Paper
Saturday, July 24, 2004
Patient Caregiver Dyads: Psychosocial Adjustment, Mood, Loneliness, Social Support, Stressors, and Reactions to Caregiving
Nancy Fleming Courts, PhD, RN, NCC, School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA and Jamie R. Kendall, BSN, Medical Floor, NC Memorial Hospital, Chapel Hill, NC, USA.
| Learning Objective #1: Describe psychosocial adjustment congruency of dyads living with multiple sclerosis |
| Learning Objective #2: Implement nursing interventions to support psychosocial adjustment of dyads living with multiple sclerosis
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Objective: The purposes of this research were to investigate: (1) couple congruency in psychosocial adjustment to illness, mood, loneliness, and social support; (2) caregiver response to caregiving; and (3) stressful aspects of having and living with MS. Design: This was a nonexperimental, descriptive, survey design study to explore dyad congruence. Sample: Fourteen dyads randomly selected responded (47%). There were 10 females with MS, 11 white and 3 black; average age of patients was 52 and spouses 60; all had a high school diploma; 4 patients and 5 spouses had a graduate degree. Variables: The variables studied were psychosocial adjustment to illness, perception of social support, loneliness, mood, and stressor identification of having and living with MS. Method: Established instruments and a demographic data collection booklet with space for responses to open-ended questions about stressors and suggestions were mailed with a return envelop to each partner. Findings: Overall scores identified high levels of social support, some feelings of loneliness, and mixed levels of psychosocial adjustment to illness. Spouses reported difficulty dealing with symptoms, especially “invisible” symptoms, expressed feelings of helplessness, identified the number of roles required, and had specific suggestions to help other caregivers. For patients, whom to tell about the diagnosis, job security, feelings of isolation, uncertainity about the future, and the ignorance of other people were challenges described. Conclusions: Instruments are inadequate for dyad assessment since scores indicated high levels of adjustment and qualitative data indicated sources of pain and suffering. Patients and spouses need to be assessed individually and together. Implications: Nursing interventions include: continuous psychosocial assessment of patient and spouse; interventions for expression and validation of feelings; opportunities to ask ongoing questions; continuing information; teaching problem solving and decision-making skills; and counseling.
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Sigma Theta Tau International
July 22-24, 2004