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Hochgraeber I, Köhler K, Stöcker H, Holle B. The dyadic relationship of family carers and people living with dementia - an umbrella review. Aging Ment Health 2023; 27:1965-1974. [PMID: 37390842 DOI: 10.1080/13607863.2023.2215191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/11/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVES The dyadic relationship of people living with dementia and their family carers is highly relevant when considering the stability of home-based care arrangements. There is a solid body of research that covers issues related to dyadic relationships. However, a synthesis of qualitative research is missing. Therefore, the aim of this review is to give an overview of the dyadic relationship, with the leading research question of what influences the dyadic relationship and how it can be maintained during the trajectory of the disease. METHODS We performed an umbrella review of qualitative literature on the basis of thematic synthesis and used the SoCA-Dem theory as a theoretical framework. Literature searches in the databases PubMed (MEDLINE), CINAHL, Scopus, and PsycInfo were performed from July to September 2020, additional papers were included until September 2022. We searched without timeframe restrictions and considered publications in English or German. RESULTS After a systematic database search, resulting in 1325 records, we included 12 reviews. Five analytical themes and 11 subthemes were identified. The analytical themes were 'change in the relationship', 'activities to maintain the relationship', 'continued togetherness', 'home as a place for enacting relationship', and 'influencing factors'. CONCLUSION The dyadic relationship is a complex and multifaceted phenomenon. It is characterized by family carers' attempts to continue togetherness using different strategies and is mainly influenced by the quality of the premorbid relationship and the mindset of the family carer.
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Affiliation(s)
- Iris Hochgraeber
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Kerstin Köhler
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Hannah Stöcker
- Faculty of Health, School of Psychology, Witten/Herdecke University, Witten, Germany
| | - Bernhard Holle
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
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Weicht B, Tolhurst E. The Spousal Unit and Dementia: Investigating the Relational Basis of the Couplehood Concept. Healthcare (Basel) 2023; 11:2191. [PMID: 37570431 PMCID: PMC10418721 DOI: 10.3390/healthcare11152191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
A strong emphasis is consistently placed upon the relational basis of experience within social scientific dementia research. Within this research corpus, the concept of couplehood is increasingly employed, albeit in rather undefined and loosely theorised ways. Moreover, the evaluation highlights that couplehood is often defined by a normative position that seeks to convey an affirmative perspective on dementia and spousal relationships. The lack of theoretical foundation, however, weakens the explanatory potential of the concept, both for theorising dementia, as well as for empirical research. This article critically evaluates the utility of the couplehood concept by delineating three underlying theoretical conceptions: phenomenological, interactional and relational perspectives. It will be argued that those theoretical threads offer different analytical angles and research opportunities. More thorough ontological development, however, can guide understandings of the complexities that underpin the relational experience of dementia. This will promote a conceptual starting point that offers a more balanced and multifaceted accommodation of two persons and their relationship.
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Affiliation(s)
- Bernhard Weicht
- Department of Sociology, University of Innsbruck, 6020 Innsbruck, Austria
| | - Edward Tolhurst
- School of Health, Science and Wellbeing, Staffordshire University, Stoke-on-Trent ST4 2DE, UK;
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Rakhshani T, Asadollahi A, Afzali Harsini P, Khoramdel H, Shiraly R, Khani Jeihooni A. Effect of Sexual Knowledge, Attitude and Quality of Life on Marital Satisfaction of Aged Couples in South Iran: APIM-SEM Analysis. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:432-446. [PMID: 36254349 DOI: 10.1080/0092623x.2022.2133758] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Marital satisfaction is important for health and well-being among aged couples. The aim of this study is to explore the relationship between knowledge, sexual attitude, and quality of life with marital satisfaction of aged couples of over 60 years in southern Iran. This APIM analytical study was performed on 510 aged couples in southern Iran in 2020. Proportionate stratified sampling was randomly performed in three stages relative to the aging population in main cities in the south Iran. Data collection tools included demographic information (age, education, occupation, living alone, type of disability, etc.), sexual knowledge and attitude scale (SKAS-10), quality of life scale (SF-12), and marital satisfaction questionnaire. Mean score of marital satisfaction, sexual attitude, sexual knowledge, and QoL (SF-12) was 49.71 (SD = 14.8), 27.5 (SD = 7.3), 24.7 (SD = 8.5), and 31.49 (SD = 3.2), respectively. The present study showed that sexual knowledge and attitude, quality of life, are among the estimators of marital satisfaction in aged couples.
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Affiliation(s)
- Tayebeh Rakhshani
- Health Policy Research Center, Institute of Health, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolrahim Asadollahi
- Department of Aging, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pooyan Afzali Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Heidar Khoramdel
- Health Policy Research Center, Institute of Health, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Shiraly
- Department of Community Medicine, School of Medicine, Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Cheung DSK, Ho GWK, Chan ACY, Ho KHM, Kwok RKH, Law YPY, Bressington D. A 'good dyadic relationship' between older couples with one having mild cognitive impairment: a Q-methodology. BMC Geriatr 2022; 22:764. [PMID: 36131229 PMCID: PMC9494827 DOI: 10.1186/s12877-022-03449-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cognitive impairment gradually brings changes to the relationship between older married couples. Therefore, this study aimed to understand the individual viewpoints of couple dyads on the important attributes of a 'good dyadic relationship' in the context of mild cognitive impairment (MCI), and to explore if the congruencies and discrepancies in their perceptions related to the quality and closeness of their relationship and well-being. METHODS Q-methodology was used to reveal the perceptions of a 'good dyadic relationship' among couples with one having MCI. The participating couples were separated in two rooms and independently ranked 18 relationship attributes from least to most important on a 7-point Q-sort response grid. All participants also completed a post-sort interview and surveys to assess their psychological well-being and closeness. Q-sorts were analyzed using by-person factor analysis. RESULTS Forty people with MCI and forty spousal partners completed the Q-sort. Three viewpoints, accounting for 48% of the total variance, were identified and were labeled 'Provider,' 'Problem-solver,' and 'Partner.' Different viewpoints of a 'good dyadic relationship' primarily varied by perceived importance of commitment, dedication, tolerance, and personal space. Despite these differences, there was wide consensus that respecting each other and cherishing the current moment are two universally salient attributes of a good relationship across all viewpoints. Couples with discrepant views scored significantly higher on perceptions of the quality of the relationship and closeness with the partner. CONCLUSIONS This study advances the theoretical understanding of the dyadic relationship between couples with one having MCI, from both perspectives. MCI is a state in which couples can openly discuss their expectations. The findings provide practitioners with insights to work with couples experiencing MCI.
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Affiliation(s)
| | - Grace Wing Ka Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Ken Hok Man Ho
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Robin Ka Ho Kwok
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Daniel Bressington
- College of Nursing and Midwifery, Charles Darwin University, Casuarina, Australia
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Smith ML, Heeren TC, Ranker LR, Fredman L. Associations of spousal and non-spousal caregiving with six-year trajectories of depressive symptoms among older women in the Caregiver-Study of Osteoporotic Fractures study. Aging Ment Health 2022; 26:1533-1540. [PMID: 34353186 DOI: 10.1080/13607863.2021.1950611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objectives:Caregiving and becoming widowed are risk factors for depression in older adults, but few studies have examined their combined effect on depressive symptom trajectories. In a cohort of older women (mean age = 80.7 years) from the Caregiver-Study of Osteoporotic Fractures, we used latent class growth curve modeling to identify trajectories of depressive symptoms over approximately six years.Method:We used multinomial logistic regression to assess the relative odds of four depressive symptom trajectories (consistently low, consistently moderate, moderate/increasing, and consistently high), among three groups: spousal caregivers (n = 149), non-spousal caregivers (n = 157), and non-caregivers (n = 422). We also repeated this analysis with combined caregiving status and widowhood as the exposure.Results:Compared to non-caregivers, spousal caregivers had greater relative odds of consistently high versus consistently low depressive symptoms (adjusted odds ratio [aOR] = 3.6, 95% confidence interval [CI]: 1.9, 6.5). Non-spousal caregivers did not differ from non-caregivers in depressive trajectories. Compared to non-caregivers who did not become widowed, both widowed and non-widowed spousal caregivers had greater relative odds of consistently high versus consistently low depressive symptoms (aOR = 4.9, 95% CI: 1.9, 12.7 and aOR = 3.0, 95% CI: 1.5, 6.0, respectively). Non-widowed spousal caregivers, but not widowed spousal caregivers, had a non-statistically-significant trend toward increased relative odds of moderate/increasing depressive symptoms (aOR = 1.5, 95% CI: 0.7, 3.4).Conclusion:Spousal caregiving and widowhood, but not non-spousal caregiving, are associated with trajectories reflecting greater depressive symptoms over time. Informal caregiving is common among older women, and women caring for spouses should be monitored for depression, both during caregiving and after spousal loss.Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2021.1950611.
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Affiliation(s)
- Meghan L Smith
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Timothy C Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Lynsie R Ranker
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Lisa Fredman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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Hellström I, Torres S. Couplehood as a compass: Spousal perspectives on the diminished everyday competence of partners. DEMENTIA 2021; 20:2380-2392. [PMID: 33626927 DOI: 10.1177/1471301221997306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research on spousal relations and caregiving, when one of the persons in the dyad has a dementia diagnosis, has recognized that the degree of diminished everyday competence (DEC) the person with dementia is experiencing has implications for these relations and for how spousal caregiving is ultimately experienced. The present exploratory study uses an inductive approach to analyze data from 22 qualitative interviews with and observation notes on couples living with dementia to shed light on the ways in which the person without dementia views the DEC his/her partner is experiencing. The findings show that spouses can choose to disregard their partners' DEC or to acknowledge it in either an egocentric or a couple-centered way; they also show that spouses' choice of approach does not seem to be dictated by how cognitively impaired their partners have become. This suggests that spouses' approach to partners' DEC deserves more of our attention as it could have implications not only for transitions into spousal caregiving but also for caregiving experiences as such.
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Affiliation(s)
- Ingrid Hellström
- Department of Health Care Sciences, 531597Ersta Sköndal Bräcke University College, Stockholm, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
| | - Sandra Torres
- Department of Sociology, Uppsala University, Uppsala, Sweden
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Happich F, König H, Hajek A. Spousal care and its effect on partnership characteristics – a longitudinal analysis of spousal caregiving and care receipt in Germany. Scand J Caring Sci 2021; 36:109-119. [DOI: 10.1111/scs.12968] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/22/2021] [Indexed: 12/29/2022]
Affiliation(s)
- Fiona Happich
- Department of Health Economics and Health Services Research University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Hans‐Helmut König
- Department of Health Economics and Health Services Research University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - André Hajek
- Department of Health Economics and Health Services Research University Medical Center Hamburg‐Eppendorf Hamburg Germany
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Gallagher E, Beard RL. Buffer or Blade: Perceived relationship closeness in couples navigating Alzheimer's. J Aging Stud 2020; 52:100832. [DOI: 10.1016/j.jaging.2020.100832] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 12/28/2019] [Accepted: 01/03/2020] [Indexed: 11/29/2022]
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McEvoy P, Morris L, Yates-Bolton N, Charlesworth G. Living with dementia: using mentalization-based understandings to support family carers. PSYCHOANALYTIC PSYCHOTHERAPY 2020. [DOI: 10.1080/02668734.2019.1709536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Phil McEvoy
- Six Degrees Social Enterprise CIC, Salford, UK
| | | | - Natalie Yates-Bolton
- School of Nursing, Midwifery and Social Work, University of Salford, Salford, UK
| | - Georgina Charlesworth
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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