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Chen X, Xu X, Wang T, Qiu C, Li M. Couple communication quality and family resilience among Chinese gynecologic cancer patients and their spouses: a dyadic study. Support Care Cancer 2023; 31:271. [PMID: 37060357 DOI: 10.1007/s00520-023-07727-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/03/2023] [Indexed: 04/16/2023]
Abstract
PURPOSE The purpose of this study was to explore the couple communication process for gynecologic cancer (GC) patients and their spouses. Particular attention was given to examining the relationship between couple communication quality and family resilience for GC dyads. METHODS In this cross-sectional study, 354 dyads were recruited from a gynecology ward of a public hospital in China. The patients and their spouses completed the Couples' Communication Quality Scale and the Family Hardiness Index. This study used the actor-partner interdependence model (APIM) to examine the effect of couple communication quality on family resilience in distinguishable GC dyads. RESULTS Both GC patients and their spouses reported a moderate level of couple communication quality and family resilience, but spouses reported better couple communication and family resilience than patients. With the exception of perceived response, for which only a patient actor effect was observed, the factors of couple communication quality had significant actor effects on family resilience for both patients and spouses. Additionally, four significant partner effects were found: spouse self-disclosure, stress coping, and productive action positively predicted patients' family resilience, while patient normalcy crafting positively predicted spouses' family resilience. CONCLUSION This study not only highlights the need for couple-based communication strategies for developing family resilience but also identifies differences in the experiences of patients and their partners, which provides a direction for future intervention research. Through the development of interventions at a dyadic level, spouses can be encouraged to actively engage in communication, which may promote mutual family resilience in a larger sense.
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Affiliation(s)
- Xiaoxin Chen
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Xiaoxiang Xu
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Tianyi Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Chengmiao Qiu
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Min Li
- Department of Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, China.
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Kapadia-Kundu N, Tamene H, Ayele M, Dana F, Heliso S, Velu S, Berhanu T, Alemayehu G, Leslie L, Kaufman M. Applying a gender lens to social norms, couple communication and decision making to increase modern contraceptive use in Ethiopia, a mixed methods study. Reprod Health 2022; 19:138. [PMID: 35765014 PMCID: PMC9237964 DOI: 10.1186/s12978-022-01440-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ethiopia, sub-Saharan Africa's second most populous country has seen improvements in women's reproductive health. The study objectives are (1) using mixed methods research, to identify determinants of contraceptive use in four regions of Ethiopia, and (2) to explore the relationship between social norms, gender equitable norms, couple communication and contraceptive use. METHODS The study includes both quantitative and qualitative methods. Researchers interviewed a total of 2770 women of reproductive age (15-49 years) in 2016 using a structured survey covering six health areas. Eligible households were identified using a multi-stage cluster-sampling technique. Using probability proportionate to size sampling, the researchers selected 10% of the proposed target woredas (24 of 240 woredas). The qualitative study included 8 rapid assessments, 16 in-depth interviews, 24 key informant interviews, and 16 focus group discussions. Qualitative data were analyzed using NVivo version 8. RESULTS Adjusted odds ratios were estimated for current modern family planning use among married women with logistic regression. The primary influencing factors for contraceptive use are gender equitable norms, high self-efficacy, and weekly exposure to the radio. Qualitative data indicate that the timing of contraceptive use is linked to the social norm of the desired family size of 4-5 children. Gender inequity is evident in couple communication with men controlling decision making even if women initiated conversations on family planning. A key finding based on an inductive analysis of qualitative data indicates that the micro-processes of couple communication and decision making are often dictated by male advantage. The study identified six micro-processes that lead to gender inequity which need to be further examined and researched. CONCLUSIONS Barriers to contraceptive use include unequal couple communication and compromised decision making. Inequitable gender norms are also barriers to modern contraceptive use. The study recommends using a gender lens to study couple communication and decision making, with the goal of making both processes more equitable to accelerate the adoption of modern family planning methods in Ethiopia.
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Affiliation(s)
- Nandita Kapadia-Kundu
- Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA.
| | - Habtamu Tamene
- Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Ethiopia, Africa Avenue (Bole Road) Dembel City Center 10th Floor, P.O. Box: 26171 Code 1000, Addis Ababa, Ethiopia
| | - Minyahil Ayele
- Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Ethiopia, Africa Avenue (Bole Road) Dembel City Center 10th Floor, P.O. Box: 26171 Code 1000, Addis Ababa, Ethiopia
| | - Feleke Dana
- Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Ethiopia, Africa Avenue (Bole Road) Dembel City Center 10th Floor, P.O. Box: 26171 Code 1000, Addis Ababa, Ethiopia
| | - Simon Heliso
- Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Ethiopia, Africa Avenue (Bole Road) Dembel City Center 10th Floor, P.O. Box: 26171 Code 1000, Addis Ababa, Ethiopia
| | - Sanjanthi Velu
- Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
| | - Tsega Berhanu
- Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Ethiopia, Africa Avenue (Bole Road) Dembel City Center 10th Floor, P.O. Box: 26171 Code 1000, Addis Ababa, Ethiopia
| | - Guda Alemayehu
- United States Agency for International Development (USAID/Ethiopia), 3Q57+9C7, Addis Ababa, Ethiopia
| | - Lindsey Leslie
- Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
| | - Michelle Kaufman
- Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
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Hernandez JH, Babazadeh S, Anglewicz PA, Akilimali PZ. As long as (I think) my husband agrees…: role of perceived partner approval in contraceptive use among couples living in military camps in Kinshasa, DRC. Reprod Health 2022; 19:6. [PMID: 35022043 PMCID: PMC8756630 DOI: 10.1186/s12978-021-01256-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Male partner's approval is a key determinant of contraceptive use for women living in Sub-Saharan Africa and improving men's support and couple communication is a cornerstone of family planning programs. However, approval is often only measured through the women's perception of their partner's opinion. METHODS This study conducted in Kinshasa compares contraceptive approval variables from matched male and female partners (n = 252 couples) to establish the frequency of (in)accurate perceptions by the woman, then test their association with modern contraceptive use. Additional regressions estimate individual and couple variables associated with (in)correct perceptions. RESULTS Results confirm women are poorly aware of their partner's opinion but indicate that perceived approval or disapproval by the woman is a much stronger determinant of modern contraceptive use than her partner's actual opinion. Higher educational achievement from the woman is the strongest driver of misunderstanding her partner's approval. CONCLUSIONS Women's perceptions of partner's approval are much stronger determinant of contraceptive use than the latter's actual opinion, and stereotyping men's opinion of family planning is a common error of appreciation. However, findings also suggest these misunderstandings might serve women's capacity to negotiate contraceptive use.
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Affiliation(s)
- Julie H Hernandez
- Department of International Health and Sustainable Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, New Orleans, LA, 70112, USA.
| | - Saleh Babazadeh
- Department of Health Policy and Management, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Philip A Anglewicz
- Department of Population, Family, and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pierre Z Akilimali
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
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Comrie-Thomson L, Gopal P, Eddy K, Baguiya A, Gerlach N, Sauvé C, Portela A. How do women, men, and health providers perceive interventions to influence men's engagement in maternal and newborn health? A qualitative evidence synthesis. Soc Sci Med 2021; 291:114475. [PMID: 34695645 DOI: 10.1016/j.socscimed.2021.114475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 12/29/2022]
Abstract
Globally, there is growing awareness of the important contributions men can make as key stakeholders in maternal and newborn health (MNH), and increased investment in interventions designed to influence men's engagement to improve MNH outcomes. Interventions typically target men, women, couples or health providers, yet how these stakeholders perceive and experience interventions is not well understood and the fact that women may experience these interventions as disempowering has been identified as a major concern. This review aims to synthesise how women, men, and providers perceive and experience interventions designed to influence men's engagement in MNH, in order to identify perceived benefits and risks of participating in interventions, and other key factors affecting uptake of and adherence to interventions. We conducted a qualitative evidence synthesis based on a systematic search of the literature, analysing a purposive sample of 66 out of 144 included studies to enable rich synthesis. Women, men and providers report that interventions enable more and better care for women, newborns and men, and strengthen family relationships between the newborn, father and mother. At the same time, stakeholders report that poorly designed or implemented interventions carry risks of harm, including constraining some women's access to MNH services and compounding negative impacts of existing gender inequalities. Limited health system capacity to deliver men-friendly MNH services, and pervasive gender inequality, can limit the accessibility and acceptability of interventions. Sociodemographic factors, household needs, and peer networks can influence how men choose to support MNH, and may affect demand for and adherence to interventions. Overall, perceived benefits of interventions designed to influence men's engagement in MNH are compelling, reported risks of harm are likely manageable through careful implementation, and there is clear evidence of demand from women and men, and some providers, for increased opportunities and support for men to engage in MNH.
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Grabert BK, Speizer IS, Domino ME, Frerichs L, Corneli A, Fried BJ. Couple communication and contraception use in urban Senegal. SAGE Open Med 2021; 9:20503121211023378. [PMID: 34158943 PMCID: PMC8182225 DOI: 10.1177/20503121211023378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 05/19/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives: Couple communication about family planning has been shown to increase uptake
of contraception. However, couple communication is often measured based
solely on one partner’s report of communication. This research investigates
the influence of couple-reported communication about family planning on
current and future use of contraception using couple-level data. Methods: We used baseline data from the Measurement, Learning, and Evaluation (MLE)
project collected through household surveys in 2011 from a cross-sectional
representative sample of women and men in urban Senegal to conduct secondary
data analysis. We used multivariable logit models to estimate the average
marginal effects of couple communication about family planning on current
contraception use and future intention to use contraception. Results: Couple communication about family planning reported by both partners was
significantly associated with an increased likelihood of current use of
contraception and with future intention to use contraception among
non-contracepting couples. Couples where one partner reported discussing
family planning had a 25% point greater likelihood of current contraception
use than couples where neither partner reported discussing, while couples
where both partners reported discussing family planning had a 56% point
greater likelihood of current contraception use, representing more than
twice the effect size. Among couples not using contraception, couples where
one partner reported discussing family planning had a 15% point greater
likelihood of future intention to use contraception than couples where
neither partner reported discussing, while couples where both partners
reported discussing family planning had a 38% point greater likelihood of
future intention to use contraception. Conclusion: These findings underscore the importance of the inclusion of both partners in
family planning programs to increase communication about contraception and
highlight the need for future research using couple-level data, measures,
and analysis.
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Affiliation(s)
- Brigid K Grabert
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ilene S Speizer
- Department of Maternal and Child Health, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.,Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marisa Elena Domino
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.,Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Leah Frerichs
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Amy Corneli
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Bruce J Fried
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
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Hawkey A, Ussher JM, Perz J, Parton C. Talking but not always understanding: couple communication about infertility concerns after cancer. BMC Public Health 2021; 21:161. [PMID: 33468106 PMCID: PMC7816453 DOI: 10.1186/s12889-021-10188-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 01/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer related infertility can have an impact on couple relationships, with evidence that couple communication facilitates coping. However, little is known about the ways in which couples communicate about cancer-related fertility concerns. The aim of this article is to examine couple communication about fertility concerns in the context of cancer, and the perceived quality of such communication from the perspective of cancer survivors and their partners. METHODS Eight-hundred and seventy-eight cancer survivors (693 women, 185 men) and 144 partners (82 women, 62 men), across a range of tumour types and age groups, completed a survey which examined cancer related fertility concerns. Seventy-eight survivors (61 women and 17 men), and 26 partners (13 women and 13 men), participated in semi-structured interviews, in order to examine the subjective experience of fertility concerns in-depth. Thematic analysis was used to analyse the interviews and open ended survey questions. Valid percentages for single items from the relationships subscale of the Fertility Preservation Inventory (FPI) related to qualitative themes, identified frequency of responses. RESULTS The major theme was 'talking but not always understanding". 89.6% of cancer survivors and partners (95.1%) reported working well together handling fertility questions (FPI), but agreed that communication could be improved (65.9% survivors; 65% partners). Open and honest couple communication was associated with feelings of support, understanding and relationship growth, including perception of partner comfort (79.2% survivors, 81.6% partners). However, 32% survivors and 31.1% partners concealed fertility concerns to avoid upsetting their partner, or reported that their partner doesn't understand their fertility concerns (survivors 25.5%, partners 14.6%), with 14.1% of cancer survivors and 19.4% partners reporting fear of relationship breakdown because of fertility issues. Fear of rejection when forming new relationships, and concerns about how to talk to future partners, was reported by non-partnered individuals. CONCLUSION Health-care professionals should include partners of cancer survivors in fertility discussions. Couple interventions developed in general psycho-oncology should be extended to the domain of fertility, in order to facilitate effective couple communication. Communication in future relationships needs to be addressed for single people and adolescents and young adults (AYAs) who have fertility concerns.
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Affiliation(s)
- Alexandra Hawkey
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, Australia
| | - Jane M Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, Australia.
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, Australia
| | - Chloe Parton
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, Australia
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Matthey S, Cibralic S, Leonard K, Baker V. Increasing partner communication and understanding during pregnancy: evaluation of 'The Great Pregnancy Quiz'. J Reprod Infant Psychol 2020; 39:435-451. [PMID: 32835505 DOI: 10.1080/02646838.2020.1802705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate a Quiz designed to enhance communication and understanding in expectant parents. BACKGROUND A supportive and understanding relationship is associated with better maternal mental health outcomes. Many services therefore advocate that couples should communicate openly with each other, particularly about worries or concerns either have. To facilitate this a quiz (The Great Pregnancy Quiz) was developed and evaluated in this project. METHOD English-speaking women (N = 442) and men (N = 146) were recruited from antenatal clinics or classes and were given the 'Great Pregnancy Quiz' to complete at home. Approximately 2-4 weeks (T2) later they participated in either a phone interview, an online survey, or a face-face interview, still during the pregnancy, concerning the impact of the Quiz. Data were available from 90 women and 46 men. Data were analysed using a mixed-methods single group post-test only design. RESULTS Most women (78 of the 90: 87%) and men (35 of the 46: 76%) reported that the Quiz had positively impacted either their understanding or knowledge of each other. For 30 of the 90 women (33%) and 3 of the 46 men (7%) one or other had implemented some new supportive behaviour due to the Quiz. Qualitative comments highlight the impacts of the Quiz. CONCLUSION Most couples who did the Quiz reported positive impacts on their communication and understanding. While the issue of low T2 contact rates may have skewed the results, the benefits associated with the quiz make this resource an inexpensive and easily implemented health promotion strategy.
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Affiliation(s)
- Stephen Matthey
- South Western Sydney Local Health District, Sydney, Australia.,University of Sydney, Sydney, Australia.,UNSW, Sydney, Australia
| | - Sara Cibralic
- South Western Sydney Local Health District, Sydney, Australia
| | - Katrina Leonard
- South Western Sydney Local Health District, Sydney, Australia
| | - Vanessa Baker
- South Western Sydney Local Health District, Sydney, Australia
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Lopez G, Milbury K, Chen M, Li Y, Bruera E, Cohen L. Couples' symptom burden in oncology care: perception of self and the other. Support Care Cancer 2018; 27:139-145. [PMID: 29948392 DOI: 10.1007/s00520-018-4298-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 05/27/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND The literature suggests that psychological distress and quality of life are interdependent in couples coping with cancer. The current study seeks to extend these findings to physical symptom burden, examining differences in symptom self-rating and perception of partner symptoms. METHODS Couples were approached while waiting for an integrative oncology service. Fifty patients and their partners completed the Edmonton Symptom Assessment Scale (ESAS-FS; twelve symptoms, scores 0-10, 10 worst possible) and a Global Health measure (PROMIS10). Patient and partner each also completed the ESAS-FS as it related to their perception of the other's symptoms. ESAS distress subscales analyzed included Global (GDS), Psychosocial (PSS), and Physical (PHS). Analyses included paired t tests to examine all measures. RESULTS Fifty-eight percent of patients were female with most common cancer diagnoses of breast (22%), gastrointestinal (16%), and thoracic/H&N (16%). For ESAS-FS self-ratings, patients had significantly higher physical distress than partners, with a no significant difference in psychosocial distress. For PROMIS10 self-ratings, patients reported significantly lower global health and physical health, (p's < 0.001); no differences were found for mental health between patients and caregivers. Patient rating of partner physical distress (PHS, p = 0.01) was significantly higher than partner self-rating, with no significant difference observed in ratings for psychosocial distress. Partner rating of patient psychosocial distress (PSS, p < 0.001) and physical distress (PHS, p = 0.001) was significantly higher than that of patient self-rating. CONCLUSIONS Our findings suggest that both patients and partners perceive physical distress of the other higher than self; however, patients may be more sensitive to psychosocial distress in their partners.
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Affiliation(s)
- Gabriel Lopez
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX, 77030, USA.
| | - Kathrin Milbury
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX, 77030, USA
| | - Minxing Chen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX, 77030, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX, 77030, USA
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Baucom KJ, Baucom BR, Christensen A. Changes in dyadic communication during and after integrative and traditional behavioral couple therapy. Behav Res Ther 2015; 65:18-28. [PMID: 25549210 DOI: 10.1016/j.brat.2014.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 11/07/2014] [Accepted: 12/05/2014] [Indexed: 11/20/2022]
Abstract
To examine changes in dyadic communication, as well as links between communication and long-term relationship outcomes, 134 distressed couples randomly assigned to either Traditional Behavioral Couple Therapy (TBCT; Jacobson & Margolin, 1979) or Integrative Behavioral Couple Therapy (IBCT; Jacobson & Christensen, 1998) were observed in video-recorded interactions. Observers rated discussions of relationship problems at 3 time points (pre-therapy, post-therapy, 2-year follow-up) and relationship outcomes (i.e., treatment response and relationship stability) were measured at a 5-year follow-up. Consistent with previous examinations of individual partner communication (K.J.W. Baucom et al., 2011; Sevier et al., 2008), TBCT produced greater improvements from pre-therapy to post-therapy (d = 0.27-0.43) and superior communication at post-therapy (d = 0.30-0.37). However, IBCT produced greater improvements from post-therapy to 2-year follow-up (d = 0.32-0.39). Both levels of, and changes in, dyadic communication were associated with relationship outcomes, even when controlling for individual communication. Our findings lend additional support for theoretical and practical differences between these two therapies and the utility of assessment at the level of the couple. Furthermore, they contribute to a broader pattern of findings in which relationship outcomes are more consistently linked with constructive communication than with destructive communication.
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