-
International Journal of Environmental... Oct 2022Positive psychology approaches (PPAs) to interventions focus on developing positive cognitions, emotions, and behavior. Benefits of these interventions may be compounded... (Review)
Review
OBJECTIVE
Positive psychology approaches (PPAs) to interventions focus on developing positive cognitions, emotions, and behavior. Benefits of these interventions may be compounded when delivered to interdependent dyads. However, dyadic interventions involving PPAs are relatively new in the cancer context. This scoping review aimed to provide an overview of the available research evidence for use of dyadic PPA-based interventions in cancer and identify gaps in this literature.
METHODS
Following PRISMA guidelines, we conducted a scoping review of intervention studies that included PPAs delivered to both members of an adult dyad including a cancer patient and support person (e.g., family caregiver, intimate partner).
RESULTS
Forty-eight studies, including 39 primary analyses and 28 unique interventions, were included. Most often (53.8%), the support person in the dyad was broadly defined as a "caregiver"; the most frequent specifically-defined role was spouse (41.0%). PPAs (e.g., meaning making) were often paired with other intervention components (e.g., education). Outcomes were mostly individual well-being or dyadic coping/adjustment.
CONCLUSIONS
Wide variability exists in PPA type/function and their targeted outcomes. More work is needed to refine the definition/terminology and understand specific mechanisms of positive psychology approaches.
Topics: Adult; Humans; Psychology, Positive; Caregivers; Adaptation, Psychological; Neoplasms; Spouses; Quality of Life
PubMed: 36294142
DOI: 10.3390/ijerph192013561 -
American Family Physician Dec 2019
Topics: Aged, 80 and over; Anniversaries and Special Events; Death; Female; Humans; Male; Spouses; Stroke
PubMed: 31790175
DOI: No ID Found -
Health Psychology : Official Journal of... Aug 2020The present study examined positive and negative aspects of relationship quality with one's spouse or partner as predictors of mortality and the role of gender in...
OBJECTIVE
The present study examined positive and negative aspects of relationship quality with one's spouse or partner as predictors of mortality and the role of gender in moderating this link.
METHOD
Data were drawn from 2 waves, 5 years apart, of the National Social Life, Health, and Aging Project ( = 1,734). Positive aspects of relationship quality (frequency of opening up to the partner to talk about worries and relying on the partner) and negative aspects (frequency of the partner making too many demands and criticism by the partner) were assessed. Survival/mortality status was recorded at the time of Wave 2 data collection 5 years later (1,567 alive; 167 deceased). Covariates included sociodemographic variables, relationship type, health status, and the network size of close family relationships and friendships.
RESULTS
Logistic regression analyses showed that negative relationship quality with one's spouse or partner was associated with significantly higher odds for mortality after 5 years (odds ratio = 1.20, 95% CI [1.03, 1.38], < .001), after including the statistical covariates. Also, age, gender, education, self-rated health, and medication use were significantly related to mortality. Propensity score matching replicated these findings. Follow-up analyses revealed that criticism from one's spouse or partner, in particular, was linked to a higher mortality risk ( = 1.44, 95% CI [1.10, 1.88]). Gender did not moderate the relationship-quality-mortality link.
CONCLUSIONS
Negative relationship quality, notably, criticism received from one's spouse or partner, heightens older adults' risk of mortality. These results suggest the value of developing interventions that target reducing expressed criticism in couple relationships. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Topics: Adult; Aged; Aging; Family Relations; Female; Humans; Male; Middle Aged; Mortality; Spouses; Time Factors
PubMed: 32406727
DOI: 10.1037/hea0000883 -
International Journal of Nursing Studies Jun 2024The number of people with dementia is on the rise worldwide, and dementia care has become the focus of global health services. People with dementia are primarily cared... (Review)
Review
BACKGROUND
The number of people with dementia is on the rise worldwide, and dementia care has become the focus of global health services. People with dementia are primarily cared for by informal caregivers, with spouses seen as a particularly vulnerable group. Focusing on the spousal caregiving experience and having a good caregiver identity contributes to group bonding and enhanced social support.
OBJECTIVE
To explore the dynamic changes that occur in the caregiving experience of spouse caregivers and explicate the identity of spouses during this process alongside its causes.
DESIGN
A qualitative systematic review.
DATA SOURCE
The following eight electronic databases were searched: PubMed, Web of Science (Core Collection), The Cochrane Library, Embase, CINAHL and CNKI, WanFang and Vip.
REVIEW METHODS
The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) and Joanna Briggs Institute Reviewer's Manual criteria were used to report the results. Study screening and data extraction were conducted independently by two reviewers, and quality was assessed using the Joanna Briggs Institute's Qualitative Research Standard Assessment tool. Data synthesis was performed using thematic analysis.
RESULTS
A total of 15 studies were included and synthesized into three analytical themes: (1) attitudes and emotions toward dementia, (2) emotional ups and downs in dementia care, and (3) who am "I". In binary care, patience and marital responsibilities are identified as facilitators, while care burden and social isolation are identified as hindrances. In addition, gender differences were identified as influencers of identity.
CONCLUSIONS
In this review, spouse identity of people with dementia is complex and affects caregiving experience together with dementia cognition. Disease cognition, caregiving burden and social isolation are identified. Interventions for barriers are suggested to enhance social support.
Topics: Dementia; Humans; Caregivers; Spouses; Qualitative Research
PubMed: 38552470
DOI: 10.1016/j.ijnurstu.2024.104757 -
Palliative & Supportive Care Oct 2023Cancer does affect not only the lives of the patients but also that of their spouses. The aims of this systematic review are to (i) explore the gender differences in the... (Review)
Review
OBJECTIVES
Cancer does affect not only the lives of the patients but also that of their spouses. The aims of this systematic review are to (i) explore the gender differences in the impact of caregiving for cancer on spousal caregivers, (ii) facilitate the conceptual understanding of gender differences in caregiving, and (iii) identify directions for future research and clinical practice targeting spousal caregivers.
METHODS
A comprehensive search was conducted of the electronic databases of MEDLINE, PsycINFO, EBSCO, and CINAHL Plus for papers published in English between 2000 and 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify, select, appraise, and synthesize the studies.
RESULTS
A total of 20 studies from seven countries were reviewed. Findings of the studies were presented using the biopsychosocial model. Spousal caregivers of cancer patients suffered from physical, psychological, and socioeconomic morbidities, with female spousal caregivers reporting a higher level of distress. The gendered positioning of spousal caregivers in the societal context had further brought about over-responsibility and self-sacrifice among women.
SIGNIFICANCE OF RESULTS
The gendered positions of cancer spousal caregivers further illustrated the gender differences in the caregiving experiences and consequences. Health-care professionals in routine clinical practice should be proactive in identifying physical, mental, and social morbidities among cancer spousal caregivers, particularly female ones, and providing timely interventions. Health-care professionals should recognize the pressing need for empirical research, political engagement, and action plans to address the health status and health-related behaviors of patients' spouses along the cancer trajectory.
Topics: Humans; Female; Caregivers; Sex Factors; Spouses; Stress, Psychological; Neoplasms
PubMed: 37334489
DOI: 10.1017/S1478951523000731 -
Behavioral Medicine (Washington, D.C.) 2022After hospital discharge, patients experience a period of generalized risk for adverse mental and physical health outcomes (post-hospital syndrome [PHS]). Hospital...
After hospital discharge, patients experience a period of generalized risk for adverse mental and physical health outcomes (post-hospital syndrome [PHS]). Hospital stressors can explain these effects in patients (e.g., sleep disruption, deconditioning). Patients' partners also experience adverse outcomes following patient hospitalization, but mechanisms of these effects are unknown. The purpose of this study was to test whether greater times and nights of patient hospitalization (proxies for partner exposure to hospital stressors) are prospectively associated with greater increases in partner depression and in partner self-reported poor health. Participants were 7,490 married couples (11,208 individuals) enrolled in the Health and Retirement Study. Outcomes were prospective changes in depressive symptoms and self-reported poor health, and primary predictors were spouse hospitalization over the past two years (/), spouse hospitalized ≥ two times (/), and spouse spent ≥ eight nights in-hospital (/). Covariates included age, gender, race, ethnicity, income, own hospitalization experiences during the past 12 months, and one's own and spouse comorbidities. Having a spouse who experienced two or more hospitalizations was associated with an increase in one's own depression over time, as was having a spouse who spent eight or more nights in-hospital. Spouse hospitalization was not associated with prospective changes in self-reported health. Results suggest that PHS mechanisms may account for adverse post-hospitalization outcomes in patients' partners.
Topics: Comorbidity; Depression; Hospitalization; Humans; Infant; Self Report; Spouses
PubMed: 33750268
DOI: 10.1080/08964289.2020.1870431 -
Psycho-oncology Aug 2020The goal of this study was to describe the quality of naturalistic communication between patients with advanced cancer and their spouse caregivers using observational... (Observational Study)
Observational Study
OBJECTIVE
The goal of this study was to describe the quality of naturalistic communication between patients with advanced cancer and their spouse caregivers using observational methods. We also assessed the association between patient and caregiver communication behaviors and psychological and physical health using the actor-partner interdependence model.
METHODS
Data on 81 dyads were gathered as part of a prospective observational study. Patients with advanced cancer and their spouse caregivers completed demographic, physical health, and emotional well-being questionnaires. Cancer and relationship communication captured in "day-in-the-life" audio recordings were coded using Gottman's Turning System to assess the quality of bids for attention and responses.
RESULTS
Bids for attention were most often informational (Low Bids) and responses were mostly positive and effortful (Turn Towards); patients and caregivers did not significantly differ in communication behavior. More effortful bids for attention (High Bids) were associated with more positive and effortful responses. Patient communication behaviors were significantly associated with caregiver emotional well-being, whereas caregiver communication behaviors were significantly associated with their own emotional well-being and patient physical health.
CONCLUSIONS
While patients may benefit from caregivers' more positive and engaged communication at home, the emotional labor of focusing on and engaging the patient may take a toll on caregivers' own well-being. This work contributes to the understanding of what everyday communication looks like for patients with advanced cancer and their spouse caregivers and how this communication may impact physical and psychological health. Our findings provide a foundation to develop guidelines for psychosocial couple-based interventions.
Topics: Adaptation, Psychological; Adult; Aged; Caregivers; Cost of Illness; Female; Humans; Male; Mental Health; Middle Aged; Neoplasms; Prospective Studies; Quality of Life; Self Concept; Social Support; Spouses; Surveys and Questionnaires
PubMed: 32419243
DOI: 10.1002/pon.5416 -
BMC Psychiatry Dec 2022Mental health disorders can adversely affect relationships and are heritable. Yet, there is a high prevalence of mental illness in spouses and partners of those with...
BACKGROUND
Mental health disorders can adversely affect relationships and are heritable. Yet, there is a high prevalence of mental illness in spouses and partners of those with mental illness. This study will assess within- and cross-mental health disorder correlations in husband-and-wife pairs.
METHODS
A cross-sectional study design was employed using medical claims data from the Deseret Mutual Benefit Administrators (DMBA), linked to demographic information from employee eligibility files, 2020. Analyses involved 21,027 contract holders aged 18-64 (68.6% male, 31.4% female), with sub-analyses on 16,543 married individuals. Summary statistics, as well as rates, and rate ratios adjusted for age, sex, and dependent child status were calculated to describe the data.
RESULTS
The rate of stress is 19.2%, anxiety is 26.4%, and depression is 23.6% in spouses of contract holders with the same respective disorders. Rates of stress, anxiety, and depression in a spouse are greatest if the contract holder has schizophrenia. Rates of mental illness in wives of male contract holders experiencing mental health disorders tend to be greater than the rates of mental illness in husbands of female contract holders experiencing mental health disorders. Rates of stress, anxiety, and depression in spouses of contract holders tend to be 2-3 times greater when the contract holder has a mental health disorder, after adjusting for the contract holder's age, sex, dependent child status, and difference in age within husband-and-wife pairs. However, differences in the magnitude of observed associations vary. The rate of a spouse having stress is 5.5 times greater if the contract holder has schizophrenia (vs. does not have schizophrenia), whereas the rate of a spouse having stress is 1.4 times greater if the contract holder has sleep apnea (vs. does not have sleep apnea).
CONCLUSION
Mental health disorders in spouses of contract holders are greater if the contract holder has a mental health disorder, more so when the contract holder has more serious mental illness. Both within- and cross-mental disorder correlations exist. These results have implications on relationship quality and the mental health of offspring.
Topics: Child; Male; Female; Humans; Spouses; Mental Health; Cross-Sectional Studies; Mental Disorders; Sleep Apnea Syndromes
PubMed: 36471289
DOI: 10.1186/s12888-022-04335-x -
Health & Social Care in the Community Jul 2022This study investigates under what conditions older spouses receive personal care from their spouse. Whether spousal care is provided is determined by individual and...
This study investigates under what conditions older spouses receive personal care from their spouse. Whether spousal care is provided is determined by individual and societal factors related to informal and formal care provision. Individual factors concern the need for care (the care recipient's health status), the spouse's ability to provide care (the spouse's health status) and the quality of the marital bond. Societal factors reflect changing policies on long-term care (indicated by the year in which care started) and gender role socialisation (gender). From the Longitudinal Aging Study Amsterdam, which completed eight observations between 1996 and 2016, we selected 221 independently living married respondents, aged 59-93, who received personal care for the first time and had at least one previous measurement without care use. The results show that if an older adult received personal care, the likelihood of receiving that care from the spouse decreased over the years: from 80% in 1996 to 50% in 2016. A husband or wife was less likely to receive spousal care when the spouse was unable to provide care or the quality of the relationship was low. No gender differences were found in either the prevalence of spousal care use or in the factors associated with that use. Thus, individual factors and the societal context seem to determine whether one receives personal care from their spouse. The decline in the likelihood of personal care provision from a spouse over the years may indicate a crumbling of family solidarity, an unmeasured and growing inability of the older spouse to provide care or an increasing complexity of care needs that requires the use of formal care. As care-giving can be a chronic stressor and most spouses provide care without assistance from others, attention from policy makers is needed to sustain the well-being of older couples.
Topics: Aged; Health Status; Humans; Independent Living; Marriage; Self Care; Spouses
PubMed: 34245192
DOI: 10.1111/hsc.13497 -
Research in Nursing & Health Dec 2023The stress of disability significantly impacts an individual's quality of life and that of a spouse. Health empowerment, based on the idea that individuals may be...
The stress of disability significantly impacts an individual's quality of life and that of a spouse. Health empowerment, based on the idea that individuals may be successful despite disability, may be meaningful to disabled persons and their spouse carers. This cross-sectional survey study aimed to explore the effect of health empowerment on the health-related quality of life (HRQOL) of older individuals with disabilities and their spouse carers on both a personal (actor effect) and interpersonal level (partner effect). A total of 1092 dyads of older individuals with disabilities and their spouse carers residing in communities were recruited from seven provinces in China. Two separate Actor-Partner Interdependence Model analyses were conducted to examine the impact of health empowerment on the two domains of HRQOL: the Physical Component Score (PCS) and the Mental Component Score (MCS). The results revealed that health empowerment had actor effects on the PCS and MCS of older individuals with disabilities, as well as on the PCS and MCS of their spouse carers. However, no significant partner effects of health empowerment on the PCS and MCS of either the individuals with disabilities or their spouse caregivers were observed. Empowering individuals with disabilities and their spouse carers may help them enhance their own HRQOL, both physically and mentally. However, more research is required to determine the interpersonal effect of health empowerment on the HRQOL.
Topics: Humans; Aged; Quality of Life; Cross-Sectional Studies; Caregivers; Spouses; Disabled Persons
PubMed: 37821227
DOI: 10.1002/nur.22345