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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 -
JAMA Network Open Apr 2024Although cardiovascular disease (CVD) is a known risk factor for depression, evidence is lacking regarding whether and to what extent a spouse's CVD is associated with...
IMPORTANCE
Although cardiovascular disease (CVD) is a known risk factor for depression, evidence is lacking regarding whether and to what extent a spouse's CVD is associated with the subsequent mental health of individuals.
OBJECTIVE
To examine the association between CVD onset in spouses and subsequent depression.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study examined 277 142 matched married couples enrolled in the Japan Health Insurance Association health insurance program between April 2015 and March 2022, covering approximately 40% of the working-age population in Japan. Index individuals (primary insured) whose spouses (dependent) experienced incident CVD between April 2016 and March 2022 were 1:1 matched to controls whose spouses did not experience CVD. Matching was based on age, sex, income, or the onset date of the spouses' CVD. Data analysis was conducted from April 2016 to March 2022.
EXPOSURE
Spousal onset of CVD between fiscal years 2016 and 2021. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes were used to identify the composite CVD outcomes (stroke, heart failure, and myocardial infarction).
MAIN OUTCOMES AND MEASURES
Multivariate Cox proportional hazards models were used to investigate the association between spouses' new-onset CVD and individuals' depression, adjusting for sociodemographic characteristics and comorbidities of index individuals (diabetes, hypertension, and CVD) and spouses (diabetes, hypertension, and depression). Subgroup analyses were conducted according to sex, age, income levels, and history of CVD.
RESULTS
Among 277 142 matched pairs of married couples, 263 610 (95.1%) had a male index individual; the mean (SD) age of index individuals was 58.2 (10.2) years. A new onset of depression was observed in 4876 individuals (1.8%). In multivariable Cox models, there was an association between the spouse's CVD and the individuals' depression (hazard ratio, 1.13 [95% CI, 1.07-1.20]). The subgroup analysis found no evidence of heterogeneity in sex, age, income level, or CVD history. The results were consistent when additionally adjusted for health behaviors (smoking, alcohol consumption, physical activity, and use of antihypertensive drugs) and objectively measured physical health conditions (body mass index, blood pressure, cholesterol levels, glucose levels, and estimated glomerular filtration rate) (hazard ratio, 1.16 [95% CI, 1.06-1.28]).
CONCLUSIONS AND RELEVANCE
In this nationwide cohort study of matched couples, a spouse's onset of CVD was associated with an increased risk of an individual's depression. These findings highlight the importance of preventive care for mental health disorders in individuals whose spouses experience incident CVD.
Topics: Humans; Male; Middle Aged; Spouses; Cohort Studies; Depression; Hypertension; Myocardial Infarction; Diabetes Mellitus
PubMed: 38607629
DOI: 10.1001/jamanetworkopen.2024.4602 -
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 -
Journal of Clinical Sleep Medicine :... Mar 2017Many adults sleep with a significant other; thus, sleep disorder symptoms and treatments of one partner are likely to impact the other partner's health. A literature... (Review)
Review
STUDY OBJECTIVES
Many adults sleep with a significant other; thus, sleep disorder symptoms and treatments of one partner are likely to impact the other partner's health. A literature review was conducted to examine the impact of obstructive sleep apnea (OSA) and OSA treatments on partner-assessed sleep and daytime functioning and partner involvement in OSA treatment.
METHODS
MEDLINE, EMBASE, and CINAHL searches yielded 38 pertinent quantitative and qualitative studies that described sleep and/or daytime functioning assessed in partners of patients with untreated OSA, sleep and/or daytime functioning assessed in partners who were referred for OSA treatment, including continuous positive airway pressure (CPAP) therapy, oral appliance (OA), or surgery, and/or associations between partner involvement and OSA treatment use.
RESULTS
The majority of studies found untreated OSA to have a negative impact on partners' objective and subjective sleep and daytime functioning, in particular mood, quality of life, and relationship quality. Improvements in partner-assessed sleep quality were reported for CPAP, OA, and surgery. Conflicting results were reported for partners' mood, quality of life, daytime sleepiness, and relationship quality. Perceived partner support was associated with greater CPAP use.
CONCLUSIONS
Symptoms associated with OSA can negatively impact partners' sleep and daytime functioning. Treatment of OSA with CPAP, OA, or surgery can have health benefits for not only patients but also partners. Collaborative partner involvement may be a useful strategy for interventions promoting CPAP adherence.
Topics: Adult; Attitude to Health; Continuous Positive Airway Pressure; Female; Humans; Male; Sleep Apnea, Obstructive; Spouses
PubMed: 28095973
DOI: 10.5664/jcsm.6504 -
BMJ Open Apr 2024This study aimed to estimate the pooled prevalence of male involvement in family planning (FP) and its association with knowledge and spouse discussion in Ethiopia. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study aimed to estimate the pooled prevalence of male involvement in family planning (FP) and its association with knowledge and spouse discussion in Ethiopia.
DESIGN
Systematic review and meta-analysis using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines.
DATA SOURCES
The study was conducted by the articles searched from different databases: (PubMed, Cochrane Library, PsycINFO, HINARI and Google Scholar).
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
This research encompassed investigations carried out within married couples in Ethiopia, specifically focusing on studies where male involvement in FP was the primary outcome. The inclusion criteria comprised studies with an observational study design, encompassing both published and unpublished works, conducted in the English language, with no restrictions on data collection and publication year.
DATA EXTRACTION AND SYNTHESIS
Following a systematic search of the articles, two independent authors assessed the quality of the studies, and data extraction was conducted using Microsoft Excel. The data analysis was performed by using STATA V.17. The overall level of male involvement in FP in Ethiopia was calculated using DerSimonian and Liard's random-effect model, with a significance level set at a p<0.05. Heterogeneity was examined using the I test, and Egger's test was employed to assess publication bias.
RESULTS
The pooled prevalence of male involvement in FP in Ethiopia was 59.71% (95% CI (47.68% to 71.73%)). Good knowledge regarding FP (AOR 6.63, 95% CI (2.58 to 17.03)) and spouse discussion on FP (AOR 4.36, 95% CI (2.50 to 7.59)) were significantly associated with male involvement in FP.
CONCLUSIONS
The prevalence of male involvement in FP in Ethiopia was low as compared with other literature conducted outside Ethiopia. Both good knowledge and spouse discussion regarding FP were significantly associated with male involvement in FP. So, the government and healthcare providers should focus on interventions that could increase their knowledge through different media. In addition, encouraging couples to have a discussion regarding FP could be a recalled intervention for healthcare providers.
Topics: Humans; Ethiopia; Spouses; Male; Family Planning Services; Health Knowledge, Attitudes, Practice; Female
PubMed: 38670601
DOI: 10.1136/bmjopen-2023-082094 -
JAMA Psychiatry Mar 2018Although spouses strongly resemble one another in their risk for alcohol use disorder (AUD), the causes of this association remain unclear.
IMPORTANCE
Although spouses strongly resemble one another in their risk for alcohol use disorder (AUD), the causes of this association remain unclear.
OBJECTIVES
To examine longitudinally, in first marriages, the association of a first registration for AUD in one spouse with risk of registration in his or her partner and to explore changes in the risk for AUD registration in individuals with multiple marriages as they transition from a spouse with AUD to one without or vice versa.
DESIGN, SETTING, AND PARTICIPANTS
Population-wide Swedish registries were used to identify individuals born in Sweden between 1960 and 1990 who were married before the end of study follow-up on December 31, 2013. The study included 8562 marital pairs with no history of AUD registration prior to their first marriage and an AUD registration in 1 spouse during marriage and 4891 individuals with multiple marriages whose first spouse had no AUD registration and second spouse did or vice versa. Final statistical analyses were conducted from August 15 to September 1, 2017.
EXPOSURES
A spousal onset or history of AUD registration.
MAIN OUTCOMES AND MEASURES
Alcohol use disorder registration in national medical, criminal, or pharmacy registries.
RESULTS
Among the 8562 marital pairs (5883 female probands and 2679 male probands; mean [SD] age at marriage, 29.2 [5.7] years) in first marriages, the hazard ratio of AUD registration in wives immediately after the first AUD registration in their husbands was 13.82, which decreased 2 years later to 3.75. The hazard ratio of AUD registration in husbands after the first AUD registration in their wives was 9.21, which decreased 2 years later to 3.09. Among the 4891 individuals with multiple marriages (1439 women and 3452 men; mean [SD] age at first marriage, 25.5 [4.2] years), when individuals transitioned from a first marriage to a spouse with AUD to a second marriage to a spouse without AUD, the hazard ratio for AUD registration was 0.50 (95% CI, 0.42-0.59) in women and 0.51 (95% CI, 0.44-0.59) in men. After a first marriage to a spouse without AUD, the hazard ratio for AUD with a second marriage to a spouse with AUD was 7.02 (95% CI, 5.34-9.23) in women and 9.06 (95% CI, 7.55-10.86) in men. These patterns were modestly attenuated when moving from second to third marriages. Controlling for AUD registration prior to first marriage or between first and second marriages produced minimal changes in risk.
CONCLUSIONS AND RELEVANCE
The increase in risk for AUD registration in a married individual following a first AUD registration in the spouse is large and rapid. When an individual with serial spouses is married, in either order, to partners with vs without an AUD registration, the risk for AUD registration is substantially increased when the partner has an AUD registration and decreased when the partner does not have an AUD registration. These results suggest that a married individual's risk for AUD is directly and causally affected by the presence of AUD in his or her spouse.
Topics: Adult; Alcoholism; Causality; Female; Humans; Longitudinal Studies; Male; Marriage; Prevalence; Proportional Hazards Models; Registries; Risk; Spouses; Sweden
PubMed: 29417130
DOI: 10.1001/jamapsychiatry.2017.4457 -
Circulation. Heart Failure Oct 2017A diagnosis of heart failure (HF) often requires a comprehensive lifestyle change to maintain disease stability. When patients with HF are married, the spouse frequently...
BACKGROUND
A diagnosis of heart failure (HF) often requires a comprehensive lifestyle change to maintain disease stability. When patients with HF are married, the spouse frequently assumes the caregiving role. Our objectives were to describe the health of spouses of married patients with HF, and examine whether the health of a spouse impacts patient outcomes.
METHODS AND RESULTS
We identified 905 patients that were married at the time of incident HF diagnosis in Olmsted County, MN, from 2000 to 2012. Using Rochester Epidemiology Project resources, the patient and their spouse's comprehensive longitudinal health histories were linked. Spousal health at patient HF diagnosis was assessed by comorbidity burden, self-reported difficulty with activities of daily living and prior hospitalizations. The associations of spousal health with patient outcomes and patient death with spousal outcomes were examined using Cox and Andersen-Gill models. Spouses of patients with HF were elderly (mean age, 71 years), often had comorbid conditions, and 16% had difficulty with ≥1 activities of daily living. After adjustment for patient age, sex, and comorbidity, there were no independent associations of spousal health and patient risk of death or hospitalization after HF diagnosis. However, the risk of hospitalization (adjusted hazard ratio, 1.34; 95% confidence interval, 1.11-1.60; =0.002) and death (hazard ratio, 2.10; 95% confidence interval, 1.60-2.75; <0.001) increased in the surviving spouse after patient death.
CONCLUSIONS
We found no evidence that the health of a spouse impacts patient outcomes after HF diagnosis. However, after a patient with HF dies, their surviving spouse's risk of hospitalization and death increases.
Topics: Activities of Daily Living; Aged; Aged, 80 and over; Caregivers; Comorbidity; Cost of Illness; Female; Health Status; Heart Failure; Hospitalization; Humans; Longitudinal Studies; Male; Middle Aged; Minnesota; Proportional Hazards Models; Quality of Life; Risk Factors; Spouses
PubMed: 29030371
DOI: 10.1161/CIRCHEARTFAILURE.117.004088 -
Pain Sep 2022The experience of pain and pain behaviors is not only determined by physiological but also psychosocial factors. In this context, the learning history of the individual...
The experience of pain and pain behaviors is not only determined by physiological but also psychosocial factors. In this context, the learning history of the individual and specifically operant reinforcement related to spouse responses might play an important role. We investigated the effect of a solicitous and habitually pain-reinforcing spouse for the processing of pain in patients with chronic pain. Using multichannel electroencephalography, pain behaviors, and self-reports of pain, we examined 20 patients with chronic back pain (10 with solicitous and 10 with nonsolicitous spouses) and 10 matched healthy controls. The participants received a series of painful and nonpainful electrical stimuli applied to the site of pain (back) and a control area (finger) in the presence vs absence of the spouse. The global field power of the electroencephalogram with a focus in the frontal region was enhanced in patients with chronic back pain who had a solicitous spouse compared to those with a nonsolicitous spouse and the healthy controls. This was specific for the painful stimulation at the back and occurred only in the presence but not the absence of the spouse. Pain ratings of intensity and unpleasantness were also higher in the patients with solicitous spouses when the spouse was present during painful stimulation. These data suggest that significant other responses indicative of operant reinforcement may have a direct effect on the cerebral processing of pain and related pain perception.
Topics: Back Pain; Central Nervous System; Chronic Pain; Humans; Pain Measurement; Spouses
PubMed: 35027517
DOI: 10.1097/j.pain.0000000000002559 -
Annals of Behavioral Medicine : a... Oct 2022Depression and marital discord are characteristic not only of individuals with chronic low back pain (ICPs) but also of their spouses.
BACKGROUND
Depression and marital discord are characteristic not only of individuals with chronic low back pain (ICPs) but also of their spouses.
PURPOSE
We examined actor-partner interdependence models to evaluate associations among depressed affect and criticism and support of partners at the same time point (concurrent effects) and 3 hr later (lagged effects). Fully dyadic models were used to account for both within-person and cross-spouse associations among depressed affect, criticism, and support for ICPs and spouses. We also examined the direction of the relationships (depressed affect predicting behavior and behavior predicting depressed affect) all while controlling for pain intensity, pain behavior, and the prior dependent variable.
METHODS
ICPs (n = 105) and their spouses completed electronic diary measures of depressed affect and behavior (criticism and support) five times a day for 2 weeks. Hierarchical linear modeling with person-mean centering was used for data analysis.
RESULTS
Within the same 3 hr epoch, more depressed affect was related to higher criticism and generally less support. Lagged analyses suggested bidirectional relationships between spouse's own depressed affect and spouse's own criticism of ICPs. Spouse depressed affect was also associated with decreased support received from ICPs. Pain behavior and pain intensity were also related to depressed affect, criticism, and support especially concurrently.
CONCLUSIONS
Theories and interventions need to address not only ICP depressed affect but also spouse depressed affect, as spouse depressed affect may be a stress generating precursor to criticism and support.
Topics: Depression; Humans; Interpersonal Relations; Low Back Pain; Pain Measurement; Spouses
PubMed: 34849529
DOI: 10.1093/abm/kaab100