Common practices of Speech and language pathologists about partner oriented training to treat aphasia.

Objective: To find the common practices among speech language pathologists regarding partner-oriented training for aphasic patients. METHODS: The exploratory, qualitative study was conducted at Riphah International University, Lahore, Pakistan, from March 1 to May 31, 2021, and comprised speech language pathologists working with aphasic patients for at least 5 years in Lahore, Karachi and Islamabad. Data was collected using a structured interview guide that were conducted online. The recorded interviews were transcribed, and the data was subjected to thematic analysis. RESULTS: Of the 10 subjects, 6(60%) were females and 4(40%) were males. Overall, 6(60%) subjects had professional experience of >10 years. Thematic analysis showed that most of the speech language pathologists used traditional approaches for aphasia treatment, and counselling of patient's caregiver was done. However, there was no formal tool in Urdu language to provide basic communication strategies for the patient's caregivers or their communication partners. The participants recommended efforts to develop such a tool. Conclusion: There was found a dire need of communication partner training (CPT) programme for aphasia patients and their partners with appropriate linguistic and cultural norms to facilitate them with the aim of improving their quality of life.

Examining contraceptive utilization behavior in Pakistani women.

BACKGROUND: There is a dearth of research examining the couple characteristics in determining contractive utilization behavior in developing countries. This study fills the gap by analyzing the roles of women's intra-household bargaining power and spousal age differentials in predicting contraceptive utilization behavior in Pakistani women. METHODS: A sample of 13,331, excluding pregnant and sexually inactive married women aged 15-49, was extracted from the Pakistan Demographic and Health Survey 2017-18. The dataset is cross-sectional. Exploratory analysis was used to examine the pattern of contraceptive knowledge, types of contraceptive utilization, and intention to use contraceptives among women. Furthermore, binary regressions were employed to examine the association of women's intrahousehold bargaining power and spousal age difference with contraceptive utilization without and after accounting for all potential covariates. RESULTS: Only 33% of women use contraceptives, while 30% express an intention to use contraceptives in the future. Almost all women (98%) knew about modern contraceptives. Compared to same-age couples, higher odds of current contraceptive use are observed among women whose husbands are at least 20 years older than them or whose husbands are young to them. The odds of the intention to use contraceptives tend to increase with the increase in spousal age difference. Women's intra-household bargaining is a significant predictor of current contraceptive utilization and intention to use contraceptives. CONCLUSION: Findings underscore the importance of considering the couple's characteristics in reproductive healthcare programming and policies. RECOMMENDATION: Greater women's intra-household bargaining power and smaller spousal age differences are associated with higher contraceptive usage. Empowering women and promoting their decision-making authority within households can enhance reproductive health outcomes.

Adjustment and coping in spousal caregivers of cervical cancer patients in Ghana: A qualitative phenomenological study.

Cervical cancer is a common and significant health issue for women worldwide. To address the dearth of research on male partners' experiences when their significant others are diagnosed with cervical cancer, we aim to explore the unique challenges and perspectives encountered by men in these circumstances. The study adopted interpretive phenomenological analysis to qualitatively assess the experiences of males with partners diagnosed of cervical cancer. A phenomenological research design with purposive sampling technique was used to recruit and collect data from 38 participants until saturation occurred. Face to face interviews were conducted using a developed semi-structured interview guide. The data collected was analyzed using content analysis after verbatim transcription was done. The study resulted in the identification of 2 main themes, and 10 subthemes. These themes focused on the multifaceted impact of cervical cancer on spousal caregivers' lives and the coping and support mechanisms utilized by spouses of cervical cancer patients. The findings indicated that men faced several challenging experiences as a result of their spouses' condition and revealed the strategies they employed to cope with the stress of caring for their wives. Almost every man adopted a strategy to cope with the condition of their wives. This study would assist other men to understand the psychological, social, emotional, and spiritual experiences the men went through to appreciate and adopt their coping strategies whenever they go through such challenges.

Young Spouses' Experiences of Having a Partner With Heart Disease and Adolescents Living at Home.

AIM: To describe the life situation of spouses having a partner with heart disease and adolescents living at home. DESIGN: Qualitative inductive design. METHOD: Participants (n = 22) were included from three Scandinavian countries. Semi-structured interviews were analysed using thematic analysis with an inductive and latent approach. RESULTS: Three themes were derived. 'Being in spousal and parental role transition' described how daily life had been affected and parental responsibilities had been doubled due to their partner's heart disease. 'Living with unpredictability and insecurity' included how the unpredictable illness trajectory caused worries and affected the well-being of the family. 'Managing a challenging life situation' highlights how spouses coped with their partners' heart disease and adapted to a new life situation. CONCLUSION: Young spouses' life situation was greatly affected by their partner's heart disease, resulting in increased responsibilities and double parenthood. Having a positive attitude and mindset towards life was used as a strategy to cope with the changed life situation and find a new way of life. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: All family members are affected by heart disease. Spouses needed additional professional support and guidance on how to involve the children when a parent is ill. IMPACTS: This study highlights how young spouses, with adolescents living at home, experience their life situation. The life situation is unpredictable due to the partner's heart disease, as they must handle both caring for their partner and taking on double parenthood. Research involving family members can improve person- and family-centred care and treatment outcomes in health care and society. REPORTING METHOD: COREQ checklist was used preparing the manuscript. PATIENT OR PUBLIC CONTRIBUTION: Data collection included interviews with spouse. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: By highlighting the spouses changed life situation due to heart disease and the importance of including them in health care.

Impact of care-recipient relationship type on quality of life in caregivers of older adults with dementia over time.

BACKGROUND: Dementia caregiving is a dynamic and multidimensional process. To gain a comprehensive understanding of informal caregiving for people living with dementia (PLWD), it is pivotal to assess the quality of life (QoL) of informal caregivers. OBJECTIVE: To evaluate whether the care-recipient relationship type predicts changes in the QoL of informal caregivers of PLWD over a two-year period. METHODS: This was a secondary analysis of longitudinal data. The data were drawn from two waves of linked data from the National Health and Aging Trends Study (NHATS) and the National Study of Caregiving (NSOC) (2015: NHATS R5 & NSOC II; 2017: NHATS R7 & NSOC III). Caregivers were categorized into spousal, adult-child, "other" caregiver and "multiple" caregivers. QoL was assessed through negative emotional burden (NEB), positive emotional benefits and social strain (SS). Generalized estimating equation modelling was used to examine changes in caregivers' QoL outcomes across types of relationship over time. RESULTS: About, 882 caregivers were included who linked to 601 PLWD. After adjusting caregivers' socio-demographics, "other" caregivers had lower risk of NEB and SS than spousal caregivers (OR = 0.34, P = 0.003, 95%CI [0.17, 0.70]; OR = 0.37, P = 0.019, 95%CI 0.16, 0.85], respectively), and PLWD's dementia status would not change these significance (OR = 0.33, P = 0.003, 95%CI [0.16, 0.68]; OR = 0.31, P = 0.005, 95%CI [0.14, 0.71], respectively). CONCLUSIONS: The study demonstrates that spousal caregivers face a higher risk of NEB and SS over time, underscoring the pressing need to offer accessible and effective support for informal caregivers of PLWD, especially those caring for their spouses.

Factors effecting on health-promoting behaviors in iranian pregnant women and their husbands: the actor-partner interdependence model (APIM).

INTRODUCTION: Pregnancy is an important period of life for women and their husbands as the couple's health is essential. The present study evaluated the impact of some factors (marital adjustment with depressive symptoms) on health-promoting behaviors in pregnant women and their husbands based on the actor-partner interdependence model (APIM). MATERIALS AND METHODS: This descriptive study examined 211 couples (pregnant women and their husbands) in pregnancy clinics of Babol University of Medical Sciences using a convenience sampling method. The participants completed Spanier's Dyadic Adjustment Scale (DAS) (1979), Edinburgh Postnatal Depression Scale (EPDS) (1987), and Walker's Health Promoting Lifestyle Profile II (HPLPII) questionnaire (1997). The relationships between women and their husbands were also evaluated using structural equation modeling with R software according to the Lavaan (latent variable analysis) package based on APIM-SEM. RESULTS: The pregnant women's marital adjustment positively affected their health-promoting behaviors (ß = 0.456, 95% Cl: 0.491-0.998, p < 0.001) and their husbands' (ß = 0.210, 95% Cl: 0.030-0.726, p = 0.048). Pregnant woman's depressive symptoms also negatively affected their health-promoting behaviors (ß=-0.088, 95% Cl: -0.974-0.074, P = 0.236) and their husbands' health-promoting behaviors (ß=-0.177, 95% Cl: -0.281 - -0.975, P = 0.011). Furthermore, the husband's marital adjustment only positively affected his studied behaviors (ß = 0.323, 95% Cl: 0.0303-0.895, P < 0.001) but did not affect the pregnant woman's health behaviors. The husband's depressive symptoms had a negative impact on his studied behaviors (ß = 0.219, 95% Cl: -0.122 - -0.917, P = 0.001) and did not affect the pregnant woman's depressive symptoms. Our findings confirmed the mediating role of depressive symptoms in pregnant women and their husbands on the association of marital adjustment and health-promoting behaviors. According to the actor-partner study, a pregnant woman's marital adjustment scores positively affected her studied behaviors and her husband (ß = 0.071, 95% Cl: 0.042-0.278, P = 0.015) by decreasing her depression score. Therefore, the husband's marital adjustment score positively affected his studied behaviors by decreasing his depression score (ß = 0.084, 95% Cl: -0.053 -0.292, P = 0.005), and it did not affect his wife's health-promoting behaviors. DISCUSSION AND CONCLUSION: These findings suggest healthcare providers, obstetricians, and psychologists evaluate the husbands' symptoms of depression and health-promoting behaviors in the routine pregnancy care of pregnant women. They also pay great attention to marital adjustment as a determinant of reducing depressive symptoms in pregnant women and their husbands.

Sexual satisfaction and attitude toward marital infidelity among married people in Iran: the role of social media and entertainment preferences.

BACKGROUND AND PURPOSE: Sexual satisfaction and attitudes toward marital infidelity are crucial components of marital quality and well-being. This study investigates the impact of social media and entertainment preferences on these aspects among married couples in Iran, acknowledging the sociocultural nuances unique to the region. METHOD AND MATERIAL: A cross-sectional survey design was employed, gathering data from 1,756 married participants through an online questionnaire in Iran. Variables included social media and entertainment preferences, sexual satisfaction, attitude toward marital infidelity, and demographic details. Descriptive statistics, non-parametric tests (Mann-Whitney U test, Kruskal-Wallis test), and GLM (Generalized linear model) were used for exploration. RESULTS: Key results reveal significant associations between demographic factors, social media usage, and attitudes toward marital infidelity. Notable trends include higher sexual satisfaction among younger participants (p < 0.05), those with shorter marital durations (p < 0.01), and those residing outside Tehran (p < 0.001). Attitudes toward marital infidelity were influenced by gender, age, ethnicity, income levels, and social media habits, reflecting a complex interplay of factors. The GLM analysis emphasizes the impact of variables such as marital duration, ethnicity, spouse's education, Iranian social media usage, and attitudes toward marital infidelity on sexual satisfaction. Participants with shorter marriages (p < 0.01), higher spouse education (p < 0.05), and more frequent Iranian social media usage (p < 0.001) reported higher sexual satisfaction. CONCLUSIONS: This study explores the dynamics of marital relationships in Iran, examining the interconnections between demographics, media habits, sexual satisfaction, and attitudes toward infidelity. The findings provide valuable insights into factors influencing marital satisfaction, emphasizing the importance of considering cultural contexts. Robust statistical methods, including Generalized Linear Models, support the reliability of results. The study contributes to understanding non-western marital dynamics, highlighting implications for research and interventions in the digital age.

Change in resilience among spousal caregivers of patients with newly-diagnosed advanced cancer over the first six months posttreatment in China.

OBJECTIVE: A longitudinal observational study was conducted and aimed to examine the change in resilience among spousal caregivers of newly-diagnosed advanced cancer patients over the first six months after initial treatment. METHODS: In total, 312 Chinese spousal caregivers who were taking care of their patients with newly-diagnosed advanced cancer were recruited. The level of resilience was measured using the Connor-Davidson Resilience Scale at the first month post-initial treatment (T1), three-month post-initial treatment (T2), and six-month post-initial treatment (T3). Latent growth modeling analyses were performed to examine changes in resilience using Mplus 8.3. RESULTS: The mean scores of resilience in spousal caregivers were 54.01 ± 7.68 at T1, 56.20 ± 6.38 at T2, and 57.97 ± 6.70 at T3, respectively. Results of latent growth modeling indicated that spousal caregivers showed a significant increase in their resilience scores over the first six months post-treatment (Mean slope = 1.98, p < 0.001). Furthermore, a significant individual variation in the rate of changes in resilience scores allowed spouses to be categorized into two groups: 42.9% participants with fast growth and 57.1% participants with slight growth. CONCLUSION: Our findings highlight the importance that new knowledge about change patterns of resilience in the nursing field is beneficial to reveal different psychosomatic health. Acknowledging that resilience is a dynamic process that changes over time, it is crucial for healthcare providers to monitor the psychological adjustment and focus of vulnerable caregivers, particularly spouses.

Quality of Life in Patients and Their Spouses and Cohabitating Partners in the Year Following a Cancer Biopsy (the Couples Cope Study): Protocol for a Prospective Observational Study.

BACKGROUND: Receiving a diagnosis of cancer is a profound and often very stressful experience. Few studies have prospectively recruited patients prior to receiving a new diagnosis of cancer and included spouses or partners. OBJECTIVE: The aim of the Couples Cope Study is to understand the impact of undergoing a diagnostic biopsy and receiving a new cancer diagnosis on quality of life (QoL) in both patients and their spouses or partners, as well as on the quality of their relationship. This protocol paper describes the study design and assesses the feasibility of recruitment and retention. METHODS: Study staff reviewed the schedules of collaborating physicians using specific encounter codes to identify patients scheduled for breast or prostate biopsies. Potential participants were prescreened via the electronic health record and sent a recruitment letter at least 2 to 3 weeks prior to their biopsy procedure. Patients subsequently underwent a phone screening to determine eligibility. Patients who enrolled provided study staff with contact information for their spouses or partners. All consent forms were completed online. Surveys were completed online prior to receiving the biopsy results (baseline), and at 1, 3, 6, and 9 months after the biopsy. Study staff engaged in ongoing, personalized contact with participants and sent assessment completion reminders via phone and email. RESULTS: A total of 2294 patients undergoing a breast or prostate biopsy were identified and 69% (n=1582) were eligible for phone screening following electronic health record prescreening. Of the 431 patients who underwent phone screening, 75% (n=321) were eligible to participate. Of the eligible patients, 72% (n=231) enrolled and 82% (n=190) of enrolled patients had an accompanying partner or spouse who also enrolled. A total of 77% (34/44) of patients who received a cancer diagnosis and 72% (26/36) of their spouses or partners were retained through 9 months, while 80% (53/66) of patients who received a benign diagnosis and 68% (42/62) of their partners were retained. CONCLUSIONS: Prospective recruitment of patients undergoing diagnostic biopsy and their partners is feasible and requires both strategic collaboration with providers and concerted prescreening and recruitment efforts by study staff. Importantly, this study was able to conduct all study activities online without disrupting clinical workflow and without requiring patients and their spouses or partners to come into the laboratory. Consideration should be given to the ratio of biopsies to cancer diagnoses, which can vary significantly by cancer type. Prospective studies are needed and can inform our ability to provide effective support earlier to couples facing a possible cancer diagnosis. Future studies should examine other tumor types that have received less attention in QoL studies, include behavioral and neurobiological assessments beyond self-report measures, and follow couples beyond 9 months in order to examine long-term effects on QoL. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/52361.

Association of psychological stress with wives' hypertension across over 10 million Chinese married female population aged 20-49 years.

BACKGROUND: Psychological stress has been reported to be a potential risk factor for hypertension among females, but it remains unclear whether spousal chronic stress levels alter the risk of hypertension among women. We examined the associations between stress within the family and hypertension among married women. METHODS: Reproductive-aged women who were planning for pregnancy and their husbands were recruited from the National Free Pre-pregnancy Checkup Projects (NFPCP) across 31 provinces in China in 2016 and 2017. Perceived stress of wives or husbands was measured with a 5-point Likert-type scale, and assessed from three domains: work/life-related stress, economic stress, and overall stress. Multivariable-adjusted logistic regression models were used to assess the associations between stress status and the prevalence of hypertension. RESULTS: Of 10,027,644 couples, 261,098 (2.60%) women had hypertension. The results showed that higher stress levels among themselves or their husbands were associated with a higher prevalence of hypertension in women ( Pfor trend <0.001). Compared with non-stressed participants, female participants with the highest stress themselves were at a greater risk of hypertension, with adjusted odds ratio (OR) of 1.31 (95% confidence interval [CI]: 1.25-1.37); and compared with participants whose husbands had no stress, those whose husbands had the highest stress level were at a higher risk of hypertension with adjusted OR of 1.24 (95% CI: 1.20-1.29). Moreover, compared with non-stressed status for both couples, only-wife-stressed, only-husband-stressed, and both-stressed couples were found to be significantly associated with increased risks of wives' hypertension, with adjusted ORs of 1.28 (95% CI: 1.25-1.31), 1.19 (95% CI: 1.17-1.21), and 1.28 (95% CI: 1.26-1.31), respectively. CONCLUSION: Moderate to severe stress in both spouses might be associated with female hypertension prevalence, which highlights the importance of paying attention to the psychological stresses of couples within the family.

Illuminating health aspects for immigrant Thai women in Swedish transnational marriages.

BACKGROUND: Women who are migrants experience discrimination and face major risks, including sexual exploitation, trafficking, and violence, which affect their health and well-being. This study explored critical health incidents experienced by immigrant Thai women in marriage migration. METHODS: A qualitative explorative approach with in-depth interviews was used. Forty immigrant Thai women who currently or previously had a Swedish spouse were recruited for the study. An inductive critical incident technique was used to collect and analyze the data as the first step. In a second deductive step, the Newman system model was used to categorize health dilemmas. RESULTS: The women reported 438 critical health incidents in five main areas. Psychological health dilemmas included emotional abuse, feeling overwhelmed due to family responsibilities and the stress of leaving family behind. Sociocultural health dilemmas included transnational family duties or not performing family duties. Physiological health dilemmas included experiencing physical violence and environmental, domestic or work accidents. Developmental health dilemmas included failing health, difficulties upholding the duties expected of a spouse in the target culture and caring for an elderly husband. Spiritual health dilemmas included critical incidents in which the women perceived themselves to have failed in their hopes and duties as a wife, which intensified their dependence on faith, particularly the Buddhist concept of karma. CONCLUSION: Professionals in health and welfare practices in Thailand together with professionals in Western countries who work with women in marriage migration situations need to recognize the psychological, sociocultural, physiological, developmental, and spiritual health dilemmas experienced by these women. Furthermore, civil organizations that meet Thai women in foreign countries, such as Buddhist cultural associations, would benefit from the multicultural knowledge revealed by the present study. This knowledge can facilitate healthcare and welfare support for women in marriage migration situations.

A comparison of adult-child and spousal cancer caregivers' participation in medical decisions.

BACKGROUND: Family caregivers often play a key role in medical decision-making for patients with cancer. Adult-children account for nearly half of caregivers, but often have less experience with serious illness care and decision-making and face unique relational challenges as the patient's child. Yet little research explores the potentially distinctive decision-making, involvement in decisions, and support needs of adult-child caregivers. METHODS: Analysis of survey data of U.S. cancer caregivers conducted by CancerCare® in 2021. Chi-square tests and multivariable regression models assessed whether adult-child and spousal caregivers differed on the type of medical decisions they participated in (e.g., treatment planning, medication management), who made the decision (e.g., caregiver or joint decision), and the resources that informed decisions (e.g., friends and family, education materials). RESULTS: Adult-children (N = 892) were less likely than spouses (N = 314) to participate in treatment planning (beta = -0.41; 95%CI = -0.81,-0.01), but more likely to be involved in decisions about whether to challenge medical authority (e.g., seeking alternative treatment, second opinion) (beta = 0.50; 95%CI = 0.22,0.78). Compared to spouses, adult-children made joint decisions with patients less often (-13.2-percentage points; 95%CI = -19.64,-6.67) and acted as primary decision-maker more frequently (5.60-percentage points; 95%CI = 0.01,10.43). More adult-children than spouses sought help and information regarding decisions from the oncology team (8.42-percentage points; 95%CI = 1.98,14.87) and friends and family (7.91-percentage points; 95%CI = 1.34,14.48). CONCLUSIONS: How cancer caregivers and patients are related to each other shapes caregivers' medical decision-making. Adult-children's and spouses' probabilities of participating in and influencing decisions differed for certain types of decisions while adult-children were more likely to seek information and social support regarding decisions. These findings highlight the importance of the patient's and caregiver's relationship type in medical decision-making, suggesting that decision support programs may be more effective if they tailor programs by relationship type.

Stronger together: the longitudinal relations between partner responsiveness, dyadic coping and PTSD recovery.

Background: Past research has primarily focused on negative associations between PTSD and relationships. Therefore, this investigation delves into the potential positive role of these relational aspects in aiding PTSD recovery during treatment.Objective: This study aimed to examine the impact of dyadic coping and perceived partner responsiveness on treatment trajectories of PTSD patients.Method: The study included 90 participants, who were requested to complete online questionnaires twice, with a six-month gap between the measures.Results: The results from linear regression analyses indicated that perceived partner responsiveness had a positive effect on PTSD recovery, whereas dyadic coping had the opposite effect: higher levels of dyadic coping were associated with an increase in posttraumatic stress symptoms over time. Additional examination of the subscales indicated that heightened communication between clients and partners regarding stress was related with increased posttraumatic stress symptoms.Conclusions: These findings underscore the importance and complexity of effective and supportive communication between patients with PTSD and their partners. While existing literature supports both perceived partner responsiveness and dyadic coping as beneficial, this study indicates that only perceived partner responsiveness positively impacted PTSD recovery.

Perceived Partner Responsiveness and PTSD Recovery: the study reveals a significant positive impact of perceived partner responsiveness on PTSD recovery. Patients perceiving higher levels of understanding from their romantic partners experience enhanced recovery, possibly through increased social support and the development of new self-narratives.Dyadic Coping and PTSD Recovery: contrary to expectations, aspects of dyadic coping, particularly stress communication, were found to hinder PTSD recovery. Unhelpful disclosure and problematic interpersonal dynamics in discussing trauma within the relationship seemed to limit recovery, indicating the nuanced nature of communication's role in PTSD recovery.

'Possibilities and challenges for older couples to continue ageing in place'.

Ageing in place is an imminent concern for both older couples and communities. Identifying ways to support ageing in place is required to meet the needs and challenges of older couples and social services systems. Through focus groups with a total of 46 participants and a constant comparative methodology, this study aimed to explore and describe the experiences and reasoning of spousal carers, healthcare professionals, and stakeholders regarding possibilities for older couples to age in place. The findings consisted of one main category, 'Facilitating ageing in place is a win-win situation with challenges' and four interrelated categories, 'Focus on older couples - building relationships and providing adequate services', 'Engaged civil society as a source of care and social inclusion,' 'Motivated professionals with competence and time,' and 'Services working together for a sustainable society,' that present possibilities and challenges for ageing in place. This study suggests that facilitating ageing in place is possible but involves a complex series of challenges that can be linked to different contexts ranging from individuals and couples to civil society, services provided, organisational systems, and existing resources. All these aspects need to be considered and balanced to achieve a situation that contributes to older couples' possibilities to age in place as well as to a sustainable society.

Gender differences in perceptions of "joint" decision-making about spending money among couples in rural Tanzania.

Family and cultural contexts can constrain the effectiveness of evidence-based interventions designed to improve the health and wellbeing of women and their children. Unequal power relationships within the household may underlie the failure of many programs targeting women to achieve their intended impact. To reduce these unequal power dynamics within the households, many programs or interventions aim to both assess and improve the gender dynamics between husbands and wives within the household. Decision-making is one important facet of these dynamics and has been linked to health outcomes for women and children. However, household decision-making is rarely observed and often difficult to capture. This study aimed to use qualitative research to further understand one aspect of decision-making, namely on how to spend money. In two regions of Tanzania, we used surveys and interviews to explore different perspectives on spending and allocation of resources among 58 couples in rural farming households. While many men and women initially reported that they made decisions jointly, most women stated they would often concede if there was a disagreement or argument around spending. These results highlight the different perceptions of joint decision-making between men and women. We compared these results to survey responses on decision-making and found differences within and between couples across interview and survey responses. Based on the differences in qualitative and survey responses within couples and how they reported dealing with disagreement, our study found households were on a spectrum from no cooperation in decision-making to full cooperation. Our results highlight challenges for assessing decision-making on spending and ultimately improving these decision-making dynamics within the household. These challenges are especially important for maternal and child behavioral change and provide insights on why many interventions aimed at improving women's decision- making power on money may not reach their full potential.

Practicing Interoceptive Sensitivity as a Couple: A Mixed-Methods Acceptance Analysis of a Dyadic vs. Single Pilot Randomized Controlled Trial.

Training interoceptive sensitivity (IS) might be a first step in effectively promoting intuitive eating (IE). A dyadic interoception-based pilot randomized controlled trial was conducted to increase IE among couples aged 50+. The training consisted of three exercises, a Body Scan (BS), a hunger exercise (HU), and a satiety (SA) exercise. This study explored how spouses accepted the (dyadic vs. single) training. In a mixed-methods convergence design, the findings of a survey (n = 68 couples) and focus groups (n = 4) were synthesized. Moderate general acceptance (e.g., regarding feasibility and low burden) and a hierarchical gradient in favor of the BS (e.g., pleasantness and improved sleep quality) emerged. Barriers concerned a perceived lack of the exercises' usefulness and a limited understanding of the training purpose. A wish for regular feedback and exchange with the study stuff and other participants was expressed. Spousal training involvement was experienced as being rather beneficial. Previously harmonized dietary practices and daily routines appeared as constructive pre-conditions for the joint training. This study highlights the potential and implications of training couples in IS. Future interventions should involve a regular exchange and closer guidance by study staff to promote a better understanding of the processes and goals of IS and IE.

Psychosocial Impact of Penile Cancer: An Unmet Need.

Penile cancer is a rare cancer, where patients not only need to deal with the anxiety around a cancer diagnosis, but also manage the consequences of treatment on their self-esteem, body image, and intimate relationships. Many find it embarrassing and difficult to talk to family and friends. Due to this, changes in urination and other physical effects of treatment, many will withdraw from social activities too. Patients need psychosocial support and more needs to be done to address this unmet need. Holistic and multidisciplinary approaches in clinic, with access to counseling, may help patients adjust to their new situation.

While You Are Sleeping: Marital Ambivalence and Blunted Nocturnal Blood Pressure.

Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors may increase CVD risk by affecting blunted nocturnal blood pressure (BP) dipping. This study tracked daytime and nocturnal SBP and DBP in 180 normotensive individuals (90 couples; participant mean age 25.04; 91.58% white) over a 24 h period using ambulatory blood pressure monitors to explore the impact of martial quality. Results showed that perceptions of spousal ambivalence were associated with blunted nocturnal BP dipping. Perceptions of one's own behavior as ambivalent also showed blunted nocturnal dipping. When in an ambivalent relationship, a gender interaction was found such that women were most likely to have blunted SBP dipping, but men were more likely to have blunted nocturnal DBP dipping. Overall, this study found an association between ambivalence and BP dipping, thus uncovering one virtually unexplored pathway by which marital relationships may have adverse effects on health.

Occurrence and Risk Factors for Cognitive Decline Shared by Couples: A Systematic Review and Meta-Analysis.

Background: To date, the magnitude of association and the quality of evidence for cognitive decline (mild cognitive impairment, Alzheimer's disease, and dementia) in couples and risk factors for outcomes have not been reviewed and analyzed systematically. Objective: The aim of this study was to investigate the concordance of cognitive impairment in unrelated spouses and to qualitatively describe potential risk factors. Methods: Eight databases were searched from inception to October 20, 2023. Eligible studies were independently screened and assessed for quality. Statistical analysis was conducted using Stata 15.1 software. The study was preregistered with PROSPERO (CRD42023488024). Results: Eleven studies involving couples were included, with moderate to high evidence quality. Compared to controls, spouses of individuals with cognitive impairment had lower cognitive scores (Cohen's d: 0.18-0.62) and higher risk of cognitive decline (OR = 1.42, 95% CI: 1.15-1.76). The consistency of cognitive impairment between spouses was attributed to three theories: 1) the impact of caregiving stress experienced by the spouse; 2) assortative mating, which suggests that individuals select partners with similar characteristics; and 3) the influence of shared living environments and lifestyles. Conclusions: The cognitive status of one spouse can affect the cognitive function of the other spouse. It is important to consider shared lifestyle, environmental, and psychobehavioral factors, as they may contribute to the risk of cognitive decline by couples. Identifying these factors can inform the development of targeted recommendations for interventions and preventive measures.

A Dyadic Study of Attachment, Coping, and Quality of Life in Couples Seeking Fertility Treatment.

This study examined attachment insecurities, infertility-specific coping strategies, and quality of life (QoL) in 87 couples seeking fertility treatment. Partners completed self-report measures. Path analyses showed that women's and men's attachment anxiety were associated with their own lower QoL, whereas attachment avoidance was associated with their own and their partner's lower QoL. Adaptive coping in men and women were associated with women's higher QoL. Non-adaptive coping was associated with men and women's lower QoL. Coping strategies explained the associations between attachment and QoL. This highlights the importance of individual and dyadic factors for understanding QoL in couples seeking fertility treatment.