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1.
The dissimilarity between myocardial infarction patients' and spouses' illness perception and its relation to patients' lifestyle.
Qin, X, Chen, J, Suo, R, Feng, L, Zhang, Y, Jun, Y
Journal of clinical nursing. 2020;(5-6):887-898
Abstract
AIM AND OBJECTIVES To examine the dissimilarity between Chinese myocardial infarction (MI) patients' and spouses' illness perceptions (IPs), and to explore the relationship between patients' IP, differences in couples' IP and patients' lifestyle after discharge. BACKGROUND An individual's IP is affected and moderated by several factors, including the social context. One of the most influential members of the social network of patients is the spouse. DESIGN Cross-sectional design. METHODS From April 2016-April 2017, 111 MI patients and their spouses were recruited. Before discharge from hospital, revised Illness Perception Questionnaire was administered to MI patients and their spouses separately. Two months after discharge, patients' lifestyle was assessed using Health Promoting Lifestyle Profile II. The manuscript was organised according to STROBE guidelines. RESULTS Spouses were more likely to believe that the illness would last for a long time, and patients perceived MI as being more controllable than their spouses did. The patient-spouse dissimilarity in the perception of consequences was negatively correlated with both nutrition and stress control behaviours. Patients in couples with more dissimilar perception of environmental factors as a cause were more likely to choose a healthy diet, while patients in couples with more dissimilar perceived treatment control were more able to control stress. CONCLUSION There are both similarities and dissimilarities between MI patients' and spouses' IP, and these dissimilarities contributed the majority of the explained variance in patients' lifestyle after discharge. RELEVANCE TO CLINICAL PRACTICE We should consider both couples when examining how a patient copes with a chronic illness.
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2.
Online couple interventions in cancer.
Vanstone, R, Fergus, KD
Current opinion in supportive and palliative care. 2020;(1):67-73
Abstract
PURPOSE OF REVIEW Cancer diagnosis and treatment can have long-lasting psychological and physical consequences that affect both patients and their intimate partners. Improved understanding of extant dyadic interventions in the context of cancer, and how access to these may be enhanced through web-based technologies, introduce new directions for how cancer-related psychological distress for couples may be ameliorated. RECENT FINDINGS Couples are negatively impacted by cancer, both individually, and as a dyad. Bolstering techniques to support effective communication about common cancer-related concerns and support for adjusting to new roles and responsibilities may help to strengthen the couple's relationship so partners are better able to cope with cancer. Although there are various intervention options available for couples dealing with cancer, many pose barriers to participation because of constraints on time and/or distance. However, online interventions have been shown to be effective, both in easing psychological distress and reducing participant burden. SUMMARY Couples dealing with cancer experience psychological distress and must learn to navigate changing roles and responsibilities in the face of the disease. Online interventions offer flexible and innovative platforms and programs that help to address couples' educational needs while strengthening dyadic coping.
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InDependent but not Alone: A Web-Based Intervention to Promote Physical and Mental Health among Military Spouses.
Mailey, EL, Irwin, BC, Joyce, JM, Hsu, WW
Applied psychology. Health and well-being. 2019;(3):562-583
Abstract
BACKGROUND Military spouses must cope with multiple threats to their physical and mental health, yet few interventions have been developed to promote health in this population. METHODS For this quasi-experimental study, military spouses (N = 231) received a standard educational intervention or an interactive, theory-based intervention; both were delivered online and lasted 10 weeks. The educational intervention directed participants to content on the existing website, Operation Live Well. The interactive intervention was based on Self-Determination Theory, delivered weekly content via podcasts, and encouraged participants to complete weekly challenges to improve physical activity, diet, and mental health. Linear mixed effects models were used to examine self-reported changes in stress, anxiety, depression, loneliness, self-esteem, physical activity, and diet from pre- to post-intervention. RESULTS Significant improvements were observed for all mental health outcomes, total physical activity, and sugar consumption. However, there were no significant group by time interaction effects. CONCLUSIONS Web-based interventions may promote positive changes in mental health and health behaviours among military spouses. In this study, an interactive theory-based intervention was no more effective than an information-based intervention. Future studies should aim to determine the minimum "dose" needed to elicit meaningful changes in this population.
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[Effects of Spouse-Participated Health Coaching for Male Office Workers with Cardiocerebrovascular Risk Factors].
Kang, SH, Hwang, SY
Journal of Korean Academy of Nursing. 2019;(6):748-759
Abstract
PURPOSE This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers. METHODS A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers' stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email. RESULTS After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention. CONCLUSION To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.
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Translating Healthy Living Messages to Postpartum Women and Their Partners After Gestational Diabetes (GDM): Body Habitus, A1C, Lifestyle Habits, and Program Engagement Results From the Families Defeating Diabetes (FDD) Randomized Trial.
McManus, R, Miller, D, Mottola, M, Giroux, I, Donovan, L
American journal of health promotion : AJHP. 2018;(6):1438-1446
Abstract
PURPOSE The Families Defeating Diabetes intervention evaluated a postpartum healthy living program for women with recent gestational diabetes mellitus (GDM). DESIGN Randomized controlled trial. SETTING Tertiary centers in London, Calgary, and Victoria, Canada. PARTICIPANTS Women with GDM and partners; 46% of eligible maternal participants agreed to participate. INTERVENTION Interventional (INT) participants received a healthy living seminar at 3 months; access to a walking group/Website; biweekly e-mails. Control (CON) participants received a contemporary postpartum diabetes prevention handout. MEASURES Maternal, partner, and offspring demographics at baseline, 3, and 12 months. ANALYSIS Percentages of women losing ≥7% of postpartum weight were compared by χ2 testing; body habitus comparisons by analysis of covariance (ANCOVA); maternal A1C comparisons by unpaired t tests; participant outcome associations by Pearson correlation coefficients. RESULTS Maternal participants were 170 (89 INT and 81 CON) with 63 partners (30 INT and 33 CON); 103 (73 maternal; 30 partners) were lost to follow-up; 57% of maternal participants completed 12 months; 33% INT women (n = 50) lost ≥7% weight versus 25% CON women (n = 47), P = .43. Interventional participant results did not correlate with accession of study elements. Maternal completion was significantly associated with partner involvement, breastfeeding, higher income, and education. Paternal weights correlated significantly with maternal and offspring weights. CONCLUSION Families Defeating Diabetes outcomes were not significantly different for INT maternal or paternal participants versus CON participants. Secondary outcomes of future value included statistically significant positive associations between paternal participation, socioeconomic indicators, and maternal study completion, significant correlations between maternal, paternal, and offspring weights as well as insights into study component engagement.
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Health and frailty among older spousal caregivers: an observational cohort study in Belgium.
Potier, F, Degryse, JM, Bihin, B, Debacq-Chainiaux, F, Charlet-Renard, C, Martens, H, de Saint-Hubert, M
BMC geriatrics. 2018;(1):291
Abstract
BACKGROUND Among older couples, spouses are first in line to provide care, and they are key elements in the home support of dependent older persons. In this context, ensuring the health of these older spousal caregivers should be an important issue for all of the providers who care for older adults. The aim of this study was to longitudinally assess the health of older spousal caregivers considering frailty, nutrition, cognition, physical performance and mood disorders. METHODS In this longitudinal, observational cohort study, participants were assessed at home in Wallonia, Belgium. At baseline, 82 community-dwelling spouses of older patients with cognitive deficits or functional impairment were assessed; 78 caregivers were assessed at follow-up (16 months). The clinical instruments used included Frailty Phenotype (Fried), the Mini Nutritional Assessment-short form (MNA-SF), Short Physical Performance Battery (SPPB), Geriatric Depression Scale (GDS-15), clock drawing test, medications, Zarit Burden Index (ZBI), and Caregiver Reaction Assessment (CRA). Biological assessments included plasma interleukin-6 (IL-6), ultrasensitive C-reactive protein (CRP), cortisol, albumin and insulin growth factor-1 (IGF-1). RESULTS Among caregivers, 54% were women, and the mean age was 80 years. Among care-receivers, 83% had cognitive impairment. Caregivers were more likely to be in a pre-frail stage. In one-third of the caregivers, the frailty status worsened. Transitions were observed between each of the states, except from frail to robust. In contrast to frailty, items including nutrition, cognitive status, SPPB and mood assessments were stable over time, with approximately 70% of the caregivers not experiencing significant change at follow-up. Caregiver experiences assessed with the Zarit Burden Interview and CRA were relatively stable over 16 months. CONCLUSION Many caregivers of geriatric patients are spouses who are old themselves. A failure in the health of the caregiver may anticipate an undesired care breakdown. Caregiver health and its determinants should be explored in future longitudinal studies that cover a longer time period.
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"Women and active life": An extended TPB-based multimedia software to boost and sustain physical activity and fitness of Iranian women.
Gholamnia-Shirvani, Z, Ghofranipour, F, Gharakhanlou, R, Kazemnejad, A
Women & health. 2018;(7):834-850
Abstract
Inactivity is prevalent in women, although regular physical activity (PA) has significant health benefits. Health education interventions based on multimedia software and the extended theory of planned behavior (TPB) with planning may be efficacious in promoting PA. This randomized controlled trial, conducted in 2014, aimed to evaluate theory-based multimedia for increasing and maintaining PA and fitness of 130 military personnel's wives in Tehran, Iran. We randomly selected respondents by multistage cluster sampling. We designed a "Women and Active Life" self-taught DVD-Rom, based on the extended TPB model with action and coping planning. We analyzed theoretical constructs and health-related physical fitness at baseline and 3 and 6 months post-education. Administering educational software raised average developed TPB constructs, cardiorespiratory endurance, and muscular fitness (strength, endurance, and flexibility) in women in the intervention group, which was sustained at follow-up (p < .001). Also, mean body composition (body fat percentage, waist-hip ratio, and body mass index) was reduced with retained reduction at follow-up (p < .001), although no significant change was found in these variables in the control group (p > .05). Using a new communication technology in TPB-directed multimedia led to improved and maintained PA, aerobic and musculoskeletal fitness, and body composition of women.
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The effect of an educational intervention in early pregnancy with spouse's participation on optimal gestational weight gain in pregnancy: a randomized controlled trial.
Kiani Asiabar, A, Amin Shokravi, F, Hajifaraji, M, Zayeri, F
Health education research. 2018;(6):535-547
Abstract
Gaining weight above the Institute of Medicine recommended range contributes to the development of obesity, which increases risk for diseases. We evaluated the effectiveness of an educational program with the spouse's participation on the optimal gestational weight gain (GWG) in pregnancy. We conducted a randomized controlled trial on 128 nulliparous women attending Najmieh Hospital-Antenatal Clinic based in Tehran-Iran. Participants randomly allocated into two groups of interventions and one control group. In group A, the women received education with their spouse's participation. In group B, the women received education without the participation of the spouses. In the control group, women received only routine prenatal care. Data were analysed by the ANOVA and Chi-square coefficient. The mean of the total GWG in the groups A and B was significantly lower than the control group (13.50 ± 3.85, 13.55 ± 3.20 and 15.53 ± 4.20 kg, respectively, P > 0.05). The rate of optimal GWG in groups A and B was 1.97 and 1.77 times of the control group, respectively (P < 0.05). The percentage of non-optimal GWG significantly decreased (P < 0.05). Groups A and B were not significantly different indicating no effect of spousal presence.
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The Impact of Husbands' Prostate Cancer Diagnosis and Participation in a Behavioral Lifestyle Intervention on Spouses' Lives and Relationships With Their Partners.
Rossen, S, Hansen-Nord, NS, Kayser, L, Borre, M, Borre, M, Larsen, RG, Trichopoulou, A, Boffetta, P, Tjønneland, A, Hansen, RD
Cancer nursing. 2016;(2):E1-9
Abstract
BACKGROUND A prostate cancer diagnosis affects the patient and his spouse. Partners of cancer patients are often the first to respond to the demands related to their husband's illness and thus are likely to be the most supportive individuals available to the patients. It is therefore important to examine how spouses react and handle their husband's prostate cancer diagnosis. OBJECTIVE The aim of this study was to explore how the prostate cancer diagnosis and the participation in their partners' behavioral lifestyle intervention program influenced the spouses' life, their relationship with their partner, and how they handle the situation. METHODS Interviews were recorded with 8 spouses of potential low-risk prostate cancer patients on active surveillance as part of a clinical self-management lifestyle trial. RESULTS We identified 3 phases that the spouses went through: feeling insecure about their situation, coping strategies to deal with these insecurities, and feeling reassured. CONCLUSIONS The framework of a clinical trial should include mobilizing spousal empowerment so that they can take on an active and meaningful role in relation to their husband's disease. The observations here substantiate that the framework of active surveillance in combination with a lifestyle intervention in 1 specific prostate cancer clinical trial can mobilize spousal empowerment. IMPLICATIONS FOR PRACTICE Creating well-designed clinical patient programs that actively involve the spouse appears to promote empowerment (meaning, self-efficacy, positive impact, and self-determination) in spouses. Spousal participation in clinical patient programs can give spouses relief from anxieties while recognizing them as a vital support for their husband.
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Effects of partners together in health intervention on physical activity and healthy eating behaviors: a pilot study.
Yates, BC, Norman, J, Meza, J, Krogstrand, KS, Harrington, S, Shurmur, S, Johnson, M, Schumacher, K
The Journal of cardiovascular nursing. 2015;(2):109-20
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Abstract
BACKGROUND Despite proven efficacy of cardiac rehabilitation (CR) in helping patients initiate physical activity and healthy eating changes, less than 50% of CR participants maintain changes 6 months later. OBJECTIVE The objective of this feasibility study was to test the Partners Together in Health (PaTH) intervention versus usual care in improving physical activity and healthy eating behaviors in coronary artery bypass graft surgery patients and their spouses. METHODS An experimental, 2-group (n = 17 couples/group), repeated-measures design was used. Coronary artery bypass surgery patients in both groups participated in phase II outpatient CR. Spouses in the PaTH group attended CR with the patient and were asked to make the same physical activity and healthy eating changes as patients did. Spouses in the usual care attended educational classes with patients. It was theorized that "2 persons would be better than 1" at making changes and sticking with them in the long-term. Physical activity behavior was measured using the Actiheart accelerometer; the activity biomarker was an exercise tolerance test. Eating behavior was measured using 3-day food records; the biomarker was the lipid profile. Data were collected at baseline (entrance in CR), at 3 months (post-CR), and at 6 months. Changes over time were examined using Mann-Whitney U statistics and effect sizes. RESULTS The PaTH intervention was successful primarily in demonstrating improved trends in healthy eating behavior for patients and spouses. No differences were found between the PaTH and usual care patients or spouses at 3 or 6 months in the number of minutes per week of physical activity. By 6 months, patients in both groups were, on average, below the national guidelines for PA recommendations (≥150 min/wk at >3 metabolic equivalents). CONCLUSIONS The couple-focused PaTH intervention demonstrated promise in offsetting the decline in dietary adherence typically seen 6 months after CR.