BACKGROUND: Previous research suggests that the quantity and quality of interactions
between 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 that
this attachment provides protective functions for ill spouses.
OBJECTIVES: Our objectives in this study were to examine spousal interactions along two diver
gent illness trajectories, Alzheimer's disease (AD) and stroke, and to relate time 1 spousal
interactions 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 emo
tional 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 protective
function of attachment; along the stroke trajectory, reciprocal adult exchanges contin
ued. (J Am Psychiatr Nurses Assoc [1998]. 4, 169-181)