This study assessed the intrapersonal and interpersonal functioning of a three-couple expedition group that included a 2 1/2-year-old child which was ice-locked on a boat in the High Arctic during a major portion of the expedition. Personality assessment indicated that team members were generally well adjusted, scoring relatively higher on well-being and achievement and relatively lower on stress reactivity. Weekly mood ratings showed that the group exhibited significantly higher positive than negative affect. Reported negative events were relatively most frequent at the beginning of the Arctic stay and toward the end of the darkness period and were lowest during the initial darkness interval. The period of darkness had both a salutary and negative impact. A highly important means of coping with stress was seeking emotional support from one's partner. Selection of couples with strong bonds with their partner appears to be one viable approach for crew selection for long-duration missions.
Obstructive sleep apnoea syndrome (OSAS) is independently associated with an increased risk for hypertension and cardiovascular disease. Continuous positive airway pressure (CPAP) can reduce mortality and morbidity, but low compliance rates are seen.
To explore and describe the experiences of CPAP-treatment in a young male patient with severe OSAS during a 6-month period from the couple's perspective. METHODS AND THE CASE: A single case study with a phenomenographic approach was employed. Diagnostic procedures of OSAS and initiation of treatment with Auto-CPAP, humidifier and a nasal mask were performed during 4 visits. Conceptions were collected at 4 different occasions during the 6-month period (before, and 2 weeks, 3 months, and 6 months after treatment initiation) by means of interviews with a 33-year old male patient and his female partner.
Totally 17 different structural aspects were found to fluctuate during the 6-month period in relation to; influence of stressors, social reactions and adaptation to increase compliance.
An increased knowledge about the influence of stressors, the social reactions, and the adaptation can help healthcare personnel to identify and better understand concerns of other patients and spouses during different time phases of the initial 6-month period of CPAP-treatment.
To investigate occupational therapists', physiotherapists' and speech language pathologists' family-related rehabilitation practice post-stroke and its association with clinician and environmental variables.
A Canadian cross-sectional telephone survey was conducted on 1755 clinicians. Three case studies describing typical patients after stroke receiving acute care, in-patient rehabilitation, or community rehabilitation, and including specific descriptors regarding family stress and concern, were used to elicit information on patient management.
One-third of the sample identified a family-related problem and offered a related intervention, but only 12/1755 clinicians indicated that they would typically use a standardized assessment of family functioning. Working in the community out-patient setting was associated (OR 9.16), whereas working in a rehabilitation in-patient setting was negatively associated (OR 0.58) with being a problem identifier, the reference group being acute care. Being a PT (OR 0.53) or an SLP (OR 0.49) vs an OT was negatively associated with being a problem identifier, whereas being older (OR 1.02 ) or working in Ontario (OR 1.58) was associated with being a problem identifier. To work in a community out-patient setting (OR 2.43), being older clinicians (OR 1.02) or not perceiving their work environment being supportive of an on-going professional learning (OR 1.72) was associated with being an intervention user,whereas being a PT (OR 0.50) was negatively associated with being a user.
For these 3 disciplines, the prevalence of a family-related focus is low post-stroke. Given the increasing evidence regarding the effectiveness of family-related interventions on stroke outcomes, it is imperative that best practice is implemented.
The call to the Emergency Medical Dispatch Centre is often a person's first contact with the health-care system in cases of acute illness or injury and acute chest pain is a common reason for calling. The aim was to illuminate how spouses to persons with acute chest pain experienced the alarm situation, the emergency call and the prehospital emergency care. Interviews were conducted with nineteen spouses. A phenomenological-hermeneutic approach was used for the analyses. The themes responsibility and uneasiness emerged as well as an overall theme of aloneness. Being a spouse to a person in need of acute medical and nursing assistance was interpreted as "Being responsible and trying to preserve life" and "Being able to manage the uneasiness and having trust in an uncertain situation." When their partners' life was at risk the spouses were in an escalating spiral of worry, uncertainty, stress, fear of loss, feeling of loneliness and desperation. They had to manage emotional distress and felt compelled to act to preserve life, a challenging situation.
The purpose of this study was to examine the meaning of lived experiences after an acute myocardial infarction (AMI) and being a partner to an afflicted woman, as it is narrated during rehabilitation. Nine women and their partners narrated their experiences three and twelve months after AMI. The interview texts were transcribed and then interpreted, using a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur. The result showed that their experiences of the illness contained two themes: 'rehabilitation needed' and 'loss of freedom' which contains eight sub-themes; 'adapting to it', 'struggling against it', 'living as normally as possible', 'having insight into how it can be', 'feeling guilty and ashamed about being weak', 'withholding feelings', 'feeling useless', and 'feeling fatigued and losing strength'. After further interpretation, the themes gave a deeper meaning of living with AMI and how it affects women and their partners. The women conceded that they felt distressed and vulnerable but struggled against the fear the illness means. The partner's role appears to be one of trying to adapt to the women's experiences of the illness. That the women withheld their feelings and did not talk about them indicates a lack of communication between the couples. As coronary care nurses often come very close both to the afflicted persons and the relatives they fill an important function in each patient's recovery. The nurses could help and prepare the patients and their relatives to understand better such feelings and reactions as could appear after discharge from hospital.
Prostate cancer challenges not only the men with the disease, but also their partners. Existing studies have focused on the relationship between type of treatment and sexual and urinary function in men, with recent qualitative work suggesting that men and their spouses have differing responses to the illness. Factors predicting women's adaptation to prostate cancer have not been examined.
Using a model derived from family stress and adaptation theory, this study examined (1) the contribution of urinary and sexual symptoms, sense of coherence, marital resources and situational appraisal to wives' global adaptation (PAIS) and emotional adaptation (POMS), and (2) the role of situational appraisal as a mediator between the set of independent variables and PAIS and POMS.
In a prospective, correlational design, data were collected from 70 women following their partners' diagnosis and again 3 months later.
Using a path analysis approach, between 30% and 62.7% of the variance in global adjustment and mood disturbance was explained across model tests. Sense of coherence was a strong and consistent predictor. Appraisal acted as a mediator only at time 2, mediating the effect of symptom distress on global adaptation. Change in sense of coherence and change in family resources predicted global adaptation and emotional adaptation at time 2, and predicted the change between time 1 and 2 in those variables.
The findings suggest nursing interventions that mobilize and build wives' sense of the manageability, meaningfulness and comprehensibility of life events, and that foster cohesion and flexibility within the marital relationship. Interventions that mitigate the impact of urinary symptoms and the appraisal of threat in the illness event are also indicated. Additional model-testing studies based on family adaptation theory with patients and family members in other types of cancer would help build nursing knowledge for interventions in cancer.
The trajectory of relationship satisfaction among married and cohabiting women in their transition to parenthood was compared in a potential sample of 71,504 women taking part in the Norwegian Mother and Child Cohort Study (MoBa). Prospective longitudinal data were collected in 4 waves over a 2-year period starting 6 months prebirth. Results from latent curve models suggested that married and cohabiting women experience similar negative change in relationship satisfaction during the transition to parenthood. However, cohabiting women start off and stay less satisfied throughout the transition period, suggesting the presence of a negative cohabitation effect that prevailed after controlling for various covariates. Extending investigation on the cohabitation effect to the transition to parenthood, and replicating it in a Scandinavian context, is discussed in relation to the understanding of what causes the cohabitation effect, and its clinical implications.
Department of Cardiothoracic Surgery, Linköping University Hospital and Department of Medical and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping S-58185, Sweden. susanna.agren@liu.se
Cardiac surgery places extensive stress on spouses who often are more worried than the patients themselves. Spouses can experience difficult and demanding situations when the partner becomes critically ill.
To identify, describe, and conceptualize the individual needs of spouses of patients with complications of heart failure after cardiac surgery.
Grounded theory using a mix of systematic coding, data analysis, and theoretical sampling was performed. Spouses, 10 women and 3 men between 39 and 85 years, were interviewed.
During analysis, the core category of confirmation was identified as describing the individual needs of the spouses. The core category theoretically binds together three underlying subcategories: security, rest for mind and body, and inner strength. Confirmation facilitated acceptance and improvement of mental and physical health among spouses.
By identifying spouses' needs for security, rest for mind and body, and inner strength, health care professionals can confirm these needs throughout the caring process, from the critical care period and throughout rehabilitation at home. Interventions to confirm spouses' needs are important because they are vital to the patients' recovery.
This study examines men's domestic aggression as a function of attachment insecurities, considering the mediating roles of the demand-withdraw communication pattern and relationship satisfaction. The sample included 55 Canadian men undergoing counseling for relationship difficulties including aggression. The men completed questionnaires assessing physical and psychological aggression, the two dimensions of attachment insecurity (anxiety over abandonment and avoidance of intimacy), the demand-withdraw communication pattern, relationship satisfaction, and social desirability (a control measure). As predicted, there was an association between attachment anxiety and aggression (both physical and psychological), which was mediated by the man demands/woman withdraws (MD/WW) pattern (as reported by the men). There was no evidence of mediation by the woman demands/man withdraws pattern, as reported by the men. Relationship satisfaction mediated the association between attachment anxiety and psychological (but not physical) aggression, but did not mediate the link between avoidance and aggression (physical or psychological). Limitations and clinical implications are discussed.
Women living with heavy snorers were more frequently affected by symptoms of insomnia, morning headache, daytime sleepiness, and fatigue than women living with non-snorers. Questionnaire data were collected from 1,032 women 30 to 64 years of age residing in Dalarna county, in mid-Sweden. There were indications of a "dose-response relationship" between the conjectured sound exposure and reported symptoms, regardless of whether the female herself snored. Sleeping in separate bedrooms did not seem to give the women any alleviation. The results point to a possible contributory cause of disturbed sleep, morning headache, and daytime sleepiness among women living with a snoring spouse. The results also indicate that prevention and treatment of snoring are important issues for the couple as well as for the snorer.
