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Spousal Interactions in Alzheimer's Disease and Stroke Caregiving: Relationship to Care Recipients' Functional Abilities and Physical and Emotional Health

School of Nursing, Medical College of Georgia, Augusta

Joanne V. Hickey

School of Nursing, University of Texas-Houston

Kathleen C. Buckwalter

College of Nursing, University of Iowa, Iowa City

Teresa Kelechi

Center for the Study of Aging, Medical University of South Carolina, Charleston

Shirley A. Hendrix

College of Nursing, Medical University of South Carolina, Charleston

BACKGROUND: Previous research suggests that the quantity and quality of interactions between caregivers and care recipients have an impact on health outcomes of ill per sons. Building on the work of Bowlby (1988) and Wright, Hickey, Buckwalter, and Clipp (1995), spousal interactions are conceptualized as adult attachment; it is argued that this attachment provides protective functions for ill spouses.

OBJECTIVES: Our objectives in this study were to examine spousal interactions along two diver gent illness trajectories, Alzheimer's disease (AD) and stroke, and to relate time 1 spousal interactions to care recipients' time 2 functional abilities and physical and emotional health. STUDY DESIGN: This longitudinal pilot study compared 42 couples (84 spouses) equally divided between early phase AD, 12 weeks after stroke, and healthy controls. Baseline (time 1) data and 6-month follow-up data (time 2) were collected in home interviews. Measures included spousal interactions and illness characteristics of persons with AD and recipients of care after a stroke.

RESULTS: AD couples reported lower quantity and quality of interactions compared with stroke couples. Spousal interactions were positively correlated to physical and emo tional health in AD care recipients and to functional abilities in stroke care recipients. Only AD care recipients' interactions were related to depression.

CONCLUSIONS: Spousal interactions along the AD trajectory represented the protective function of attachment; along the stroke trajectory, reciprocal adult exchanges contin ued. (J Am Psychiatr Nurses Assoc [1998]. 4, 169-181)

Journal of the American Psychiatric Nurses Association, Vol. 4, No. 6, 169-181 (1998)
DOI: 10.1177/107839039800400601


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