title: Emotional well-being in spouses of patients with advanced heart failure.
abstract: BACKGROUND
  The physical demands and psychological stressors of caregiving negatively impact the emotional well-being of spouses in many chronically ill populations such as patients with Alzheimer's disease and end-stage renal failure. Heart failure (HF) is a chronic illness with a poor prognosis that is increasing in prevalence and incidence, yet little is know about its effect on the family, particularly the spouse.
  
  
  OBJECTIVE
  We conducted this study to describe the emotional well-being of spouses of patients with HF, to identify factors associated with spouses' decreased emotional well-being, and to compare emotional well-being between spouses with higher and lower levels of perceived control. We proposed a model that included age, sex, employment status, perceived control, and caregiver burden to explain the emotional well-being of spouses.
  
  
  METHODS
  Data were collected from 69 spouses of patients with advanced HF (mean age 54 years and predominantly female) using 2 subscales of the SF-36, control attitudes scale-family version and caregiver appraisal tool. Descriptive statistics, Pearson correlations, and stepwise multiple regression were used to analyze data.
  
  
  RESULTS
  The model explained 40% of the variance in the emotional well-being of spouses (P = 0.001). Perceived control (P = 0.001) and age (P = 0.046) were associated with emotional well-being. In spouses with higher levels of control, emotional well-being was significantly higher than in spouses with lower levels of control (P = 0.003). Older spouses had higher levels of emotional well-being compared with younger spouses (P = 0.01).
  
  
  CONCLUSIONS
  Health care professionals must assess the level of control perceived by spouses of patients with advanced HF and provide information and counseling directed toward increasing their sense of control. Younger spouses are particularly at risk for decreased emotional well-being and may require special intervention.
authors.affiliation: School of Nursing, University of California, San Francisco School of Nursing N319C, 2 Kirkham St., Box 0604, San Francisco, CA 94143-0604 USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dracup
authors.forename: Lorraine S
authors.initials: LS
authors.lastname: Evangelista
authors.forename: Lynn
authors.initials: L
authors.lastname: Doering
authors.forename: Dorothy
authors.initials: D
authors.lastname: Tullman
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Michele
authors.initials: M
authors.lastname: Hamilton
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D004644:Emotions; D005192:Family Health; D005260:Female; D006333:Heart Failure / Q000523:psychology / Q000628:therapy; D006801:Humans; D007389:Internal-External Control; D007398:Interpersonal Relations; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D018454:Spouses / Q000523:psychology*