Chronically disabling health impairments affect an increasing number of people worldwide. In close relationships, disability is an interpersonal experience. Psychological distress is thus common in ...patients as well as their spouses. Dyadic coping can alleviate stress and promote adjustment in couples who face disabling health impairments. Much research has focused on dyadic coping with cancer. However, other health problems such as physical and sensory impairments are also common and may strongly impact couple relationships. In order to promote couples' optimal adjustment to impaired health, the identification of disability-related relationship challenges is required. Furthermore, ways in which dyadic coping with these challenges may benefit couples could inform researchers and practitioners how to support couples in coping with health impairments. Accordingly, the aims of this study were to systematically review dyadic challenges and dyadic coping when one partner has a chronically disabling physical or sensory impairment. Out of 873 articles identified through database searches, 36 studies met inclusion criteria. The disability-related dyadic challenges identified in the review were changed roles and responsibilities within the couple, altered communication, compromised sexual intimacy, and reduced social participation. These challenges were reported to burden both partners and the couple relationship. Dyadic adjustment benefitted from a we-perspective, i.e., when couples viewed the disability as a shared challenge and engaged in conjoint dyadic coping. The results suggest that patient/care recipient and partner/caregiver roles should be de-emphasized and that disability should be recognized as an interpersonal experience.
In couples dealing with health problems, we-disease appraisals can influence dyadic coping strategies to alleviate distress. This study describes the development and validation of a self-report scale ...to assess we-disease appraisals of health problems. The newly developed We-Disease Questionnaire (WDQ) was administered in three samples: parents of children with type 1 diabetes (
= 240) or cancer (
= 125) and individuals with visual impairment and their partners (
= 216). Reliability was measured by coefficient omega. To assess construct validity, correlations with other measures of individual and dyadic adjustment were examined. Descriptive statistics across all samples were compared. A 4-item version of the WDQ demonstrated good reliability and validity and showed meaningful associations with established scales. We-disease appraisals were highest among parents of children with cancer and lowest among couples with visual impairment. The WDQ is a reliable and valid measure that can be used across different health problems.
It is well known that although relationship external stressors can harm couples, dyadic coping behavior can buffer the negative effects of stress. Thus far, however, less is known about how vocally ...encoded stress (i.e.,
f
0
) might affect the stress-coping process in couples during an interaction. Therefore, the goal of the current study was to compare two different stress hypotheses (i.e., paraverbal communication stress hypothesis and emotional resonance hypothesis). We observed 187 mixed-gender couples (
N
= 374 participants) interacting naturally after an experimental stress induction (Trier Social Stress Test), for which couples were randomly allocated into three groups (women stressed, men stressed, and both stressed). Results of a multi-group actor-partner interdependence mediation model (APIMeM) show that either the paraverbal communication stress hypothesis or the emotional resonance hypothesis could be confirmed, depending on whether the man, the woman, or both partners were stressed.
Objectives
The aim of the study was to examine baseline neurocognitive impairment (NCI) prevalence and factors associated with NCI among patients enrolled in the Neurocognitive Assessment in the ...Metabolic and Aging Cohort (NAMACO) study.
Methods
The NAMACO study is an ongoing, prospective, longitudinal, multicentre and multilingual (German, French and Italian) study within the Swiss HIV Cohort Study. Between 1 May 2013 and 30 November 2016, 981 patients ≥ 45 years old were enrolled in the study. All underwent standardized neuropsychological (NP) assessment by neuropsychologists. NCI was diagnosed using Frascati criteria and classified as HIV‐associated or as related to other factors. Dichotomized analysis (NCI versus no NCI) and continuous analyses (based on NP test z‐score means) were performed.
Results
Most patients (942; 96.2%) had viral loads < 50 HIV‐1 RNA copies/mL. NCI was identified in 390 patients (39.8%): 263 patients (26.8%) had HIV‐associated NCI 249 patients (25.4%) had asymptomatic neurocognitive impairment (ANI) and 127 patients (13%) had NCI attributable to other factors, mainly psychiatric disorders. There was good correlation between dichotomized and continuous analyses, with NCI associated with older age, non‐Caucasian ethnicity, shorter duration of education, unemployment and longer antiretroviral therapy duration.
Conclusions
In this large sample of aging people living with HIV with well‐controlled infection in Switzerland, baseline HIV‐associated NCI prevalence, as diagnosed after formal NP assessment, was 26.8%, with most cases being ANI. The NAMACO study data will enable longitudinal analyses within this population to examine factors affecting NCI development and course.
Hazardous alcohol consumption and HIV infection increase the risk of neurocognitive impairment (NCI). We examined the association between alcohol consumption and specific neurocognitive domain ...function in people with HIV (PWH) taking modern antiretroviral therapy.
The Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study is a prospective, longitudinal, multicentre and multilingual (French, German and Italian) study of patients aged ≥45 years old enrolled in the Swiss HIV Cohort Study (SHCS). Baseline data from 981 study participants were examined. Five neurocognitive domains were evaluated: motor skills, speed of information processing, attention/working memory, executive function and verbal episodic memory. NCI was examined as binary (presence/absence) and continuous (mean z-score) outcomes against Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) scores using logistic and linear regression models, respectively.
Most participants (96.2%) had undetectable viral loads and 64% were aged >50 years old. Hazardous alcohol consumption was observed in 49.4% of participants and binge drinking in 4.2%. While alcohol consumption frequency and quantity were not associated with NCI, the practice of binge drinking was significantly associated with impaired motor skills and overall neurocognitive function in both binary (odds ratio, OR ≥2.0, P <0.05) and continuous (mean z-score difference -0.2 to -0.4, P ≤0.01) outcomes. A significant U-shaped distribution of AUDIT-C score was also observed for motor skills and overall neurocognitive function.
In this cohort of PWH with well-controlled HIV infection, NCI was associated with the practice of binge drinking rather than alcohol consumption frequency or quantity. Longitudinal analysis of alcohol consumption and NCI in this population is currently underway.
Transcatheter (or percutaneous) renal denervation is a novel technique developed for the treatment of resistant hypertension. So far, only one randomised controlled trial has been published, which ...has shown a reduction of office blood pressure. The Swiss Society of Hypertension, the Swiss Society of Cardiology, The Swiss Society of Angiology and the Swiss Society of Interventional Radiology decided to establish recommendations to practicing physicians and specialists for good clinical practice. The eligibility of patients for transcatheter renal denervation needs (1.) confirmation of truly resistant hypertension, (2.) exclusion of secondary forms of hypertension, (3.) a multidisciplinary decision confirming the eligibility, (4.) facilities that guarantee procedural safety and (5.) a long-term follow-up of the patients, if possible in cooperation with a hypertension specialist. These steps are essential until long-term data on safety and efficacy are available.
Objectives
Diagnosing neurocognitive impairment (NCI) in HIV infection requires time‐consuming neuropsychological assessment. Screening tools are needed to identify when neuropsychological referral ...is indicated. We examined the positive and negative predictive values (PPVs and NPVs, respectively) of the three European AIDS Clinical Society (EACS) screening questions in identifying NCI.
Methods
The Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study recruited patients aged ≥45 years enrolled in the Swiss HIV Cohort Study between 1 May 2013 and 30 November 2016. NAMACO participants (1) answered EACS screening questions, (2) underwent standardized neuropsychological assessment and (3) completed self‐report forms Center for Epidemiologic Studies Depression Scale (CES‐D) rating mood. NCI categories were defined using Frascati criteria. PPVs and NPVs of the EACS screening questions in identifying NCI categories were calculated.
Results
Of 974 NAMACO participants with complete EACS screening question data, 244 (25.1%) expressed cognitive complaints in answer to at least one EACS screening question, of whom 51.3% had NCI (26.1% HIV‐associated and 25.2% related to confounding factors). The PPV and NPV of the EACS screening questions in identifying HIV‐associated NCI were 0.35 and 0.7, respectively. Restricting analysis to NCI with functional impairment or related to confounding factors, notably depression, the NPV was 0.90. Expressing cognitive complaints for all three EACS screening questions was significantly associated with depression (P < 0.001).
Conclusions
The EACS screening questions had an NPV of 0.7 for excluding patients with HIV‐associated NCI as defined by Frascati criteria. The PPV and NPV may improve if NCI diagnoses are based on new criteria.
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