"July 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 195-203). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Apesar de pais e mães de crianças com câncer estarem em um processo interativo nos cuidados ao filho, pouca atenção tem sido dada às maneiras como a doença da criança afeta a relação conjugal desses casais. O objetivo deste trabalho foi compreender as repercussões do câncer infantil na relação conjugal de pais e mães de crianças com câncer, na experiência da doença de seus filhos. Trata-se de um estudo exploratório, de abordagem qualitativa. Participaram do estudo nove casais, totalizando 18 sujeitos. Utilizamos a entrevista em profundidade como principal técnica de coleta de dados, e a consulta em prontuários como recurso auxiliar para obter dados importantes da criança e de seus pais. A análise dos dados empíricos foi feita por meio da análise de conteúdo indutiva. Os resultados foram agrupados por similaridades nas seguintes categorias: a trajetória do casal na experiência do câncer infantil: as primeiras mudanças; o câncer infantil, o relacionamento conjugal dos pais e o papel da comunicação: fragilidades e potencialidades; alterações na dinâmica familiar e implicações para o casal: trabalho, lazer, papéis e relações de gênero; e enfrentando o desafio juntos: balanço da experiência e expectativas do casal. O presente estudo não objetivou distinguir se as mudanças ocorridas na relação conjugal desses pais e mães foram positivas ou negativas, mas, sim, mostrar que alguns aspectos contribuem para o estremecimento da relação desses homens e mulheres. Entretanto, alguns casais vivenciam aspectos que promovem o fortalecimento da relação com o cônjuge no contexto de doença da criança. O estudo evidenciou a importância da comunicação como um dos pilares do relacionamento conjugal desses casais, a necessidade da oferta adequada de apoio social, principalmente vindo do próprio cônjuge e a relevância das questões de gênero nos aspectos relacionados à sexualidade e intimidade do casal e no intercâmbio de papéis que se faz necessário durante a trajetória da doença. Os resultados deste estudo contribuem para que os profissionais de saúde, dentre eles o enfermeiro, tenham o casal como importante foco de seu cuidado, voltando-se para suas necessidades e ajudando-os a reconhecer as fortalezas no relacionamento com o cônjuge durante as adversidades, oportunizando e incentivando o diálogo e a parceria para lidar com os desafios impostos pela doença da criança. / Although fathers and mothers of children with cancer are going through an interactive process in care for their child, little attention has been given to how the childs disease affects these couples marital relationship. This research aimed to understand the repercussions of childhood cancer on the marital relationship between fathers and mothers of children with cancer, in the experience of their childrens disease. We carried out an exploratory study with a qualitative approach. Participants were nine couples, totaling 18 subjects. In-depth interviews were used as the main data collection technique, and patient files were consulted as an auxiliary resource to obtain important data about the children and their parents. Inductive content analysis was applied for empirical data analysis. The results were grouped according to similarity in the following categories: the couples trajectory in the experience of childhood cancer: the first changes; childhood cancer, the parents marital relationship and the role of communication: fragilities and potentials; changes in family dynamics and implications for the couple: work, leisure, roles and gender relations; and facing the challenge together: balancing the experience and the couples expectations. This research did not intend to distinguish whether the changes occurred in these fathers and mothers marital relationship were positive or negative, but to show that some aspects contribute to shake up these men and womens relationship. On the other hand, some couples experience aspects that promote the strengthening of the spousal relationship in the context of the childs disease. This study evidenced the importance of communication as one of the pillars of these couples marital relationship, the need for adequate social support supply, mainly from the spouse and the relevance of gender issues in aspects related to the couples sexuality and intimacy and in the role exchange needed along the disease trajectory. The results of this study contribute for health professionals, including nurses, to adopt the couple as an important focus in care delivery, looking at their needs and helping them to acknowledge the strengths in their spousal relationship during adversities, permitting and stimulating dialogue and partnership to deal with the challenges imposed by the childs disease.

Research on infidelity has suffered from inconsistency in how infidelity has been operationalized across studies. This study was designed to advance methodological considerations for defining infidelity and identifying offending spouses. A subjective definition of infidelity was obtained from each respondent via both closed- and open-ended items. The open-ended responses were applied to explore the definition of infidelity. Additionally, an indirect questioning method was adopted to identify offending spouses according to their own subjective definitions of cheating and test the effectiveness of this approach relative to direct questioning for identifying offending spouses. Furthermore, gender differences in acknowledging infidelity through both direct and indirect approaches in general as well as across the four self-defined categorical infidelity were examined. A community sample of 465 married or divorced individuals anonymously completed the survey via MTurk. Results showed two defining characteristics of infidelity that cut across modes of infidelity (sexual, emotional, computer-mediated, and solitary) were that infidelity occurs outside the relationship and without consent. The definition of infidelity of infidelity provided in response to an open-ended inquiry tended to be shorter among offending spouses—especially male offending spouses—than among non-offending spouses. More offending spouses were found via the indirect (42.9%) approach than the direct approach (12.7%), and more men than women acknowledged engaging in infidelity behaviors according to both the direct (16.6% vs. 9.1%) and indirect (48.2% vs. 38.0%) approaches. That said, gender-based statistical differences in propensity to commit self-defined infidelity were only found in sexual and computer-mediated forms of infidelity; propensity to commit self-defined emotional and solitary infidelity did not statistically differ between men and women; in all cases, however, gender differences were small. Results suggested that the indirect approach is better than direct questioning for identifying infidelity behaviors; the indirect approach elicited less social desirability bias. Implications for research and clinical practice are provided.

Military spouses are often left at home when their service member deploys to areas outside the United States. These deployments can have a lasting impact on the military spouses' perception of marital happiness. Communication problems can occur within the marriage and military spouses may use their religious orientation to alleviate the stress that comes from deployments. This quantitative study used an online survey method to conduct bivariate correlations and multiple regression analysis from a sample of 128 military spouses. This study focused on the family stress theory and used the Kansas Marital Satisfaction Scale, Extrinsic and Intrinsic Religious Orientation Scale, and Primary Communication Inventory. Bivariate correlations indicated a significant relationship between communication, extrinsic religious orientation, intrinsic religious orientation, and marital happiness. Multiple regression indicated a strong significant relationship with communication and a negative significant relationship with extrinsic and intrinsic religious orientation. After controlling for the covariates, communication and age of spouse were significant, while the remaining variables were nonsignificant. In addition, binary logistic regression was conducted, and communication and intrinsic religious orientation were significant, while extrinsic religious orientation was nonsignificant with marital happiness. The experiences that military spouses undergo with deployments may be useful for therapists, chaplains, or military leaders to provide learning techniques on coping after deployments, promote longevity with military marriages through premarital workshops, chaplain-sponsored marital retreats, and marriage therapy for military spouses to promote marital happiness.

There are over 615,000 women military spouses and 1,786 known military spouse business owners who relocate every 2 to 3 years to follow their active duty spouse. The research problem addressed was the lack of strategies military spouse small business owners used to sustain their business during a mandatory military relocation. The purpose of this multiple case study was to explore the strategies that 5 women military spouse small business owners, located near Shaw Air Force Base or Fort Jackson, South Carolina, used to sustain their businesses during a relocation. The sampling method used was census sampling. The systems theory was the conceptual framework of this research supported by sustainability theory, strategic management theory, and event system theory. In-depth semistructured interviews and archival documentations (e.g., pamphlets, flyers, websites) were the chosen methods of data collection. A CADQAS software program was used to organize the data and content analysis method was to analyze the data gathered from the interviews and documents. The emergent themes were small businesses, work-life balance, business finance, barrier to business ownership, initiatives to support military spouses, and personal finances quality of life. For the military spouse small business owners or other potential business owners, a simple and accessible method to obtain information and access to government grants could assist the implication for positive social change to create new employment opportunities, growth, and innovation in communities and the economy. Additionally, the results from the study may provide insight and strategies to assist other military spouse business owners or other business owners in sustaining their business when relocating.

Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment on communication means that not only does the person with hearing impairment experience the consequences but also his or her frequent communication partners. This thesis investigates the impact of hearing impairment on spouses and uses the World Health Organization’s term “third-party disability.” Third-party disability is defined as the impairments, activity limitations, and participation restrictions experienced by the family due to the health condition of their significant other, and was identified by the World Health Organization as an area for future development and application of the International Classification of Functioning, Disability and Health (ICF). Despite a number of studies previously published on the effect of hearing impairment on family members, including younger couples and carers, there remain substantial gaps in knowledge and understanding of the difficulties specifically relating to older people and factors associated with third-party hearing disability. This thesis focuses on the third-party disability experienced by normally hearing spouses (termed the “spouses” in this thesis) of older people with hearing impairment (termed the “partners” in this thesis). To add empirical data to the body of research, this series of studies first explored the lived experience of spouses of older people with hearing impairment in a qualitative study, then identified the ICF domains and categories that described third-party hearing disability, described the extent of third-party hearing disability in this population, modelled the contribution of factors to third-party hearing disability, and developed and psychometrically tested a scale to measure the third-party disability of spouses of older people with hearing impairment. Studies conducted within this thesis were therefore completed in two phases. Ten spouses of older people with hearing impairment participated in the first qualitative phase, consisting of semi-structured in-depth interviews. Results of this study showed that spouses experience a number of effects as a result of their partners’ hearing impairment including: (1) the broad ranging effects of the hearing impairment on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ hearing impairment; (3) the effect of acceptance of the hearing impairment on the spouse; and (4) the impact of ageing and retirement. Findings were then linked to the ICF to identify the most typical and relevant domains and categories of the ICF for spouses of older people with hearing impairment. The majority of themes were able to be linked to the ICF, with most linking to codes in the activities and participation component. A number of contextual factors were also identified that influenced the spouses’ third-party disability. In the second phase, a further 100 older couples affected by hearing impairment participated in a quantitative face-to-face survey to describe the nature and degree of third-party disability in spouses, and to examine factors associated with third-party hearing disability. Concepts identified in the first qualitative study were used to formulate a 36-item tool for measuring spouses’ third-party hearing disability, namely the Significant Other Scale for Hearing Disability (SOS-HEAR). The majority of spouses in this study (98%) reported some degree of third-party hearing disability on at least one item of the SOS-HEAR. Communication difficulties between the couple were the central source of stress reported by spouses, followed by emotional problems in the spouse. Three factors were found to be significantly associated with greater third-party hearing disability: (1) lower relationship satisfaction as described by spouses; (2) a larger spouse-partner age difference; and (3) greater hearing disability in the hearing impaired partner as perceived by the spouse. The scaling properties of the SOS-HEAR were then examined, with a revised 27-item questionnaire found to be a reliable means of measuring older spouses’ third-party hearing disability. Use of the SOS-HEAR is proposed as a means of identifying spouses of older people with hearing impairment in need of intervention. If spouses are identified as experiencing third-party hearing disability, health professionals are then in a position to facilitate discussions with the couple about the impact of the hearing loss on their daily functioning. The inclusion of spouses in rehabilitation takes into account the needs of both members of the couple such that they become partners in rehabilitation. In summary, this research has shown that hearing impairment in older people has an effect on the spouse, as they too experience situations of communication activity limitations and participation restrictions. It is clear that the lives of participants in this study were considerably affected as a result of their partners’ hearing impairment, with spouses reporting a wide variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. This series of studies has highlighted the potentially important role of family-centred intervention in rehabilitation for older adults with hearing impairment, and strongly suggests the need for increased inclusion of spouses and significant others in the rehabilitation process.

Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment on communication means that not only does the person with hearing impairment experience the consequences but also his or her frequent communication partners. This thesis investigates the impact of hearing impairment on spouses and uses the World Health Organization’s term “third-party disability.” Third-party disability is defined as the impairments, activity limitations, and participation restrictions experienced by the family due to the health condition of their significant other, and was identified by the World Health Organization as an area for future development and application of the International Classification of Functioning, Disability and Health (ICF). Despite a number of studies previously published on the effect of hearing impairment on family members, including younger couples and carers, there remain substantial gaps in knowledge and understanding of the difficulties specifically relating to older people and factors associated with third-party hearing disability. This thesis focuses on the third-party disability experienced by normally hearing spouses (termed the “spouses” in this thesis) of older people with hearing impairment (termed the “partners” in this thesis). To add empirical data to the body of research, this series of studies first explored the lived experience of spouses of older people with hearing impairment in a qualitative study, then identified the ICF domains and categories that described third-party hearing disability, described the extent of third-party hearing disability in this population, modelled the contribution of factors to third-party hearing disability, and developed and psychometrically tested a scale to measure the third-party disability of spouses of older people with hearing impairment. Studies conducted within this thesis were therefore completed in two phases. Ten spouses of older people with hearing impairment participated in the first qualitative phase, consisting of semi-structured in-depth interviews. Results of this study showed that spouses experience a number of effects as a result of their partners’ hearing impairment including: (1) the broad ranging effects of the hearing impairment on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ hearing impairment; (3) the effect of acceptance of the hearing impairment on the spouse; and (4) the impact of ageing and retirement. Findings were then linked to the ICF to identify the most typical and relevant domains and categories of the ICF for spouses of older people with hearing impairment. The majority of themes were able to be linked to the ICF, with most linking to codes in the activities and participation component. A number of contextual factors were also identified that influenced the spouses’ third-party disability. In the second phase, a further 100 older couples affected by hearing impairment participated in a quantitative face-to-face survey to describe the nature and degree of third-party disability in spouses, and to examine factors associated with third-party hearing disability. Concepts identified in the first qualitative study were used to formulate a 36-item tool for measuring spouses’ third-party hearing disability, namely the Significant Other Scale for Hearing Disability (SOS-HEAR). The majority of spouses in this study (98%) reported some degree of third-party hearing disability on at least one item of the SOS-HEAR. Communication difficulties between the couple were the central source of stress reported by spouses, followed by emotional problems in the spouse. Three factors were found to be significantly associated with greater third-party hearing disability: (1) lower relationship satisfaction as described by spouses; (2) a larger spouse-partner age difference; and (3) greater hearing disability in the hearing impaired partner as perceived by the spouse. The scaling properties of the SOS-HEAR were then examined, with a revised 27-item questionnaire found to be a reliable means of measuring older spouses’ third-party hearing disability. Use of the SOS-HEAR is proposed as a means of identifying spouses of older people with hearing impairment in need of intervention. If spouses are identified as experiencing third-party hearing disability, health professionals are then in a position to facilitate discussions with the couple about the impact of the hearing loss on their daily functioning. The inclusion of spouses in rehabilitation takes into account the needs of both members of the couple such that they become partners in rehabilitation. In summary, this research has shown that hearing impairment in older people has an effect on the spouse, as they too experience situations of communication activity limitations and participation restrictions. It is clear that the lives of participants in this study were considerably affected as a result of their partners’ hearing impairment, with spouses reporting a wide variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. This series of studies has highlighted the potentially important role of family-centred intervention in rehabilitation for older adults with hearing impairment, and strongly suggests the need for increased inclusion of spouses and significant others in the rehabilitation process.

<p>När en man diagnostiseras med prostatacancer innebär det en psykisk påfrestning för mannen och hans kvinnliga partner. Reaktioner som chock, meningsförlust, ensamhet och ångest är vanligt förekommande. Syftet med denna litteraturstudie var att beskriva hur det vardagliga livet upplevs och påverkas hos par där mannen lever med diagnostiserad prostatacancer. Resultaten i studien baseras på tio vetenskapliga artiklar med fokus på parens erfarenheter av sjukdomen. Impotens, inkontinens och fatigue var symtom som drabbade mannen till följd av sjukdomen. Dessa förändringar inverkade på parets vardag och relation. Förändringarna var psykiskt påfrestande för parets hälsa och både mannens och kvinnans livskvalitet försämrades på grund av cancersjukdomen. Psykiska problem som depression, oro, ångest och skuld var dock mer förekommande hos kvinnan. Trots att paren var i stort behov av information upplevde de att hälso- och sjukvården inte uppmärksammade deras behov. Tydligare riktlinjer inom sjukvården för hur par som lever med prostatacancer ska bemötas efterlyses. På så sätt kan sjuksköterskan lättare tillgodose parets behov av information och stöd. Sjuksköterskan bör uppmärksamma och bemöta kvinnans individuella önskemål samt visa en öppenhet gentemot de sexuella problem som kan drabba paren. Mer forskning, speciellt i Skandinavien, efterlyses för att få en klarare bild över hur både en homosexuellt och heterosexuell relation påverkas av prostatacancer.  </p> / <p>When a man is diagnosed with prostate cancer it implies a psychological strain for the man and his female partner where reactions such as shock, loss of meaning, loneliness and anxiety are common. The purpose of this literature review was to describe how everyday life is perceived and influenced in couples where the man has been diagnosed with prostate cancer. The results of the study are based on ten scientific articles focused on exploring couple’s experiences of the disease and how they are affected by the situation. Symptoms such as impotence, incontinence and fatigue were changes that affected the couple’s everyday life and their relationship. These changes were psychologically trying for the couple’s health and their quality of life decreased because of the cancer.  Psychological problems like depression, anxiety and guilt were more common for the woman. Despite the fact that the couples were in great need of information, they felt that health care providers were not attentive to these needs. Clearer guidelines are needed within the health-care system for how couples living with prostate cancer should be treated. The nurse would thereafter be better equipped to meet the couple’s needs for information and support. The nurse should highlight and approach women’s individual needs and show openness towards the sexual problems that can befall couples. More research is needed, particularly in Scandinavia, in order to get a clearer picture of how a homosexual and heterosexual relationship is affected by prostate cancer.</p>

<p>Psykisk ohälsa är ett samhällsproblem som kräver mer uppmärksamhet från sjukvårdens sida. En kronisk sjukdom drabbar både patienter och deras livskamrater och präglas av olika förluster som förändrar livet. Förlusterna skapar en klyfta mellan det liv patienter och livskamrater lever och de liv de egentligen vill leva. Det är i denna klyfta som den kroniska sorgen skapas. Kronisk sorg skiljer sig från vanlig sorg då den återkommer i perioder och växlar i intensitet. Syftet med studien var att beskriva upplevelsen av kronisk sorg hos patienter och livskamrater i samband med en kronisk sjukdom. Studien är genomförd som en litteraturstudie där 15 vetenskapliga artiklar samlades in och granskades. Resultatet visar att patienter och livskamrater upplever olika typer förluster, både fysiska, sociala och psykiska. Dessa förluster ligger till grund för upplevelsen av kronisk sorg. Genom att få kunskap om patienter och livskamraters upplevelse av kronisk sorg i samband med kronisk sjukdom kan sjuksköterskan få förståelse för dessa patienter och utifrån det hjälpa dem att hantera sorgen. Kronisk sorg är ett relativt nytt begrepp inom sjukvården och det krävs därför mer forskning för att öka kunskapen om begreppet.</p> / <p>Mental health is a problem in society and it requires more attention from the healthcare side. A chronic disease means that both patients and spouses undergo different periods of losses that change their lives in different ways. These losses create a gap between the patients and spouse’s ongoing lives and the life they really want to live. It is in this gap that the chronic sorrow is created. Chronic sorrow differs from normal grief when it recurs in periods and switches in intensity. The aim of this study was to describe the experience of chronic sorrow in patients and spouses related to a chronic disease. The study was conducted as a literature review where 15 research articles were collected and examined. The results show that patients and spouses experience different types of losses, physical, social and psychological. These losses create their chronic sorrow. By gaining knowledge of patients and spouses experiences of chronic sorrow the nurse can obtain an understanding of their situations and based on that help they cope with grief. Chronic sorrow is a relatively new concept in healthcare and therefore more research is required to increase understanding of the concept. <strong></strong></p>

<p>The general aim was to explore philosophy of life, expectations and optimism in patients and spouses in two different cancer situations, and to determine whether these aspects had relevance for psychological distress and quality of life. The first situation was being newly diagnosed with advanced cancer. Data on philosophy of life, optimism and psychological distress were gathered on one occasion (I). In addition, changes in life were described using a qualitative approach in a sub-sample (II). The second situation was having completed curative cancer treatment. Data on expectations for the recovery period, optimism, psychological distress and quality of life were gathered on three occasions (III). Moreover, expectations and how these turned out were described using a qualitative approach in a sub-sample (IV). The results show that being diagnosed with an advanced cancer influenced aspects of patients’ and spouses’ philosophy of life, including that existential questions were common and were related to higher psychological distress (I). All experienced substantial mental changes in life, often also physical, practical and sometimes positive changes. Patients more often seemed to accept their situation and prepared themselves for death, whereas spouses had more difficulties in handling the situation (II). Patients who had completed curative treatment generally had higher expectations for the recovery period than did their spouses, and patients expectations were fulfilled to a lesser degree, however, this generally had little importance for psychological distress or quality of life (III). Patients’ expectation for their recovery period was generally that they would get well. For those whose recovery period had been tough, expectations were often unfulfilled, but they were often satisfied with their current life anyway owing to positive changes (IV). Being optimistic was the most beneficial for decreased psychological distress in both samples, as well as for better quality of life in the recovery group (I, III).</p>