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Liu W, Lewis FM, Oxford M, Kantrowitz-Gordon I. Common dyadic coping and its congruence in couples facing breast cancer: The impact on couples' psychological distress. Psychooncology 2024; 33:e6314. [PMID: 38459736 DOI: 10.1002/pon.6314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/28/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE Psychological distress is prevalent in couples facing breast cancer. Couples often deal with breast cancer as a unit instead of as individuals. Couple's dyadic coping is important for their adjustment to breast cancer; however, little is known about how couple's coping congruence influences their distress. This study examined how common dyadic coping (CDC) and coping congruence impact psychological distress in couples facing breast cancer. METHODS Baseline data were analyzed from 343 women with recently diagnosed early-stage breast cancer and their partners who participated in a randomized clinical trial. Psychological distress was indicated by depressed mood and state anxiety. Common dyadic coping was measured by a self-report scale. Coping congruence was assessed by the absolute difference between a woman's and her partner's CDC scores. RESULTS Higher CDC scores were associated with lower psychological distress in both women and partners. In the CDC subscales, women who suffered less scored higher on open communication, sharing a positive outlook, and lower on avoidance coping. Partners who suffered less scored higher on open communication, sharing a positive outlook, spending time talking, and lower on avoidance coping. Greater congruence in CDC was associated with lower psychological distress in women and their partners. Congruence in sharing a positive outlook benefited both members of the dyad; congruence in avoidance coping significantly benefited patients; congruence in open communication significantly benefited partners. CONCLUSIONS CDC and its congruence in specific areas have potential benefit to couple's psychological distress when facing breast cancer. Health care providers could consider enhancing couple's CDC and coping congruence to improve their adjustment.
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Affiliation(s)
- Wenjia Liu
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, USA
| | - Frances Marcus Lewis
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, USA
- Affiliate, Public Health Sciences & Member, Clinical Sciences Divisions, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Monica Oxford
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, USA
| | - Ira Kantrowitz-Gordon
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, USA
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2
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Irani E, Buck HG, Lyons KS, Margevicius S, Vellone E, Bugajski A, De Maria M. Examining how congruence in and satisfaction with dyadic care type appraisal contribute to quality of life in heart failure care dyads. Eur J Cardiovasc Nurs 2023; 22:158-165. [PMID: 35709307 DOI: 10.1093/eurjcn/zvac052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/14/2022]
Abstract
AIMS Given the complexity of heart failure (HF) management, persons with HF and their informal caregivers often engage in dyadic illness management. It is unknown how congruent appraisal of dyadic HF care type is associated with dyadic health. Our aim was to examine how congruence in and satisfaction with appraisal of dyadic HF care type contribute to quality of life (QOL) for dyads. METHODS AND RESULTS This is a secondary analysis of cross-sectional data on 275 HF care dyads (patients 45.1% female, caregivers 70.5% female). Congruent appraisal and satisfaction were assessed using the Dyadic Symptom Management Type instrument. Quality of life was measured using the Short Form-12. Multilevel dyadic models were estimated to examine the contribution of congruence and satisfaction with dyadic care type to physical and mental QOL. Congruent appraisal of dyadic care type was positively associated with caregivers' mental QOL (B = 2.69, P = 0.026). Satisfaction with dyadic care type was positively associated with physical and mental QOL for persons with HF (B = 1.58, P = 0.011 and B = 2.09, P = 0.002, respectively) and informal caregivers (B = 1.70, P = 0.004 and B = 2.90, P < 0.001, respectively), while controlling for age, New York Heart Association class, daily hours spent together, relationship type, and congruence with dyadic care type. CONCLUSION Satisfaction with dyadic care type appraisal was a stronger contributor to QOL for HF care dyads, compared with congruent appraisals. It is important to understand reasons for dissatisfaction within the dyad to assist dyad members in reaching shared appraisals while managing HF.
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Affiliation(s)
- Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4904, USA
| | - Harleah G Buck
- College of Nursing, University of Iowa, Iowa City, IA, USA
| | - Karen S Lyons
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
| | - Seunghee Margevicius
- Department of Population and Quantitative Health Sciences, School of Medicine and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy
| | | | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy
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Taking Care of Us© (TCU) study protocol: feasibility and acceptability of a dyadic intervention for couples living with heart failure. Pilot Feasibility Stud 2023; 9:16. [PMID: 36698174 PMCID: PMC9875187 DOI: 10.1186/s40814-023-01249-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 01/16/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND There are more than 1 million hospital admissions and 3 million emergency visits for heart failure in the USA annually. Although spouse/partners make substantial contributions to the management of heart failure and experience poor health and high levels of care strain, they are rarely the focus of heart failure interventions. This protocol describes a pilot randomized controlled trial that tests the feasibility, acceptability, and preliminary change in outcomes of a seven-session couple-based intervention called Taking Care of Us© (TCU). The TCU© intervention is grounded in the theory of dyadic illness management and was developed to promote collaborative illness management and better physical and mental health of adults with heart failure and their partners. METHODS A two-arm randomized controlled trial will be conducted. Eligible adults with heart failure and their co-residing spouse/partner will be recruited from a clinical site in the USA and community/social media outreach and randomized to either the TCU© intervention or to a control condition (SUPPORT©) that offers education around heart failure management. The target sample is 60 couples (30 per arm). TCU© couples will receive seven sessions over 2 months via Zoom; SUPPORT© couples will receive three sessions over 2 months via Zoom. All participants will complete self-report measures at baseline (T1), post-treatment (T2), and 3 months post-treatment (T3). Acceptability and feasibility of the intervention will be examined using both closed-ended and open-ended questions as well as enrollment, retention, completion, and satisfaction metrics. Preliminary exploration of change in outcomes of TCU© on dyadic health, dyadic appraisal, and collaborative management will also be conducted. DISCUSSION Theoretically driven, evidence-based dyadic interventions are needed to optimize the health of both members of the couple living with heart failure. Results from this study will provide important information about recruitment and retention and benefits and drawbacks of the TCU© program to directly inform any needed refinements of the program and decision to move to a main trial. TRIAL REGISTRATION ClinicalTrials.gov (NCT04737759) registered on 27 January 2021.
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Lai C, Aceto P, Pellicano GR, Servidei G, Gambardella A, Lombardo L. Will I or my loved one die? Concordant awareness between terminal cancer patients and their caregivers is associated with lower patient anxiety and caregiver burden. Eur J Cancer Care (Engl) 2021; 31:e13546. [PMID: 34931734 DOI: 10.1111/ecc.13546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 11/22/2021] [Accepted: 12/02/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aims of this study were to investigate the association between patients' awareness of their terminal illness and the levels of anxiety and depression, whether the concordance between the patients' and caregivers' belief about the patient's terminal illness was associated with patient's anxiety and depression, and with the caregiver burden. METHOD The study recruited 31 terminally ill patients with cancer along with their caregivers from a Palliative Care Unit. All data about patients and caregivers' awareness of the illness, patients' depression and anxiety, and caregiver burden were collected. RESULTS Patients aware of their short-term prognosis of death showed lower levels of anxiety than the unaware ones, especially women. Aware patients with concordant caregivers showed lower levels of anxiety but not of depression. Caregivers concordant with the patients' awareness presented lower levels of strain and burden. Finally, terminal patients who had an adult child caregiver were less likely to be aware of their terminal condition. CONCLUSIONS It appears that illness awareness and the caregiver's concordance with the patient's belief on the terminal condition are associated with lower anxiety, especially in women, and a reduced burden for caregivers.
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Affiliation(s)
- Carlo Lai
- Dynamic and Clinical Psychology, and Health Department, Sapienza University of Rome, Rome, Italy
| | - Paola Aceto
- Department of Anaesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Anaesthesiology and Intensive Care, Catholic University of Sacred Heart, Rome, Italy
| | - Gaia Romana Pellicano
- Dynamic and Clinical Psychology, and Health Department, Sapienza University of Rome, Rome, Italy
| | - Giulia Servidei
- Dynamic and Clinical Psychology, and Health Department, Sapienza University of Rome, Rome, Italy
| | - Aldo Gambardella
- Dynamic and Clinical Psychology, and Health Department, Sapienza University of Rome, Rome, Italy
| | - Luigi Lombardo
- Centro di Cure Palliative, Fondazione Sanità e Ricerca, Rome, Italy
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Kassir ZM, Li J, Harrison C, Johnson JT, Nilsen ML. Disparity of perception of quality of life between head and neck cancer patients and caregivers. BMC Cancer 2021; 21:1127. [PMID: 34670507 PMCID: PMC8527693 DOI: 10.1186/s12885-021-08865-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 10/07/2021] [Indexed: 11/25/2022] Open
Abstract
Background Caregivers are invaluable sources of support for individuals recovering from head and neck cancer (HNC). Accordingly, minimizing caregiver distress is essential to promote the well-being of both caregivers and their patients. This study assessed if psychosocial distress (i.e., anxiety and depression) among HNC caregivers is associated with a difference in how caregivers and their patients perceive patients’ quality of life (QOL) after treatment completion. Methods Caregivers’ and patients’ perceptions of patient QOL were assessed using the University of Washington QOL Questionaire (UWQOL), a validated HNC-specific health-related QOL questionnaire. The survey is interpreted in terms of its two composite scores: a physical QOL score and a social-emotional QOL score with higher scores indicating better QOL. Caregiver anxiety was assessed using the Generalized Anxiety Questionaire-7 (GAD-7) and caregiver depression was assessed using the Patient Health Questionaire 8 (PHQ-8). Patients completed the UWQOL as part of clinic intake while caregivers were asked to complete the UWQOL for their patients in addition to the PHQ-8 and GAD-7 in private. Linear regression was used to analyze the association between differences in caregivers’ and patients’ QOL scores (both social-emotional and physical QOL subscale scores) and GAD-7 and PHQ-8 scores. Results Of 47 caregivers recruited, 42.6% (n = 20) viewed patients’ social-emotional QOL more negatively than patients themselves, while 31.9% viewed patients’ physical QOL more negatively. After controlling for covariates, differences in perception of social-emotional QOL (p = .01) and differences in perception of physical QOL (p = .007) were significantly associated with caregiver depression, but not anxiety. Caregivers who disagreed with patients regarding patients’ social-emotional QOL scored 6.80 points higher on the PHQ8 than agreeing caregivers. Caregivers who disagreed regarding patients’ physical QOL scored 6.09 points higher. Conclusion Caregivers commonly view patients’ QOL more negatively than patients themselves. These caregivers tend to have greater psychosocial distress than caregivers who agree with their patients. Interventions designed to identify and aid at-risk caregivers are critically needed. We propose screening for differences in perception of patient QOL as a way of identifying distressed caregivers as well as provider-facilitated communication between patients and caregivers as possible interventions that should be examined in future research. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08865-7.
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Affiliation(s)
- Zachary M Kassir
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye & Ear Institute, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Jinhong Li
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Christine Harrison
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye & Ear Institute, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Jonas T Johnson
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye & Ear Institute, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Marci L Nilsen
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye & Ear Institute, 203 Lothrop Street, Pittsburgh, PA, 15213, USA. .,Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, 318A Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA.
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Bensley JG, Dhillon HM, Evans SM, Evans M, Bolton D, Davis ID, Dodds L, Frydenberg M, Kearns P, Lawrentschuk N, Murphy DG, Millar JL, Papa N. Self-reported lack of energy or feeling depressed 12 months after treatment in men diagnosed with prostate cancer within a population-based registry. Psychooncology 2021; 31:496-503. [PMID: 34623735 DOI: 10.1002/pon.5833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Feeling depressed and lethargic are common side effects of prostate cancer (PCa) and its treatments. We examined the incidence and severity of feeling depressed and lack of energy in patients in a population based PCa registry. METHODS We included men diagnosed with PCa between 2015 and 2019 in Victoria, Australia, and enrolled in the Prostate Cancer Outcomes Registry. The primary outcome measures were responses to two questions on the Expanded Prostate Cancer Index Composite (EPIC-26) patient reported instrument: problems with feeling depressed and problems with lack of energy 12 months following treatment. We evaluated associations between these and age, cancer risk category, treatment type, and urinary, bowel, and sexual function. RESULTS Both outcome questions were answered by 9712 out of 12,628 (77%) men. 981 patients (10%) reported at least moderate problems with feeling depressed; 1563 (16%) had at least moderate problems with lack of energy and 586 (6.0%) with both. Younger men reported feeling depressed more frequently than older men. Lack of energy was more common for treatments that included androgen deprivation therapy than not (moderate/big problems: 31% vs. 13%), irrespective of disease risk category. Both outcomes were associated with poorer urinary, bowel, and sexual functional domain scores. CONCLUSIONS Self-reported depressive feelings and lack of energy were frequent in this population-based registry. Problems with feeling depressed were more common in younger men and lack of energy more common in men having hormonal treatment. Clinicians should be aware of the incidence of these symptoms in these at-risk groups and be able to screen for them.
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Affiliation(s)
- Jonathan G Bensley
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Sue M Evans
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie Evans
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Damien Bolton
- Department of Surgery, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia.,Olivia Newton-John Cancer and Wellness Centre, Austin Health, Melbourne, Victoria, Australia
| | - Ian D Davis
- Medical Oncology Unit, Eastern Health, Melbourne, Victoria, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Lachlan Dodds
- Ballarat Health Services, Ballarat, Victoria, Australia
| | - Mark Frydenberg
- Department of Surgery, Cabrini Institute, Cabrini Health, Monash University, Melbourne, Victoria, Australia
| | | | - Nathan Lawrentschuk
- Department of Surgery and Department of Urology, University of Melbourne at Royal Melbourne Hospital, Melbourne, Victoria, Australia.,EJ Whitten Prostate Cancer Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jeremy L Millar
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia.,Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
| | - Nathan Papa
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Bonds K, Song M, Whitlatch CJ, Lyons KS, Kaye JA, Lee CS. Patterns of Dyadic Appraisal of Decision-Making Involvement of African American Persons Living With Dementia. THE GERONTOLOGIST 2021; 61:383-391. [PMID: 32609831 DOI: 10.1093/geront/gnaa086] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Greater everyday decision-making involvement by persons living with dementia (PLWD) and congruent appraisal between PLWDs and their caregivers have been associated with a better quality of life (QOL) for both members of the dyad. However, no study has examined the association between the appraisals of everyday decision-making involvement of PLWDs and their QOL among African Americans. RESEARCH DESIGN AND METHODS A secondary analysis of cross-sectional data from 62 African American dementia dyads was conducted. Multilevel and latent class mixture modeling was used to characterize dyadic appraisal of the decision-making involvement of African American PLWDs and identify distinct patterns thereof. RESULTS Three distinct patterns were observed. "Incongruent, PLWD Low Involvement" labeled 19.4% of the sample, 53.2% were labeled "Incongruent, PLWD Moderate Involvement," and 27.4% were labeled "Congruent, PLWD High Involvement." The Congruent, PLWD High Involvement pattern consisted of PLWDs who were significantly younger and had significantly less cognitive impairment than PLWDs in the other patterns. In the Incongruent, PLWD Moderate Involvement pattern, PLWDs had significantly better QOL than PLWDs in the Incongruent, PLWD Low Involvement pattern, but QOL did not significantly differ from PLWDs in the Congruent, PLWD High Involvement pattern. DISCUSSION AND IMPLICATIONS There is a need to tailor strategies to optimize QOL in African American dementia dyads. While increasing everyday decision-making involvement for PLWDs in the Incongruent, PLWD Low Involvement pattern is an important goal, other strategies may be needed to improve the QOL of PLWDs in the remaining patterns.
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Affiliation(s)
- Kalisha Bonds
- School of Nursing, Oregon Health & Science University, Portland
| | - MinKyoung Song
- School of Nursing, Oregon Health & Science University, Portland
| | - Carol J Whitlatch
- Benjamin Rose Institute on Aging, Center for Research and Education, Cleveland, Ohio
| | - Karen S Lyons
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
| | - Jeffrey A Kaye
- Department of Neurology, Layton Aging & Alzheimer's Disease Center, Oregon Health & Science University, Portland
| | - Christopher S Lee
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
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Lyons KS, Johnson SH, Lee CS. The role of symptom appraisal, concealment and social support in optimizing dyadic mental health in heart failure. Aging Ment Health 2021; 25:734-741. [PMID: 31920088 DOI: 10.1080/13607863.2020.1711866] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objectives: Heart failure patients and their family care partners experience poor mental health, yet the majority of the research focuses on patients and care partners separately. Guided by the Theory of Dyadic Illness Management, the purpose of the current study was to identify distinct patterns of dyadic mental health in heart failure and identify the individual, dyadic and familial factors associated with group membership.Method: Fifty nine heart failure community-dwelling patients and their spouse care partners were recruited from an outpatient heart failure clinic. Mental health was operationalized by depressive symptoms, measured with the Patient Health Questionnaire-9 (PHQ-9) measure of depression. Distinct groups of dyadic mental health were determined by categorizing depression scores within dyads.Results: Three groups of dyadic mental health were identified: an optimal dyadic mental health group (31%), a poor dyadic mental health group (32%) and an incongruent dyadic mental health group (37%). Patient age, patient fatigue, patient concealment, incongruent dyadic appraisal of pain interference and social/familial support were significantly associated with group membership.Conclusion: Findings underscore the salience of a dyadic approach to health and the clinical relevance of identifying patterns of dyadic mental health so we may determine those most in need of intervention.
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Jeong A, Shin D, Park JH, Park K. Attributes of caregivers' quality of life: A perspective comparison between spousal and non-spousal caregivers of older patients with cancer. J Geriatr Oncol 2020; 11:82-87. [DOI: 10.1016/j.jgo.2019.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 02/13/2019] [Accepted: 05/22/2019] [Indexed: 11/16/2022]
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Lim JW, Shon EJ. The Dyadic Effects of Family Cohesion and Communication on Health-Related Quality of Life: The Moderating Role of Sex. Cancer Nurs 2019; 41:156-165. [PMID: 28114262 PMCID: PMC5519452 DOI: 10.1097/ncc.0000000000000468] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Spouses' ability to care for survivors can be particularly challenging because patients and spouses are interdependent and mutually influence one another. Family functioning such as family cohesion and communication may play a primary role in improving the health-related quality of life (HRQOL) of couples, given that cancer can influence family dynamics. OBJECTIVE The aims of this study were to investigate the mediating effect of family communication on the relationship between family cohesion and HRQOL and examine the moderating effect of sex on this relationship among cancer survivor-spouse dyads. METHODS A total of 91 cancer survivors with a diagnosis of breast, colorectal, or prostate cancer and their spouses were recruited from the University Hospital Registry in Cleveland, Ohio. The dyadic data were analyzed using structural equation modeling with the actor-partner interdependence mediation model. RESULTS Findings demonstrated that the spouses' own perceived family communication mediated the associations between their own family cohesion and physical HRQOL and between the survivors' family cohesion and physical HRQOL. The spouse actor effects between family communication and HRQOL significantly differed by sex. CONCLUSIONS Enhancing family cohesion and communication within the family can improve the spouses' HRQOL. Findings regarding sex differences serve as a rationale for gender-based approaches to improving HRQOL in survivorship care in the family context. IMPLICATIONS FOR PRACTICE Couple- and/or family-based interventions should be designed to enhance family cohesion and improve family communication skills for effective adjustments within couples and families. Supportive care within the family context can be promoted to address the diverse challenges of survivorship care.
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Affiliation(s)
- Jung-Won Lim
- Author Affiliations: College of Social Welfare, Kangnam University, Yongin, Gyeonggi, Korea (Dr Lim); and Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH (Ms Shon)
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Mehta A, Pollack CE, Gillespie TW, Duby A, Carter C, Thelen-Perry S, Witmann D. What Patients and Partners Want in Interventions That Support Sexual Recovery After Prostate Cancer Treatment: An Exploratory Convergent Mixed Methods Study. Sex Med 2019; 7:184-191. [PMID: 30833226 PMCID: PMC6522943 DOI: 10.1016/j.esxm.2019.01.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/02/2019] [Accepted: 01/07/2019] [Indexed: 02/06/2023] Open
Abstract
Introduction Men treated for prostate cancer suffer from treatment-related sexual side effects that adversely affect their relationships and quality of life. Aim To investigate what prostate cancer survivors and their partners want from a sexual recovery intervention, and whether they consider an online tool acceptable for use in promoting sexual recovery. Methods This mixed-methods study included focus groups and interviews with both heterosexual and gay cancer survivors, as well as their partners. Focus groups and interviews probed experiences with treatment, side effects, and support received/needed for sexual recovery. Participants responded to proposed web-based intervention content. Interviews were analyzed with thematic content analysis. Their sexual function was assessed with validated measures. Main Outcome Measures Acceptability of online tools for promoting sexual recovery was evaluated. Results Participants included 14 patients and 10 partners (2 male). Patient and partner median age was 62 and 62.5 years, respectively. Treatment ranged from surgery alone to combined radiation and hormonal therapy. Qualitative data analysis yielded 5 main intervention needs: (i) pretreatment discussion of sexual side effects, rehabilitation, emotional impact and realistic expectations, (ii) improved sexual communication within couples, (iii) strategies for promoting sexual intimacy beyond penetrative intercourse, (iv) attentiveness to partners' needs, and (v) access to peer support. Gay men specifically expressed the need for improved provider understanding of their sexuality and experiences. Most considered a web-based approach to be acceptable. Conclusion Patients and partners value both pretreatment preparation for sexual recovery and support for sexual recovery for both after treatment. A web-based approach may help mitigate barriers to access to these support services. Mehta A, Pollack CE, Gillespie T., et. al. What Patients and Partners Want in Interventions That Support Sexual Recovery After Prostate Cancer Treatment: An Exploratory Convergent Mixed Methods Study. Sex Med 2019;7:184–191.
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Affiliation(s)
- Akanksha Mehta
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Craig Evan Pollack
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Theresa W Gillespie
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA; Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
| | - Ashley Duby
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Caroline Carter
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | | | - Daniela Witmann
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
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12
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Wood A, Barden S, Terk M, Cesaretti J. Prostate cancer: the influence of stigma on quality of life and relationship satisfaction for survivors and their partners. J Psychosoc Oncol 2018; 37:350-366. [PMID: 30580663 DOI: 10.1080/07347332.2018.1489442] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Prostate cancer (PCa) stigma and its relationship to quality of life (QoL) is a relatively new finding. As the experiences of couples facing PCa are shared, the study examined the relationship between of PCa stigma, QoL, and relationship satisfaction of PCa survivors and their spouses. DESIGN A correlational design with dyadic data was used. SAMPLE Participants (N = 80 dyads) were PCa survivors and their spouses sampled from an oncology center and PCa support groups. METHODS Structural equation modeling was used to assess how stigma related to the QoL and relationship satisfaction of participants. FINDINGS Stigma had a negative association with QoL, but not relationship satisfaction. There were no significant demographic differences in regards to stigma. CONCLUSION Overall, stigma has a relationship with the experience of couples, but not with every aspect of their experience. Implications for psychosocial providers: Implications for clinicians in regards to addressing PCa stigma with clients and areas for future research are discussed.
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Affiliation(s)
- Andrew Wood
- a School of Human Services , University of Cincinnati , Cincinnati , Ohio , USA
| | - Sejal Barden
- b Department of Child, Family, and Community Sciences , University of Central Florida , Orlando , Florida , USA
| | - Mitchell Terk
- c Southpoint Cancer Center , Jacksonville , Florida , USA
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Berzins TL, LaBuda JE, Gere J. An examination of accuracy and bias in perceptions of a partner's motives for health behaviour regulation. Br J Health Psychol 2018; 23:872-887. [PMID: 29882307 DOI: 10.1111/bjhp.12321] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 04/24/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study assessed accuracy and bias in people's perceptions of their romantic partner's adoption of short-term (avoid conflict) and long-term (later health) motives for interpersonally regulating their health behaviours. DESIGN A cross-sectional Web-based survey of 114 cohabiting romantic couples (N = 228 individuals) living in the United States. METHODS Romantic partners separately completed measures of their short-term and long-term motives for self-regulation and partner regulation of health behaviours, as well as their perceptions of partner regulation of their own health behaviours. Dyadic path analyses were conducted using the truth and bias model of judgement. RESULTS Targets of interpersonal regulation perceived their romantic partner's short-term and long-term motives for influencing their (the target's) health behaviour with significant accuracy. However, targets' perceptions of their partner's motives simultaneously contained about the same amount of projection of the target's own short- and long-term motives for self-regulation. There was no similarity between the target's motives for self-regulation and their partner's motives for interpersonal regulation. Targets also tended to underestimate their partner's long-term motives for interpersonal regulation. CONCLUSIONS Although people are somewhat accurate in their perceptions of their romantic partner's motives for attempting to influence their health behaviours, their perceptions are also contaminated by biases. This suggests that people's judgements about their partner's motives could be substantially improved. Statement of contribution What is known about this subject? Romantic partners use social influence tactics to improve each other's health behaviours. People who perceive their partner's influence attempts positively often make healthy changes. Misperceptions of a partner's motives for influence attempts may have health and relationship implications. What does this study add? People are aware of whether partner influence attempts are motivated by convenience or concern. People also project their own motives for self-regulating health behaviours onto their partner.
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Affiliation(s)
- Tiffany L Berzins
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Jessica E LaBuda
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Judith Gere
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
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14
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Abstract
Despite the importance of both members of the adult patient-care partner dyad, a majority of research on illness management is focused on the patient or the care partner. The basic principle of the Theory of Dyadic Illness Management is that illness management is a dyadic phenomenon; the theory focuses extensively on the dyad as an interdependent team. The way dyads appraise illness as a unit influences the ways in which they engage in behaviors to manage illness together in a recursive fashion that influences dyadic health. Optimizing the health of both members of the dyad is a goal of the theory. In turn, the health of the dyad can feedback to influence how they appraise and manage illness together. Finally, dyadic illness management is an inherently variable process that is influenced by several contextual factors. Supportive evidence and implications for practice and future research are presented.
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15
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Guercio C, Mehta A. Predictors of Patient and Partner Satisfaction Following Radical Prostatectomy. Sex Med Rev 2017; 6:295-301. [PMID: 29128271 DOI: 10.1016/j.sxmr.2017.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 08/09/2017] [Accepted: 08/17/2017] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The diagnosis and treatment of prostate cancer adversely affects the physical and emotional well-being of patients and partners and has been associated with sexual dysfunction in patients and their intimate partners. AIM To identify predictors of sexual satisfaction in prostate cancer survivors and their partners based on a review of the current literature. METHODS We performed a comprehensive review of the PubMed database from January 2000 to May 2017 focused on the (i) prevalence of patient and partner sexual dysfunction related to radical prostatectomy, (ii) differences in patient and partner perspectives of sexual function and dysfunction, and (iii) predictors of patient and partner sexual satisfaction after radical prostatectomy. MAIN OUTCOME MEASURES Patient- and partner-reported sexual satisfaction. RESULTS There is a paucity of published data examining sexual satisfaction in prostate cancer survivors and their partners. Patients and partners can have different expectations of sexual outcomes after radical prostatectomy and different attitudes toward the relative importance of recovery of sexual function after surgery. Available data suggest that patients' and partners' mental and physical health and the quality of communication between them are important contributors to their sexual satisfaction. Patient-perceived partner support also is associated with better patient-reported erectile function and greater relationship satisfaction. CONCLUSION Mental health, physical health, quality of interpersonal communication, and patient-perceived partner support appear to be the most important predictors of sexual satisfaction for patients and partners in the post-prostatectomy period. There is a definite need for further research on this topic to develop interventions to improve sexual function and quality of life for prostate cancer survivors and their intimate partners. Guercio C, Mehta A. Predictors of Patient and Partner Satisfaction Following Radical Prostatectomy. Sex Med Rev 2018;6:295-301.
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Affiliation(s)
- Cailey Guercio
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Akanksha Mehta
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA.
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16
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Chien CH, Chuang CK, Liu KL, Huang XY, Pang ST, Wu CT, Chang YH, Liu HE. Individual and mutual predictors of marital satisfaction among prostate cancer patients and their spouses. J Clin Nurs 2017; 26:4994-5003. [DOI: 10.1111/jocn.13998] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2017] [Indexed: 01/04/2023]
Affiliation(s)
- Ching-Hui Chien
- College of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| | - Cheng-Keng Chuang
- Division of Urology; Department of Surgery; Chang Gung Memorial Hospital at Linkou; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Kuan-Lin Liu
- Division of Urology; Department of Surgery; Chang Gung Memorial Hospital at Linkou; Tao-Yuan Taiwan
| | - Xuan-Yi Huang
- College of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| | - See-Tong Pang
- Division of Urology; Department of Surgery; Chang Gung Memorial Hospital at Linkou; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Chun-Te Wu
- Division of Urology; Department of Surgery; Chang Gung Memorial Hospital at Keelung, Taiwan; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Ying-Hsu Chang
- Division of Urology; Department of Surgery; Chang Gung Memorial Hospital at Linkou; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Hsueh-Erh Liu
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
- Department of Nursing; College of Nursing; Chang Gung University of Science and Technology; Tao-Yuan Taiwan
- Department of Rheumatology; Chang Gung Memorial Hospital; LinKou Tao-Yuan Taiwan
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17
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Harju E, Rantanen A, Kaunonen M, Helminen M, Isotalo T, Åstedt-Kurki P. The health-related quality of life of patients with prostate cancer and their spouses before treatment compared with the general population. Int J Nurs Pract 2017; 23. [DOI: 10.1111/ijn.12572] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 04/04/2017] [Accepted: 05/18/2017] [Indexed: 02/01/2023]
Affiliation(s)
- Eeva Harju
- Faculty of Social Sciences, Nursing Science; University of Tampere; Finland
| | - Anja Rantanen
- Faculty of Social Sciences, Nursing Science; University of Tampere; Finland
| | - Marja Kaunonen
- Faculty of Social Sciences, Nursing Science; University of Tampere; Finland
- Department of General Administration; Pirkanmaa Hospital District; Finland
| | - Mika Helminen
- Faculty of Social Sciences, Nursing Science; University of Tampere; Finland
- Science Centre; Pirkanmaa Hospital District; Finland
| | - Taina Isotalo
- Department of Surgery; Päijät-Häme Central Hospital; Lahti Finland
| | - Päivi Åstedt-Kurki
- Faculty of Social Sciences, Nursing Science; University of Tampere; Finland
- Department of General Administration; Pirkanmaa Hospital District; Finland
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18
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La IS, Yun EK. Effects of stress appraisal on the quality of life of adult patients with multiple myeloma and their primary family caregivers in Korea. Psychooncology 2017; 26:1640-1646. [DOI: 10.1002/pon.4348] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 11/01/2016] [Accepted: 12/12/2016] [Indexed: 12/23/2022]
Affiliation(s)
- In Seo La
- College of Nursing Science, Kyung Hee University; Seoul South Korea
| | - Eun Kyoung Yun
- College of Nursing Science, Kyung Hee University; Seoul South Korea
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19
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Harju E, Rantanen A, Kaunonen M, Helminen M, Isotalo T, Åstedt-Kurki P. Marital relationship and health-related quality of life after prostate cancer diagnosis. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2016. [DOI: 10.1111/ijun.12131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Eeva Harju
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
| | - Anja Rantanen
- University Teacher, School of Health Sciences, Nursing Science, University of Tampere; Arvo FI-33014 University of Tampere Finland
| | - Marja Kaunonen
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
- Department of General Administration; Pirkanmaa Hospital District; FI-33521 Tampere University Hospital Finland
| | - Mika Helminen
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
- Science Centre; Pirkanmaa Hospital District; FI-33521 Tampere University Hospital Finland
| | - Taina Isotalo
- Department of Surgery; Päijät-Häme Central Hospital; Keskussairaalankatu 7 FI-15850 Lahti Finland
| | - Päivi Åstedt-Kurki
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
- Department of General Administration; Pirkanmaa Hospital District; FI-33521 Tampere University Hospital Finland
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Umberson D, Thomeer MB, Reczek C, Donnelly R. Physical Illness in Gay, Lesbian, and Heterosexual Marriages: Gendered Dyadic Experiences. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2016; 57:517-531. [PMID: 27799592 PMCID: PMC5123905 DOI: 10.1177/0022146516671570] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The inclusion of same-sex married couples can illuminate and challenge assumptions about gender that are routinely taken for granted in studies of physical illness. We analyze gender dynamics in gay, lesbian, and heterosexual marriages with in-depth interview data from 90 spouses (45 couples) to consider how spouses co-construct illness experiences in ways that shape relationship dynamics. Overall, findings indicate that men tend to downplay illness and thus provide minimal care work, whereas women tend to construct illness as immersive and involving intensive care work-in both same-sex and different-sex marriages. Yet same-sex spouses describe similar constructions of illness much more so than different-sex couples, and as such, same-sex spouses describe less illness-related disagreement and stress. These findings help inform policies to support the health of gay and lesbian, as well as heterosexual, patients and their spouses, an important goal given health disparities of gay and lesbian populations.
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21
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Saltmarsh N, Murphy B, Bennett P, Higgins R, Macvean M, Le Grande M, Thompson D, Ski C, Worcester M, Jackson A. Distress in partners of cardiac patients: relationship quality and social support. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/bjca.2016.11.8.397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Nadine Saltmarsh
- Research Fellow, Australian Centre for Heart Health; Department of Psychology and Counselling, La Trobe University, Bendigo, Australia
| | - Barbara Murphy
- Associate Professor, Australian Centre for Heart Health, Melbourne; Faculty of Health, Deakin University; Department of Psychology, University of Melbourne; Department of Behavioural Medicine, University of Newcastle, Australia
| | - Pauleen Bennett
- Associate Professor, Department of Psychology and Counselling, La Trobe University, Bendigo, Australia
| | - Rosemary Higgins
- Associate Professor, Australian Centre for Heart Health, Melbourne; Department of Psychology, Deakin University, Melbourne; Department of Physiotherapy, University of Melbourne, Australia
| | - Michelle Macvean
- Former Research Fellow, Heart Research Centre, Melbourne, Australia
| | - Michael Le Grande
- Research Fellow, Australian Centre for Heart Health, Melbourne; Faculty of Health, Deakin University, Melbourne, Australia
| | - David Thompson
- Professor, University of Melbourne, Department of Psychiatry, Melbourne, Australia
| | - Chantal Ski
- Associate Professor, University of Melbourne, Department of Psychiatry, Melbourne, Australia
| | - Marian Worcester
- Former Director, Heart Research Centre, Melbourne; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Alun Jackson
- Professor, Australian Centre for Heart Health, Melbourne; Faculty of Health, Deakin University, Melbourne, Australia; Centre on Behavioural Health, Hong Kong University, Hong Kong
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22
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Van Dam D, Wassersug RJ, Hamilton LD. Androgen deprivation therapy's impact on the mood of prostate cancer patients as perceived by patients and the partners of patients. Psychooncology 2015; 25:848-56. [PMID: 26332203 DOI: 10.1002/pon.3932] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 06/04/2015] [Accepted: 07/15/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the relationship between of androgen deprivation therapy (ADT) and the mood of prostate cancer (PCa) patients and partners of PCa patients. METHODS PCa patients (n = 295) and partners of patients (n = 84) completed an online survey assessing the patients' current mood and mood prior to treatment, relationship adjustment, and sexual function. We compared men on ADT to men who received non-hormonal treatments for their PCa. RESULTS Patients currently treated with ADT (n = 82) reported worsened mood as measured by the Profile of Mood States compared to those not on ADT (n = 213). The negative impact of ADT on mood, however, was reduced in older patients. Partners of patients on ADT (n = 42) reported similar declines in the patient's mood that patients reported, but to a greater degree than patient-reported levels. CONCLUSIONS Our data support ADT's impact on PCa patients' mood and verify that partners concurrently see the effects. The psychological changes related to ADT can impact relationships and affect the quality of life of both PCa patients and partners. Patients and their partners are likely to benefit from being well informed about the psychological effects of androgen deprivation on men beginning ADT. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Dexter Van Dam
- Psychology Department, Mount Allison University, Sackville, NB, Canada
| | - Richard J Wassersug
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.,Australian Research Centre in Sex, Health, and Society, La Trobe University, Melbourne, VIC, Australia
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23
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Giannousi Z, Karademas EC, Dimitraki G. Illness representations and psychological adjustment of Greek couples dealing with a recently-diagnosed cancer: dyadic, interaction and perception-dissimilarity effects. J Behav Med 2015; 39:85-93. [PMID: 26260786 DOI: 10.1007/s10865-015-9664-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 07/30/2015] [Indexed: 01/06/2023]
Abstract
The aim was to examine the impact of the dyadic, interaction and dissimilarity effects of the illness representations on the psychological health of recently diagnosed cancer patients and spouses in Greece. The sample consisted of 298 individuals nested in 149 couples. Effects were examined with the Actor-Partner Interdependence Model. Both actor (i.e., within person) and partner (i.e., between partners) effects were detected for both patients' and spouses' psychological symptoms. The negative association of patients' psychological symptoms with their representations of illness coherence was weak at the higher and medium levels, and stronger at the lower levels of spouse corresponding representations. Patient-partner discrepancy in perceived illness consequences was associated with more psychological symptoms in patients. Adaptation to cancer is a dyadic process within the context of which patient and partner psychological well-being is affected by each other's understanding of illness. Thus, the parallel examination of the illness representations of both partners is needed from the early phases of the illness trajectory.
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Affiliation(s)
- Zoe Giannousi
- Bank of Cyprus Oncology Centre, 32, Akropoleos Av., 2006, Nicosia, Cyprus.
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24
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Magsamen-Conrad K, Checton MG, Venetis MK, Greene K. Communication Efficacy and Couples' Cancer Management: Applying a Dyadic Appraisal Model. COMMUNICATION MONOGRAPHS 2015; 82:179-200. [PMID: 25983382 PMCID: PMC4430110 DOI: 10.1080/03637751.2014.971415] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The purpose of the present study was to apply Berg and Upchurch's (2007) developmental-conceptual model to understand better how couples cope with cancer. Specifically, we hypothesized a dyadic appraisal model in which proximal factors (relational quality), dyadic appraisal (prognosis uncertainty), and dyadic coping (communication efficacy) predicted adjustment (cancer management). The study was cross-sectional and included 83 dyads in which one partner had been diagnosed with and/or treated for cancer. For both patients and partners, multilevel analyses using the actor-partner interdependence model (APIM) indicated that proximal contextual factors predicted dyadic appraisal and dyadic coping. Dyadic appraisal predicted dyadic coping, which then predicted dyadic adjustment. Patients' confidence in their ability to talk about the cancer predicted their own cancer management. Partners' confidence predicted their own and the patient's ability to cope with cancer, which then predicted patients' perceptions of their general health. Implications and future research are discussed.
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Affiliation(s)
| | - Maria G Checton
- Department of Health Care Management, College of Saint Elizabeth
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25
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Parrott RL, Smith RA, Hong SJ, Worthington A. Congruence-Incongruence Patterns in Alpha-1 Antitrypsin Deficiency Couples' Genetic Determinist Beliefs and Perceived Control over Genes: Implications for Clinical and Public Health Genomic Communication. J Genet Couns 2015; 24:532-40. [PMID: 25413221 PMCID: PMC4437887 DOI: 10.1007/s10897-014-9786-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022]
Abstract
Genomics makes possible the isolation of multiple genes as co-factors that increase, but do not determine, risk for many adult-onset medical conditions, including alpha-1 antitrypsin deficiency (AATD). Those diagnosed with an adult-onset medical condition, such as AATD, are often married and make decisions about testing and care as a couple. We examined genetic essentialist and threat beliefs, focusing on beliefs about the genetic contribution to disease susceptibility and severity, as well as perceptions of control related to genes and health for married couples (N =59), in which one spouse has been tested for genetic mutations associated with AATD. The intraclass correlation for spouses' beliefs about genetic essentialism was strong and statistically significant, but the associations for their other beliefs were not. Incongruence between AATD participants and their spouses regarding genes' influence on disease severity directly related to incongruent perceptions of control and genetic contribution to disease susceptibility. Results revealed an inverse relationship to AATD participants' perceptions of behavioral control and a direct relationship to their beliefs about genes' influence on disease severity. This suggests a pattern of incongruence in which AATD participants have low levels of perceived control over genes' influence on health and high levels of perceived genetic influence on disease severity compared to spouses. With public health communication efforts lagging behind the science of genomics, insights regarding the congruence or incongruence associated with married couples' beliefs about genes' influence on disease afford pathways to guide clinical and public health communication about genomics.
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Affiliation(s)
- Roxanne L Parrott
- Communication Arts and Sciences, The Pennsylvania State University, University Park, PA, USA,
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26
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Checton MG, Magsamen-Conrad K, Venetis MK, Greene K. A Dyadic Approach. HEALTH EDUCATION & BEHAVIOR 2014; 42:257-67. [DOI: 10.1177/1090198114557121] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of the present study was to apply Berg and Upchurch’s developmental-conceptual model toward a better understanding of how couples cope with chronic illness. Specifically, a model was hypothesized in which proximal factors (relational quality), dyadic appraisal (illness interference), and dyadic coping (partner support) influence adjustment (health condition management). The study was cross-sectional and included 308 dyads in which one partner has a chronic health condition. The actor partner interdependence model shows how congruence and noncongruence in relational quality, dyadic appraisal, and dyadic coping influence dyadic adjustment.
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27
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Lafaye A, Petit S, Richaud P, Houédé N, Baguet F, Cousson-Gélie F. Dyadic effects of coping strategies on emotional state and quality of life in prostate cancer patients and their spouses. Psychooncology 2014; 23:797-803. [PMID: 24493581 DOI: 10.1002/pon.3483] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 11/01/2013] [Accepted: 12/17/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND During cancer, coping strategies adopted by patients with prostate cancer and their spouses have an effect on their own emotional state and quality of life (QoL). However, the effects of coping strategies used by a member of a couple on the well-being of the other member are unknown. The aim of this study is to examine the dyadic effects of coping strategies on the emotional state and QoL of couples dealing with cancer. METHODS Ninety-nine couples completed various self-questionnaires to assess psychological and physical QoL, anxiety, depressive symptoms, and coping strategies at the beginning, middle, and end of primary treatment. RESULTS Results obtained with the actor-partner interdependence model showed that coping strategies used by patients or spouses play a key role not only in their own well-being but also in their partners'. Indeed, when patients use problem-focused coping or social support-seeking, they, as well as their spouses, experience fewer anxiety and depressive symptoms. Conversely, patients or spouses who use emotion-focused coping experience higher levels of anxiety and depressive symptoms. Finally, and it is a surprising result, when spouses seek social support, patients feel greater anxiety. CONCLUSIONS These findings suggest that both patients and spouses should be included in psychosocial programs, which develop and reinforce their ability to cope with cancer. Couples may benefit from membership in support groups allowing them to share their experiences.
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Affiliation(s)
- Anaïs Lafaye
- Laboratory Epsylon EA4556 Dynamics of Human Abilities and Health Behaviors, University of Montpellier, Montpellier, France
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28
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Li Q, Loke AY. A literature review on the mutual impact of the spousal caregiver–cancer patients dyads: ‘Communication’, ‘reciprocal influence’, and ‘caregiver–patient congruence’. Eur J Oncol Nurs 2014; 18:58-65. [DOI: 10.1016/j.ejon.2013.09.003] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 09/02/2013] [Accepted: 09/04/2013] [Indexed: 10/26/2022]
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Patterns and predictors of symptom incongruence in older couples coping with prostate cancer. Support Care Cancer 2013; 22:1341-8. [PMID: 24337765 DOI: 10.1007/s00520-013-2092-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE Prostate cancer survivors (PCSs) may experience persistent symptoms following treatment. If PCSs and spouses differ in their perceptions of symptoms, that incongruence may cause mismanagement of symptoms and reduced relationship quality. The purpose of this study was to examine symptom incongruence and identify the PCS and spouse characteristics associated with symptom incongruence in older couples coping with prostate cancer. METHODS Participants in the study were older PCSs (>60 years) and their spouses (N=59 couples). Symptom incongruence was determined by comparing patient and spouse independent ratings of the severity of his cancer-related symptoms. Predictor variables included PCS age, time since diagnosis, PCS comorbidity, PCS and spouse depressive symptoms, and spouse caregiving strain. RESULTS PCS and spouse ratings of his symptom severity and the amount of incongruence over his symptoms varied significantly across couples. Overall, couples rated a moderate level of PCS symptom severity, but PCSs and their spouses significantly differed in their perceptions of PCS symptom severity with spouses rating severity higher (t=-2.66, df=51, p<0.01). PCS younger age and high spouse caregiver strain accounted for 29 % of incongruence in perceptions of PCS symptom severity. CONCLUSIONS This study is among the first to show that PCSs and spouses may perceive cancer-related persistent symptoms differently. Among this older sample, younger PCS age and spouse caregiver strain were associated with incongruence in symptoms perceptions in couples. These and other factors may inform future interventions aimed at preserving relationship quality in older couples who have experienced prostate cancer.
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Walker LM, Tran S, Wassersug RJ, Thomas B, Robinson JW. Patients and partners lack knowledge of androgen deprivation therapy side effects. Urol Oncol 2013; 31:1098-105. [DOI: 10.1016/j.urolonc.2011.12.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 11/23/2011] [Accepted: 12/20/2011] [Indexed: 10/14/2022]
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31
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Hill DL, Miller VA, Hexem KR, Carroll KW, Faerber JA, Kang T, Feudtner C. Problems and hopes perceived by mothers, fathers and physicians of children receiving palliative care. Health Expect 2013; 18:1052-65. [PMID: 23683168 DOI: 10.1111/hex.12078] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2013] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The quality of shared decision making for children with serious illness may depend on whether parents and physicians share similar perceptions of problems and hopes for the child. OBJECTIVE (i) Describe the problems and hopes reported by mothers, fathers and physicians of children receiving palliative care; (ii) examine the observed concordance between participants; (iii) examine parental perceived agreement; and (iv) examine whether parents who identified specific problems also specified corresponding hopes, or whether the problems were left 'hopeless'. METHOD Seventy-one parents and 43 physicians were asked to report problems and hopes and perceived agreement for 50 children receiving palliative care. Problems and hopes were classified into eight domains. Observed concordance was calculated between parents and between each parent and the physicians. RESULTS The most common problem domains were physical body (88%), quality of life (74%) and medical knowledge (48%). The most common hope domains were quality of life (88%), suffering (76%) and physical body (39%). Overall parental dyads demonstrated a high percentage of concordance (82%) regarding reported problem domains and a lower percentage of concordance on hopes (65%). Concordance between parents and physicians regarding specific children was lower on problem (65-66%) and hope domains (59-63%). Respondents who identified problems regarding a child's quality of life or suffering were likely to also report corresponding hopes in these domains (93 and 82%, respectively). CONCLUSION Asking parents and physicians to talk about problems and hopes may provide a straightforward means to improve the quality of shared decision making for critically ill children.
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Affiliation(s)
- Douglas L Hill
- Pediatric Advanced Care Team, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Victoria A Miller
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kari R Hexem
- Pediatric Advanced Care Team, The University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| | - Karen W Carroll
- Pediatric Advanced Care Team, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jennifer A Faerber
- Pediatric Advanced Care Team, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Tammy Kang
- Pediatric Advanced Care Team, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Chris Feudtner
- Pediatric Advanced Care Team, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Wu LM, Mohamed NE, Winkel G, Diefenbach MA. Patient and spouse illness beliefs and quality of life in prostate cancer patients. Psychol Health 2012; 28:355-68. [PMID: 22971045 DOI: 10.1080/08870446.2012.722219] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Among married prostate cancer (PC) patients, the spouse is often the primary provider of emotional support and personal care. However, few studies have investigated spouses' illness beliefs (i.e. about disease duration and treatment control) and their impact on patients' quality of life (QOL). Spouses' beliefs about disease duration (timeline) were hypothesised to mediate relationships between spouses' treatment control beliefs and patients' QOL six months later. METHODS Fifty-three patients who underwent localised treatment for PC, and their spouses, completed an illness beliefs measure (the revised Illness Perception Questionnaire). Patients completed a QOL measure (the Functional Assessment of Cancer Therapy - General) six months later. RESULTS Spouse timeline beliefs mediated the association between spouse treatment control beliefs and patient QOL six months later (total indirect effect = -0.71, 95% CI 0.02-2.03). That is, spouse beliefs that the treatment would control their loved one's illness led to beliefs that the disease would be of shorter duration, which in turn led to improved patient QOL six months later. This relationship did not occur with patients' beliefs. CONCLUSION Results highlight the important influence of spouse illness beliefs over time on patient QOL with implications for clinical care and dyadic research.
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Affiliation(s)
- Lisa M Wu
- Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA
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Karademas EC, Giannousi Z. Representations of control and psychological symptoms in couples dealing with cancer: a dyadic-regulation approach. Psychol Health 2012; 28:67-83. [PMID: 22891688 DOI: 10.1080/08870446.2012.713954] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The aim of this study was to examine the relation between illness representations of personal and treatment control and psychological symptoms (i.e. symptoms of anxiety and depression) in 72 married couples dealing with a recently diagnosed cancer. Patients were first-diagnosed with early stage (45.83%) or metastatic cancer (54.17%). Dyadic responses were examined with the actor-partner interdependence model. Also, in order to examine whether patients and spouses' representations of control moderate the relation of their partners' corresponding representations to psychological symptoms, we used the relevant bootstrapping framework developed by Hayes and Matthes [(2009). Computational procedures for probing interactions in OLS and logistic regression: SPSS and SAS implementations. Behavior Research Methods, 41, 924-936]. Patients' symptoms of anxiety and depression were associated with both partners' representations of control. Chi-square difference tests indicated that actor and partner effects were equal. Spouses' symptoms of anxiety and depression were related only to their own representations. Moreover, spouses' representations of personal control moderated the relation of patients' corresponding representations to depressive symptoms, whereas patients' representations of treatment control moderated the relation of their spouses' corresponding representations to both anxiety and depression. Findings suggest that both partners' representations of control are important for adaptation to illness. Moreover, they indicate that dyadic regulation may be equally important to self-regulation as far as adaptation to illness is concerned.
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