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1.
Cochrane Database Syst Rev ; 8: CD010515, 2020 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-32786083

RESUMO

BACKGROUND: People with dementia living in the community, that is in their own homes, are often not engaged in meaningful activities. Activities tailored to their individual interests and preferences might be one approach to improve quality of life and reduce challenging behaviour. OBJECTIVES: To assess the effects of personally tailored activities on psychosocial outcomes for people with dementia living in the community and their caregivers. To describe the components of the interventions. To describe conditions which enhance the effectiveness of personally tailored activities in this setting. SEARCH METHODS: We searched ALOIS: the Cochrane Dementia and Cognitive Improvement Group's Specialized Register on 11 September 2019 using the terms: activity OR activities OR occupation* OR "psychosocial intervention" OR "non-pharmacological intervention" OR "personally-tailored" OR "individually-tailored" OR individual OR meaning OR involvement OR engagement OR occupational OR personhood OR "person-centred" OR identity OR Montessori OR community OR ambulatory OR "home care" OR "geriatric day hospital" OR "day care" OR "behavioural and psychological symptoms of dementia" OR "BPSD" OR "neuropsychiatric symptoms" OR "challenging behaviour" OR "quality of life" OR depression. ALOIS contains records of clinical trials identified from monthly searches of a number of major healthcare databases, numerous trial registries and grey literature sources. SELECTION CRITERIA: We included randomised controlled trials and quasi-experimental trials including a control group offering personally tailored activities. All interventions comprised an assessment of the participant's present or past interests in, or preferences for, particular activities for all participants as a basis for an individual activity plan. We did not include interventions offering a single activity (e.g. music or reminiscence) or activities that were not tailored to the individual's interests or preferences. Control groups received usual care or an active control intervention. DATA COLLECTION AND ANALYSIS: Two review authors independently checked the articles for inclusion, extracted data, and assessed the methodological quality of all included studies. We assessed the risk of selection bias, performance bias, attrition bias, and detection bias. In case of missing information, we contacted the study authors. MAIN RESULTS: We included five randomised controlled trials (four parallel-group studies and one cross-over study), in which a total of 262 participants completed the studies. The number of participants ranged from 30 to 160. The mean age of the participants ranged from 71 to 83 years, and mean Mini-Mental State Examination (MMSE) scores ranged from 11 to 24. One study enrolled predominantly male veterans; in the other studies the proportion of female participants ranged from 40% to 60%. Informal caregivers were mainly spouses. In four studies family caregivers were trained to deliver personally tailored activities based on an individual assessment of interests and preferences of the people with dementia, and in one study such activities were offered directly to the participants. The selection of activities was performed with different methods. Two studies compared personally tailored activities with an attention control group, and three studies with usual care. Duration of follow-up ranged from two weeks to four months. We found low-certainty evidence indicating that personally tailored activities may reduce challenging behaviour (standardised mean difference (SMD) -0.44, 95% confidence interval (CI) -0.77 to -0.10; I2 = 44%; 4 studies; 305 participants) and may slightly improve quality of life (based on the rating of family caregivers). For the secondary outcomes depression (two studies), affect (one study), passivity (one study), and engagement (two studies), we found low-certainty evidence that personally tailored activities may have little or no effect. We found low-certainty evidence that personally tailored activities may slightly improve caregiver distress (two studies) and may have little or no effect on caregiver burden (MD -0.62, 95% CI -3.08 to 1.83; I2 = 0%; 3 studies; 246 participants), caregivers' quality of life, and caregiver depression. None of the studies assessed adverse effects, and no information about adverse effects was reported in any study. AUTHORS' CONCLUSIONS: Offering personally tailored activities to people with dementia living in the community may be one approach for reducing challenging behaviour and may also slightly improve the quality of life of people with dementia. Given the low certainty of the evidence, these results should be interpreted with caution. For depression and affect of people with dementia, as well as caregivers' quality of life and burden, we found no clear benefits of personally tailored activities.


Assuntos
Demência/reabilitação , Vida Independente , Preferência do Paciente , Qualidade de Vida , Participação Social , Idoso , Idoso de 80 Anos ou mais , Cuidadores/educação , Cuidadores/psicologia , Efeitos Psicossociais da Doença , Demência/psicologia , Depressão/reabilitação , Feminino , Humanos , Masculino , Testes de Estado Mental e Demência/estatística & dados numéricos , Comportamento Problema/psicologia , Angústia Psicológica , Ensaios Clínicos Controlados Aleatórios como Assunto , Cônjuges/educação , Cônjuges/psicologia , Resultado do Tratamento
2.
PLoS One ; 15(8): e0237512, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776980

RESUMO

OBJECTIVES: This study aims to examine associations between spousal communication about contraception and ever use of modern contraception, overt modern contraceptive use (with husband's knowledge), and covert modern contraceptive use (without husband's knowledge) among adolescent wives and their husbands in Niger. STUDY DESIGN: Cross-sectional data, from the Reaching Married Adolescents Study, were collected from randomly selected adolescent wives (ages 13-19 years) and their husbands from 48 randomly selected villages in rural Niger (N = 1,020 couples). Logistic regression models assessed associations of couples' reports of spousal communication about contraception with wives' reports of contraception (overall, overt, and covert). RESULTS: About one-fourth of adolescent wives and one-fifth of husbands reported spousal communication about contraception. Results showed couples' reports of spousal communication about contraception were positively associated with ever use of modern contraception. Couples' reports of spousal communication about contraception were negatively associated with covert modern contraceptive use compared to overt use. Wives' reports of spousal communication were marginally associated with covert use compared to no use but husbands' reports were not. CONCLUSION: Among a sample of couples in Niger, spousal communication about contraception was positively associated with modern contraceptive use (compared to no use) and negatively with covert use (compared to overt use) but wives' and husbands' reports showed differential associations with covert use compared to no use. Since there is little understanding of couple communication surrounding covert contraceptive use decisions, research should focus on characterizing content and context of couple communication particularly in cases of disagreement over fertility decisions.


Assuntos
Comunicação , Comportamento Contraceptivo/estatística & dados numéricos , Serviços de Planejamento Familiar/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Casamento , Cônjuges/psicologia , Adolescente , Adulto , Comportamento Contraceptivo/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Níger , Fatores Socioeconômicos , Adulto Jovem
3.
PLoS One ; 15(6): e0232401, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32516312

RESUMO

Population ageing has rapidly increased the number of people requiring end-of-life care across the globe. Governments have responded by promoting end-of-life in the community. Partly as a consequence, older spouses are frequently providing for their partner's end-of-life care at home, despite potentially facing their own health issues. While there is an emerging literature on young-old caregivers, less is known about spouse carers over 75 who are likely to face specific challenges associated with their advanced age and relationship status. The aim of this review, therefore, is to identify and synthesise the literature concerning the experiences of caregiver's aged 75 and over whose partner is approaching end-of-life. We conducted a mixed-method systematic review and narrative synthesis of the empirical literature published between 1985 and May 2019, identified from six databases: Medline, PsychINFO, Cumulative Index to Nursing and Allied Health Literature, Embase, Sociological Abstracts and Social Service Abstracts. Hand searching and reference checking were also conducted. Gough's Weight of Evidence and Morgan's Feminist Quality Appraisal tool used to determine the quality of papers. From the initial 7819 titles, 10 qualitative studies and 9 quantitative studies were included. We identified three themes: 1) "Embodied impact of care" whereby caring was found to negatively impact carers physical and psychological health, with adverse effects continuing into bereavement; 2) "Caregiving spouse's conceptualisation of their role" in which caregiver's navigated their self and marriage identities in relation to their partner's condition and expectations about gender and place; 3) "Learning to care" which involved learning new skills and ways of coping to remain able to provide care. We identified a recent up-surge in published papers about very old spousal caregivers, which now comprise a small, medium-quality evidence base. This review outlines a range of potential lines of inquiry for future research including further clarification of the impact of caregiving on the likelihood of mortality, the incidence of men and women providing end-of-life care amongst this age group, and the role of anticipatory grief in shaping their perceptions of their relationship and their own longevity.


Assuntos
Cuidadores/psicologia , Cônjuges/psicologia , Assistência Terminal , Adaptação Psicológica , Bases de Dados Factuais , Nível de Saúde , Humanos
4.
PLoS One ; 15(5): e0232795, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32413053

RESUMO

INTRODUCTION: There is growing evidence to suggest the importance of self-regulatory practices amongst older adults to sustain mobility. However, the decision to self-regulate driving is a complex interplay between an individual's preference and the influence of their social networks including spouse. To our best knowledge, the influence of an older adult's spouse on their decisions during driving transition has not been explored. MATERIALS AND METHODS: This qualitative descriptive study was conducted amongst married older adults aged 60 years and above. All interview responses were transcribed verbatim and examined using thematic approach and interpretative description method. RESULTS: A total of 11 married couples were interviewed. Three major themes emerged: [1] Our roles in driving; [2] Challenges to continue driving; and, [3] Our driving strategies to ensure continued driving. Older couples adopted driving strategies and regulated their driving patterns to ensure they continued to drive safely. Male partners often took the active driving role as the principal drivers, while the females adopted a more passive role, including being the passenger to accompany the principal drivers or becoming the co-driver to help in navigation. Other coping strategies include sharing the driving duties as well as using public transportation or mixed mode transportation. DISCUSSION: Our findings suggest spouse play a significant role in their partners' decision to self-regulate driving. This underscores a need to recognise the importance of interdependency amongst couples and its impact on their driving decisions and outcomes.


Assuntos
Acidentes de Trânsito/prevenção & controle , Envelhecimento/psicologia , Condução de Veículo/psicologia , Comportamentos Relacionados com a Saúde , Idoso , Envelhecimento/fisiologia , Tomada de Decisões , Feminino , Humanos , Malásia/epidemiologia , Masculino , Casamento/psicologia , Pessoa de Meia-Idade , Rede Social , Cônjuges/psicologia , Transportes
5.
Health Psychol ; 39(8): 689-699, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32378962

RESUMO

OBJECTIVE: Dyadic coping theories posit that spousal involvement may benefit illness management through collaborative and supportive (C&S) strategies and shared illness appraisals. Illness appraisals have only been examined as individual differences rather than fluctuating daily as individuals manage the difficult Type 1 diabetes regimen. The study examined how daily illness appraisals of individuals with Type 1 diabetes and their spouses were linked to spouses' daily C&S strategies and whether C&S strategies were most beneficial for daily diabetes outcomes when they occurred in the context of shared illness appraisals. METHOD: Couples (N = 199) in which one person had Type 1 diabetes (M age patients = 46.81; 52.3% female; spouses = 46.40, 47.5% female) completed a 14-day diary assessing illness appraisals (ranging from nonshared through shared) and spouses' C&S strategies. Patients reported daily self-regulation failures, self-care behaviors, and perceived coping effectiveness. Daily blood glucose was gathered from glucometers. RESULTS: Multilevel models indicated both within-person and between-person effects of patients' and spouses' illness appraisals on C&S strategies with higher shared illness appraisals associated with greater C&S strategies. Greater shared illness appraisals were associated with fewer self-regulation failures and better self-care. C&S strategies were associated with lower self-care and higher blood glucose levels. Appraisal interacted with C&S strategies such that C&S strategies were associated with more self-regulation failures, lower self-care, and lower perceived coping effectiveness when patients reported lower shared appraisals. CONCLUSIONS: Results suggest that C&S strategies may be more detrimental for diabetes management when individuals view diabetes as less shared. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Adaptação Psicológica/fisiologia , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/terapia , Autocuidado/psicologia , Cônjuges/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
6.
Health Psychol ; 39(8): 633-641, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32406727

RESUMO

OBJECTIVE: The present study examined positive and negative aspects of relationship quality with one's spouse or partner as predictors of mortality and the role of gender in moderating this link. METHOD: Data were drawn from 2 waves, 5 years apart, of the National Social Life, Health, and Aging Project (N = 1,734). Positive aspects of relationship quality (frequency of opening up to the partner to talk about worries and relying on the partner) and negative aspects (frequency of the partner making too many demands and criticism by the partner) were assessed. Survival/mortality status was recorded at the time of Wave 2 data collection 5 years later (1,567 alive; 167 deceased). Covariates included sociodemographic variables, relationship type, health status, and the network size of close family relationships and friendships. RESULTS: Logistic regression analyses showed that negative relationship quality with one's spouse or partner was associated with significantly higher odds for mortality after 5 years (odds ratio [OR] = 1.20, 95% CI [1.03, 1.38], p < .001), after including the statistical covariates. Also, age, gender, education, self-rated health, and medication use were significantly related to mortality. Propensity score matching replicated these findings. Follow-up analyses revealed that criticism from one's spouse or partner, in particular, was linked to a higher mortality risk (OR = 1.44, 95% CI [1.10, 1.88]). Gender did not moderate the relationship-quality-mortality link. CONCLUSIONS: Negative relationship quality, notably, criticism received from one's spouse or partner, heightens older adults' risk of mortality. These results suggest the value of developing interventions that target reducing expressed criticism in couple relationships. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Envelhecimento/psicologia , Relações Familiares/psicologia , Cônjuges/psicologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Fatores de Tempo
7.
Arch Sex Behav ; 49(5): 1533-1543, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32246223

RESUMO

Trauma survivors who suffer from posttraumatic stress symptoms (PTSS) are known to experience impairments in sexual satisfaction. However, the negative effects of PTSS are not limited to the primary survivors, as they can lead to secondary PTSS in their spouses as well. The implications of secondary PTSS in the sexuality of couples remain unknown. This study aimed to investigate whether specific symptom clusters of PTSS (i.e., intrusions, hyperarousal, and avoidance) are implicated in the sexual satisfaction of couples. We assessed a sample of primarily exposed Israeli veterans from the Yom Kippur War and their wives who had been secondarily exposed (N = 191). The dyadic data were analyzed in an Actor-Partner Independence Model. When scrutinizing specific PTSS clusters, the husbands' avoidance related to their own sexual satisfaction. The wives' hyperarousal related to their own and their spouses' sexual satisfaction, whereas their intrusions were associated only with their husbands' sexual satisfaction. In conclusion, PTSS in one spouse is related to both spouses' sexual satisfaction; it is therefore recommended that clinicians adopt a dyadic approach when delivering interventions.


Assuntos
Orgasmo/fisiologia , Parceiros Sexuais/psicologia , Cônjuges/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
8.
J Gerontol Soc Work ; 63(3): 227-249, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32264770

RESUMO

This study aims to assess the effectiveness of peer support groups for low-income older adults' caregivers in the Hong Kong community. It compares the effectiveness of peer support groups on spouse and adult children caregivers. The peer support program was structured into three stages, including six training sessions for peer specialists, eight caregiver support group sessions, and non-structured informal contact. The study adopted a quasi-experiment design supplemented with qualitative data collected from focused group interviews. It involved a user group of 58 participants and a control group of 42 participants. Both quantitative and qualitative data were collected before, after the peer support groups, and at a three-month follow-up. The quantitative results showed that the peer support program was more effective in promoting social support for adult children caregivers but not for spousal caregivers. Three focus group interviews suggested that the community-based peer-support group could be helpful to improve stress management, emotional regulation skills, and social networks of the caregivers. Based on the research findings, we discuss the various needs of spousal and adult children caregivers, provide recommendations for service providers and practitioners to consider homogenous group services to address the diverse needs of spousal and adult children caregivers.


Assuntos
Crianças Adultas/psicologia , Cuidadores/psicologia , Grupo Associado , Grupos de Autoajuda , Cônjuges/psicologia , Atividades Cotidianas , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Aconselhamento , Feminino , Grupos Focais , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , Pesquisa Qualitativa , Qualidade de Vida , Apoio Social , Estresse Psicológico/psicologia
9.
PLoS One ; 15(4): e0232028, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32339180

RESUMO

BACKGROUND: Despite the progress made so far in reducing mother-to-child transmission (MTCT), Nigeria still contributes significantly to the global burden of new pediatric HIV infections. The elimination target for MTCT has not been reached and the decline in new infections among all Global Plan countries from 2009 to 2015 was lowest in Nigeria. This qualitative study explores the barriers to uptake of prevention of mother-to-child transmission (PMTCT) intervention in Kano, the second most populous state in Nigeria. METHODS: Key informant interviews (KIIs) were conducted among twelve stakeholders who were purposively selected based on their knowledge and involvement in PMTCT program activities in the state. The KII guide explored the status and challenges of PMTCT uptake in Kano state. Qualitative data analysis was managed using NVIVO 11 software and themes were analyzed using thematic analysis. RESULTS: We found that the key barriers to uptake of PMTCT identified by stakeholders cut across the domains of the socio-ecological model. These include-fear of stigma associated with being seen accessing HIV related services, low male partner involvement, socio-cultural beliefs about the dangers of hospital-based delivery, poor attitude of health workers, distance/cost to facilities, issues with availability of HIV test kits and poor organization of health services. CONCLUSION: The implementation of effective PMTCT programs would require innovative strategies that leverage improvement of Antenatal care (ANC) uptake as an entry point for PMTCT. In addition, sustaining engagement in care requires creating a supportive stigma-free environment in the community as well as spousal support to ensure women can navigate the socio-cultural barriers that limit access to health services.


Assuntos
Infecções por HIV/transmissão , Pessoal de Saúde/psicologia , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Cuidado Pré-Natal/normas , Estigma Social , Cônjuges/psicologia , Adolescente , Adulto , Criança , Feminino , HIV/isolamento & purificação , Infecções por HIV/virologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Cuidado Pré-Natal/psicologia , Pesquisa Qualitativa , Cônjuges/estatística & dados numéricos , Adulto Jovem
10.
Malar J ; 19(1): 133, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228613

RESUMO

BACKGROUND: Conceptualizing gender dynamics and ways of bridging entrenched gender roles will contribute to better health promotion, policy and planning. Such processes are explored in relation to malaria in Mozambique. METHODS: A multi-method, qualitative study using focus group discussions (FGDs) and in-depth interviews (IDIs) explored the perspectives of community members, leaders and stakeholders on malaria. The study was conducted in Nampula Province, in an intervention district for the Tchova Tchova Stop Malaria (TTSM) gender-sensitive community dialogues, and in a non-intervention district. RESULTS: Participants (n = 106) took part in six FGDs and five IDIs in each district. Those exposed to TTSM commonly stated that the programme influenced more equalitarian gender roles, attitudes and uptake of protective malaria-related practices. These positive changes occurred within the context of an observed, gendered decision-making matrix, which aligns inward- or outward-facing decisions with malaria prevention or treatment. Decisions more dependent on male or elder sanctioning at community level are outward-facing decisions, while decisions falling within women's domain at household level are inward-facing decisions. Related to prevention, using bed nets was largely an inward-facing prevention decision for women, who were generally tasked with hanging, washing and making nets usable. Net purchase and appropriation for malaria prevention (rather than for instance for fishing) was men's prerogative. Regular net use was associated with sleeping together more regularly, bringing couples closer. Attending antenatal care to access intermittent preventive treatment during pregnancy was often an outward-facing prevention decision, under the purview of older, influential women and ultimately needing sanctioning by men. With respect to seeking care for malaria symptoms, women typically sought help from traditional healers first. This inward-facing treatment decision was within their control, in contrast to the frequently transport-dependent, outward-facing decision to attend a health facility. Sharing decisions was described as a feature of a "harmonious household," something that was said to be encouraged by the TTSM intervention and that was both lived and aspirational. CONCLUSIONS: TTSM community dialogues helped communication on both interpersonal (couple) and community levels, ultimately encouraging malaria-related behaviours. Leveraging ways of bringing men and women together to share decision making will improve malaria intervention success.


Assuntos
Tomada de Decisões , Identidade de Gênero , Comportamentos Relacionados com a Saúde , Malária/tratamento farmacológico , Malária/prevenção & controle , Cônjuges/psicologia , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Moçambique , Adulto Jovem
11.
Gerontology ; 66(4): 340-350, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32241016

RESUMO

This study investigated the dissimilarity in midlife adults' reports of support they and their spouse provide to their parents-in-law, gender differences in these dissimilarity patterns, and implications of this dissimilarity for marital quality. Middle-aged married participants (n = 164, mean age = 53.96 years) from Wave 2 of the Family Exchanges Study reported on the support they and their spouse provided to at least 1 living parent-in-law. Regression models examined associations of marital satisfaction with support for parents-in-law, evaluations of support for parents-in-law, and spousal dissimilarity in support. Gender differences in own and spousal support for parents-in-law revealed matrilineal focused support among married adults. Spousal dissimilarity in support was negatively associated with marital satisfaction for middle-aged adults. This pattern suggests the importance of a perceived balance in supporting one's spouse's parents for marital quality.


Assuntos
Crianças Adultas/psicologia , Cuidadores/psicologia , Casamento/psicologia , Cônjuges/psicologia , Relações Familiares , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pais , Satisfação Pessoal , Fatores Sexuais , Apoio Social
12.
BMC Public Health ; 20(1): 480, 2020 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-32276624

RESUMO

BACKGROUND: Screening for sexually transmitted infection (STI) especially HIV as early detection and treatment have been financially supported under the Thai Universal Coverage (UC) scheme since 2009 (THB140 for HIV). However, the implementation has not been evidence-based, strategic risk-based, nor economically evaluated whereas husbands who accompanied the pregnant women are likely to have a lower risk than those who did not come along. This study is aimed to determine the husband's willingness-to-pay (WTP) for his HIV and syphilis screening tests and potential factors affecting STI screenings at the antenatal care (ANC) clinic of a tertiary hospital in Thailand. METHODS: A pilot open-ended interview was conducted among 50 participants to estimate the mean and standard deviation of WTP prices for HIV and syphilis screening tests. A questionnaire was developed to obtain demographics, STI knowledge and screening history, as well as two contingent valuation methods (bidding and payment scale), using the mean WTP prices identified from the pilot study as a starting WTP with »SD step-up/down. The survey of 200 randomly selected husbands of pregnant women was conducted at King Chulalongkorn Memorial Hospital from April to June 2018. Descriptive statistics and logistic regression were used for data analysis. RESULTS: During the study period, 597 pregnant women received their first ANC. Of 368 accompanying husbands, 200 were enrolled in the study. Their median age was 31 (IQR 27-36) years old and 67% had a first child. Eighty-eight percent of the participants were willing to test for the STIs. Based on the bidding method, WTP prices for HIV and syphilis screening tests were US$14.5 (IQR 12.4-14.5) and US$9.7 (IQR 10-12), respectively. The payment scale method suggested approximately three-quarters of the WTP prices from the bidding method. CONCLUSIONS: The husbands who accompanied their pregnant wives to the ANC clinic showed positive behaviors according to the propitious selection theory. They tend to cooperate well with STI testing and are willing to pay at least two times the price of the STI screening tests. The financial support to promote STI screenings should be reconsidered to cover other groups with higher sexual behavior risks and less WTP.


Assuntos
Financiamento Pessoal , Infecções por HIV/prevenção & controle , Programas de Rastreamento/economia , Cônjuges/psicologia , Sífilis/prevenção & controle , Adulto , Instituições de Assistência Ambulatorial , Feminino , Humanos , Masculino , Projetos Piloto , Gravidez , Cuidado Pré-Natal , Cônjuges/estatística & dados numéricos , Inquéritos e Questionários , Tailândia , Cobertura Universal do Seguro de Saúde
13.
PLoS One ; 15(3): e0227795, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32142517

RESUMO

INTRODUCTION: All individuals and couples have a basic human right to decide freely and responsibly the number, spacing, and timing of their child. However, In Ethiopia, the prevalence of contraceptive utilization remains low and it varies in different regions. Therefore, this study was aimed to determine prevalence and determinant factors affecting the utilization of modern contraception in the reproductive age group (15-49 years) in Edaga-Hamus Town. METHODOLOGY: A community based Cross-Sectional study was carried out on April 23 to May 10, 2017. A systemic random sampling method was used to select study participants. Information was collected using a structured, pre-tested questionnaire. The data were entered into EPI-info version 7.1 and imported to SPSS version 20. Summary statistics and logistic regression analysis were performed using SPSS version 20. Those variables having a P-value of less than 0.2 in the bivariable analysis were fitted in multivariable analysis. AOR with 95% CI and P-value<0.05 were used during multivariable analysis to identify the factors associated with the utilization of modern in reproductive. RESULT: In this study the overall prevalence of modern contraceptive utilization was 58.5%. Age (AOR = 0.406,95%,Cl: (0.000,0.398)), Educational status (AOR = 0.901,95% Cl (0.340,4.107)), Feeling of husband towards Modern contraceptive (AOR = 0.186, 95% CI (0.056,0.617) had protective effect of utilization of modern contraceptive. But Number of children 1-3 and 4-5 wanted(AOR = 10.802,95%(4.027,28.975)), AOR = 2.624,95% CI (1.437,4.791), was a risk for utilization of modern contraceptive. CONCLUSION AND RECOMMENDATION: The prevalence of Modern contraceptive utilization was still to be low (far below the national target). Therefore, providing educational opportunities, creating awareness about contraception and effective counseling would increase modern contraceptive methods utilization.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/psicologia , Serviços de Planejamento Familiar/organização & administração , Cônjuges/psicologia , Adolescente , Adulto , Anticoncepção/instrumentação , Anticoncepção/métodos , Anticoncepção/estatística & dados numéricos , Anticoncepcionais , Dispositivos Anticoncepcionais , Aconselhamento/organização & administração , Estudos Transversais , Escolaridade , Etiópia , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/organização & administração , Cônjuges/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
14.
PLoS One ; 15(3): e0229670, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32134961

RESUMO

The role of fathers in (co-)parenting their children among refugee and disadvantaged families in low and middle-income countries (LMICs) remains poorly understood. This study sought to examine the associations among mothers' perceptions of their husband's involvement (hereafter referred to as paternal involvement), and her perceptions of her own well-being and a number of other variables, as well as observed mother-child interactions in families living in refugee and disadvantaged communities in Beirut, Lebanon. We analyzed baseline data from 104 mother-child dyads (mean age of children = 4.34 years; range = 2.05 to 7.93 years of age) who participated in a randomized controlled trial aimed at evaluating the impact of the Mother-Child Education Program in Beirut. In addition to the mother's perception of paternal involvement and the videotaped mother-child interactions, data were collected concerning the mother's well-being and her level of social support, as well as her level of stress as a parent and the way her children were disciplined in the family. Mother-child pairs were videotaped while completing a puzzle together and dyadic interactions were coded. Path analysis showed that paternal involvement was significantly associated with a higher level of maternal well-being and lower distress levels. In addition, higher levels of maternal distress were associated with higher levels of harsh discipline and parenting stress. Correlation analysis showed that higher perceptions of paternal involvement were associated with more positive affect displayed by the child, more positive regard for the child, and better mother-child synchrony during the dyadic interactions. Limitations include the cross-sectional design and the modest sample size, which hinder causal inferences and generalizability of the findings. These preliminary findings suggest that higher levels of paternal involvement may have an impact on markers of maternal mental health and positive mother-child interactions in families living in disadvantaged communities or humanitarian settings. Paternal involvement should be considered when designing and implementing parenting programs in LMICs.


Assuntos
Pai/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Refugiados/psicologia , Adulto , Criança , Pré-Escolar , Estudos Transversais , Relações Pai-Filho , Feminino , Humanos , Líbano , Masculino , Saúde Mental , Pessoa de Meia-Idade , Poder Familiar/psicologia , Pais/psicologia , Cônjuges/psicologia , Adulto Jovem
15.
BMC Womens Health ; 20(1): 25, 2020 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-32046703

RESUMO

BACKGROUND: Domestic violence (DV) has become a global burden. The high occurrence of intimate partner violence (IPV) across the globe has implications for the socioeconomic wellbeing and health of children and women. METHODS: Data for the study was from the 2014 Ghana Demographic and Health Survey (GDHS). The association between approval of wife-beating and background characteristics of women was examined by the use of a Binary Logistic Regression model. RESULTS: A higher proportion of respondents were from urban areas (53.7 and 52.2% women and men respectively). The ages of women ranged from 15 to 49 (mean = 30, SD = 9.7) whilst the age range of men was 15-59 (mean = 32, SD = 12.5). Twenty-four percent of the men and 23% of the women were within the richest wealth category. The results showed that few women (6.3%) and men (11.8%) had attained higher education. Both women (AOR = 1.3; CI = 1.01-1.24) and men (AOR = 2.2; CI = 1.72-2.76) aged 15-24 had higher odds of approving wife-beating than those aged 35-49 (reference category). Poorest women (AOR = 2.7; CI = 2.14-3.38) and men (AOR = 1.7; CI = 1.11-2.69) alike had higher odds of approving wife-beating, as compared with those in the richest wealth status (reference category). As compared to research participants with higher/tertiary education, both women (AOR = 5.1; CI = 3.52-7.51) and men (AOR = 4.2; CI = 2.37-7.16) without any formal education were found to be at higher odds to approve wife-beating; however, this observation seems to decline as one's educational status advances. CONCLUSION: Age, wealth status, level of education, frequency of listening to radio, frequency of reading newspaper/magazine, frequency of watching television, ethnicity, and religion were found to be significantly associated with Ghanaian men and women's approval of wife-beating. Policies, interventions, and campaigns must target Ghanaians without formal education and young adults on the need to uphold human rights in order to dissuade them from endorsing intimate partner violence. Mass media has also proven to be a protective factor against domestic violence approval and, as such, much progress can be made if utilised by human rights activists, especially through radio, magazine and television broadcasting.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Fatores Socioeconômicos , Cônjuges/estatística & dados numéricos , Adolescente , Adulto , Demografia , Grupos Étnicos/psicologia , Feminino , Gana/epidemiologia , Inquéritos Epidemiológicos , Humanos , Violência por Parceiro Íntimo/psicologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Religião e Psicologia , Cônjuges/psicologia , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-32079358

RESUMO

Spousal separation, lack of companionship, and increased household responsibilities may trigger mental health problems in left-behind female spouses of migrant workers. This study aimed to examine mental ill-health risk in the left-behind female spouses of international migrant workers in Nepal. A cross-sectional survey was carried out in the Nawalparasi district. Study areas were purposively chosen; however, participants were randomly selected. Nepali versions of the 12-item General Health Questionnaire (GHQ), Beck Depression Inventory (BDI), and Connor-Davidson Resilience Scale (CD-RISC) were used. Mental ill-health risk was prevalent in 3.1% of the participants as determined by GHQ. BDI identified mild or moderate depression in 6.5% of the participants with no one having severe depression. In bivariate analysis, a high frequency of communication with the husband was associated with lower mental ill-health risk and depression, as well as increasing resilience. Reduced return intervals of husbands and a high frequency of remittance were also associated with a low GHQ score. In a multiple regression model, adjusting for potential confounding variables, participants who communicated with their husbands at least once a day had a greater mean CD-RISC score (i.e., high resilience against mental ill-health risk) compared to those who did so at least once a week; a mean difference of 3.6 (95% CI 0.4 to 6.9), P = 0.03. To conclude, a low mental ill-health risk was found in the female spouses of migrants.


Assuntos
Depressão/epidemiologia , Saúde Mental , Cônjuges/psicologia , Migrantes , Adulto , Estudos Transversais , Depressão/etiologia , Feminino , Humanos , Relações Interpessoais , Nepal/epidemiologia , Prevalência , Cônjuges/estatística & dados numéricos , Adulto Jovem
18.
J Fam Psychol ; 34(4): 402-413, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32027150

RESUMO

The post-9/11 conflicts have taken a substantial toll on military families. Although positive effects of reintegration-focused programs are well-documented for service members, less is known about military spouses who are parents of young children. This article examines the outcomes of a formal reflective parenting program developed for military families who have very young children, and whether aspects of informal social support moderate spouse outcomes of anxiety, depression, and parenting stress. Data are drawn from a randomized, clinical trial (RCT) of 103 military families with children ages birth to 5 years of age. Structural equation models examined the main effects of the program and the relationship of 3 social support dimensions (perceived support, social connectedness and dyadic satisfaction) to program outcomes of interest. Analyses revealed a statistically significant reduction in anxiety in the treatment group, with a small effect size. No significant program effects emerged on parenting stress or depression. None of the social support dimensions was significantly associated with outcomes of interest. The interaction of dyadic support and treatment showed a significant moderate effect on parenting stress. Spouses with lower baseline satisfaction who were assigned to the treatment condition reported similar levels of parenting stress at baseline and posttest, whereas their counterparts in the waitlist condition reported significantly higher parenting stress at posttest compared with baseline. Findings suggest a targeted approach to preventive intervention for military spouses who are mothers of young children. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Ansiedade/psicologia , Depressão/psicologia , Família Militar/psicologia , Poder Familiar/psicologia , Psicoterapia , Apoio Social , Cônjuges/psicologia , Estresse Psicológico/psicologia , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Avaliação de Resultados em Cuidados de Saúde
19.
Eur J Oncol Nurs ; 45: 101721, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32065935

RESUMO

PURPOSE: Many patients with advanced cancer choose palliative chemotherapy. Considering its purpose of palliation and not treatment, it is important to consider the life of family caregivers. Family caregivers who experience bereavement undergo extreme stress, which is particularly high among patients' spouses. The present study aims to clarify the experiences of the spouses of patients at the hospitals in Japan after the notification of palliative chemotherapy discontinuation until bereavement. METHOD: We interviewed the spouses of 13 patients who received palliative chemotherapy using a semistructured interview guide. Each spouse was interviewed twice. The interviews were transcribed verbatim, and key concepts were identified using a grounded theory analytic approach. RESULTS: After the hospital's recommendation for palliative chemotherapy discontinuation, the spouses had "bewilderment over having to discontinue palliative chemotherapy" and experienced "difficulty in facing bereavement." The spouses having "difficulty to give up hope for the patient's survival," felt "bafflement over caregiving at the terminal stage," which would be their responsibility in the future. Further, they had "hesitation in being honest to the patient" and were engaged in "knowing how to live with the patient until bereavement." CONCLUSION: Nurses need to encourage the patients and spouses to honestly express how they feel from the early stages of palliative chemotherapy. Furthermore, nurses should help spouses with how they face bereavement. This result may help prevent anticipatory grief, which may lead to excessive stress and emotional distress on the family caregivers.


Assuntos
Luto , Cuidadores/psicologia , Pesar , Neoplasias/tratamento farmacológico , Cuidados Paliativos/psicologia , Cônjuges/psicologia , Suspensão de Tratamento , Idoso , Idoso de 80 Anos ou mais , Feminino , Teoria Fundamentada , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
20.
Clin Interv Aging ; 15: 61-74, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32021134

RESUMO

Purpose: The present study investigates behavioral conformity regarding physical activity (PA) and sedentary behavior (SB) in older couples where one partner suffers from osteoarthritis (OA). Hereby the question is addressed whether and to what extent the typical physical limitations of OA patients have negative effects on their partners. Patients and Methods: The habitual PA and SB of end-stage osteoarthritis patients (n = 32, 52-81 years | n = 14 gonarthrosis, n = 18 coxarthrosis), their spouses (n = 32, 50-83 years) and control couples (n = 26 subjects, 52-78 years) were assessed by accelerometry. Besides individual results of accelerometry hourly couple-specific performance ratios were calculated for four parameters of PA (number of steps, vector magnitude (VM), metabolic rate (MET), and total time in moderate-to-vigorous PA (MVPA)) and two parameters of SB (number of sedentary bouts and total time of sedentary bouts per hour). Analyses of covariance were used to explore differences in hourly couple-specific performance ratios between couples affected by osteoarthritis and control couples. Results: Significant differences in PA were observed between the three groups, whereby the patients showed the lowest PA and the subjects of the control group the highest PA. In contrast to this, SB did not differ between the three groups. The hourly analyses of couple-specific performance ratios revealed significant differences between the target couples (patients and spouses) and the control couples for all parameters of PA. Thereby, the deviance in PA between the patients and their spouses was always smaller than in control couples and also decreased with age. The investigation of SB, on the other hand, revealed larger deviations between the patients and their spouses as compared to control couples and no changes with age. Conclusion: This study confirmed the known negative impact of osteoarthritis on the PA and SB of elderly patients. More important, however, was the finding that the patients' spouses adapt to this poor health behavior and show reduced PA as well. Consequentially, spouses of OA patients should be considered as a risk group for inactivity-related diseases in old age. This should be considered in interventions that aim to use the individual support of spouses to increase the PA of OA patients.


Assuntos
Atividades Cotidianas/psicologia , Exercício Físico/psicologia , Comportamentos Relacionados com a Saúde/fisiologia , Relações Interpessoais , Osteoartrite , Comportamento Sedentário , Acelerometria/métodos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/diagnóstico , Osteoartrite/psicologia , Fatores de Risco , Cônjuges/psicologia
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