[Joint estate. Remarried spouse. Universal community law. Complete allocation clause. Surviving spouse, next of kin, the right to bring claims].
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Sex differences in the relationship of pain patient dysfunction to spouse adjustment.
Recent studies have suggested that spouses of chronic pain patients are at risk for emotional and marital maladjustment. This study explored the role of patient and spouse gender in mediating the effects of chronic pain on the spouse's adjustment. Eight-three chronic low back pain patients and their spouses completed measures of physical and psychosocial disability, pain behaviors, marital satisfaction, and depression. The following findings characterized male but not female patient couples: (a) spouses reported significantly lower marital satisfaction than did patients; (b) lesser spouse marital satisfaction was associated with greater patient depression; and (c) greater spouse depression was associated with greater depression and lower marital satisfaction in patients. In female but not male patient couples, spouses reported significantly less depression than did patients. Significant relationships were more frequently observed between spouse-rated patient dysfunction and spouse's depression and marital adjustment in male patient couples. The results suggest a stronger relationship for female than for male spouses between the spouse's perception of patient dysfunction and the spouse's emotional and marital adjustment.
Adult↗
Fatal violence among spouses in the United States, 1976-85.
In this paper we examine patterns and trends in homicides between marriage partners in the United States for 1976 through 1985 using data from the Federal Bureau of Investigation's Supplemental Homicide Reports (FBI-SHR). We identified 16,595 spouse homicides accounting for 8.8 per cent of all homicides reported to the FBI-SHR during this 10-year period. The rate of spouse homicide for this 10-year period was 1.6 per 100,000 married persons. The risk of being killed by one's spouse was 1.3 times greater for wives than for husbands. Black husbands were at greater risk of spouse homicide victimization than Black wives or White spouses of either sex. The risk of victimization was greater for spouses in interracial than in intraracial marriages and increased as age differences between spouses increased. From 1976 through 1985, the risk of spouse homicide declined by more than 45.0 per cent for both Black husbands and wives but remained relatively stable for White husbands and wives. Demographic patterns in the risk of spouse homicide were similar to those reported for nonfatal spouse abuse suggesting that the causes of spouse homicide and nonfatal spouse abuse may be similar.
Adult↗
Spouses' psychosocial problems, resources, and marital functioning postmyocardial infarction.
The psychosocial problems and adjustments of 40 myocardial infarction (MI) patients and their spouses were examined 3 months after hospitalization. The following relationships were explored: spouse anxiety and coping methods with marital functioning; and couple-shared responsibility and the patient's perception of spouse's beliefs about patient compliance in regard to actual patient compliance. Results indicate that spouses received minimal information about expected roles and responsibilities, and no information about the patients' symptoms or the spouses' personal needs after discharge. Approximately 50% of the spouses received information on the medical regimen and cardiac condition. Patient compliance was high for all regimen prescriptions, and patient's perception of spouse's beliefs was significantly related to patient compliance. There was almost no agreement between patient and spouse on shared responsibility for regimen compliance. Marital functioning was negatively related to state/trait anxiety with trait anxiety predictive of marital functioning. Problem solving was the coping method most frequently used by spouses, with emotive (affective) coping methods negatively related to marital functioning. These findings lend support for future studies to examine the most effective method of couple inclusion in rehabilitation programs. In addition, program content should reflect the information spouses perceive as necessary for them to receive in such programs.
Adaptation, Psychological↗
Coronary artery bypass surgery--impact upon the patient's spouse.
The spouses of 65 coronary artery bypass graft surgery (CAGS) patients were assessed to determine levels of psychological symptoms and social impairment both before and 12 months after surgery. There was substantial psychological morbidity in spouses pre-operatively, with from one-third to one-half having clinically significant levels of depression and/or anxiety symptoms. Pre-operatively there was also significant global psychosocial impairment in the spouse. Of the specific domains of psychosocial adjustment, recreational and psychological adjustment was most severely affected, vocational/domestic adjustment and sexual adjustment being less impaired, and extended family relationships showing minimal impairment. There was significant improvement in spouses' psychological and global psychosocial adjustment at 12 months, with recreational adjustment showing the greatest improvement. Significant improvements also occurred in vocational adjustment but not in domestic or sexual adjustment. Neither physical, psychological nor social adjustment variables preoperatively in either the patient or spouse were predictive of psychological morbidity in the spouse (anxiety or depression) at 12 months. Similarly there were no significant patient or spouse preoperative predictors of social adjustment in the spouse at 12 months. However, the patients post-operative psychological morbidity and the spouses social and psychological morbidity were related.
Adult↗
Spouse attitudes toward the person with aphasia.
This investigation evaluated the attitudes of individuals towards their aphasic spouse. Using modified Q-methodology, 15 spouses of fluent aphasic patients, 15 spouses of nonfluent aphasic patients, and 30 matched controls completed a 70-item Q-sort. The spouses of nonfluent aphasic patients had a significantly greater number of negative attitudes toward their spouses than the spouses of fluent aphasic patients. The spouses of patients in both aphasia groups had a significantly greater number of negative attitudes toward their spouses than the matched controls. The most common attitudes of spouses of patients in both aphasic groups divided into six factors: compliance, desirability, egocentricity, independence, maturity, and sociability.
Aphasia, Broca↗
Husband-wife diet concordance and changes in dietary practices by surviving spouses of cancer cases.
Diet concordance and changes in dietary practices by surviving spouses of cancer cases were investigated by studying 69 husband-wife pairs during an eight-year period spanning the death from cancer of one spouse. The data base consisted of reports for each cancer case from the Adventist Health Study (AHS) where a surviving spouse was available. Two questions were addressed. 1. Do husbands and wives eat similar diets? 2. Did survivors change their diet practices during the eight-year period? Three sets of dietary data were compared with the AHS food frequency questionnaire: reports made in 1976 by cases; reports made in 1976 by their spouses (initial); and the spouses' reports in 1984 (current). Diet concordance and dietary changes for 35 key food groups were evaluated both for individual foods and across foods by computing recall scores. The results were analyzed with univariate and multivariate methods. Comparison of means and Spearman rank-order correlations revealed good initial concordance between the spouses, which was not significantly related to age, sex, or education. However, eight years later subsequent to the deaths of the cases, the agreement was poor because the surviving spouses had changed their diets. The changes in dietary practices were significantly related to education and body mass index in univariate analysis but not in analysis of covariance. These results indicate that retrospective recall by spouses for the cases rather than the spouses' own current reports should be used as an estimate for the deceased cases. Repeated recalls are necessary to increase reliability.
Adult↗
Stress, social support, and symptoms of depression in spouses of the medically ill.
This study investigated the level and frequency of depressive symptoms in spouses of dialysis patients, as a function of a) severity of patient disease, b) level of stress experienced by the spouse, and c) perception of support from the ill partner. The subjects were forty patients who had begun dialysis in the last year and their spouses. Measures of depression, impact on family, perceived social support, and disease severity were applied. Significant depressive symptoms were reported by 20 percent of spouses. Symptom severity was not correlated with age, sex, or occupation of the spouses, nor with level of depression or functional impairment of the dialysis patients. The amount of social support received from the ill partner accounted for 37 percent of the variance in spouse depression, while social and financial stressors reported by the spouse explained 13 percent of the variance in spouse symptoms. These findings suggest that depressive symptoms in spouses of dialysis patients are associated with the social and economic consequences of the illness for the family but even more so with the amount of perceived support from the patient. The determinants of this perceived support need further exploration.
Adaptation, Psychological↗
Needs of the grieving spouse in a hospital setting.
In an attempt to determine whether the spouse whose mate is terminally ill or had died can recognize his own needs and whether he, himself, perceives that he has been helped by nurses, 27 spouses were interviewed during the terminal illness of their mates. Subsequently, 18 mates died; 14 of the spouses were interviewed after the death event. Data were collected by means of tape-recorded semistructured interviews, with the exception of one written second interview. Eight needs of grieving spouses were noted. Twenty-five spouses identified all eight needs and the other two spouses identified five and seven needs, respectively. The fact that the needs were identified did not mean, however, that these needs had been met. Spouses believed nurses had been helpful to the dying mates. The spouses recognized that the nurses' primary responsibility was to the patients and felt that nurses were too busy to help the families. The death event did not alter the identified needs and concerns of the spouses. Eighty-seven percent of the needs identified in the second interview had been identified in the first interview.
Adult↗
Spouse adjustment to stroke: aphasic versus nonaphasic partners.
A survey of spouses of stroke patients examined the impact of stroke with and without aphasia on spouse role change, emotional problems, social adjustment, and the partner's perceived communication abilities. The results of this study support earlier findings that stroke with aphasia has a greater negative impact on the patient's spouse than does stroke without aphasia. For the spouses of aphasic patients sampled in this study, role changes represented the major adjustment made to a partner's stroke. These adjustments were greater than those experienced by the spouses of nonaphasic patients. The inability of aphasic patients to communicate well with their spouses served to make necessary role adjustments more difficult. Both spouse groups were affected to some degree by the communication problems associated with stroke, with the spouses of aphasic partners being affected the most.
Aphasia↗
Depression in spouses of chronic pain patients: the role of patient pain and anger, and marital satisfaction.
Although several studies have shown that spouses of chronic pain patients may experience clinically significant depressive symptoms few studies have comprehensively examined the role of both patient and spouse-related factors in the development and maintenance of this emotional distress. Twenty-nine married male chronic benign low back pain patients and their spouses were recruited in order to examine the role of patient, spouse, and marital factors in spouse depressive symptomatology. The results indicated that 28% percent of the spouses in the sample reported significantly depressed mood. A 2-stage regression analysis was employed that revealed 3 significant predictors of spouse's depressed mood, namely patient's average pain; patient's reported levels of anger and hostility, and the spouse's level of marital satisfaction. These findings are discussed in terms of their implications for clinical interventions for pain patients and their families.
Adult↗
Psychiatric morbidity among spouses of patients with stroke.
The medium term psychiatric morbidity of spouses of patients with stroke was evaluated one to three years after the event. Compared with a control group the spouses were more likely to be depressed (p less than 0.005) and had more physical symptoms (p less than 0.01). Depression increased with the severity of the stroke in the spouse (p less than 0.05) and with time during the three years. Regular contact with friends and neighbours protected spouses (p less than 0.005). Depressed spouses were more likely to be taking tranquillisers than non-depressed spouses (p less than 0.0001) but no more likely to be taking antidepressants. Social rehabilitation after stroke was less successful when the spouse was depressed. Proper attention paid to spouses of patients with stroke might improve the prospects of these patients.
Attitude to Health↗
[Concordance of risk factors for cerebro-cardiovascular diseases among spouses].
The present study was carried out to clarify the concordance or similarity of risk factors among 298 spouse pairs in a random sample who lived in Mizobe town of Kagoshima Prefecture. A sample of 298 spouse pairs was surveyed by using the house-to-house interviewing method and was classified into three groups by the marriage duration. The following results were obtained. 1) Statistically significant partial correlation coefficients were demonstrated among the spouses for blood pressure in the present study. However, they were smaller than among spouses in remote islands, this fact suggested that there was no higher spouse concordance in this surveyed area than in remote island areas, and also that there might be a difference in the shared environment of spouse pairs and the genetic effect on blood pressure between the former area and the latter. 2) In regard to the intake of salt in miso soup and the ratio of sodium to potassium (Na/K), an increasing gradient of partial correlation coefficients for the risk factors among the spouses was observed with increasing marriage duration, suggesting that the intake might be caused by the shared environment on the basis of a similar dietary pattern for the spouse pairs.
Adult↗
Fulminant hepatitis related to transmission of hepatitis B variants with precore mutations between spouses.
A precore defective variant of hepatitis B virus has been indicated to cause fulminant hepatitis in various instances such as intrahospital outbreaks or mother-to-child transmission of hepatitis B virus. To learn whether similar variants are involved in interspouse transmission, we analyzed three cases of fulminant hepatitis B that developed in formerly healthy subjects whose only exposure to hepatitis B virus was contact with their longtime spouses, who were carriers of HBV and positive for antibody to HBe. The DNA clones for precore and S genes were propagated from patients and spouses and sequenced. Because of the conservation of S-gene sequences and the identity of subtypes between patient and spouse, it was suggested that patients were infected with hepatitis B virus from their spouses, not from other sources. A TGG-to-TAG mutation at the 28th codon of the precore gene of hepatitis B virus was commonly observed in all DNA clones from patients with fulminant hepatitis and from their spouses. A 29th-codon GGC-to-GAC mutation was additionally evident in DNAs from one patient-and-spouse couple. A significant rise in the circulating hepatitis B virus concentration was transiently observed in the index spouse of this case just before development of fulminant hepatitis in her husband. The increase in circulating HBV DNA was associated with a rise in abundancy of variants with mutations at both the 28th and 29th codons, compared with variants with only a 28th-codon mutation. The double mutation in hepatitis B virus DNA may either help the virus escape immune surveillance or replicate at a higher rate than before.
Base Sequence↗
The relationship between spouse solicitousness and pain behavior: searching for more experimental evidence.
In this study 42 chronic back pain patients participated twice in a treadmill test. During 1 of these 2 sessions, the partner was present. Walking time, pain intensity ratings, and heart rate were measured before and after the tests. From the results of previous studies it was expected that, in the presence of a relatively solicitous spouse, patients would report more pain, would have a shorter walking time, and would exert themselves less physically. Spouse solicitousness was measured in 2 ways: from the patient's perspective as well as from that of the spouse. Results based on the patient's interpretation of his/her partner's responses are not in accordance with previous findings. Results based on the spouse's view demonstrate, however, that patients with solicitous spouses do, in fact, report more pain and walk for a shorter duration in the presence of the spouse than patients with relatively non-solicitous spouses. Theoretical and practical implications are discussed.
Adult↗
Cancer pain in the marital system: a study of patients and their spouses.
Forty married patients with metastatic cancer, who were receiving opioid medication for cancer pain, were interviewed for this study. They were asked about their pain and its treatment, their beliefs regarding cancer pain, their concerns about opioid analgesics, their mood state, and the nature of their interaction with their spouse in relation to these issues. The spouses of these cancer patients were interviewed separately about the same issues. For example, patients who were concerned about medication side effects tended to suffer high levels of pain before requesting additional analgesics. Spouses are shown in this study to be an important support for the patient and an essential source of information regarding the patient's pain and its management. For example, although spouses were generally accurate in their estimates of the patients' pain levels, in the case of relatively stoic patients, who may underreport their pain levels, the spouses' estimates were higher than the patients'. The results also indicate that patients underestimate the distress their pain causes to their spouses and that spouses tend to downgrade their own support to the patients. Implications and limitations of these findings are discussed.
Adult↗
Comparison of psychologic stress responses in patients and spouses ten weeks after a cardiac illness event.
A stress scale that is brief and easy to administer would be clinically useful to assess patients' and spouses' psychological stress responses to a cardiac illness situation and provide objective data for health care recommendations. The purpose of this study was to: a) develop and test an instrument to evaluate the stress or difficulties associated with the recovery process after a cardiac event; and b) assess the similarities and differences between patients' and spouses' perceptions of stress. Stress was conceptualized to be reflected by two broad dimensions, namely environmental stress and individual stress. A correlational survey design was used to examine patients' (n = 180) and spouses' (n = 168) stress responses 10 weeks after the cardiac event. The findings suggested that the tool demonstrated satisfactory reliability and validity in measuring the patients' but to a lesser extent the spouses' stress responses. The three most significant stresses reported by most patients were uncertainty about if and when the illness might recur, not being able to participate in work or retirement activities, and adopting a low cholesterol diet. For the majority of spouses, the three most significant stresses were uncertainty about the husband's illness, increased demands within the marital relationship, and assuming more family roles. For those individuals trying to quit smoking or who quit immediately prior to the cardiac event, smoking was the most stressful change for patients and the second most stressful for spouses. Educational programs for cardiac patients and spouses need to provide information related to these stresses to offset the potentially adverse impact of stress and promote adjustment.
Adult↗
What do cancer patients' spouses know about the patients?
A large body of research shows that social support in general and of family members in particular plays an important role in determining cancer patients' quality of life. We assumed that the spouse's information about how the patient experiences the situation determines the spouse's ability to help. The present study was designed to examine how much the spouse knows about the attitudes and experiences of their husband or wife who is a cancer patient, and whether this knowledge depends on the questions' structure, disease duration, its severity, or level of patient's information about the disease and prognosis. A questionnaire with multiple-choice and open-ended questions assessing 13 domains (e.g., fears and worries concerning health, functioning in the family, and anxiety) was administered to patients and their partners. Subjects were 55 head-and-neck cancer patients, 40 men and 15 women, with disease stages I to IV, grade of tumors G1 to G3-4, and disease duration of 0.5 to 21 years. The results showed that correspondence between the patients' and their spouses' responses was very low, and was not affected by the structure of the questions or the disease's duration and severity. Correspondence was high only in patients informed about their disease. In the discussion, it was pointed out that when the patient is informed, communication channels in the family are opened and this brings about an increase in the spouses's information about the patient and hence in the spouse's ability to provide the patient the needed social support as a psychotherapeutic agent and a friend. The cancer nurse may play a crucial role in instituting the patient-spouse dialogue.
Adult↗