Patients' Self Regulation Competence (SRC) subscales are also related to relatives' ‘loneliness’. The strongest relation is found for patients' ‘Motivation Control’. Relatives who feel lonely tend to have spouses who lack ‘Motivation Control’ (r = -.26^**), and ‘Conflict Avoidance’ (r = -.19^*). That is to say, avoiding conflicts, and difficulties in motivating oneself in patients is linked to rather lonely relatives.

Relatives' feeling lonely are related to patients' who feel sad (r = .21^*), less self-efficacious (r = -.22^*), and lonely, too (r = .25^**).

Relatives' optimism is strongly related to patients' optimism (r = .36^**), and it is inversely related to patients' ‘sadness’ (Profile of Mood States (POMS)) (r = -.27^**) and patients' ‘loneliness’ (r = -.21^*). Moreover, there are associations between relatives' optimism, and all Self Regulation Competence (SRC) subscales, the only exception being ‘Readiness to Feel Resigned’ again, ranging from r = .23^* to r = .31^**. Also patients' social support and self-efficacy is positively related to relatives' optimism (r = .21^* and r = .32^**, respectively).

Optimistic relatives have spouses who are optimistic, too, who feel neither sad, nor lonely, and who feel a great competence in self regulation. These patients also feel more supported, and more self-efficacious.

Relatives high on social support go together with patients who feel well-supported, too, who feel self-efficacious (both r = .27^**), and who tend to be optimistic (r = .30^**). These patients feel neither sad, nor lonely (both r = -.26^**), and they are in control of their motivation (r = .26^**).

Relatives' high self-efficacy is related to high patients' self-efficacy (r = .34^**), and inversely related to patients' ‘sadness’ (r = .-28^**).

Again, all patients' Self Regulation Competence (SRC) subscales, with the only exception of ‘Readiness to Feel Resigned’, are positively related to relatives' self-efficacy, with an average r = .30^**.

As it is to be seen from the correlation pattern, relatives who experience high self-efficacy also have self-efficacious, and cheerful spouses. In addition, these patients show the tendency of being rather stable in their decisions, a good control of their motivation, and they do not show avoidance of conflicts.

The following results pertain to associations between relatives' Profile of Mood States (POMS) subscales and patients' variables.

A noteworthy result is the negative association among patients' perceived social support and the three relatives' Profile of Mood States (POMS) subscales ‘fatigue’, ‘displeasure’, and ‘sadness’ (r = -.25^**, r = -.28^**, and r = -.20^*, respectively). Thus, patients who feel poorly supported tend to have tired, sad, and discontent relatives.

Relatives' ‘vigour’ and their ‘decisiveness’ correspond moderately to patients' self-efficacy (r = .27^** and r = .26^**). Moreover, they correspond to patients' ‘vigour’, ‘decisiveness’, and inversely to patients' ‘sadness’ (to relatives' ‘vigour’: r = .39^**, r = .30^**, and r = -.22^*, respectively; to relatives' ‘decisiveness’: r = .27^**, r = .25^**, and r = -.31^**, respectively). In addition, relatives' ‘decisiveness’ is related to patients' ‘displeasure’ with r = -.24^*.

That means, relatives who are vigorous, and decisive are related to patients that are self-efficacious. These relatives are also related to patients who themselves are vigorous, decisive, and cheerful. Decisive relatives also have rather content spouses.

Patients' optimism is associated with four out of five relatives' Profile of Mood States (POMS) subscales. It is negatively related to relatives' ‘displeasure’, and ‘sadness’ (r = -.22^* and r = -.28^**), and positively related to relatives' ‘vigour’, and ‘decisiveness’ (r = .22^* and r = .23^*). It can be stated that optimistic patients tend to have vigorous, and decisive spouses, who are neither discontent, nor sad.

Relatives' ‘fatigue’ is only associated with patients' ‘displeasure’, and ‘sadness’ (both r = .22^*), but astonishingly unrelated to the other Profile of Mood States (POMS) subscales. Nor is it related to patients' optimism. Relatives suffering from fatigue are related to patients that feel discontent, and sad. But that does not seem to deprive those patients much of their optimism, their vigour, or their decisiveness.

Discontent relatives match with discontent, and sad patients (r = .29^** and r = .23^*, respectively).

Patients' ‘loneliness’ is significantly related to relatives' ‘displeasure, and their ‘decisiveness’ (r = .21^* and r = -.25^**). Patients who feel lonely have more discontent, and indecisive partners.

The following results refer to the associations between the relatives' Profile of Mood States (POMS) subscales, and patients' Self Regulation Competence (SRC) subscales.

The sum score of patients' Self Regulation Competence (SRC) subscales is related to all relatives' Self Regulation Competence (SRC) subscales (r = 24^*, r = .20^*, and r = .21^*, respectively), again, ‘Readiness to Feel Resigned’ being the exception.

Patients' ‘Motivation Control’ is strongly related to all five relatives' Profile of Mood States (POMS) subscales. That is to find patients highly in control of their motivation being related to relatives, who are vigorous, and decisive, and who are neither sad, nor discontent, nor tired.

The only association between patients' ‘Readiness to Feel Resigned’ and any of the relatives' variables is the correlation with relatives' ‘displeasure’ (r = -.22^*). Patients who give up easily tend to have discontent spouses.

‘Indecisiveness’ in patients is associated with relatives' Profile of Mood States (POMS) subscales ‘displeasure’, and ‘decisiveness’ (r = -.22^* and r = .25^**). Patients who feel secure in their decisions are associated with decisive spouses who are little discontent.

Before turning to the last topic of this chapter, the associations between relatives' variables, and patients coping scales, it is worth to mention that the single item relatives' Profile of Mood States (POMS) subscale ‘decisiveness’ in most of the cases is yielding higher correlations than the subscales ‘vigour’ from which it is stemming.

None of the patients' coping strategies is correlated to relatives' anger.

Relatives' Self Regulation Competence (SRC) subscales are interestingly only related to patients' ‘Seeking Support in Religion’, showing one significant correlation of r = -.26^** to relatives' ‘Conflict Avoidance’. Patients seeking help in religion tend to have spouses that avoid conflicts.

Relatives' traits are all found to be strongly related to patients' ‘Rumination’. Patients with a tendency for rumination are associated with relatives who feel rather lonely (r = .20^*), who are neither optimistic (r = -.35^**), nor self-efficacious (r = -.26^**), nor do they feel well-supported (r = -.19^*). In addition, relatives' optimism, and their self-efficacy are negatively correlated to patients’ ‘Seeking Information and Exchange of Experience’ (r = -.30^** and r = -.20^*). Patients who look for information in trying to cope with stressful events tend to have less optimistic, and less self-efficacious spouses.

To summarize the finding concerning relatives' traits it can be stated that patients who tend to be withdrawn in their coping efforts have spouses who do not feel close to the patient. Patients who use a more active way of coping by looking for information are counterintuitively also associated with relatives who do not feel optimistic, self-efficacious.

These rather counterintuitive results might be interpreted in a way that patients who are actively, and rather indepentendly trying to cope with their illness might make spouses feel rather insecure, less much in contact (see also correlations with relatives’ loneliness, and perceived support), and less responsible, and/or in control (see correlations with relatives’ Self Regulation Competence (SRC) subscales).

Relatives' Physical Symptoms are again unrelated to patients' coping strategies.

As far as relatives' Profile of Mood States (POMS) is concerned, again a tendency for ‘Rumination’ in patients is found to be correlated to three of the Profile of Mood States (POMS) subscales, namely ‘displeasure’ (r = .22^*), ‘vigour’ (r = -.20^*), and ‘decisiveness’ (r = -.23^*). Also patients' ‘Seeking Information and Exchange of Experience’ shows an association with relatives' ’displeasure’ (r = .18^*). Moreover, patients high on ‘Seeking Social Integration’ are associated with relatives' ‘vigour’ (r = .32^**), and relatives' ‘decisiveness’ (r = .26^**).

That is to say, relatives who are vigorous, and decisive have partners who actively try to look for social integration, and who inversely do not have a tendency for rumination. In addition, discontent relatives are associated with patients who show a tendency for rumination. They are also associated with those patients who try to look for information.

It appears to be rather counterintuitive that ‘Rumination’ and ‘Seeking Information and Exchange of Experience’ show the same prevailing pattern of correlations, since these two scales seem to represent rather contradictory positions.

Of the whole sample of N = 381 the information if patients live alone or with a partner was assessed of n = 345 subjects. Within this subsample, n = 294 patients stated to be living with a partner, n = 51 stated to be living alone.

For these two groups a lot of highly significant mean differences were found for patients’ major variables at point in time 1. All results are shown in Table 3.3.1.

The most striking finding is the highly significant mean difference for patients’ perceived social support. Their support is able to explain 22% of the differences between the two groups.

A consistent finding is the difference for patients’ loneliness which still can make up for 9% of the variance. Both variables are referring to a feeling of being well integrated, so they should both be related to patients who have partners to live with. But this finding also emphasizes the importance of the perception of social support in relationships. Moreover, this result contributes to the justification of treating social support in detail later on (see Chapter 3.9), since this paper is mainly concerned to investigate the influence of a relationship with a loved person on recovery and readjustment.

The remaining six significant mean differences for patients’ variables do not explain as much variance as the first two, presumably because these variables assess rather illness specific measures. Physical Symptoms, e.g., is a measure which scores are mainly related to symptoms due to the heart disease patients are suffering from. The influence of a relationship with a partner on this variable should therefore not be too strong.

Table 3.3.1: Comparison between Patients living alone, and Patients living with a Partner

The same can be said about the remaining five patients’ measures: Profile of Mood States (POMS) ‘sadness’, the Self Regulation Competence (SRC) sumscore, as well as the subscales ‘Readiness to Feel Resigned’, and ‘Motivation Control’, and about the Trier Coping with Illness subscale ‘Search of Support in Religion’. All yield significant mean differences but the amount of explained variance is only ranging from 1% to 2%.

Thus, it can be concluded that there is a strong influence of living alone or living with a partner. If patients do not live alone they feel less sad, they search less support in religion, they do not give up easily, and can motivate themselves well, and they even suffer from less physical symptoms. And most of all they feel well-supported, and less lonely.

3.4 Differences between Patients and Relatives in Statistical Interactions
between Gender and Group Membership (Patient vs. Relative)

 

 

 

 

 

 

 

 

To be able to identify differences between male or female patients, and male or female relatives, a new variable was created, called ‘group’. It has two values, one for being a patient, one for being a relative. Next, a multivariate analysis of variance was computed, comparing a set of major patient variables by group, and by gender.

The MANOVA yielded significant interactions between the factor ‘group’ and ‘sex’ on eight of the major variables.

 

 

 

 

 

First, a similar pattern is found for the four variables ‘self-efficacy’, ‘social support’, ‘Goal-directed SRC’, and ‘Motivation Control’. On all of these variables, male patients score higher than male relatives (see Figures 3.4.1 to 3.4.4). That is to say, they receive significantly more social support, feel more self-efficacious, and report a higher level of motivational control, as well as a higher level of ‘Goal-directed SRC’. Since the opposite pattern arises for female subjects, the same can be stated about female relatives, who also scores higher on all these variables than female patients.

 

 

 

 

 

 

  A very similar pattern appears for the subscale ‘Readiness to Feel Resigned’ (see Figure 3.4.5), although not as clearly. Male and female relatives do not differ very much. Only female patients give up more easily than male patients.

Just the opposite pattern arises for ‘anger’, and for ‘loneliness’, as should be expected (Figures 3.4.6 and 3.4.7). Male patients report a smaller degree of anger, as well as a smaller degree of loneliness. The same is true for female relatives, also being less lonely, and less angry than female patients.

 

 

 

 

 

 

 

This is also true for one of the Profile of Mood States (POMS) subscales, namely ‘fatigue’, where especially female subjects differ (Figure 3.4.8). Female patients report high degrees of fatigue, and female relatives are much lower, whereas male patients, and male relatives are almost on the same level (M = 13.70 and 13.65, respectively).

In sum, there is a prevailing pattern of results across these eight variables with male patients having more favourable characteristics than female patients, and male relatives having less favourable characteristics than their female counterparts.

 

 

 

 

© by Gerdamarie Schmitz