Dyadic analyses of chronic conditions and distress within marriage : a gendered perspective
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Chronic conditions negatively impact well-being, and the negative impact of a chronic condition can extend beyond the diagnosed person to his or her spouse. This association may be further influenced by gender, as gender can shape how individuals experience their own chronic conditions-- including what conditions they develop-- and how they react to the conditions and distress of their spouses. In my dissertation, I examine how one spouse’s chronic conditions are related to the other spouse's psychological distress over time. I address this using quantitative analysis of the Health and Retirement Study and qualitative analysis of in-depth interviews. In my quantitative analysis, I find that the association between one spouse’s chronic conditions and the other spouse’s distress differs by gender, number of conditions, whether one or both spouses have chronic conditions, and type of condition. Regarding number of conditions, a husband’s number of chronic conditions increases his wife’s distress more so than a wife’s number of chronic conditions increases her husband’s. These associations are mitigated by the chronically ill spouse’s own distress and functional limitations. Additionally, this gender difference is more pronounced if both spouses have chronic conditions compared to if only one has chronic conditions. Regarding type of condition, lung disease and stroke are the most negatively impactful for spouses’ distress, whereas high blood pressure, cancer, and arthritis are not related to spouses’ distress. All conditions, except for stroke, relate to husbands’ and wives’ distress similarly, but a husband's stroke increases a wife's distress initially whereas the wife's stroke increases the husband's distress over time. In my qualitative analysis, I find that when women are chronically ill, they continue to emotionally care for their husbands, which likely protects their husbands from psychological distress but exacerbates women’s own distress. My results point to the importance of promoting the psychological well-being of both spouses during periods of chronic conditions. This is especially critical for spouses of people with more than one condition, chronically ill women whose husbands are also chronically ill, and spouses of people experiencing stroke and lung disease.