Atkins Louise, Brown Richard G, Leigh P Nigel, Goldstein Laura H
Cancer Research UK Promoting Early Presentation Group, Institute of Psychiatry, King's College London, St. Thomas' Hospital, London, UK.
Amyotroph Lateral Scler. 2010 Aug;11(4):344-50. doi: 10.3109/17482960903307797.
Our objective was to determine change over time in quality of marital relationships of people with ALS (pwALS). Fifty pwALS and their spouse carers completed measures of marital intimacy, pwALS's functional status, their own psychological status, and beliefs about the pwALS's illness. Twenty-seven dyads completed two further assessments, at six-monthly intervals. Post-ALS diagnosis ratings of current marital relationship did not change over time for pwALS or their spouses. However, spouse carers' ratings of their current marital relationship were lower than their ratings prior to illness onset. After adjusting for the pre-illness marital relationship, pwALSs' current ratings of their marital relationship were initially predicted by their self-rated psychosocial functional impairment and satisfaction with their personal relationships, and subsequently by levels of self-esteem. After adjusting for ratings of the pre-illness marital relationship, carers' current marital intimacy scores at first and second interview were predicted by ratings of the patients' psychosocial functional impairment and by feelings of burden at the third interview. In conclusion, quality of the pre-illness marital relationship is a significant predictor of ongoing marital relationship in both pwALS and their spouse carers. Additionally, social and psychological rather than disease symptoms are important predictors of marital relationship quality after ALS diagnosis.
我们的目标是确定肌萎缩侧索硬化症患者（pwALS）婚姻关系质量随时间的变化情况。50名pwALS患者及其配偶护理者完成了婚姻亲密度、pwALS的功能状态、他们自身的心理状态以及对pwALS疾病看法的测量。27对夫妻每隔六个月进行了另外两次评估。pwALS患者及其配偶对当前婚姻关系的ALS诊断后评分并未随时间变化。然而，配偶护理者对当前婚姻关系的评分低于疾病发作前的评分。在对病前婚姻关系进行调整后，pwALS患者对其婚姻关系的当前评分最初由他们自我评定的心理社会功能损害和对个人关系的满意度预测，随后由自尊水平预测。在对病前婚姻关系评分进行调整后，护理者在第一次和第二次访谈时的当前婚姻亲密度得分由患者心理社会功能损害评分以及第三次访谈时的负担感预测。总之，病前婚姻关系质量是pwALS患者及其配偶护理者当前婚姻关系的重要预测指标。此外，社会和心理因素而非疾病症状是ALS诊断后婚姻关系质量的重要预测指标。
