title: Effects of marital closeness on the transition from caregiving to widowhood.
abstract: OBJECTIVE
  To examine the effects of marital closeness on indicators of well-being (depressive symptoms, grief, and relief) as spouses transition from the role of caregiver to that of widowed person.
  
  
  METHODS
  118 spouses of persons with end stage renal disease were interviewed prior to and after the death of the patient. Spouses reported on marital closeness, multiple indicators of pre-death strain as reflected by subjective health, depressive symptoms, caregiving burden, and caregiving satisfaction, as well as post-loss feelings of grief, depression, and relief.
  
  
  RESULTS
  Hierarchical regressions indicated that post-loss grief was predicted by gender (b = 0.32, p < 0.001), self-reported health (b = -0.28, p < 0.01), marital closeness (0.22, p < 0.05), and pre-loss depressive symptoms (b = 0.19, p < 0.10). Caregiver burden (b = 0.28, p < 0.05) and marital closeness (b = -0.41, p < 0.001) before the death, predicted relief from the caregiver role post-loss. Subjective health (b = -0.21, p < 0.05) and pre-loss depressive symptoms (b = 0.47, p < 0.001) predicted change in depressive symptoms over time.
  
  
  CONCLUSIONS
  These data highlight differences in the experiences of grief, relief, and depressive symptoms and suggest that marital closeness plays a central role. Results are interpreted in terms of theory regarding marital quality. Implications for interventions to improve the lives of caregivers and newly widowed spouses are discussed.
authors.affiliation: School of Osteopathic Medicine, New Jersey Institute for Successful Aging, University of Medicine & Dentistry of New Jersey, Stratford, NJ 08084, USA. pruchnra@umdnj.edu
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Pruchno
authors.forename: Francine P
authors.initials: FP
authors.lastname: Cartwright
authors.forename: Maureen
authors.initials: M
authors.lastname: Wilson-Genderson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D001601:Bereavement; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology; D005260:Female; D006117:Grief; D006304:Health Status; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D008393:Marriage / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D010549:Personal Satisfaction; D011446:Prospective Studies; D017678:Sex Distribution; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology; D017805:Widowhood / Q000523:psychology* / Q000706:statistics & numerical data