Sensory loss and its consequences for couples' psychosocial and relational wellbeing: an integrative review

From stress communication to depressive symptoms among couples facing vision impairment: The mediating role of dyadic coping

Vision impairment is considered one of the most common disability worldwide, can induce considerable stress for both patients and their spouses and may subsequently affect couples' psychological functioning. This study examined whether dyadic coping (DC) mediated the association between stress communication (SC) and depressive symptoms among couples coping with one partner's vision impairment. A total of 99 Swiss couples completed questionnaires assessing SC, various types of DC, and depressive symptoms. An Actor-Partner Interdependence Mediation Model was performed. Results showed that (1) the more one partner communicated stress, the less the other partner perceived negative DC and, consequently, the less the partner perceiving negative DC reported depressive symptoms; (2) the more partners communicated stress, the more they and their partners engaged in common DC and, consequently, the less the partner engaging in common DC reported depressive symptoms; (3) the more partners communicated stress, the less they and their partners engaged in protective buffering and, consequently, the less the partner engaging in protective buffering reported depressive symptoms. This pattern of associations occurred similarly for patients and their spouses. Our findings underline the interpersonal experience of vision impairment within couples and the importance of fostering explicit SC and common DC in psychosocial rehabilitation interventions directed at couples facing one partner's vision impairment.

What impact does hearing impairment have on cognitive health in older married couples in China?

Hearing impairment is a common geriatric health problem and chronic stressor, and it is associated with poor cognitive outcomes. However, little is known about the impact of hearing impairment in married couples, particularly its potential spillover effects on the cognitive health among spouses of individuals with impairment. Drawing on a stress-proliferation perspective, we used actor-partner interdependence models to examine (1) whether an individual's hearing impairment influences their spouse's cognitive function; and (2) whether AL, symptoms of depression, and social participation serve as mediators for such an association. We utilized data from the 2015 (baseline) and 2018 (3-year follow-up) waves of the China Health and Retirement Longitudinal Study. 4434 couples were included at baseline, and 2190 couples remained after the 3-year follow-up. Hearing impairment among married women was associated with negative impacts on their spouses' cognitive function. Symptoms of depression and social participation may have served as potential mediators in this relationship. For married men, there was no statistically significant association between hearing impairment and spouses' cognitive function. Our findings suggest that hearing impairment among one spouse can lead to negative impacts on the other, but that this effect may depend on gender. Early diagnosis and couple-based interventions for hearing impairment are important for the cognitive health of both hearing-impaired individuals and their spouses.

Vision and Hearing Difficulties and Life Expectancy Without ADL/IADL Limitations: Evidence From the English Longitudinal Study of Ageing and the Health and Retirement Study

BACKGROUND

Hearing and vision difficulties are some of the most common deficits experienced by older adults. Having either visual or hearing difficulties increases the risk of comorbidity, disability, and poor quality of life. So far, however, few studies have examined the association between vision and hearing difficulties on life expectancy without activities of daily living (ADL) or instrumental ADL (IADL) limitations (LEWL).

METHODS

Data came from the English Longitudinal Study of Ageing and the Health and Retirement Study in the United States from 2002 to 2013. The outcome was defined as reporting 2+ limitations with ADL/IADL. Life expectancy was estimated by discrete-time multistate life table models for hearing and vision difficulties separately as well as for combined vision and hearing difficulties by sex and age.

RESULTS

Thirteen percent of men in England and the United States had ADL/IADL limitations, whereas, for women, it was 16% and 19% in England and the United States. At all ages, either vision or hearing difficulty was associated with shorter LEWL compared to no difficulties. Dual sensory difficulty (vision and hearing) reduced LEWL by up to 12 years in both countries. At the ages of 50 and 60 in England, hearing difficulty was associated with fewer years lived without ADL/IADL limitations than vision difficulty. In contrast, in the United States, vision difficulty led to fewer years lived without ADL/IADL limitations than hearing difficulty.

CONCLUSIONS

The implementation of strategies to reduce the prevalence and incidence of vision and hearing difficulties has the potential to increase the number of years spent without ADL/IADL limitations.

The impact of hearing loss on trajectories of depressive symptoms in married couples

Hearing loss is a prevalent chronic stressor among older adults and is associated with numerous adverse health outcomes. The life course principle of linked lives highlights that an individual's stressors can impact the health and well-being of others; however, there are limited large-scale studies examining hearing loss within marital dyads. Using 11 waves (1998-2018) of the Health and Retirement Study (n = 4881 couples), we estimate age-based mixed models to examine how 1) one's own hearing, 2) one's spouse's hearing, or 3) both spouses' hearing influence changes in depressive symptoms. For men, their wives' hearing loss, their own hearing loss, and both spouses having hearing loss are associated with increased depressive symptoms. For women, their own hearing loss and both spouses having hearing loss are associated with increased depressive symptoms, but their husbands' hearing loss is not. The connections between hearing loss and depressive symptoms within couples are a dynamic process that unfolds differently by gender over time.

Non-cognitive factors associated with driving cessation among older adults: An integrative review

Exploring the factors that affect driving cessation is crucial, because sustained mobility plays an important role in successful aging. This study aimed to collect evidence on the non-cognitive factors associated with driving cessation among older adults. The method used in this study was an integrated review of published research on the factors affecting driving cessation. A comprehensive search was performed using electronic databases including PubMed, Web of Science, Scopus, CINHAL, ProQuest, EBSCO, and Google Scholar. The results revealed six main categories (physical health, psychological health, interpersonal influence, transportation support, policies, and sociodemographic characteristics) and 24 subcategories for driving cessation. Given the potentially serious consequences of driving cessation in the older adult population, exploring the predictors of driving cessation can be used to design interventions for optimizing drivers' health, rehabilitating the functional limitations that affect driving ability, creating a safer driving environment, and optimizing vehicles to meet the needs of older drivers.

Prevalence and impact of combined vision and hearing (dual sensory) impairment: A scoping review

Hearing and vision impairments are common globally. They are often considered separately in research, and in planning and delivering services. However, they can occur concurrently, termed dual sensory impairment (DSI). The prevalence and impact of hearing and vision impairment have been well-examined, but there has been much less consideration of DSI. The aim of this scoping review was to determine the nature and extent of the evidence on prevalence and impact of DSI. Three databases were searched: MEDLINE, Embase and Global Health (April 2022). We included primary studies and systematic reviews reporting the prevalence or impact of DSI. No limits were placed on age, publication dates, or country. Only studies where the full text was available in English were included. Two reviewers independently screened titles, abstract, full texts. Data were charted by two reviewers independently using a pre-piloted form. The review identified 183 reports of 153 unique primary studies and 14 review articles. Most evidence came from high-income countries (86% of reports). Prevalence varied across reports, as did age groups of participants and definitions used. The prevalence of DSI increased with age. Impact was examined across three broad groups of outcomes-psychosocial, participation, and physical health. There was a strong trend towards poorer outcomes for people with DSI across all categories compared to people with one or neither impairment, including activities of daily living (worse for people with DSI in 78% of reports) and depression (68%). This scoping review highlights that DSI is a relatively common condition with substantial impact, particularly among older adults. There is a gap in evidence from low and middle-income countries. There is a pressing need for a consensus position on the definition(s) of DSI and standardisation of reporting age groups to enable reliable estimates to be ascertained and compared and responsive services developed.

Living an ordinary life – yet not: the everyday life of children and adolescents living with a parent with deafblindness

Introduction

The family life of people living with one family member with deafblindness has been sparsely described.

Purpose

The aim of the study was to explore how children experience their everyday family life when having a parent with deafblindness.

Methods

An explorative study in which data have been collected by qualitative interviews of children. Qualitative content analysis has been used for analysing the data.

Results

Overall theme; Living an ordinary life—yet not, is based on four categories with subcategories. A family like any other describes: Having the same family life as their friends, Acting like other children and It is what it is. Different everyday life describes: Acknowledging differences, Adjusting to the parent’s needs and Financial strain. Being there for the parent describes: Helping the parent and Protecting the parent from harm. Being emotionally affected describes: Feelings of frustration, Feelings of compassion and Need for support.

Conclusion

Children as relatives of parents with deafblindness have been given a voice. The children live an ordinary life, but at the same time a different ordinary life. Professionals need to take the child and their needs into account when support is given.

When one partner can no longer see: Exploring the lived experiences of romantic partners in the context of vision loss

This qualitative descriptive study aims to explore the lived experience of the adjustment process of couples who face vision loss, investigating the impact of such loss on daily life and the adjustments and adaptations that ensue. To undertake such an exploration, the application of an occupational perspective is relevant where the meaning and purpose partners ascribe to their everyday activities can be investigated. A total of 16 couples living in Western Switzerland were interviewed between January and June 2020. Data collection was carried out with semi-structured face-to-face interview. Three themes emerge from the thematic analysis of transcripts. The first theme emphasizes that either separate or joint everyday activities of partners can be shared within couples, which all give sense to the partnership; the second one shows that vision loss disrupts the engagement of partners in such shared everyday activities. The third theme highlights partners’ efforts to reshape their engagement in their shared everyday activities in order to maintain a sense of couple’s we-ness. While navigating vision loss requires both partners to jointly engage in this process of reshaping, couples described tension that arises because of the partners with vision loss’ growing dependence on the other partner. One’s sense of control when navigating vision loss is critical to adjust to a changing and changed daily life. Further research is needed that focuses on how romantic partners ascribe a shared meaning and purpose to their engagement in everyday activities, separate or joint, and how such meaning and purpose are impacted by the onset or aggravation of one partner’s vision loss.

The "In It Together" digital intervention to treat distress among older adults with sensory loss and their spouses: Study protocol for a randomized controlled trial study

Sensory impairment is common in older age and may be associated with intra- and interpersonal struggles. Treatment and intervention efforts may be hampered by functional difficulties or unwillingness to receive face-to-face mental health services. The current study seeks to assess the efficacy of an online psychological intervention for older adults with sensory loss and their spouses in Denmark, using a two-arm, parallel-group, randomized controlled trial study design. Participants will be randomly assigned to the intervention group or waiting list control group. The intervention consists of four digital, sequential modules that contain psychoeducation and Acceptance and Commitment Therapy inspired therapeutic activities. Individuals will be assessed at baseline, 6 weeks, and 10 weeks post-baseline, and for the intervention group only, at 18-weeks. The outcomes are well-being (primary), relationship satisfaction (secondary), and depressive symptoms (tertiary). The data will be analyzed using multilevel modeling to account for non-independence of data (nesting within participant and within couple). This is the first randomized controlled trial study of an online psychological intervention for older adults with sensory loss and their spouses and it will provide valuable knowledge regarding whether internet-delivered intervention is effective for this population group.

Qualitative Review on Domains of Quality of Life Important for Patients, Social Care Users, and Informal Carers to Inform the Development of the EQ-HWB

OBJECTIVES

To identify the themes to inform the content of a new generic measure, the EQ-HWB (EQ Health and Wellbeing), that can be used in economic evaluation across health, social care, and public health, based on the views of users and beneficiaries of these services including informal carers.

METHODS

A qualitative review was undertaken. Systematic and citation searches were undertaken focusing on qualitative evidence of the impact on quality of life from reviews for selected health conditions, informal carers, social care users, and primary qualitative work used in the development of selected measures. A subset of studies was included in the review. Framework analysis and synthesis were undertaken based on a conceptual model.

RESULTS

A total of 42 reviews and 24 primary studies were selected for inclusion in the review. Extraction and synthesis resulted in 7 high-level themes (with subthemes): (1) feelings and emotions (sadness, anxiety, hope, frustration, safety, guilt/shame); (2) cognition (concentration, memory, confusion, thinking clearly); (3) self-identity (dignity/respect, self-esteem); (4) "coping, autonomy, and control" relationships; (5) social connections (loneliness, social engagement, stigma, support, friendship, belonging, burden); (6) physical sensations (pain, discomfort, sleep, fatigue); and (7) activity (self-care, meaningful activities, mobility, communication, hearing, vision). Apart from physical sensations, most of the other themes and subthemes were relevant across both health and social care, including for informal carers.

CONCLUSIONS

The findings from this broad review identified themes that go beyond health and that are relevant to patients, informal carers, and social care users. The themes and subthemes informed the domains for the EQ-HWB.

The consequences of deafblindness rules the family: Parents’ lived experiences of family life when the other parent has deafblindness

Deafblindness is a combined vision and hearing disability that restricts communication, access to information, and mobility, thus limiting a person’s activities and full participation in society. Literature on how this might affect the lives of family members is sparse. The aim of this study is to describe the lived experience of family life from the perspective of one parent when the other has deafblindness. Six partners of deafblind parents, four men and two women, agreed to participate. Three were deaf and communicated in Swedish sign language. Qualitative interviews were conducted and analysed using interpretative phenomenological analysis. Seven themes were identified during the analysis. When one parent has deafblindness, communication within the family and with people outside the family is affected. The non-deafblind partners tried to integrate deafblindness into everyday family life and constantly strove to compensate for the losses caused by deafblindness. They tried to enhance participation and engagement in everyday family life for the parent with deafblindness by facilitating communication and taking a greater part in some areas of their shared responsibilities at home. The results reveal that these partners often put themselves in second place. They and their families needed support to manage family life. Deafblindness affects the life of the entire family, and the non-deafblind partner has to take considerable responsibility for everyday life. Everyday life can be facilitated by an adapted environment and appropriate support, which should be offered to the entire family.

Dyadic Coping in Couples Facing Chronic Physical Illness: A Systematic Review

Objective: Chronic physical illness affects not only patients but also their partners. Dyadic coping (DC)-the ways couples cope in dealing with a stressor such as chronic illness-has received increased attention over the last three decades. The aim of the current study was to summarize the state of research on DC in couples with chronic physical illnesses. Methods: We conducted a systematic review of qualitative, quantitative, and mixed-methods studies published between 1990 and 2020, assessing DC in couples affected by severe physical illnesses. We used DC and related search terms for the literature search in Psycinfo, Psyndex, and Medline. Five thousand three hundred thirty studies were identified in three electronic databases and 49 of these were included in the review (5,440 individuals reported on 2,820 dyads). We excluded studies on cancer, cardiovascular disease, and multiple sclerosis because of existing reviews in the respective fields. Half of the studies included were on diabetes. Other studies were on arthritis, chronic obstructive pulmonary disease (COPD), cystic fibrosis, human immunodeficiency virus (HIV), Huntington's disease, lupus erythematosus, Parkinson's disease, renal diseases, stroke, and endometriosis. Two raters extracted data using a predefined protocol, including study quality. Results were collated in a narrative synthesis organized by illness and DC operationalization. Results: Overall, DC was associated with beneficial outcomes in physical health, well-being, and relationship satisfaction. Differential effects became apparent for certain chronic conditions potentially depending on certain disease characteristics, such as early-onset, sudden-onset, or life-threatening conditions. Conclusion: Facing challenges together as a couple seemed indispensable for adapting to a diverse range of demands related to chronic illnesses with some specific demands of particular chronic diseases. There is a need for the development of truly dyadic interventions with an eye on the specific challenges of the various chronic conditions.

The link between vision impairment and depressive symptomatology in late life: does having a partner matter?

Visual impairment contributes to poor mental health among older adults by restricting everyday functioning and participation. This study examined whether the negative link between vision impairment and depressive symptomatology was less severe among partnered than among single older adults. We merged data from a survey among people with vision impairment with a reference population from the most recent wave of the Danish Longitudinal Study of Ageing (DLSA) (N = 5831 M_age = 74.37, range: 65–97 years, 53.1% female), investigating whether paths from poor vision via three mediators—functional limitations, emotional support and participation in social activities—to depressive symptomatology differ by partnership status. Structural equation modeling suggested that the direct path from vision impairment to depressive symptomatology is more than twice as strong for single than for partnered older adults. Thus being partnered reduces the negative link from vision impairment to depressive symptomatology. However, the path from vision impairment to emotional support is significantly stronger among single than among partnered individuals. Thus negative spillover effects from the visual impairment on the non-impaired partner’s mental health may compromise that partner’s ability to provide emotional support. Taking into account both partnership status and the mental health of both partners may help professionals more precisely target interventions aimed at reducing the risk of depression in visually impaired older adults.

Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress

INTRODUCTION

Appearance dissatisfaction is a sensitive issue and has been tied to depression, dissatisfaction in romantic relationships, and reduced sexual satisfaction.

AIM

This study sought to examine associations between appearance satisfaction and specific sexual problems and related distress, testing also the moderating role of relationship satisfaction.

METHODS

A large web-sample of Norwegians in romantic relationships (N = 2,903) completed a one-time survey.

OUTCOMES

Participants reported on their experience of five different sexual problems and associated level of distress.

RESULTS

We found that appearance satisfaction was associated with reporting fewer sexual problems, and specifically, with a smaller likelihood of experiencing problems with lack of enjoyment, lack of excitement, and lack of climax. Furthermore, appearance satisfaction was unrelated to overall sexual problem-related distress, but was associated with feeling less distress about lack of excitement and lack of climax. Relationship satisfaction did not serve as a moderator of the associations.

CLINICAL TRANSLATION

These findings suggest the importance of attending to appearance satisfaction when working with clients with multiple sexual problems, particularly those related to excitement and enjoyment.

STRENGTHS AND LIMITATIONS

Strengths of the study include a large sample of partnered adults and assessment of specific sexual problems and associated distress. A limitation is that outcomes were assessed using single items, rather than multi-item scales.

CONCLUSION

The study highlights the importance of examining the presence of sexual problems and associated distress separately, and to consider appearance satisfaction as a predictor of sexual functioning. Øverup CS, Strizzi JM, Cipric A, et al. Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress. J Sex Med 2021;XX:XXX-XXX.

Hearing Impairment and Mental Health Among Married Couples

OBJECTIVES

Disablement is a significant health problem and chronic stressor for older adults and is associated with negative mental health outcomes. Although some research has explored how disability extends beyond individuals to influence the mental health of their support networks, less population-based research has assessed the consequences of hearing impairment, a growing public health concern that affects 72.4% of people aged 65 and older. Moreover, although much research has examined the negative individual impact of hearing impairment, less population-based research has assessed its consequences on spouses. To fill this gap, the current study builds on gender, marriage, and stress proliferation research to examine (a) the association between own hearing impairment and spouses' depressive symptoms, and (b) whether this association varies by the gender of the spouse.

METHOD

Fixed-effects regression models were conducted using data from 5,485 couples (10,970 individuals) from 10 waves of the Health and Retirement Study (1998-2016).

RESULTS

Wives' fair or poor hearing is significantly associated with an increase in husbands' depressive symptoms, net of controls. However, husbands' fair or poor hearing is not associated with an increase in wives' depressive symptoms.

DISCUSSION

These findings suggest that hearing impairment can proliferate from one spouse to the other, but that this proliferation depends on gender. Health care providers need to be aware of the implications for husbands when treating women with hearing impairment.

Disability as an Interpersonal Experience: A Systematic Review on Dyadic Challenges and Dyadic Coping When One Partner Has a Chronic Physical or Sensory Impairment

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.

What couples say about living and coping with sensory loss: a qualitative analysis of open-ended survey responses

The current study reports the results of open-ended questions from a follow-up survey of adults with sensory loss and their spouses who had previously taken part in an online study. In total, 111 participants completed the survey (72 adults with a sensory loss and 39 spouses). Open-ended questions asked about the overall experience of living with sensory loss, sensory loss-related challenges, and support and coping mechanisms. Thematic analysis was used to identify dominant themes in participants' responses. Three core themes capturing their overall experience emerged: (1) sensory loss-related challenges, (2) support and coping, and (3) adjustment and readjustment. Sensory loss was characterized as a challenging experience, causing communication and emotional disturbances. Coping strategies reported by both partners included the use of assistive technology, positive re-appraisal, acceptance and/or denial of the loss, while support strategies were mostly derived from the comments of spouses (for AWSLs), family members and peer networks (for both partners). Finally, respondents described sensory loss as an adventurous learning experience. Our findings underscore the significance of considering sensory loss from a social relational/family perspective and highlight the importance of addressing the needs of both adults with sensory loss and their partners in treatment and rehabilitation.Implications for rehabilitationStudy highlights the need to consider sensory loss from a relational/family perspective.Healthcare professionals should try to increase the involvement of significant others and close family members (e.g., spouses, parents, children) into the rehabilitation process.Greater emphasis should be placed on exploring and reinforcing positive experiences and attitudes associated with sensory loss during counselling/rehabilitation sessions.Improved education about sensory loss for both the general public and health care professionals could minimize the adverse outcomes associated with sensory loss.

Third-Party Impact of Dual Sensory Loss on Neuropsychiatric Symptom-Related Distress among Friends and Family

BACKGROUND

Vision loss and hearing loss are common in later life and are associated with cognitive impairment and neuropsychiatric symptoms. There is a need to better understand how individual characteristics, such as poor sensory functioning, are linked with familial well-being.

OBJECTIVES

The aim of this study was to investigate whether, among persons with neuropsychiatric symptoms, age-related sensory loss is related to increased emotional distress reported by their family and friends.

METHODS

The sample comprised 537 participant-informant dyads from the Personality and Total Health through Life (PATH) study, a community-based cohort. Participants were aged between 72 and 79 years (56% men), and all were reported to exhibit at least 1 neuropsychiatric symptom. Informants were participants' spouse (50%), child (35%), friend (7%), or other relatives (7%). Neuropsychiatric symptom-related distress of friends and family was assessed with the distress subscale of the Neuropsychiatric Inventory (NPI). Sensory functioning in participants was assessed by visual acuity and self-reported hearing difficulties. Ordinal logistic regression analyses estimated the association between sensory problems and NPI distress.

RESULTS

In models adjusted for informant dyadic relationship and socio-demographics, both lower visual acuity (B = 0.23, SE = 0.10) and self-reported hearing difficulty (B = 0.15, SE = 0.06) were associated with increased levels of distress. The increased informant distress associated with poor visual acuity was attenuated after adjusting for neurocognitive disorder and health conditions (p = 0.069). A significant interaction between vision and hearing remained after multivariable adjustment (χ2(1) = 6.73, p = 0.010).

CONCLUSIONS

Friends and family of persons with poor visual acuity and perceived hearing difficulties report elevated levels of neuropsychiatric symptom-related distress relative to friends and family of persons with poor sensory functioning in only 1 sensory domain or unimpaired levels of vision and hearing. These findings provide evidence of the third-party effects of sensory loss in the context of neuropsychiatric symptoms, and in particular show how dual sensory loss can confer additional challenges over and above the effects of a single sensory loss.

Associations Between Perceived Stress and Chemotherapy-Induced Peripheral Neuropathy and Otoxicity in Adult Cancer Survivors

CONTEXT

The most common adverse effects from neurotoxic chemotherapy are chemotherapy-induced neuropathy (CIPN), hearing loss, and tinnitus. Although associations between perceived stress and persistent pain, hearing loss, and tinnitus are documented, no studies have examined these associations in cancer survivors who received neurotoxic chemotherapy.

OBJECTIVES

In this cross-sectional study, we evaluated for associations between perceived stress and the occurrence of CIPN, hearing loss, and tinnitus, in 623 adult cancer survivors who received platinum and/or taxane compounds.

METHODS

Survivors completed self-report measures of hearing loss, tinnitus, and perceived stress (i.e., Impact of Events Scale-Revised [IES-R]). Separate logistic regression analyses were done for each neurotoxicity to evaluate whether each of the IES-R subscale (i.e., intrusion, avoidance, hyperarousal) and total scores made a significant independent contribution to neurotoxicity group membership.

RESULTS

Of the 623 survivors in this study, 68.4% had CIPN, 34.5% reported hearing loss, and 31.0% reported tinnitus. Older age, higher body mass index, poorer functional status, being born prematurely, cancer diagnosis, and higher intrusion (P = 0.013), hyperarousal (P = 0.014), and total (P = 0.047) IES-R scores were associated with CIPN. Older age, being male, poorer functional status, a worse comorbidity profile, and a higher IES-R hyperarousal (P = 0.007) score were associated with hearing loss. Being male, having less education, a worse comorbidity profile, and a higher IES-R hyperarousal (P = 0.029) score were associated with tinnitus.

CONCLUSION

These findings suggest that increased levels of perceived stress are associated with the most common chemotherapy-induced neurotoxicities.

Couples coping with sensory loss: A dyadic study of the roles of self- and perceived partner acceptance

OBJECTIVES

Hearing-, vision-, and dual-sensory loss have been linked to relational and psychological distress among adults with sensory loss (AWSLs) and their spouses. Regardless, research on factors associated with couples' adjustment is lacking. This study examined the stability and strength of associations between self-acceptance of sensory loss, perceived partner acceptance of sensory loss, and relationship satisfaction and psychological distress among AWSLs and their spouses over time.

DESIGN

A total of 122 AWSLs and their spouses completed an online survey at two time points over a 6-month period.

METHODS

A multigroup (i.e., time 1 and time 2) actor-partner interdependence model assessed the stability and strength of actor and partner effects of self-acceptance and perceived partner acceptance on each partner's relationship satisfaction and psychological distress over time.

RESULTS

No moderation by time was identified, indicating stability in associations over the 6-month period. Overall, both actor and partner effects were evident. Specifically, self-acceptance among AWSLs was inversely associated with own psychological distress and the relationship satisfaction of spouses. Self-acceptance by spouses was inversely associated with the psychological distress of AWSLs and spouses. Perception of spouse acceptance by AWSLs was positively associated with own and spouse relationship satisfaction.

CONCLUSIONS

Interventions targeting acceptance that incorporate a family systems perspective may be beneficial in alleviating psychological and relational distress among couples coping with sensory loss. Statement of contribution What is already known on this subject? The experience of hearing and/or vision loss has been linked to heightened distress both psychologically and within intimate relationships. Prior research has demonstrated a link between an individual's ability to accept their sensory loss and healthier well-being. What does this study add? This is the first dyadic study of sensory loss acceptance and its link to relationship satisfaction and distress. Acceptance operates interpersonally protecting against distress for those with sensory loss and their spouses. Perceiving that one's spouse accepts the sensory loss is important for both partner's relationship satisfaction.

Combined impairments in vision, hearing and cognition are associated with greater levels of functional and communication difficulties than cognitive impairment alone: Analysis of interRAI data for home care and long-term care recipients in Ontario

OBJECTIVES

The objective of the current study was to understand the added effects of having a sensory impairment (vision and/or hearing impairment) in combination with cognitive impairment with respect to health-related outcomes among older adults (65+ years old) receiving home care or residing in a long-term care (LTC) facility in Ontario, Canada.

METHODS

Cross-sectional analyses were conducted using existing data collected with one of two interRAI assessments, one for home care (n = 291,824) and one for LTC (n = 110,578). Items in the assessments were used to identify clients with single sensory impairments (e.g., vision only [VI], hearing only [HI]), dual sensory impairment (DSI; i.e., vision and hearing) and those with cognitive impairment (CI). We defined seven mutually exclusive groups based on the presence of single or combined impairments.

RESULTS

The rate of people having all three impairments (i.e., CI+DSI) was 21.3% in home care and 29.2% in LTC. Across the seven groups, individuals with all three impairments were the most likely to report loneliness, to have a reduction in social engagement, and to experience reduced independence in their activities of daily living (ADLs) and instrumental ADLs (IADLs). Communication challenges were highly prevalent in this group, at 38.0% in home care and 49.2% in LTC. In both care settings, communication difficulties were more common in the CI+DSI group versus the CI-alone group.

CONCLUSIONS

The presence of combined sensory and cognitive impairments is high among older adults in these two care settings and having all three impairments is associated with higher rates of negative outcomes than the rates for those having CI alone. There is a rising imperative for all health care professionals to recognize the potential presence of hearing, vision and cognitive impairments in those for whom they provide care, to ensure that basic screening occurs and to use those results to inform care plans.

Mental Health and Spouse Support Among Older Couples Living With Sensory Loss

Objectives: The current study examined the mental health of couples living with and without sensory loss; compared the mental health of couples living with hearing, vision, or dual-sensory loss; and investigated the association between spouse support and the mental health of couples living with sensory loss. Method: The study included 513 couples with sensory loss and 1,079 couples without sensory loss. Actor–Partner Interdependence Models were used to examine associations between spouse support and mental health. Results: Controlling for potential covariates, individuals with sensory loss and their spouses were at a greater risk of mental health problems. Sensory loss modality (hearing and/or vision) did not explain any differences. Both actor and partner effects of spouse support on anxiety and depression were found. Discussion: The findings highlight the need to support the mental health of couples living with sensory loss and indicate the importance of considering the intimate relationship in future studies.