was measured with the Caregiver Strain Index (B. C. Robinson, 1983). Descriptive statistics were calculated for each of the demographic and disability variables. Pearson product-moment correlations were employed to assess the relation between caregiver coping behavior and caregiver stress. Findings revealed significant correlations between caregiver stress and caregiver coping behavior. These findings indicate that as stress in the caregiving role increases, there is an increase in the use of various forms of coping behaviors, both problem focused and emotion focused. Types of stressors and coping strategies used by caregivers are described, and nursing implications are discussed.

Activities of Daily Living↗
PubMed1977

Social remedial measures for multiple sclerosis patients in Denmark.

A total of 57 patients admitted to the Danish Multiple Sclerosis Society's treatment and nursing home in Haslev have been interviewed about their socio-medical situation concerning their course of disease, physical, psychic and economic status, family relationships, and different assistance needs. Sixty per cent lived together, and of the solitary only 9 were unmarried. None were employed fulltime and as a whole they received higher allowances than other disabled persons. All suffered from walking impairment. 17 had no wheelchair, 21 had a wheelchair and limited walking ability, 19 could move around only by wheelchair. None were bedridden. The distribution of housing corresponded to that of other disabled persons but was inferior to that of the population as a whole. 54 per cent had got modifications to housing paid for by the public authorities and 42 per cent had a car for the disabled. 47 per cent alleged that their need for transportation remained uncared for. None of the patients were lonely to a severe degree. Expenses for medicine and transportation varied greatly, showing inequality of grant administration. The results of the investigation are discussed.

Adult↗
PubMed1993

Multiple sclerosis: health-promoting behaviors of spousal caregivers.

This pilot study examined the relationship between health-promoting behaviors of spousal caregivers of individuals with multiple sclerosis (MS) and dependency needs of the afflicted spouses. The study sample included 20 subjects who were residing with their spouses and served as primary caregivers. The data were collected through a semistructured interview of caregiving spouses. The health-promoting lifestyle profile (HPLP) was used to measure health-promoting behavior. The Index of ADL was employed to measure independence in activities of daily living (ADL). Descriptive statistics were calculated for demographic, ADL and health-promoting variables. Pearson product-moment correlations were employed to assess the relationship between the care recipient dependency needs and the health-promoting behavior of the caregiving spouse. Findings revealed a significant inverse relationship between level of recipient dependency and health-promoting behavior of the caregiver (r = -.394, p < .04). Further examination of health behaviors revealed that caregiving wives reported higher total frequency of health-promoting behaviors than did their husband counterparts. Additional analyses revealed subjects scored highest on the self-actualization dimension and lowest on the exercise dimension of the HPLP scale.

Activities of Daily Living↗
PubMed1992

Conjugal multiple sclerosis: immunogenetic characterization and analysis of T- and B-cell reactivity to myelin proteins.

We describe two families with conjugal multiple sclerosis. Onset of symptoms in the husbands occurred 11 and 17 years after onset of relapsing/remitting symptoms in their wives. There were no similarities regarding clinical manifestations of MS within each family. Evaluation of T-cell repertoire by enumeration of cells secreting interferon-gamma in response to proteolipid protein (PLP), myelin basic protein (MBP), and to various synthetic MBP peptides revealed similar patterns of T-cell reactivity within the families both in MS-affected parents and unaffected children. Genomic HLA-DR-DQ typing showed that T-cell reactivity was independent of HLA class II phenotype. Analysis of B-cell responses in blood showed low numbers of cells secreting IgG, IgA, or IgM antibodies against MBP, PLP, myelin-associated glycoprotein, and myelin-oligodendrocyte glycoprotein both in MS-affected and unaffected family members. In conclusion, our study of two families with conjugal MS has shown a dominant T-cell response against the same MBP peptide within the family both in MS-affected parents and unaffected children, and this T-cell response seems to be independent of the HLA class II phenotypes of the family members.

Adult↗
PubMed2005

Predictors of dyadic adjustment in multiple sclerosis.

Because multiple sclerosis (MS) is usually diagnosed between the ages of 20 and 50, a time during which most people begin serious relationships, dyadic adjustment for MS patients is a salient issue. However, little is known about factors that might contribute to dyadic adjustment problems in MS. In the present study, we predicted that MS patients showing evidence of three common sequelae of MS--depression symptoms, fatigue and cognitive dysfunction--would be most likely to display problems with dyadic adjustment. Sixty-four MS patients and 49 significant others were assessed. Patient-reported dyadic adjustment was significantly (P at least <0.05) associated with depression (r = -0.48) and fatigue (r = -0.31), but not cognitive functioning. Significant other-reported dyadic adjustment was significantly associated with patients' depression (r = -0.38), fatigue (r = -0.30) and executive functioning impairments (r = 0.37). Stepwise regression analyses revealed that depression was the only significant predictor of dyadic adjustment, regardless of whether significant other (r2 change = 0.16) or patient-reported (r2 change = 0.22) dyadic adjustment was used as the criterion variable. If depression leads to dyadic problems in MS patients, treatment of depression may result in improved dyadic adjustment. Conversely, if dyadic problems contribute to depression in MS, then treatment of dyadic problems may lead to relief from depression in these patients.

Adaptation, Psychological↗
PubMed1980

Characteristics of women with dysplasia or carcinoma in situ of the cervix uteri.

To identify risk factors for various cervical abnormalities, 237 women with abnoromal cervical smears and 422 control women were interviewed. Cervical biopsy specimens taken from the patients with abnormal smears were reviewed according to standard criteria by one pathologist and classified as follows: 65 carcinoma in situ, 81 severe dysplasia, 44 mild dysplasia and 47 normal histology. Factors associated with risk of mild dysplasia, severe dysplasia and carcinoma in situ were similar to those previously identified for invasive carcinoma, and included age at first intercourse, multiple sexual partners and pregnancy outside marriage. Analysis to disentangle correlated factors revealed that number of sexual partners exerted effects independently of age at first intercourse, whereas the reverse was not true. This finding fails to support suggestions that adolescence is a period when the cervix is most vulnerable to the effects of sexual behaviour. Other factors relating to risk of cervical abnormalities were smoking and use of oral contraceptives. It was not possible to show that these relationships were incidental, but further investigation is required to establish whether they are causal.

Adolescent↗
PubMedDate not supplied

Psychological regression and marital status: determinants in psychiatric management of burn victims.

Major burn trauma is ordinarily associated with psychological regression, which regularly assumes either an immature, dependent (childlike), or primitive (animal-like) form. Also, the severely burned patient is exquisitely responsive, both constructively and destructively, to behavioral nuances in his or her "significant other," typically, the spouse. Two variables, type of regression and marital status, provide an empirically derived rationale for the psychiatric treatment of behavioral problems affecting patient management, including especially (1) pain-related behavior, (2) intrusive reexperiencing of the trauma, (3) depletion/despair phenomena, and (4) problems related to scarring. Results are more favorable when regression is of the dependent type rather than primitive type. Treatment is enhanced when the partner in a committed relationship is included in the treatment program.

Adolescent↗
PubMed1992

Conjugal MS.

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Female↗