Spousal Interactions in Alzheimer's Disease and Stroke Caregiving: Relationship to Care Recipients' Functional Abilities and Physical and Emotional Health
Restricted accessOtherFirst published online December, 1998
Spousal Interactions in Alzheimer's Disease and Stroke Caregiving: Relationship to Care Recipients' Functional Abilities and Physical and Emotional Health
BACKGROUND: Previous research suggests that the quantity and quality of interactionsbetween caregivers and care recipients have an impact on health outcomes of ill per sons. Building on the work of Bowlby (1988) and Wright, Hickey, Buckwalter, and Clipp(1995), spousal interactions are conceptualized as adult attachment; it is argued thatthis attachment provides protective functions for ill spouses.
OBJECTIVES: Our objectives in this study were to examine spousal interactions along two divergent illness trajectories, Alzheimer's disease (AD) and stroke, and to relate time 1 spousalinteractions to care recipients' time 2 functional abilities and physical and emotional health. STUDY DESIGN: This longitudinal pilot study compared 42 couples (84 spouses) equally divided between early phase AD, 12 weeks after stroke, and healthy controls. Baseline(time 1) data and 6-month follow-up data (time 2) were collected in home interviews.Measures included spousal interactions and illness characteristics of persons with AD and recipients of care after a stroke.
RESULTS: AD couples reported lower quantity and quality of interactions compared with stroke couples. Spousal interactions were positively correlated to physical and emotional health in AD care recipients and to functional abilities in stroke care recipients.Only AD care recipients' interactions were related to depression.
CONCLUSIONS: Spousal interactions along the AD trajectory represented the protectivefunction of attachment; along the stroke trajectory, reciprocal adult exchanges continued. (J Am Psychiatr Nurses Assoc [1998]. 4, 169-181)
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References
1.
Bowlby, J. (1988). The origins of attachment theory. In A secure base (pp. 20-38). New York: Basic Books.
2.
Corbin, J.M., & Strauss, A. (1988). Unending work and care managing chronic illness at home. San Francisco, CA: Jossey-Bass .
3.
Draper, B.M., Poulos, C.J., Cole, A., Poulos, R.G., & Ehrlich, F. (1992). A comparison of caregivers for elderly stroke and dementia victims. Journal of the American Geriatrics Society , 40, 896-901.
4.
Evans, R.L., Bishop, D.S., & Haselkorn, J.K. (1991). Factors predicting satisfactory home care after stroke. Archives of Physical Medicine Rehabilitation , 72, 144-147.
5.
Fillenbaum, G.G. (1988). Multidimensional functional assessment of older adults. Hillsdale, NJ: Lawrence Erlbaum.
Gonzalez-Torrecillas, J.L., Mendlewicz, J., & Lobo, A. (1995). Effects of early treatment on poststroke depression on neuropsychological rehabilitation. International Psychogeriatrics , 4, 547-560.
8.
Hickey, J.V. (1997). The clinical practice of neurological and neurosurgical disease (4th ed.). Philadelphia : Lippincott.
9.
Lawton, M.P., Moss, M., Fulcomer, M., & Kleban, M.H. (1982). A research and service oriented multilevel assessment instrument. Journal of Gerontology, 37, 91-99.
10.
Norris, V.K., Stephens, M.A.P., & Kinney, J.M. (1990). The impact of family interactions on recovery from stroke: Help or hindrance ?The Gerontologist, 30, 535-542.
11.
Robinson, R., Starr, L.B., & Price, T.R. (1984). A two year longitudinal study of mood disorders following stroke prevalences and duration at 6 months follow-up. BritishJournal of Psychiatry, 144, 256-262.
12.
Spanier, G.B. & Filsinger, E.E. (1983). The dyadic adjustment scale . In E. E. Filsinger (Ed.), Marriage andfamily assessment (pp. 155-168). Newbury Park, CA: SAGE Publications.
13.
Spanier, G.B., & Thompson, L. (1982). A confirmatory analysis of the dyadic adjustment scale. Journal of Marriage and the Family, 38, 731-741.
14.
Teri, L., & Wagner, A. (1992). Alzheimer's disease and depression. Journal of Consulting and Clinical Psychology, 60, 379-391.
15.
Tucker, M.A., Ogle, S.J., Davinson, J.G., & Eilenberg, M.D. (1987). Validation of a brief screening test for depression in the elderly. Age andAgeing, 16, 139-144.
16.
U.S. Department of Health and Human Services. ( 1994). Alzheimer's disease (NIH Publication No. 94-3676). Rockville, MD: Government Printing Office.
17.
U.S. Department of Health and Human Services. ( 1995). Post-stroke rehabilitation: Assessment, referral, and patient management (AHCPR Publication No. 95-0663). Rockville, MD: Government Printing Office.
18.
Wright, L.K. (1993). Alzheimer's disease and marriage. Newbury Park, CA: SAGE Publications.
19.
Wright, L.K. (1994). Alzheimer's disease afflicted spouses who remain at home: Can human dialectics explain the findings?Social Science Medicine, 38, 1037-1046.
20.
Wright, L.K., Hickey, J.V., Buckwalter, K.C., & Clipp, E.C. (1995). Human development in the context of aging and chronic illness: The role of attachment in Alzheimer's disease and stroke . International Journal of Aging and Human Development, 41, 131-148.
