Middle-aged couples' exchanges of support with aging parents: patterns and association with marital satisfaction

We examined the context of intergenerational support exchanges with aging parents and its association with middle-aged couples' marital satisfaction. A sample of 197 middle-aged couples reported support they gave to and received from their parents (n = 440). Results indicated that couples provided more total support to and received more from their parents as a function of number of living parents, but the amount of support each parent received ('parent-adjusted support') was lower when there were more living parents. The amount of support given to and received from parents had no association with the couple's marital satisfaction, but discrepancies in support given to and received from parents did have a significant association with marital satisfaction. Husbands who gave more support to their living parent(s) than their wives reported lower marital satisfaction. A similar effect on marital satisfaction was found for wives who gave more support to their living parents than their husbands. These findings contrast with caregiving studies where amount of support affected marital satisfaction and suggest that inequalities in involvement with parents may be a critical dimension in marriages of midlife adults.     

The association between discontinuing hormonal contraceptives and wives’ marital satisfaction depends on husbands’ facial attractiveness

How are hormonal contraceptives (HCs) related to marital well-being? Some work suggests HCs suppress biological processes associated with women’s preferences for partner qualities reflective of genetic fitness, qualities that may be summarized by facial attractiveness. Given that realizing such interpersonal preferences positively predicts relationship satisfaction, any changes in women’s preferences associated with changes in their HC use may interact with partner facial attractiveness to predict women’s relationship satisfaction. We tested this possibility using two longitudinal studies of 118 newlywed couples. Trained observers objectively rated husbands’ facial attractiveness in both studies. In study 1, wives reported their marital satisfaction every 6 mo for 4 y and then reported the history of their HC use for their relationship. In study 2, wives reported whether they were using HCs when they met their husbands and then their marital satisfaction and HC use every 4 mo for up to three waves. In both studies, and in an analysis that combined the data from both studies, wives who were using HCs when they formed their relationship with their husband were less satisfied with their marriage when they discontinued HCs if their husband had a relatively less attractive face, but more satisfied if their husband had a relatively more attractive face. Beginning HCs demonstrated no consistent associations with marital satisfaction. Incongruency between HC use at relationship formation and current HC use was negatively associated with sexual satisfaction, regardless of husbands’ facial attractiveness. These findings suggest that HC use may have unintended implications for women’s close relationships.The majority of women living in industrialized nations use hormonal contraceptives (HCs) at some point during their lives (1, 2). Adding to a robust literature that already documents important intrapersonal implications of HCs (3), a growing literature suggests that HCs may also have an important interpersonal implication—they may affect women’s evaluations of their romantic relationships.According to biological perspectives on human mating, women evolved to be attracted to partner qualities reflective of genetic fitness, qualities that may be summarized by facial attractiveness (4–7). However, there is some evidence that HC use weakens the hormonal processes that partially account for these preferences (8) (for exceptions, see refs. 9 and 10). Specifically, a few studies demonstrate that women using HCs show weaker cyclical shifts in preferences for cues of genetic fitness than do nonusers (11–14). Further, a few additional studies demonstrate that women using HCs demonstrate weaker overall preferences for cues of genetic fitness than do nonusers (15, 16). In one study, for example, women showed a weaker preference for facial masculinity when using HCs versus not (16).What then are the implications of HCs for women’s long-term relationships? Some women use HCs before entering a committed relationship and thus choose a long-term partner while using HCs. However, at some point during the relationship, women must discontinue using HCs to conceive, which the majority of women eventually do (17). Other women, in contrast, may choose a partner while not using HCs and at some point during the relationship may begin using HCs as they become sexually active. It is possible that any changes in preferences for partner genetic fitness associated with changes in HC use may have implications for women’s relationship satisfaction. According to interdependence theory (18, 19) and supportive research (20), having a partner who meets one’s interpersonal preferences is positively associated with overall relationship satisfaction. Thus, the changes in women’s preferences for cues of partner genetic fitness that may accompany corresponding changes in their HC use may interact with actual cues of their partners’ genetic fitness, such as overall facial attractiveness, to predict women’s relationship satisfaction. Specifically, women who form a relationship when using HCs and later discontinue using HCs may begin to prioritize cues of partner genetic fitness to a greater extent and thus experience increases in satisfaction if their partner’s face contains numerous cues of genetic fitness (i.e., is relatively attractive), but decreases in satisfaction if their partner’s face contains fewer cues of genetic fitness (i.e., is relatively less attractive). In contrast, women who form a relationship when not using HCs and later begin using HCs may begin to prioritize cues of partner genetic fitness to a lesser extent and thus experience decreases in satisfaction if their partner’s face contains numerous cues of genetic fitness (given that such cues may become less important to them), but subsequent increases in satisfaction if their partner’s face contains fewer cues of genetic fitness.We are aware of two published studies that have examined the implications of HCs for women’s established relationships. Roberts et al. (21) reported that women who used HCs when they chose their partner and then bore children with those partners (and thus must have discontinued using HCs) were less satisfied with the sexual aspects of their relationships, but more satisfied with their partners’ financial provision. Likewise, Roberts et al. (22) reported that women who discontinued using HCs during an ongoing relationship reported lower levels of sexual satisfaction and no changes in satisfaction with their partners’ financial provision and intelligence. However, neither of these studies examined the role of cues of partner genetic fitness. As noted, any shifts in women’s preferences for partner genetic fitness that coincide with changes in HC use should interact with such cues to predict women’s relationship satisfaction.We used data obtained from two longitudinal studies to examine whether the association between wives’ HC use and their marital satisfaction depended on (i) whether wives were using HCs when they entered into their relationship with their husband and (ii) their husband’s facial attractiveness. Based on the possibility that HC discontinuation leads wives to more strongly prioritize partner facial attractiveness, we expected HC discontinuation to interact with husbands’ facial attractiveness to predict wives’ marital satisfaction, such that HC discontinuation would be negatively associated with marital satisfaction among wives married to husbands with relatively less attractive faces but positively associated with marital satisfaction among wives married to husbands with relatively more attractive faces. We also examined whether beginning the use of HCs was positively associated with marital satisfaction among wives married to husbands with relatively less attractive faces but negatively associated with satisfaction among wives married to husbands with relatively more attractive faces. Finally, we attempted to replicate the association between changing HC use and wives’ sexual satisfaction (21, 22).     

Assessment of sexual dysfunction in male patients with Ankylosing Spondylitis

We evaluated sexual dysfunction in male patients with ankylosing spondylitis (AS) using the Brief Male Sexual Function Inventory (BMSFI). We assessed sexual dysfunction using the BMSFI in male patients with AS followed at the outpatient clinic and compared results with those in healthy controls. Depression status was measured by the Beck Depression Inventory in AS patient and control group. The Bath AS functional index was used to measure functional status, the Bath AS metrology index was used to measure joint mobility, and the Bath AS disease activity index was used to evaluate disease activity in AS cases. Compared to healthy controls patients with AS had significantly lower sexual drive, erection, problem assessment and overall satisfaction scores according to the BMSFI. Ejaculation scores were also lower but not statistically significant. According to the Beck Depression Inventory, AS patients had higher scores than healthy controls (14.9 ± 9.4 and 10.3 ± 11.8, P = 0.026, respectively). As for the relation between the BMSFI domains and BDI scores, relation was found only in the domains of problem assessment and overall satisfaction (P < 0.05). The incidence rate of sexual dysfunction is higher in patients with AS, when compared to the healthy people. In patients with AS, sexual dysfunction was associated with depression and limited joint mobility.     

Marital and parental satisfaction of married physicians with children

OBJECTIVE: To evaluate personal and professional factors associated with marital and parental satisfaction of physicians. STUDY DESIGN: Cross-sectional study. PARTICIPANTS: A survey was sent to equal numbers of licensed male and female physicians in a Southern California county. Of 964 delivered questionnaires, 656 (68%) were returned completed. Our sample includes 415 currently married physicians with children, 64% male and 36% female. MEASUREMENTS AND MAIN RESULTS: Ratings of marital and parental satisfaction were measured on a 5-point Likert scale, 5 being extremely satisfied. Prevalence of work and home life factors was also evaluated. The mean score for marital satisfaction was 3.92 (range 1.75-5.0). Approximately half of the physicians reported high levels of marital satisfaction (63% of male physicians and 45% of female physicians). The gender difference disappeared after adjusting for age differences. Two factors were associated with high marital satisfaction: a supportive spouse (odds ratio [OR] 10.37; 95% confidence interval [CI] 2.66, 40.08) and role conflict (OR 0.61; 95% CI 0.42, 0.88). The mean score for parental satisfaction was 3. 43 (range 1.0-5.0), and approximately two thirds of both male and female physicians reported at least moderate levels of parental satisfaction. The major factors associated with parental satisfaction were a supportive spouse (OR 2.24; 95% CI 1.32, 3.80), role conflict (OR 0.35; 95% CI 0.23, 0.53), salaried practice setting (OR 2.14; 95% CI 1.21, 3.81), marriage to a spouse working in a profession (OR 2.14; 95% CI 1.21, 3.81), and marriage to a spouse working as a homemaker (OR 2.33; 95% CI 1.20, 4.56). Number of hours worked was not found to be related to either satisfaction score, but rather to an intervening variable, role conflict. CONCLUSIONS: For physicians with children, our study indicates that minimizing the level of role conflict and having a supportive spouse are associated with higher levels of marital and parental satisfaction. Working in salaried positions and marriage to a spouse who is either working in a profession or who is a stay-at-home parent are also related to high parental satisfaction.     

Marital Functioning in Early Versus Late-Onset Alcoholic Couples

Current knowledge about alcohol and marital functioning is limited by restrictive sample selection, inattention to the literature on individual-based alcoholic subtypes, and lack of research linking individual differences among alcoholics to marital functioning. The present study was designed to study marital functioning of alcoholics in light of current alcohol typologies. Subjects were part of a larger study on conjoint treatment of alcoholic males and their female partners. Four typologies—including Type 1/2, In-Home/Out-of-home, SteadyIEpisodic, and EarlyILate Onset—were tested for replicability and discriminant validity before linking them to marital functioning. Discriminant validity was found only for the Early (59%)-versus Late (41 %)-Onset typology; thus, further analyses linked only this typology with marital functioning. At baseline, Early-Onset couples reported more marital instability, and the females in these couples were more distressed. During treatment, Early-Onset couples reported higher daily marital satisfaction than Late-Onset couples. Regardless of age of onset, males reported higher marital satisfaction than their spouses during treatment, but their satisfaction did not increase during treatment. Female partners' marital satisfaction increased during treatment. Female partners of Late-Onset males reported particularly low marital satisfaction during treatment. Parsing the sample according to the early-/late-onset typology yielded different predictors of marital satisfaction for males and females within each subtype. For female partners of Early-Onset alcoholics, psychological distress unrelated to her pattner's drinking severity was most associated with her own marital satisfaction, whereas marital adjustment of female partners of Late-Onset alcoholics was most associated with the male's level of perceptual accuracy regarding her needs. This pattern was reversed for the males; marital adjustment of Early-Onset alcoholics was most associated with his partner's perceptual accuracy of his needs, whereas marital functioning of Late-Onset alcoholics was best accounted for by his own psychological distress.     

Marital Interactions and the Duration of Alcoholic Husbands′ Sobriety

Recent studies of the family interactions of alcoholics have suggested that the alcoholic's general drinking adjustment may influence marital interactions. The present investigation examined the marital interactions of 30 male alcoholics who had maintained continuous sobriety for various lengths of time ranging from a few days to over 7 years. It was predicted that longer periods of sobriety would be associated with less conflict and fewer struggles for control between husbands and wives. The findings supported the hypothesis, in that the duration of the husbands′ sobriety was significantly negatively correlated with the number of statements of disagreement emitted by husbands and wives. Also, there were trends for duration of sobriety to be negatively associated with the frequencies of question-asking and aggressive behaviors by husbands, and positively associated with the amount of talk time by husbands. Contrasts of 11 high sobriety couples (duration of sobriety: 2 years or longer) and 11 low sobriety couples (duration of sobriety: less than 4 months) revealed that high sobriety husbands asked fewer questions, stated fewer disagreements, and emitted fewer aggressive behaviors than husbands in the low sobriety group. In addition, high sobriety husbands displayed a trend toward more active talk time, and their wives showed a trend toward asking fewer questions than their low sobriety counterparts. The results suggest that marital functioning is superior in couples with longer periods of sobriety. The need for examining possible causal links in this relationship is emphasized.     

Husbands' and wives' perceptions of marital fairness across the family life cycle

Marital fairness, or the subjective balance between two spouses' gains and losses, was evaluated by a cross-sectional sample of 134 married Australian men and women representing five phases in the family life cycle: preparental, childbearing, the full house, launching, and the empty nest. Husbands' perceptions of their own marital equity described a U-shaped curve across these phases, with significantly more men feeling equitably treated both initially and after children's departure than during any of the three phases with children in the home. Wives' perceptions, by contrast, showed little variation with life cycle phase. Overall, a slight majority (52 percent) of husbands and wives perceived their marriages as equitable. Both sexes were inclined to agree, however, that whenever deviations from strict marital equity arose during family life, these were most likely to overbenefit husbands and to underbenefit wives. Results are discussed in relation to 1) equity theory, 2) marital satisfaction research, and 3) Bernard's model of the intrinsic sexual inequality of marriage as an institution [1].     

Chronic duodenal ulcer, marital status and personality pattern. A case-control study

Abstract The aim of the study was to assess the association of chronic duodenal ulcer (DU) with marital status and psychological factors. Sixty-six consecutive patients with DU were compared with 66 randomly selected age, sex, and social-grade matched community controls, with regard to marital status and personality profile. Personality was assessed at interview by the Spielberger State-Trait Anxiety Questionnaire, Beck Depression Inventory, Costello-Comrey Personality Questionnaire and the Eysenck Personality Inventory.
It was found that patients with higher scores on the Beck Depression Inventory and patients who were unmarried were significantly more likely to have DU (odds ratio = 1.2 and 3.3, respectively). None of the other psychometric measures were statistically significant on a multivariate analysis. However, the absolute differences observed and the odds ratio for depression were small. The results suggest that the psychological factors studied were of only minor clinical importance in DU.     

Does the etiology affect the outcome and satisfaction rates of penile prosthesis implantation surgery?

Our aim was to compare the outcomes and satisfaction rates of men undergoing penile prostheses implantation (PPI) secondary to radical prostatectomy (RP) and other causes of vasculogenic erectile dysfunction (ED). A total of 142 patients, of whom 60 underwent PPI due to ED following RP (Group 1) and 82 underwent PPI due to ED with other vasculogenic causes (Group 2) were included in this study. The preoperative erectile status was evaluated with the International Index of Erectile Function (IIEF). The satisfaction of patients and partners were evaluated by a telephone interview using Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire and Erectile Dysfunction Inventory of Treatment Satisfaction Partner Survey. Preoperative mean IIEF scores were significantly lower in Group 1 (17.5 ± 6.4 vs. 24.2 ± 5.1, p = 0.01). For Groups 1 and 2, the mean EDITS scores of the patients were 58 ± 10 and 71 ± 8, respectively, and that for the partners were 46 ± 8 and 65 ± 7, respectively. Group 1 had significantly lower scores both for the EDITS and the EDITS Partner Survey (p = 0.03, p = 0.01, respectively). Patients who had undergone RP and their partners were found to have lower satisfaction rates compared to patients with other causes of vasculogenic ED who had penile implant surgery. From this point of view, it is important to know the patient's expectations about the treatment outcomes and a preoperative psychological and sexual counseling should be managed for possible treatment alternatives after RP.     

Development of an Awareness Context Theory Typology for Addressing Communication Patterns in Mild Dementia

Abstract

A two-step qualitative/quantitative method was used to study the applicability and utility of awareness context theory (ACT) for understanding couples' communication when one member has early-stage dementia. Results indicate that the majority of early-stage demented spouses, primarily male in this study, maintain an idealized perception of communication and marital satisfaction that is often not matched by their partner. Where communication is acknowledged as mutually open, there are accompanying elevations in scores on marital satisfaction and intimacy. Disagreement about communication style is positively related to openness to professional help. Findings support the utility of ACT for understanding couples in early-stage dementia. A 6-category typology of ACT is presented for consideration.     

Patient satisfaction scores for endoscopic procedures: impact of a survey-collection method

BACKGROUND: Many endoscopy units administer patient satisfaction surveys. We hypothesized that the survey collection method would affect satisfaction scores. OBJECTIVE: To compare satisfaction scores obtained by using on-site (OS) surveys versus mail-back (MB) surveys. DESIGN: Quasi-randomization based on alternating weeks. SETTING: Teaching hospital. PATIENTS: Patients undergoing elective routine outpatient colonoscopy or upper endoscopy. INTERVENTIONS: Every patient was given an 11-question survey that asked about the patient's satisfaction with the nurses and the physician, wait times, the bowel-preparation process, patient education, procedural comfort, and sedation. Survey collection methods alternated weekly between an OS versus an MB method. MAIN OUTCOME MEASUREMENTS: Satisfaction scores on a Likert scale ranged from 1 (worst) to 7 (best). RESULTS: A total of 1698 subjects were included. The response rate was higher for the OS group (95%) than the MB group (62%). OS scores were significantly higher than MB scores for 5 of 11 questions, which concerned nurse satisfaction, physician satisfaction, bowel-preparation comfort, postprocedure education, and overall satisfaction (Bonferroni adjusted P < .05 for all). Younger patients gave lower scores than older patients for all questions, whereas women gave significantly lower scores than men for bowel-preparation satisfaction. LIMITATIONS: Lack of true randomization and formal validation of the satisfaction survey. CONCLUSIONS: Survey collection methods may bias not only response rates but also satisfaction scores. OS survey collection methods tend to result in higher satisfaction scores than MB methods. This bias should be noted when comparing scores among studies that used different survey collection methods.     

Gender Differences and Psychosocial Factors Associated with Quality of Life Among ART Initiators in Oromia,Ethiopia

Health-related quality of life (HRQoL) is an important outcome to assess among persons living with HIV/AIDS, but few studies have been conducted in sub-Saharan Africa. We examined HRQoL among 1180 ART-initiating adults from six clinics in Ethiopia in 2012–2013, and compared the correlates of two subscale scores between women and men. Women scored significantly higher than men on both overall function (8.4 points higher) and life satisfaction (6.3 points higher). In multivariable models, psychological distress, low CD4+ count, unemployment, and food insecurity were associated with lower quality of life scores among women and men. Men whose last sexual encounter occurred 3 months to 1 year from the interview date had lower overall function and life satisfaction scores. Men between the ages of 30–39 had lower overall function scores. Protestant women and women in the low-middle social support category had lower life satisfaction scores. Assessment of HRQoL over time will help inform HIV care and treatment practices to ensure favorable patient outcomes.     

Marital quality and psychological adjustment to widowhood among older adults: a longitudinal analysis

OBJECTIVES: This study examined whether psychological adjustment to widowhood is affected by three aspects of marital quality--warmth, conflict, and instrumental dependence-assessed prior to the loss. METHODS: The Changing Lives of Older Couples (CLOC) is a prospective study of a two-stage area probability sample of 1,532 married individuals aged 65 and older. The CLOC includes baseline data on marital quality and mental health and data on grief, anxiety, and depression collected 6, 18, and 48 months after spousal loss. RESULTS: Widowhood was associated with elevated anxiety among those who were highly dependent on their spouses and lower levels of anxiety among those who were not dependent on their spouses. Levels of yearning were lower for widowed persons whose relationships were conflicted at baseline and higher for those reporting high levels of marital closeness and dependence on their spouses. Women who relied on their husbands for instrumental support had significantly higher levels of yearning than men who depended on their wives. DISCUSSION: The findings contradict the widespread belief that grief is more severe if the marriage was conflicted and suggest a more complex relationship between bereavement and characteristics of the marriage.     

Assessing patient satisfaction in inflammatory bowel disease using the QUOTE-IBD survey: A small step for clinicians,a potentially large step for improving quality of care

BackgroundPatient satisfaction is thought integral to high quality of care (QoC) in chronic disease models, including inflammatory bowel disease (IBD). Here we utilized the QUOTE-IBD survey in IBD clinic patients, in order to examine potential deficiencies in QoC from the patients' perspective, thus possibly amenable to change.MethodsConsecutive patients attending a single clinic were asked to complete the QUOTE-IBD survey, where 22 items (in seven domains) were rated for importance (I), and actual performance (P), and a quality index (QI) was derived. A QI < 9.0 indicated suboptimal satisfaction. Other data were extracted from hospital records and CRP was measured. Factorial ANOVA examined effects of relevant clinical and demographic factors on satisfaction (QI) scores per domain.ResultsOf 367 potential participants, 187 (51%) responded. 86 (46%) had Crohn's disease, 101 (54%) ulcerative colitis; 52% were females, and median age was 45 y (range 18,82). The only QI score < 9.0 was ‘kept in waiting room > 15 min’ (QI 8.73). In bivariate analyses, those with Crohn's, post-resection and longer IBD duration each had lower domain QI's than their respective counterparts, whereas those on concurrent anti-TNF therapy gave higher QI scores (each p < 0.05). Factorial ANOVA showed female gender and IBD duration ≥ 5 years were each associated with significantly lower mean QI scores in multiple domains.ConclusionsPatients with adverse disease characteristics (e.g. longer duration, post-resection) and females reported lower satisfaction. Conversely, those on anti-TNF therapy reported higher satisfaction. Targeting these ‘at-risk’ groups and assessing satisfaction longitudinally may enhance QoC in IBD.     

Asking fathers: a study of psychosocial adaptation

Although few contemporary studies specifically address paternal adaptation, the theme of paternal estrangement from medical care and from family relationships is pervasive in the psychosocial literature on haemophilia. This estrangement has been shown to have a negative effect on fathers' psychological well-being, marital relationships and the adaptive outcome of their sons who have haemophilia. The goals of this study were to provide contemporary data on the psychosocial adaptation of fathers of boys with haemophilia and to examine specific variables that might influence their adjustment. Eighty-three eligible fathers returned a survey instrument that collected demographic and medical information, as well as scores on self-measures of adaptation in marital and parenting roles. Statistically significant direct correlations (P < 0.01) were found between fathers' scores on the Marital Adjustment Test and the Parenting Sense of Competence subscales (parenting efficacy and satisfaction). Variables specific to rearing a son with haemophilia that negatively affected fathers' marital adjustment scores included: feeling left out of medical decision making by their wives or partners, worry about their sons' having limited activity, and the presence of a secondary diagnosis in the affected child. Scores on the parenting efficacy subscale of the PSOC were statistically significantly reduced (i.e. fathers felt less effective in the parenting role) in men who 'rarely' or 'never' infused their sons (42/80, 53%). Variables that negatively affected scores on the parenting satisfaction subscale included frustrating interactions with medical staff and concern about their sons' potential to contract an infection or secondary diagnosis. This paper presents a model to examine the interrelationships among the data and discusses the clinical implications.     

Differential effects of daughters' marital status on their parent care experiences.

This study compared the parent care experiences of five groups of daughters (N = 492) (married, remarried, separated/divorced, widowed, and never married). Data include demographic characteristics and measures of depression, positive affect, personality strength, health, social support, relationship quality, caregiving burden, caregiving mastery, and caregiving satisfaction. Women with husbands had more socio-emotional and instrumental support, much higher incomes, less financial strain from caregiving, and less depression. They felt their own particular marital status made caregiving easier than did the three groups of not-married women.     

Marital interactions and the duration of alcoholic husbands' sobriety

Recent studies of the family interactions of alcoholics have suggested that the alcoholic's general drinking adjustment may influence marital interactions. The present investigation examined the marital interactions of 30 male alcoholics who had maintained continuous sobriety for various lengths of time ranging from a few days to over 7 years. It was predicted that longer periods of sobriety would be associated with less conflict and fewer struggles for control between husbands and wives. The findings supported the hypothesis, in that the duration of the husbands' sobriety was significantly negatively correlated with the number of statements of disagreement emitted by husbands and wives. Also, there were trends for duration of sobriety to be negatively associated with the frequencies of question-asking and aggressive behaviors by husbands, and positively associated with the amount of talk time by husbands. Contrasts of 11 high sobriety couples (duration of sobriety: 2 years or longer) and 11 low sobriety couples (duration of sobriety: less than 4 months) revealed that high sobriety husbands asked fewer questions, stated fewer disagreements, and emitted fewer aggressive behaviors than husbands in the low sobriety group. In addition, high sobriety husbands displayed a trend toward more active talk time, and their wives showed a trend toward asking fewer questions than their low sobriety counterparts. The results suggest that marital functioning is superior in couples with longer periods of sobriety. The need for examining possible causal links in this relationship is emphasized.     

Treatment of diabetic impotence with a vacuum device: efficacy and effects on psychological status.

Twelve patients with erectile impotence related to diabetic neuropathy were treated with a vacuum device, Pos-T-Vac. Efficacy of the device and psychological evaluation (Dyadic Adjustment Scale for marital satisfaction and Hamilton Rating Scale for depression) were performed before and 3 months after treatment. Vacuum therapy was successful in 75% of the patients. Patients with successful impotence treatment and normal baseline marital satisfaction scores showed a modest increase in the scores of marital satisfaction (from 114 +/- 3 points, baseline, to 121 +/- 3 points, posttreatment; p less than 0.05). Vacuum therapy for the treatment of erectile dysfunction due to diabetic autonomic neuropathy appears to be safe and effective.     

A comparative evaluation of quality of life and life satisfaction in patients with psoriatic and rheumatoid arthritis

Both rheumatoid arthritis (RA) and psoriatic arthritis (PsA) have a negative impact on patients’ quality of life (QOL). The aim of this study was to compare QOL and life satisfaction in patients with RA and PsA. Forty patients with PsA, 40 patients with RA, and 40 healthy control subjects were included in the study. Demographic data and clinical characteristics including age, sex, disease duration, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), peripheral pain assessed by visual analog scale (VAS) and Larsen scores of hand X-rays were recorded. Nottingham Health Profile (NHP) was used to evaluate QOL, and Life satisfaction index (LSI) was used to measure psychological well-being in both groups. The demographic data of the subjects were similar between the groups. The scores of all NHP subscales were significantly higher and the scores of LSI were significantly lower in PsA and RA patients than in control subjects. The inflammation markers including ESR, CRP, pain by VAS and Larsen scores were found to be significantly higher in RA patients. The scores of LSI were similar between the groups. Although the scores of physical domains of NHP (pain and physical disability) were statistically higher in RA patients (p<0.05), the scores of psychosocial subgroups of NHP were similar between RA and PsA patients (p>0.05). Both PsA and RA patients had disturbed QoL and decreased life satisfaction. In conclusion, peripheral joint damage, inflammation, and physical disability are significantly greater in RA but psychosocial reflection of QOL and life satisfaction are the same for both groups which can be explained by the additional impact of skin disease in patients with PsA.     

The Increase in Alcohol Consumption among Women: a phenomenon related to accessibility or stress? A General Population Study

This population survey of Norwegian women (N=3997) and their husbands explore the relative importance of accessibility and stress variables in explaining the level of women's alcohol consumption. Among the accessibility-variables, population density and husbands’alcohol consumption have a significant impact on the women's consumption. Employment among women is not significantly related to their alcohol use when controlling for the husbands’consumption. Stress variables (work stress, nervousness) have no significant influence on consumption when controlling for accessibility variables. The findings show that the increase in women's consumption of alcohol is more specifically related to accessibility, variables with a close relationship to lifestyle, rather than to general accessibility to alcoholic beverages.