Article

Marital adjustment, satisfaction and dissolution among hematopoietic stem cell transplant patients and spouses: a prospective, five-year longitudinal investigation

School of Social Work, University of Washington, Seattle, WA 98105 , USA.
Psycho-Oncology (Impact Factor: 4.04). 02/2010; 19(2):190-200. DOI: 10.1002/pon.1542
Source: PubMed

ABSTRACT To examine the trajectory of marital adjustment, satisfaction and dissolution among 121 hematopoietic stem cell transplant (HSCT) couples-as a function of role (patient or spouse) and gender.
Prospective, longitudinal design. Participants completed the Dyadic Adjustment Scale at six time points: pre-transplant (4-7 days after beginning medical workup prior to starting transplant), 6 months post-transplant, and 1, 2, 3 and 5 years post-transplant. They also reported on marital status over time.
Participants ranged in age from 23-68 (52% female patients and 48% female spouses). Ninety-eight patients received an allogeneic transplant; 23 received an autologous transplant. Marital dissolution was uncommon (four divorces since the transplant among 55 participating 5-year survivors, 7%). Dyadic satisfaction was stable over time for both male and female patients and male spouses, but not for female spouses who reported reductions in satisfaction at all time points relative to baseline.
Couples were by and large resilient. However, caregiver-specific gender differences indicate an increased risk for relationship maladjustment and dissatisfaction among female spouses and ultimately, female spouse/male patient couples.

1 Follower
 · 
89 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Patients living with multiple myeloma (MM) face complex decisions throughout their journey relative to their diagnosis, options for treatment, and how their disease and treatment choices may affect them physically, emotionally, financially, and spiritually. Patients considering a hematopoietic stem cell transplantation face specific self-management challenges. The availability of a reliable caregiver is a prerequisite to transplantation eligibility. Currently, the majority of clinical management is episodic and provided in the outpatient setting. Therefore, the bulk of care for patients living with MM is provided by the patient together with his or her caregivers. Caregivers face similar challenges to those faced by the patient living with MM. They are required to take in complex information, perform often complicated or technical procedures such as line care or injections, assist the patient with activities of daily living, and attend the myriad of appointments required. Understanding the dynamics of the patient-caregiver relationship, the strengths and weaknesses unique to that relationship, common elements of caregiver stress or strain, and available tools and strategies to promote a sense of control and enhance self-management skills may improve the health-related quality of life for both the patient with MM and his or her caregiver.
    Clinical Journal of Oncology Nursing 12/2013; 17:25-32. DOI:10.1188/13.CJON.S2.25-32
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Older couples are likely to be confronted with health problems of both spouses and these health problems may negatively influence their marital satisfaction. The present study examined these possible negative effects using a dyadic perspective. Data from 78 independently living older couples were analyzed using the Actor-Partner Interdependence Model (APIM). Health problems were modeled as a latent factor of functional disability, the number of chronic diseases, and self-rated health. The couple's health context, that is, similarity or dissimilarity, was examined with an actor-partner interaction variable. For wives, spousal health problems were negatively associated with their marital satisfaction, but only under the condition that their own health was relatively good. For husbands, neither own nor spousal health problems were associated with their marital satisfaction. Future research focusing on older couples needs to consider the couple's health context next to health at the individual level.
    Journal of Aging and Health 09/2013; 25(8). DOI:10.1177/0898264313501387 · 1.56 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Due to expanding indications and improvements in supportive care, utilization of blood and marrow cell transplantation (BMT) to treat various conditions is increasing exponentially, and currently more than 60,000 BMT's are performed annually worldwide. By the year 2030, it is projected that the number of BMT survivors will increase five-fold, potentially resulting in half a million survivors in the United States (US) alone. As the majority of survivors now live beyond the first two years after BMT, they are prone to a unique set of complications and late effects. Until recently, BMT experts assumed responsibility for almost all of the care of these survivors, but now oncologists/hematologists, pediatricians and internists are involved frequently in offering specialized care and preventive services to these survivors. To integrate and translate into clinical practice the unique BMT survivorship issues with current preventive guidelines, a team effort is required. This can be facilitated by a dedicated "long-term-follow-up (LTFU)" clinic that provides life-long care for BMT survivors. In this review, we first illustrate with clinical vignettes the need for LTFU and then focus upon: (1) types of LTFU clinic models, (2) challenges and possible solutions to the establishment of LTFU clinic, and (3) vulnerable transition periods.
    Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation 07/2014; 21(2). DOI:10.1016/j.bbmt.2014.06.035 · 3.35 Impact Factor

Preview

Download
1 Download
Available from