Comparison of life satisfaction within couples one year after a partner's stroke.

OBJECTIVE: To compare life satisfaction within couples one year after a partner's stroke and with norm values and social factors. SUBJECTS AND METHODS: A total of 56 couples were consecutively included. The respondents estimated life satisfaction using the Life Satisfaction Checklist 9-item version. Patients' impairments, self-care ability and handicap were assessed. Social characteristics were registered. Non-parametrical statistical methods were used for analyses. RESULTS: Patients were physically mildly disabled by their stroke. The most common symptom was mental fatigability. Patients were, in general, less satisfied than spouses. The couples were less satisfied than norms. Satisfaction with life as a whole, leisure and sex life were most affected for both patients and spouses. Relationship with partner was the only domain in which patients were more satisfied than their spouses and almost equally satisfied compared with norms. The proportion of couples in which both partners agreed they were satisfied, for the following domains was: leisure time 20%, sex life 25%, vocation/occupation 29%, life as a whole 30%, finances 47%, social contacts 48%, relationship with partner 60%, family life 66% and ability in self-care 66%. CONCLUSION: Life satisfaction was negatively affected in both partners, although in different life domains. Support should address the different needs of patients and spouses as well as their mutual needs.     

Developmental and ethnic issues experienced by emerging adult African American women related to developing a mature love relationship

This qualitative study explored perspectives of emerging adult African American women on the development of mature love relationships. Inductive analysis of focus group interviews, conducted with a purposive sample of 31 African American women, yielded themes related to relationship goals and characteristics, and interpersonal and societal challenges to finding the right partner and developing a mature love relationship. Core categories that emerged from analysis of the discussions were (1) age and relationship goal differences within the emerging adult group, (2) mature love relationship goals and characteristics, (3) interpersonal obstacles to finding the right partner, and (4) societal obstacles to finding the right partner. Two approaches-black womanist/feminist thought (Collins, 2000 ; Walker, 1983 ) and relationship maturity theory (Paul & White, 1990 )-were then combined to explain the influence of historic and contemporary interpersonal and societal factors on developmental and ethnic issues that challenge positive gender identity formation, hasten intimacy maturity, and hinder the development of mature love relationships among emerging adult African American women. For these women, premature responsibility, especially early caregiver burden, was related to the early development of intimacy capacity and the desire for a mature love relationship, to be protected, and to have someone to help carry the load. Interracial dating, negative stereotypic images of African American women, and even positive images of enduring black love relationships posed difficult challenges to positive identity formation and intimacy maturity. A primary challenge was to counteract negative stereotypic images, so that they could develop their own self-identities as women and as relationship partners.     

Partner relationships and long‐term sick leave among female workers: consequences and impact on dimensions of health and return to work

Few efforts have been made to prospectively identify resources and obstacles outside work that may predict regained work ability and return to work when workers are on sick leave. This study investigates the association between partner relationships and sick leave. Our research questions were as follows: (i) What is the influence of sick leave, pain, stress and domestic strain on the quality of the dyadic partner relationship?, and (ii) What is the influence of the partner and social relationship on pain, stress, work ability, self‐rated health and return to work? A cohort of female workers (n = 225) on long‐term sick leave (>60 days), all in a partner relationship, at 6‐month intervals completed a questionnaire based on the Quality of Dyadic Relationship (QDR) instrument, the Interview Schedule of Social Interaction (ISSI), the Work Ability Index (WAI) and the Copenhagen Psychosocial Questionnaire (COPSOQ). Univariate and multivariate analyses of baseline and prospective data were performed. The results showed that decreased partner relationship quality was related to having major responsibility for household work despite being on sick leave, having pain and having decreased social integration. Among younger individuals on sick leave, a reduction in the quality of the partner relationship was shown already at the first (6‐month) follow‐up, while among middle‐aged women, such a reduction was seen only at the 12‐month follow‐up. No dimensions of partner relationship quality at baseline were related to dimensions of return to work, either as a resource or as an obstacle. Consequently, our results show that a good relationship does not keep the woman from returning to work. Having main responsibility for household work, which implies domestic strain while on sick leave, predicts lower partner relationship quality. The practical implications are that healthcare professionals treating women on sick leave should emphasize the importance of keeping a social network as well as making sufficient adjustments at home for the relationship quality to be safeguarded. Special attention should be given to the young woman on sick leave as being on sick leave seems to influence her partner relationship considerably.     

Partner influences on smoking cessation: A longitudinal study of couple relationships

Introduction: Despite declines in population tobacco use, smoking remains unacceptably high. Smoking cessation may be particularly difficult in couple relationships when partners continue to smoke, and when relationship satisfaction is low. This study examined the longitudinal influence of partner tobacco use and relationship satisfaction on the likelihood of smoking cessation. Methods: Data were obtained from 238 tobacco-using couples aged between 18 and 45 over three assessments from a nationally representative sample of Australian households. Results: There was high concordance between partner smoking six years after the initial assessment, with a little more than three-quarters (76.1%) of non-smokers residing with partners who had also ceased smoking. Step-wise logistic regression models indicated that females were more likely to cease smoking if their partners had previously quit. Males were more likely to quit smoking when they perceived their relationship as highly satisfying and their partner had stopped smoking. Female partners were also more likely to quit smoking when they were highly satisfied with their relationships. Conclusions: Both partner’s smoking status and relationship satisfaction are important considerations in smoking-related cessation. For entrenched smokers in couple relationships, involvement of partners in interventions may be useful.     

Partner understanding of the breast and prostate cancer experience.

PURPOSE: This exploratory study was designed to examine partners' understanding of patients' experience with prostate or breast cancer and to assess the congruence between patient and partner perceptions regarding social support and the cancer experience. METHODS: Partner understanding of patient mood was assessed by comparing the Profile of Mood States (POMS) questionnaire scores of patients with the POMS scores of their partners (who were instructed to complete the questionnaire as patient proxies). A semistructured interview with corresponding questions for patients and partners assessed the congruency between patient and partner perceptions regarding social support and the cancer experience. RESULTS AND CONCLUSIONS: Twenty-three couples participated. Eight couples were woman with breast cancer and their husbands, and 15 couples were men with prostate cancer and their wives. The patients with breast cancer and their partners were an average age of 48 years and had been married for 20 years, while the patients with prostate cancer and their partners were 67 years of age and had been married for 40 years, on average. Overall, female partners possessed a more accurate understanding of their husbands' experience with prostate cancer than male partners had of women's breast cancer experience. These men tended to overestimate the breast cancer patients' self-reported levels of distress. Patient and partner perceptions regarding social support in the relationship and the cancer experience were also more congruent in prostate couples than in breast couples. This may be a factor not only of gender but also of age and the length of time that these couples had been together, which was twice as long for the prostate couples. Overall, however, patients were well adjusted and felt understood by their partners and satisfied with the support their partners provided.     

Factors Related to the Quality and Stability of Partner Relationships After Traumatic Brain Injury: A Systematic Literature Review

ObjectiveThe latest literature review on partner relationships after traumatic brain injury (TBI), conducted a decade ago, discussed solely quantitative work and noted significant knowledge gaps. The current review updates and expands on this work by providing an overview of the current state of knowledge on factors related to relationship quality and stability after TBI.Data SourcesCumulative Index to Nursing and Allied Health, Embase, MEDLINE, Psychology and Behavioral Sciences Collection, APA PsycINFO, and PubMed were searched on April 23, 2020, for literature on factors associated with (1) relationship quality; and (2) relationship stability after TBI.Study SelectionEnglish quantitative and qualitative studies investigating factors associated with relationship quality and/or stability after TBI were included. Two reviewers independently assessed eligibility. If consensus was not reached, a third reviewer's conclusion was decisive. Forty-three studies were included.Data ExtractionInformation regarding study objectives and characteristics, participant demographics, independent and dependent variables, and main findings was extracted. Study quality was rated using the JBI Checklist for Analytical Cross-Sectional Studies and/or the CASP Checklist for Qualitative Research. Both were performed by the lead reviewer and checked by the second reviewer.Data SynthesisThirty-eight factors related to relationship quality and/or stability were identified, covering injury characteristics (eg, severity), body functions (eg, personality changes), activities (eg, communication), participation (eg, social dependence), environment (eg, children), and personal factors (eg, coping strategies).ConclusionsRelationship quality and stability after TBI are related to a multitude of factors, including newly identified factors such as personality changes and dependence. Future research may wish to quantitatively investigate factors thus far only identified in qualitative research, explore possible positive effects of TBI on relationships, study the experiences of same-sex couples, and include the perspectives of both partners with and without the injury.     

Regional gray matter variation in male-to-female transsexualism

Gender identity—one's sense of being a man or a woman—is a fundamental perception experienced by all individuals that extends beyond biological sex. Yet, what contributes to our sense of gender remains uncertain. Since individuals who identify as transsexual report strong feelings of being the opposite sex and a belief that their sexual characteristics do not reflect their true gender, they constitute an invaluable model to understand the biological underpinnings of gender identity. We analyzed MRI data of 24 male-to-female (MTF) transsexuals not yet treated with cross-sex hormones in order to determine whether gray matter volumes in MTF transsexuals more closely resemble people who share their biological sex (30 control men), or people who share their gender identity (30 control women). Results revealed that regional gray matter variation in MTF transsexuals is more similar to the pattern found in men than in women. However, MTF transsexuals show a significantly larger volume of regional gray matter in the right putamen compared to men. These findings provide new evidence that transsexualism is associated with distinct cerebral pattern, which supports the assumption that brain anatomy plays a role in gender identity.     

Couples surviving prostate cancer: Long-term intimacy needs and concerns following treatment

Couples surviving prostate cancer face long-term challenges in their relationships as they adapt to chronic illness. Ten couples surviving prostate cancer were brought together in a focus group to discuss their experiences and concerns regarding intimacy in their relationships. During three 30-minute segments, couples described their experiences (a) as couples, (b) as individual men and women in two concurrent break-out groups, and (c) regarding current intimacy and relationship needs. Questions asked of couples focused on (a) the process of being diagnosed and treated for prostate cancer, (b) what the experience was like for them as a couple, (c) what was helpful, harmful, and surprising throughout the experience, (d) what they currently needed most as a couple, and (e) what advice they had for other couples. Findings suggested that men and women think and respond differently to intimacy and relationship challenges that occur as a result of prostate cancer, diagnosis, and treatment. Consequently, healthcare providers in any clinical setting who may interact with prostate cancer survivors must consider the relationship and intimacy needs that are unique to men, women, and couples.     

Social participation of relatives post-stroke: the role of rehabilitation and related ethical issues

Purpose.?(1) Describe the challenges facing relatives of persons with stroke in accomplishing their daily activities and social roles (participation). (2) Reflect on the role of rehabilitation for relatives and ethical issues that may emerge following the adoption of a family-centred approach.

Method.?Review of the scientific literature in Medline (1996 to July 2009), Embase (1996 to July 2009) databases using keywords: stroke AND participation AND family OR spouse OR caregivers AND ethics AND burden. Selection criteria were as follows: study must examine the participation of relatives post-stroke (or equivalent concept such as burden), rehabilitation interventions for relatives post-stroke or ethical issues related to being a relative of a person with stroke. Articles not written in English or French were excluded.

Results.?The sample comprised 17 scientific articles. According to five studies, social participation of relatives is characterised by increased responsibilities and a reduction in interpersonal relationships and leisure. In rehabilitation, there is no consensus regarding what should be done for relatives; guidelines exist but are not applied in practice. Little has been formally reported regarding ethical issues likely to emerge for relatives.

Conclusions.?The main impact of stroke is on social roles of relatives such as responsibilities, interpersonal relationships and leisure. The role of rehabilitation and related ethical issues needs further examination.     

Relationship satisfaction moderates the associations between male partner responses and depression in women with vulvodynia: A dyadic daily experience study

Vulvodynia is a prevalent vulvovaginal pain condition that interferes with women’s psychological health. Given the central role of sexuality and relationships in vulvodynia, relationship satisfaction may be an important moderator of daily partner responses to this pain and associated negative sequelae, such as depression. Sixty-nine women (M age = 28.12 years, SD = 6.68) with vulvodynia and their cohabiting partners (M age = 29.67 years, SD = 8.10) reported their daily relationship satisfaction, and male partner responses on sexual intercourse days (M = 3.74, SD = 2.47) over 8 weeks. Women also reported their depressive symptoms. Relationship satisfaction on the preceding day moderated the associations between partner responses and women’s depressive symptoms in several significant ways: (1) On days after women reported higher relationship satisfaction than usual, their perception of greater facilitative male partner responses was associated with their decreased depression; (2) on days after women reported lower relationship satisfaction than usual, their perception of greater negative male partner responses was associated with their increased depression; (3) on days after men reported higher relationship satisfaction than usual, their self-reported higher negative responses were associated with decreased women’s depression, and higher solicitous responses were associated with increased women’s depression, whereas (4) on days after men reported lower relationship satisfaction than usual, their self-reported higher negative responses were related to increased women’s depression, and higher solicitous responses were associated with decreased women’s depression. Targeting partner responses and relationship satisfaction may enhance the quality of interventions aimed at reducing depression in women with vulvodynia.     

Associations between young adult dating partners’ drinking and relationship satisfaction

Background: The link between drinking and relationship functioning is well documented among married couples, particularly by using survey methods of retrospective drinking focusing on negative relationship outcomes. However, few studies have examined the link between drinking in daily life and relationship satisfaction among young adult dating couples. Methods: This study used a 7-day daily diary method by drawing on dyadic data from 57 heterosexual couples. This study utilized the Actor–Partner Interdependence Model and dyadic hierarchical linear modeling. Results: Controlling for same day relationship satisfaction, a positive association was found between females’ number of alcoholic drinks and their own next-day relationship satisfaction. Males’ higher consumption of drinks across the study period was linked with their female partners’ lower daily relationship satisfaction ratings. Drinking behavior by either partner was not reliably linked with males’ relationship satisfaction. Conclusions: This study suggests differential implications of partners’ drinking for females in dating relationships. Findings encourage continued examination of young adult romantic relationships as a context for drinking behavior.     

Being in- or out-of-sync: Couples' adaptation to change in multiple sclerosis

Purpose.?To examine how couples adapt to the challenges of multiple sclerosis (MS) and to identify possible risk factors for relational stress.

Method.?Semi-structured interviews were conducted with eight couples to explore how participants defined and identified the strengths and challenges in their relationship, negotiated role changes and received external support. Conceptual frameworks on how families adapt to chronic illness guided within and across case analyses. We identified patterns in the couples' current responses to the demands and stressors of MS.

Results.?Two patterns of adaptation to MS were identified as being ‘in-sync’ or ‘out-of-sync’. Characteristics of the four couples currently in-sync included having a relapsing-remitting type of MS, which proceeded at a pace that enabled both partners to maintain their social roles and identity, and a collaborative problem solving style. The four couples currently out-of-sync had a rapid progression of MS, loss of employment before retirement age, differences in personal styles that shifted from being complementary to oppositional in the face of increased demands and struggles with parenting adolescent children.

Conclusions.?Clinicians can use these data to assess possible relational strain in couples with MS and identify families who might benefit from referrals to family therapy or other relational support.     

NARRATIVE ENRICHMENT IN THE PSYCHOTHERAPY FOR PERSONS WITH SCHIZOPHRENIA: A SINGLE CASE STUDY

Recovery from schizophrenia may involve persons developing a renewed sense of their illness, identity, agency, and worth within their life stories. To explore the requirements and challenges of psychotherapy that could facilitate this, we present a case study of a person with schizophrenia enrolled in treatment for over 19 months. Observed challenges to this process include the therapist's inclinations to “fix” the client, the client's own deficits and symptoms, and discomfort within the therapeutic relationship. Techniques to address these difficulties are presented, along with an objective means of assessing the treatment outcomes in terms of changes in narrative processes.     

The (re)construction of self after the death of a partner to HIV/AIDS

The aim of this study was to explore individuals' self-construals after the loss of a partner from HIV/AIDS for whom they were a caregiver. Seven gay or transsexual bereaved caregivers were interviewed after the death of their partners. The data revealed patterns suggestive of A. Aron and E. N. Aron's (1986) “inclusion of others in the self” (IOS) with partners described as part of participants' identity. Using the metaphor of the IOS, the results illustrate how care-giving became a part of the self as well as aspects of the partner. Upon the death of the partner, the loss resulted in a crisis of meaning due to the loss of the person and relationship that had contributed significance and purpose to life. Regaining meaning involved making sense of both the relationship and the caregiving role.     

Is social participation associated with quality of life of older adults with physical disabilities?

Purpose:?To explore the relationships between subjective quality of life and social participation of older adults with physical disabilities.

Method:?A cross-sectional design was used with a convenience sample of 46 people aged 60 to 90 living in the community. Subjective quality of life was estimated with the Quality of Life Index and social participation with the Assessment of Life Habits.

Results:?Only a weak relationship was found between total scores of quality of life and social participation. Interpersonal relationships, responsibilities, fitness and recreation were the categories of social participation most associated with quality of life. Social roles were more associated with quality of life than daily activities. Finally, satisfaction with the accomplishment of life habits was also more associated with quality of life than the performance itself.

Conclusions:?The importance of social participation in regard to the quality of life of older persons with physical disabilities living in the community is partially supported by these findings. Other studies are needed to clarify how social participation influences quality of life in this population.     

A recipe for mealtime resilience for families living with dementia

To date, research delving into the narratives of persons living with dementia is limited. Taking part in usual mealtime activities such as preparing food can sustain the identity of persons living with dementia. Yet if capacity for mealtime activities changes, this can put a strain or demand on the family, which must adjust and adapt to these changes. The aim of this study was to develop an in‐depth story of resilience in one family living with dementia that was experiencing mealtime changes. Thematic narrative analysis following the elements of Clandinin and Connelly's (2000) 3D narrative inquiry space was used. One family's dementia journey was highlighted using the metaphor of a baking recipe to reflect their story of resilience. Developing positive strategies and continuing to learn and adapt were the two approaches used by this resilient family. Reminiscing, incorporating humour, having hope and optimism, and establishing social support were specific strategies. This family continued to learn and adapt by focusing on their positive gains and personal growth, accumulating life experiences, and balancing past pleasures while adapting to the new normal. Future work needs to further conceptualise resilience and how it can be supported in families living with dementia.     

Primary care needs of patients who have undergone gender reassignment

PURPOSE: The purpose of this article is to inform nurse practitioners (NPs) about the primary care needs of patients who have undergone gender reassignment, either by hormone therapy alone or in conjunction with surgery. DATA SOURCES: Data sources used were mainly from a review of the literature about gender identity disorder and gender reassignment. Information was also gathered from several leading surgeons on gender reassignment surgical procedures and subsequent clinical considerations. CONCLUSIONS: There is very little written on the primary care clinical ramifications of transsexual patients and how clinicians can adapt their approaches to healthcare delivery to accommodate their special situations. IMPLICATIONS FOR PRACTICE: Implications for practice include how an NP can adapt clinical practice approaches to provide for patients who have undergone gender reassignment. Changes that occur in the transsexual process may warrant noncustomary primary healthcare screening and examination.     

Understanding Social Support and the Couple's Relationship Among Women with Depressive Symptoms in Pregnancy

This qualitative study explored the experiences of seven couples where the female partner experienced depressive symptoms during pregnancy. Female and male partners were interviewed together and data was collected and analyzed according to Colaizzi's () phenomenological research design. The interviews yielded the following themes: (a) Challenges and stressors associated with depressive symptoms during pregnancy, (b) Pregnancy's effect on mood states, (c) Relationship dynamics that influence moods, (d) Pregnancy and the influence of mood on relationship dynamics, and (e) Reliance on external sources of support. The findings extend current research and provide insight into possibilities of how to enhance assessment and intervention for women who are depressed during pregnancy by including a relational component. Findings, clinical implications, and future research are discussed.