Search Results (55)

Background: Spousal caregivers and adult-child caregivers are the main sources of informal care of patients with dementia. They are primarily responsible for providing daily assistance, emotional support, and long-term care within the family. Methods: A cross-sectional survey was conducted in June 2024 in Nanjing, Jiangsu Province, China. A total of 410 family caregivers (154 spousal and 256 adult-child caregivers) participated. Perceived family cohesion was measured using the Family Adaptability Cohesion Scale, Second Edition, Chinese version (FACES II-CV). Caregiver-related characteristics included the following: caregivers’ self-reported physical health, social support, self-efficacy, and the number of family members assisting in caregiving. Results: (1) adult-child caregivers reported significantly higher perceived family cohesion than spousal caregivers (p < 0.001); (2) regression analyses revealed that caregiver role and caregiver-related characteristics were positively associated with perceived family cohesion (all p < 0.05); and (3) mediation analyses revealed that caregiver-related characteristics mediate the relationship between caregiver role and perceived family cohesion, with mediating effects of 0.109, 0.293, 0.087 and 0.174, respectively. Conclusions: Given that caregiver-related characteristics act as mediators of family cohesion, interventions should focus on strengthening caregivers’ physical health, social support, self-efficacy, and family involvement in caregiving to equalize the perception of family cohesion between spousal caregivers and adult-child caregivers. Full article

The choice to age in a familiar home environment within the community without relying on residential services can prolong independence, provided care services are customised to the specific needs of the household. However, this model of care provision frequently conceals the hidden costs for women who are often the spousal carer. The navigation of care needs of a spouse when aged 65 and above often contains challenges linked to accessing quality community care and respite. These challenges are further compounded by the impact of personal health realities that come with ageing. To explore the support needs of older adults choosing to remain in their own homes, qualitative semi-structured interviews took place with 26 individuals aged 65 plus. This article concentrates on a specific subset of research using constructivist grounded theory to examine the caregiving realities of six women and one man. A significant finding was that these predominantly female carers often felt unsupported, fatigued, and time-poor, largely attributable to the scale of care needed. Formal care support was particularly valued when it prioritised relationships over task-oriented care. A key recommendation to enable couples to remain living at home and avoid residential care is that more support for spousal (informal) carers is required. Full article

Background: Psychosocial support that enhances caregivers’ clinical communication skills can alleviate distress while enhancing their ability to communicate with nurses and clinical teams to achieve care goals. We sought to adapt a cancer caregiver clinical communication model (C³PM-Cancer) for dementia spousal caregivers that identifies key communication strategies they can enact before, during, after, and between appointments to promote better care. Methods: Interviews were conducted with caregivers of spouses diagnosed with dementia within the last 10 years. Data were thematically analyzed to confirm and extend the communication strategies and care goals in C³PM-Cancer to develop C³PM-Dementia. Results: Caregivers for spouses with dementia in our sample reported the same strategies and goals in each communication phase of C³PM-Cancer, which provides support for the utility of these caregiving communication skills across these two disease contexts. They described the importance of new communication strategies, which informed an emotionally focused communication approach used to protect their spouse’s personhood and dignity. The findings inform the adapted C³PM-Dementia. Conclusions: C³PM-Dementia can be an educational tool offered by clinicians to caregivers to provide guidance on key communication strategies to enact before, during, after, and between appointments to achieve critical care goals. The model can enhance communication between caregivers and clinicians, which can promote better outcomes in both cancer and dementia care. Full article

This study investigates the configurational pathways enabling women in Oman to translate entrepreneurial intentions into technology venture creation. By integrating institutional theory and resource-based view, we develop a novel framework examining how formal institutional support (FIS), informal institutional support (IIS), and digital self-efficacy (DSE) interact in Oman’s conservative context. We emphasize the significant enabling role of work–life balance resources (WLBR) and the cultural legitimacy of spousal endorsement. Our mixed-methods design utilizes survey data from 418 female IT graduates and 20 semi-structured interviews, analyzed through fuzzy-set Qualitative Comparative Analysis (fsQCA). The findings indicate that FIS predicts entrepreneurial intention (β = 0.34, p < 0.001) but not venture creation (OR = 0.85, p = 0.298), revealing a visibility gap in policy implementation. IIS predicts venture creation (OR = 1.43, p = 0.033), with spousal endorsement acting as a cultural legitimacy signal. DSE alone fails to predict venture creation but is vital when combined with WLBR. FsQCA identifies a sufficient configuration pathway characterized by the combination of spousal endorsement, domestic support, DSE, and WLBR with solution consistency of 0.93 and coverage of 0.78. WLBR is a necessary condition with necessity consistency of 0.96, demonstrating that venture creation is improbable without it. Qualitative evidence shows founders reposition conservative norms as legitimacy signals, while non-founders emphasize funding barriers despite policy awareness. We recommend that policymakers subsidize care infrastructure, leverage women-led community networks for targeted outreach, and formalize state-backed legitimacy programs that reduce kinship dependency while building autonomy-focused alternatives. Full article

This paper presents a thematic literature review of 35 studies to examine key developmental factors influencing expatriate adaptation, including language, identity integration, cultural intelligence, and spousal/family relations, impacting expatriate adaptation and acclimation to the host country. For the purposes of this review, the term “expatriate” refers to individuals who temporarily relocate abroad for education or professional assignments (self-initiated and assigned), often accompanied by spouses or family members. “Adaptation” is defined as the multidimensional process of adjustment to new academic, workplace, and social environments, encompassing both practical adjustment (e.g., communication, work/study tasks) and psychological well-being. This review uses two bibliometric reviews to set the foundation for exploring the impacts of language, identity integration, cultural intelligence, and family, highlighting that interactions with locals foster language development, identity integration, and cultural intelligence, which collectively enhances expatriates’ perceived sense of comfort and belonging. Spousal and family dynamics appear to be particularly influential, with the potential to either support or hinder successful adaptation. Although prior literature often focuses on these factors in isolation, this paper synthesizes them to provide a more holistic understanding of expatriate acclimation. It emphasizes the need for future research to explore the interrelated nature of these variables and their combined impact on expatriate well-being. Full article

This study examines the role of financial literacy as a catalyst for women’s economic empowerment in the MENA region, focusing on its impact on financial performance through the mediating effects of autonomy and family support, as well as the moderating effects of male partners and employment type. Drawing on data from 515 women professionals across five MENA countries, the research employs Partial Least Squares Structural Equation Modeling (PLS-SEM) to examine both direct and indirect relationships among key variables. The findings reveal that financial literacy significantly enhances financial performance, primarily by fostering greater autonomy in financial decision-making. While parental and spousal support also contribute, their mediating effects are comparatively weaker. Moreover, the relationship between financial literacy and autonomy is moderated by employment type and the presence of male partners, with employed women and those in collaborative environments experiencing stronger gains in autonomy. These results underscore the importance of targeted financial education and autonomy-enhancing policies to support women’s economic advancement in culturally complex and economically volatile contexts. The study contributes to the literature on gender and development economics by offering empirical evidence from an under-researched region and provides actionable insights for policymakers, educators, and organizations aiming to promote inclusive economic growth. Full article

Background: In the Republic of Kazakhstan, informal caregivers remain the main source of patient support. Caregivers of individuals with dementia experience an increased caregiver burden and significantly higher levels of stress. We investigated the levels of caregiver burden, depression, anxiety, and stress among informal dementia caregivers and assessed the relationships between these indicators and the caregivers’ socio-demographic characteristics. Methods: With the cooperation of two regional mental health centers and three polyclinics in Kazakhstan, we conducted a cross-sectional study of 174 informal caregivers of dementia patients. The caregiver burden was assessed using the Zarit Burden Interview, and psychological distress was measured with the Depression Anxiety Stress Scale-21. The caregivers’ sociodemographic data were collected and analyzed. The adjusted odds ratios and 95%CIs were calculated using logistic and ordinal regressions. Results: Overall, 75.9% of the caregivers reported experiencing at least a mild burden, and the levels of depression, anxiety, and stress among the caregivers were higher than expected. Spousal caregivers had higher odds of abnormal depression (p = 0.022) and anxiety (p = 0.020); in severity models, spouses more often had a severe burden (p = 0.042) and anxiety (p = 0.006). Conclusions: Caregiver burden and psychological distress are highly prevalent among informal dementia caregivers in Kazakhstan, particularly among spouses. It is especially important to provide support for spouse caregivers. Culturally tailored psychoeducation, support groups, and respite services are urgently needed to mitigate the mental health risks faced by dementia caregivers in Kazakhstan. Full article

Overweight has become a major public health concern in China’s rapidly urbanizing cities. Patterns of environmental exposure differ notably between men and women, both before and after marriage. This study examines how built environment characteristics influence the risk of overweight, with particular attention to nonlinear associations as well as variations by marital status and gender. Drawing on survey data from 2634 Shanghai residents, we applied extreme gradient boosting to model complex environment–health relationships. The results indicate that greenness, park accessibility, population density, and transit conditions are associated with overweight through nonlinear pathways, with threshold and plateau effects suggesting that benefits taper off, or risks escalate, beyond certain levels. These optimal ranges differ across gender–marriage groups: moderate density and green exposure were generally protective, but the effective ranges were narrower for women and unmarried individuals. Married men benefited more consistently, likely supported by healthier routines reinforced through spousal support, whereas married women showed weaker or even adverse effects, potentially due to greater family responsibilities. Overall, the findings reveal that overweight is shaped by socially differentiated nonlinearities in environmental exposures. Urban planning and public health policies should therefore optimize built environment attributes within effective ranges and tailor interventions to diverse demographic groups. Full article

When LGBTQ+ people get married, they enter into a union that promises mutual reliance and caregiving, such as in the event of financial need or health care crisis. This mixed-methods study explores how 484 married LGBTQ+ individuals in the United States (192 cisgender men, 186 cisgender women, 106 trans/nonbinary) (a) negotiate disability (38% of couples) and illness in the context of unpaid and paid labor divisions, (b) provide care for each other, and (c) receive support from family in the face of health or financial needs. Findings revealed diversity in the ways that disability and illness shaped household and paid labor, underscoring how flexibility enabled couples to adapt to changes and highlighting the role of marriage in providing security amidst changes. Logistic regression models examining predictors of family support during health or financial crises revealed that participants in couples in which at least one partner (a) had a disability and/or (b) was a partner’s caregiver had greater odds of reporting receiving help in a health care crisis. Participants who were lower income, younger, and perceived their partners’ families as becoming more accepting after marrying had greater odds of reporting financial help from family. Additionally, disability interacted with gender such that those with a disability in female or trans couples were more likely to report financial help than those without, while the reverse was true for male couples. Participants describe multiple forms of family support, revealing the key role of family support during times of crisis and need. Full article

Background: Fear of childbirth (FOC) or tokophobia has a detrimental impact on women during and after pregnancy. Childbirth fear is multidimensional and may differ across nations and cultures. We aimed to determine the psychosocial determinants of tokophobia among Asians. Methods: We conducted a systematic literature search using the PubMed, Scopus, and Web of Science databases in September 2023. Included were original English-language articles that focused on Asian cohorts. We identified independent variables associated with maternal childbirth fear based on multivariable logistic and linear regression analysis. Results: Twenty-three studies are discussed in this review. We categorized the factors into (1) psychiatry, (2) psychology, (3) perception and experience, (4) relationships and support, (5) spirituality, and (6) COVID-19. The studies involved 10,538 women with overall FOC prevalence ranging between 56.6% to 82.1%. Maternal history of psychiatric disorder, depression, and anxiety were positive predictors of childbirth fear. Childbirth self-efficacy protects Asian mothers against tokophobia. A reduced level of fear was associated with higher maternal psychological and spiritual well-being, as well as stronger maternal resilience. Spousal and social support alongside good family function were shown to exert a protective effect against childbirth fear. Intimate partner abuse was associated with an increased risk of tokophobia in women. Studies during the pandemic indicated that maternal fear, obsession, and anxiety about COVID-19 were positively correlated to fear of childbirth. Conclusions: Childbirth fear among Asian women is greatly influenced by various psycho-social factors. More culturally driven research is needed to help develop relevant interventions that will enhance maternal psychological and spiritual well-being and reduce the fear of childbirth. Full article

Background and Objectives: Pregnant women may experience various difficulties when abnormal conditions are detected in their babies. We examined the relationship between anxiety and depression levels, spousal support, and stress-coping styles in pregnant women diagnosed with fetal anomalies. Materials and Methods: A total of 157 pregnant women, 59 of whom were diagnosed with fetal anomalies and 98 of whom were healthy with no obstetric complications, were included in this study. All participants were administered the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Spousal Support Scale (SSS), and Coping Styles Scale (CSS) questionnaires. The data were compared statistically. Results: The BAI (p < 0.001) and the Submissive Approach (p = 0.004), which is a subdimension of the CSS, were significantly higher in the group of pregnant women diagnosed with fetal anomalies than in the control group. Multivariate logistic regression analysis performed to calculate the risk of fetal anomalies showed that having a high school education or below and living in the city were associated with a higher risk of fetal anomaly than living in the countryside. The cut-off value of 4 for the BAI had a sensitivity of 64.4% and a specificity of 65.3. Additionally, a cut-off value of 6 for the Submissive Approach, a CSS subdimension, had a 66.1% sensitivity and a 57.1% specificity. A significant negative correlation was observed between the Spousal Support Scale, the BDI, and the gravidity in the case group. There was a positive correlation between the BAI and the BDI and a significant negative correlation between the BAI and these CSS subdimensions: Self-Confident Approach, Seeking Social Support, and Optimistic Approach. There was a positive correlation between the BDI and the Helpless Approach subdimension of the CSS and a significant negative correlation between the BDI and the Self-Confident Approach and Optimistic Approach subdimensions, as well as the gestational age at which fetal anomaly was detected. A significant positive correlation was observed between the BDI and the Helpless Approach subdimension of the CSS, while significant negative correlations were observed between the BDI and the Self-Confident Approach and Optimistic Approach subdimensions and the gestational age at which the fetal anomaly was detected. Conclusions: The pregnant women diagnosed with fetal anomalies experienced anxiety, but most tended to use the submissive coping style to deal with stress, and their partners also supported them. Full article

Background/Objectives: The present study aimed to reveal the differences in changes in and risk factors for depressive symptoms between people with and without various psychiatric disorders during the pandemic. Methods: Longitudinal web-based surveys were conducted from 2020 to 2022. The diagnosis of mental disorders was based on self-reports by participants. Depressive symptoms were measured via the Patient Health Questionnaire-9 (PHQ-9), and coping was measured via the Brief Coping Orientation to Problems Experienced Inventory. A linear mixed model of PHQ-9, two-sample t-tests on Brief-COPE, and multiple linear regression for with and without mental disorders were conducted. Results: A total of 1443 participants were analyzed, of whom 9.3% had mental disorders. Depressive symptoms significantly decreased from January 2021 to January 2022, regardless of mental disorder status. Participants with mental disorders used certain coping styles more frequently than those without mental disorders. In a multiple linear regression analysis, no coping strategy was significantly effective for PHQ-9 scores among participants with mental disorders. However, being single was a risk factor, and emotional support use was associated with PHQ-9 scores. Additionally, behavioral disengagement was linked to PHQ-9 scores, regardless of mental disorder status. Conclusions: These results showed depressive symptoms might decrease in the long term regardless of the presence of mental disorders. Although there was no evidence of coping strategies effectively reducing depressive symptoms in people with mental disorders, the presence of a spousal relationship may play an important protective role for people with mental disorders and behavioral guidelines regardless of the presence of mental disorders. Full article

The reintegration of survivors and their children born because of war rapes is a major issue in the eastern Democratic Republic of the Congo. This study analyzed survivors’ posttraumatic stress disorder (PTSD) and the support received from their spouses, both in terms of their own well-being and that of their children. The PTSD form, DAS-16, Marital Support Survey, Sexual Desire Scale, and Connor–Davidson Resilience Scale tests were administered to 28 survivor couples and 32 control couples selected from the Kabamba cluster in Kabare, South Kivu. Over 70% of the respondents had PTSD scores above 34, required clinical assistance, and were not satisfied with their marital relationships. Based on survivors’ perceptions, the balance of marital support and the coherence of couple responses were negative. The survivors typically feel that they provide more support to their husbands than they receive. Unlike husbands, survivors presented low individual sexual desire and high dyadic sexual desire scores, while husbands’ dyadic desire decreased, and they no longer wished to have sexual relations with their partners. Rape survivors derive resilience from prayer and internal self-control, as they live in an environment in which war-related stress causes chronic trauma. Full article

Objective: To investigate primiparous women’s knowledge, attitudes, and practices regarding the physical home food environment (PHFE) and to assess if the first pregnancy provides a teachable opportunity to enhance the PHFE of first-time pregnant couples. Design: Longitudinal in-depth qualitative study involving questionnaires and individual interviews during and after pregnancy. Participants: Fifteen primigravida women. Main outcome measures: Knowledge, attitudes, and behaviors concerning PHFE; lifestyle and dietary habits; and interest in guidance regarding healthy PHFE during the first pregnancy and the transition to motherhood. Analysis: Thematic analysis for qualitative data and descriptive statistics. Results: Key findings include the significance of health, nutrition, and spousal support in the transition to motherhood. The first pregnancy was recognized as a critical period for establishing a healthy PHFE, while noting the physical and emotional challenges involved. A gap was found in guidance regarding PHFE for first-time pregnant women despite their interest in practical advice. Conclusions and Implications: The first pregnancy presents a significant opportunity to improve PHFE. ‘Nestrition’ (nutritional nesting), a new health-promotion strategy, incorporates nutrition education to enhance this process. These data support future research encompassing partners and diverse at-risk populations prior to the development of effective nutrition education for PHFE in the first pregnancy. Full article

(1) Background: Illness perception (IP) is an important psychological construct for couples dealing with cancer, which impacts health outcomes and the psychological adjustment to cancer. More research is needed to explore the traits of IP and the efforts of couples coping with cancer. Thus, this study was designed to explore the coping experiences and features of the IPs of couples dealing with cancer. (2) Methods: A total of 24 patients with colorectal cancer (CRC) and 20 spousal caregivers (SCs) participated in semi-structured interviews. All interviews were recorded digitally, transcribed, and analyzed by using an inductive thematic analysis. (3) Results: Two themes (individualized and predominant IP; IP sharing and restructuring) were developed. A preliminary framework was formulated to illustrate the relations among subthemes and the relations between themes with an adjustment of a positive IP to CRC. In this framework, based on multiple sources and factors, the natural disparities formed the IPs of the partners of couples and determined the incongruence of IPs. The effects of IP incongruence on lives under the disease guided the three directions of coping approaches (i.e., information and available support, appropriate disclosure and reflection, and leaving the CRC diagnosis behind) which were adopted by couples dealing with CRC to share and restructure the IP with their spouses for effective dyadic coping. (4) Conclusions: This study provides insights to healthcare providers into the experiences of couples dealing with CRC and the development of couple-based IP intervention programs: (a) it initially provides adequate factual knowledge for enhancing beliefs in the ability to control illness, (b) encourages illness-centered conversations and disclosure regarding thoughts and emotions for promoting positive congruence of IP between the partners of couples dealing with a hard dilemma, and (c) guides couples to perceive positive changes and explore the illness’s meaning. Understanding each theme of personalized IP and adopting effective IP coping approaches can help guide couples dealing with CRC to efficiently promote constructive IP and better health outcomes. Full article