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An H, Yang HW, Oh DJ, Lim E, Shin J, Moon DG, Suh SW, Byun S, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Lee DW, Lee SB, Lee JJ, Jhoo JH, Bae JB, Han JW, Kim KW. What is the impact of one's chronic illness on his or her spouse's future chronic illness: a community-based prospective cohort study. BMC Med 2023; 21:367. [PMID: 37840129 PMCID: PMC10578032 DOI: 10.1186/s12916-023-03061-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 09/04/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Integrating a joint approach to chronic disease management within the context of a couple has immense potential as a valuable strategy for both prevention and treatment. Although spousal concordance has been reported in specific chronic illnesses, the impact they cumulatively exert on a spouse in a longitudinal setting has not been investigated. We aimed to determine whether one's cumulative illness burden has a longitudinal impact on that of their spouse. METHODS Data was acquired from a community-based prospective cohort that included Koreans aged 60 years and over, randomly sampled from 13 districts nationwide. Data from the baseline assessment (conducted from November 2010 to October 2012) up to the 8-year follow-up assessment was analyzed from October 2021 to November 2022. At the last assessment, partners of the index participants were invited, and we included 814 couples in the analysis after excluding 51 with incomplete variables. Chronic illness burden of the participants was measured by the Cumulative Illness Rating Scale (CIRS). Multivariable linear regression and causal mediation analysis were used to examine the longitudinal effects of index chronic illness burden at baseline and its change during follow-up on future index and spouse CIRS scores. RESULTS Index participants were divided based on baseline CIRS scores (CIRS < 6 points, n = 555, mean [SD] age 66.3 [4.79] years, 43% women; CIRS ≥ 6 points, n = 259, mean [SD] age 67.7 [4.76] years, 36% women). The baseline index CIRS scores and change in index CIRS scores during follow-up were associated with the spouse CIRS scores (β = 0.154 [SE: 0.039], p < 0.001 for baseline index CIRS; β = 0.126 [SE: 0.041], p = 0.002 for change in index CIRS) at the 8-year follow-up assessment. Subgroup analysis found similar results only in the high CIRS group. The baseline index CIRS scores and change in index CIRS scores during follow-up had both direct and indirect effects on the spouse CIRS scores at the 8-year follow-up assessment. CONCLUSIONS The severity and course of one's chronic illnesses had a significant effect on their spouse's future chronic illness particularly when it was severe. Management strategies for chronic diseases that are centered on couples may be more effective.
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Affiliation(s)
- Hoyoung An
- Department of Neuropsychiatry, Keyo Hospital, Uiwang-Si, South Korea
| | - Hee Won Yang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eunji Lim
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Jin Shin
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dong Gyu Moon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | | | - Seonjeong Byun
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, South Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University, School of Medicine, Chuncheon, South Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea.
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea.
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Jibb LA, Nanos SM, Alexander S, Malfitano C, Rydall A, Gupta S, Schimmer AD, Zimmermann C, Hales S, Nissim R, Marmar C, Schultebraucks K, Mah K, Rodin G. Traumatic stress symptoms in family caregivers of patients with acute leukaemia: protocol for a multisite mixed methods, longitudinal, observational study. BMJ Open 2022; 12:e065422. [PMID: 36332954 PMCID: PMC9639100 DOI: 10.1136/bmjopen-2022-065422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION The diagnosis, progression or recurrence of cancer is often highly traumatic for family caregivers (FCs), but systematic assessments of distress and approaches for its prevention and treatment are lacking. Acute leukaemia (AL) is a life-threatening cancer of the blood, which most often presents acutely, requires intensive treatment and is associated with severe physical symptoms. Consequently, traumatic stress may be common in the FCs of patients with AL. We aim to determine the prevalence, severity, longitudinal course and predictors of traumatic stress symptoms in FCs of patients with AL in the first year after diagnosis, and to understand their lived experience of traumatic stress and perceived support needs. METHODS AND ANALYSIS This two-site longitudinal, observational, mixed methods study will recruit 223 adult FCs of paediatric or adult patients newly diagnosed with AL from two tertiary care centres. Quantitative data will be collected from self-report questionnaires at enrolment, and 1, 3, 6, 9 and 12 months after admission to hospital for initial treatment. Quantitative data will be analysed using descriptive and machine learning approaches and a multilevel modelling (MLM) approach will be used to confirm machine learning findings. Semi-structured qualitative interviews will be conducted at 3, 6 and 12 months and analysed using a grounded theory approach. ETHICS AND DISSEMINATION This study is funded by the Canadian Institutes of Health Research (CIHR number PJT 173255) and has received ethical approval from the Ontario Cancer Research Ethics Board (CTO Project ID: 2104). The data generated have the potential to inform the development of targeted psychosocial interventions for traumatic stress, which is a public health priority for high-risk populations such as FCs of patients with haematological malignancies. An integrated and end-of-study knowledge translation strategy that involves FCs and other stakeholders will be used to interpret and disseminate study results.
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Affiliation(s)
- Lindsay A Jibb
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie M Nanos
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Sarah Alexander
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Carmine Malfitano
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Anne Rydall
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Sumit Gupta
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Aaron D Schimmer
- Department of Medical Oncology/Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Camilla Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Hales
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Rinat Nissim
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Charles Marmar
- Department of Psychiatry, New York University, New York, New York, USA
| | - Katharina Schultebraucks
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Kenneth Mah
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Marital Adjustment in Patients with Cancer: Association with Psychological Distress, Quality of Life, and Sleep Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137089. [PMID: 34281026 PMCID: PMC8297374 DOI: 10.3390/ijerph18137089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 01/06/2023]
Abstract
Marital adjustment plays a key role in the physical and psychosocial wellbeing. We conducted a cross-sectional study to evaluate marital adjustment and its association with psychological distress, suicidal ideation, sleep problems, and quality of life in patients with cancer. We collected demographic and clinical information using a structured survey. We assessed marital adjustment, quality of life, psychological distress profile, and sleep problems of participants using validated instruments: the Locke and Wallace Marital Adjustment Test (LWMAT), the Short-Form Health Survey-12, the Beck’s Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the Insomnia Severity Index (ISI). Suicidal ideation was assessed with item nine of the BDI. Of the 130 patients (52.3% females, mean age 57.9 ± 12.4 years) enrolled, 20 (15%) were classified as experiencing poor marital adjustment. Moderate to severe depression, anxiety, and insomnia were found in 25.4%, 34.6%, and 24.7% of participants, respectively. Positive suicidal ideation was documented in 13.8% of participants. We found a significant association between poor marital adjustment and depression, anxiety, suicidal ideation, and poor sleep. Our study confirms the relevance of marital adjustment in relation to the psychological wellbeing of patients with cancer. Depression, anxiety, and poor sleep were found to be significantly associated with poor marital adjustment.
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Zhou Y, Hu D, Zhang K, Mao J, Teng F, Yu T, Xu K, Tan R, Ding X, Liu Y. The mechanism of family adaptability and cohesion in suicidal ideation among Chinese cancer patients. J Psychosoc Oncol 2020; 38:612-626. [PMID: 32508254 DOI: 10.1080/07347332.2020.1757799] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Yi Zhou
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Deying Hu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Keke Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fen Teng
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ting Yu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ke Xu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Rong Tan
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoping Ding
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Badger TA, Segrin C, Sikorskii A, Pasvogel A, Weihs K, Lopez AM, Chalasani P. Randomized controlled trial of supportive care interventions to manage psychological distress and symptoms in Latinas with breast cancer and their informal caregivers. Psychol Health 2019; 35:87-106. [DOI: 10.1080/08870446.2019.1626395] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
| | - Chris Segrin
- Department of Communication, University of Arizona, Tucson, AZ, USA
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, East Lansing, MI, USA
| | - Alice Pasvogel
- Department of Communication, University of Arizona, Tucson, AZ, USA
| | - Karen Weihs
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | - Ana Maria Lopez
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Stinesen Kollberg K, Wiley JF, Ross KM, Jorge-Miller A, Hammen C, Weihs KL, Stanton AL. Chronic Stress in Vocational and Intimate Partner Domains as Predictors of Depressive Symptoms After Breast Cancer Diagnosis. Ann Behav Med 2019; 53:333-344. [PMID: 29931262 PMCID: PMC6594296 DOI: 10.1093/abm/kay045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND After cancer diagnosis, depressive symptoms are elevated on average and decline over time, but substantial variability is apparent. Few studies have examined to what extent chronic stress in distinct life domains affects depressive symptoms. PURPOSE Chronic stress in vocational and intimate partner life domains, and their interaction, were tested as predictors of depressive symptoms after breast cancer diagnosis. METHODS Women (N = 460) completed validated interviews regarding chronic stress in specific life domains shortly after diagnosis and a measure of depressive symptoms every 6 weeks for 6 months. RESULTS In latent growth curve modeling analyses, greater chronic stress in work (b = 2.90; p < .001) and intimate partner domains (b = 1.38, p = .02) was associated with higher depressive symptoms at study entry (intercept), and greater work stress predicted faster recovery from depressive symptoms over time (b = -0.10; p = .01). The two domains of chronic stress also interacted significantly on depressive symptoms at study entry (b = -1.54; p < .02) and over time (b = 0.14; p < .001). Greater work stress was associated with higher depressive symptoms at study entry regardless of intimate partner stress, but greater intimate partner stress was associated with higher depressive symptoms when work stress was low. The decline over 6 months in initially elevated depressive symptoms predicted by high work stress was significantly steeper when intimate partner stress was low. CONCLUSIONS Targeting interventions to recently diagnosed breast cancer patients living with chronically stressful vocational and intimate partner life circumstances could be worthwhile.
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Affiliation(s)
- Karin Stinesen Kollberg
- Department of Psychology, University of California, Los Angeles, Box, Los Angeles, CA, USA
- Center for Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Joshua F Wiley
- School of Psychological Sciences, Monash Institute for Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia
| | - Kharah M Ross
- Department of Psychology, University of California, Los Angeles, Box, Los Angeles, CA, USA
| | - Alexandra Jorge-Miller
- Department of Psychology, University of California, Los Angeles, Box, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Constance Hammen
- Department of Psychology, University of California, Los Angeles, Box, Los Angeles, CA, USA
| | - Karen L Weihs
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
- Cancer Prevention and Control Program, University of Arizona Comprehensive Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, Box, Los Angeles, CA, USA
- Center for Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
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Stinesen Kollberg K, Thorsteinsdottir T, Wilderäng U, Hugosson J, Wiklund P, Bjartell A, Carlsson S, Stranne J, Haglind E, Steineck G. Social constraints and psychological well-being after prostate cancer: A follow-up at 12 and 24 months after surgery. Psychooncology 2017; 27:668-675. [PMID: 29024232 DOI: 10.1002/pon.4561] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 09/05/2017] [Accepted: 09/28/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Studies indicate that social constraints (barriers to emotional expression) may be a risk factor for psychological morbidity. We aimed to investigate the association between prostate cancer-related social constraints and psychological well-being following prostate cancer surgery. METHODS In a group of 3478 partnered patients, participating in the Laparoscopic Prostatectomy Robot Open trial, a prospective multicenter comparative study of robot-assisted laparoscopic and retropubic radical prostatectomy for prostate cancer, we used log-binomial regression analysis to investigate the links between prostate cancer-related social constraints at 3 months after surgery and psychological well-being at 12 and 24 months. RESULTS A total of 1086 and 1093 men reported low well-being at 12 and 24 months, respectively. Prostate cancer-related social constraints by partner predicted low psychological well-being at 12 months (adjusted RR: 1.4; 95% CI, 1.1-1.9) and by others (adjusted RR: 1.9; 95% CI, 1.1-3.5). Intrusive thoughts mediated the association. CONCLUSIONS Negative responses from the social environment, especially from partner to talking about the prostate cancer experience affected patients' psychological well-being 2 years after radical prostatectomy. Results emphasize the importance of helping patients mobilize psychosocial resources within their social network, especially among those with a lack of quality psychosocial support.
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Affiliation(s)
- Karin Stinesen Kollberg
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Ulrica Wilderäng
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jonas Hugosson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Wiklund
- Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institute, Stockholm, Sweden
| | - Anders Bjartell
- Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Stefan Carlsson
- Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institute, Stockholm, Sweden
| | - Johan Stranne
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Haglind
- Department of Surgery, Institute of Clinical Sciences, SSORG-Scandinavian Surgical Outcomes Research Group, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Gunnar Steineck
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
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Thyroid cancer has a small impact on patient–partner relationships and their frequency of sexual activity. Palliat Support Care 2017; 16:335-346. [DOI: 10.1017/s1478951517000384] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTObjective:This cross-sectional survey examined changes in perceived relationships and sexual activity in a sample of thyroid cancer patients and their partners, taking into account sociodemographic and disease-related variables, as well as such outcome measures as anxiety, depression, fatigue, and quality of life (QoL).Method:A total of 38 patients with thyroid cancer who were being treated at the department of nuclear medicine in Zürich or Lucerne over the preceding seven years, as well as their partners, completed questionnaires about the quality of their relationships (RQ), about perceptions of changes in their relationships, and about their frequency of sexual activity. They also filled out prevalidated questionnaires related to anxiety, depression, fatigue, and QoL.Results:Some 17 patients (44.7%) and 16 partners (42.1 %) reported that the cancer diagnosis had changed their relationships. Of these, 10 (26.3%) patients and 9 (23.7%) partners reported positive changes only, while 7 patients (18.4%) and 7 partners (18.4%) reported mixed or negative changes. A perceived mixed/negative relationship change was associated with increased depression and lower RQ in patients and partners, as well as with increased anxiety in patients. While the frequency of sexual activity only changed in roughly half of patients and partners (16 patients [42.1%] and 20 partners [52.6%]), increased sexual activity was associated with lower physical QoL scores and a higher depression score than in counterparts who reported no change.Significance of Results:Compared to other cancer sites, in our sample thyroid cancer had a relatively small impact on patient–partner relationships and levels of intimacy. We found that screening patients and their partners with a simple question—“Did the diagnosis of cancer change your relationship?”—can lead to early detection of couples who are potentially at risk for perceived negative relationship changes and can facilitate timely psychosocial referral for couple's therapy.
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Abstract
BACKGROUND Individuals with cancer and their partners often experience communication difficulties. However, questions still remain regarding the influence of gender and role in cancer survivor-partner communication within couples. OBJECTIVE The current study intended to examine the communication patterns in breast, colorectal, and prostate cancer survivor-partner couples during cancer survivorship and whether gender and role differences in couples communication exist. METHODS The dominant-less dominant method of sequential mixed design was used. Ten couples who were recruited from the University Hospital registry in Cleveland, Ohio, participated in both mail surveys and individual interviews. Family and cancer-related communication was assessed in the quantitative phase. RESULTS Both male survivors and partners demonstrated better family communication scores compared with their female counterparts, whereas there were no gender differences in the cancer-related communication scores. In the qualitative phase, 3 major themes were identified: (1) selective sharing of cancer-related issues, (2) initiation of cancer-related communication, and (3) emotional reaction in communication. The patterns associated with these themes differed between the male survivor-female partner and female survivor-male partner couples. CONCLUSIONS This study provides new knowledge about family and cancer-related communication. Our findings highlight the importance of understanding different perspectives in the quality of communication by gender and role. IMPLICATIONS FOR PRACTICE Exploring couples' communication patterns by gender and role stimulates the research and the development of effective consumer-centered communication interventions. The findings provide assessment tools to inform dyadic communication patterns for clinical and scientific purposes.
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Corney R, Puthussery S, Swinglehurst J. Couple relationships in families with dependent children after a diagnosis of maternal breast cancer in the United Kingdom: Perspectives from mothers and fathers. J Psychosoc Oncol 2016; 34:413-31. [PMID: 27295387 DOI: 10.1080/07347332.2016.1199080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This article examines the facilitators and the barriers to couple relationships in families in the UK with dependent children after a diagnosis of maternal breast cancer. Qualitative data were collected through in-depth semi-structured interviews with 23 participants, including 10 couples and three women whose partners did not take part. Recorded interviews were analyzed using a thematic approach identifying themes and patterns in the interview transcripts and categorizing them using a framework. Key individual and contextual factors perceived as barriers or facilitators to couple relationships included: being a "young" family with young children, frustration and resentment from male partners, women's reactions to the illness, individual communication styles, differing needs for "personal space," body image concerns, and social support. Findings indicated the need for strengthening "family focus" in services with adequate support for male partners. Health and family services should consider variability in the experiences of couples with dependent children and be sensitive to the needs of partners alongside the women.
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Affiliation(s)
- Roslyn Corney
- a Department of Psychology , Faculty of Education and Health, University of Greenwich , London , UK
| | - Shuby Puthussery
- b Department of Clinical Education and Leadership & Institute for Health Research , University of Bedfordshire , Luton , Bedfordshire , UK
| | - Jane Swinglehurst
- a Department of Psychology , Faculty of Education and Health, University of Greenwich , London , UK
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Lee Y, Tak Y. Experiences of Spouses of Patients with Hematologic Malignancies: Finding a Way to Get Out of the Endless Tunnel. ASIAN ONCOLOGY NURSING 2016. [DOI: 10.5388/aon.2016.16.1.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Youngshin Lee
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Youngran Tak
- College of Nursing, Hanyang University, Seoul, Korea
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Haj Mohammad N, Walter AW, van Oijen MGH, Hulshof MCCM, Bergman JJGHM, Anderegg MCJ, van Berge Henegouwen MI, Henselmans I, Sprangers MAG, van Laarhoven HWM. Burden of spousal caregivers of stage II and III esophageal cancer survivors 3 years after treatment with curative intent. Support Care Cancer 2015; 23:3589-98. [PMID: 25894882 PMCID: PMC4624832 DOI: 10.1007/s00520-015-2727-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 03/29/2015] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The aim of this study is to examine caregiver burden of spousal caregivers of patients with esophageal cancer after curative treatment with neoadjuvant chemoradiation followed by resection and to assess factors associated with caregiver burden. METHODS In this exploratory, cross-sectional study, spousal caregivers and patients were eligible if the caregiver was the patient's spouse and the patient had been treated with chemoradiation followed by surgery after esophageal carcinoma diagnosis. Forty-seven couples were included. Spousal caregivers completed a questionnaire, examining caregivers' burden (Self-Perceived Pressure from Informal Care (SPPIC, Dutch)), caregiver unmet needs (SCNS-P&S), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), and marital satisfaction (Maudsley Marital Questionnaire (MMQ)). Patients completed the latter two questionnaires and a cancer specific quality of life questionnaire (EORTC-QLQ C30 and OES18 (oesophageal module). Logistic regression analysis was performed to identify correlates for caregiver burden. RESULTS The median time after esophagectomy was 38 months. Thirty-four percent of the spousal caregivers reported moderate or high burden. Spousal caregivers most frequently reported unmet needs were managing concerns about the cancer coming back (43%), dealing with others not acknowledging the impact on your life of caring for a person with cancer (38%), and balancing the needs of the person with cancer and one's own needs. A comparable proportion of spousal caregivers and patients showed symptoms of anxiety (23 vs 17%) and depression (17 vs 17%). Spousal caregivers reported significantly more dissatisfaction than patients on the marital scale (p < 0.01). Factors independently associated with higher caregiver burden were fatigue of the patient (OR = 1.66, 95% CI 1.12-2.47) and depression of the spousal caregiver (OR = 1.44, 95% CI 1.11-1.86). CONCLUSIONS More than a third of the spousal caregivers of patients with esophageal cancer treated with curative intent report moderate or high burden 3 years after treatment. Fatigue of the patient and depression of the spousal caregiver are associated with caregiver burden. To improve clinical care, identification of spousal caregivers at risk for experiencing higher caregiver burden and implementation of specific interventions is needed.
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Affiliation(s)
- N Haj Mohammad
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, F4-222, Meibergdreef 9, PO box 22600, 1100 DD, Amsterdam, The Netherlands.
| | - A W Walter
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, F4-222, Meibergdreef 9, PO box 22600, 1100 DD, Amsterdam, The Netherlands
| | - M G H van Oijen
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, F4-222, Meibergdreef 9, PO box 22600, 1100 DD, Amsterdam, The Netherlands
| | - M C C M Hulshof
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J J G H M Bergman
- Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M C J Anderegg
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M I van Berge Henegouwen
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - I Henselmans
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M A G Sprangers
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - H W M van Laarhoven
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, F4-222, Meibergdreef 9, PO box 22600, 1100 DD, Amsterdam, The Netherlands
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The role of social and cognitive processes in the relationship between fear network and psychological distress among parents of children undergoing hematopoietic stem cell transplantation. J Clin Psychol Med Settings 2014; 21:223-33. [PMID: 25081956 DOI: 10.1007/s10880-014-9403-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The current study examined whether cognitive and social processing variables mediated the relationship between fear network and depression among parents of children undergoing hematopoietic stem cell transplant (HSCT). Parents whose children were initiating HSCT (N = 179) completed survey measures including fear network, Beck Depression Inventory, cognitive processing variables (positive reappraisal and self-blame) and social processing variables (emotional support and holding back from sharing concerns). Fear network was positively correlated with depression (p < .001). Self-blame and holding back emerged as individual partial mediators in the relationship between fear network and depression. Together they accounted for 34.3% of the variance in the relationship between fear network and depression. Positive reappraisal and emotional support did not have significant mediating effects. Social and cognitive processes, specifically self-blame and holding back from sharing concerns, play a negative role in parents' psychological adaptation to fears surrounding a child's HSCT.
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McMahon ME, Gremore TM, Cella D, Sher TG. Partners empowered: a couple-based intervention for newly diagnosed cancer. Psychooncology 2014; 23:832-4. [PMID: 24497302 DOI: 10.1002/pon.3490] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 12/29/2013] [Accepted: 01/03/2014] [Indexed: 11/06/2022]
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15
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Gottlieb BH, Maitland SB, Brown J. Social Support and Adjustment Among Wives of Men with Prostate Cancer. J Psychosoc Oncol 2014; 32:16-36. [DOI: 10.1080/07347332.2013.855962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Kurowecki D, Fergus KD. Wearing my heart on my chest: dating, new relationships, and the reconfiguration of self-esteem after breast cancer. Psychooncology 2013; 23:52-64. [PMID: 24038654 DOI: 10.1002/pon.3370] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 07/12/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study investigated women's experiences of establishing an intimate relationship with a new partner after breast cancer diagnosis and treatment. METHODS Fifteen breast cancer survivors, who were either actively dating or in a new intimate relationship that began post-diagnosis, participated in semi-structured interviews. Interview transcripts were analyzed using the grounded theory method. RESULTS The analysis yielded Wearing My Heart on My Chest as the core category with three underlying categories: (1) Losing and Regaining Self and Bodily Esteem; (2) Taking the Leap: Dating and the Obligation to Disclose; and (3) Reclaiming of Self through the New Relationship. The categories refer to the experience of profound vulnerability invoked by the history of breast cancer and the act of verbally and physically revealing this past to a new intimate partner. Disclosure entailed a series of successive 'tests' of the new partner for his ability to accept the physical and psychological ramifications of breast cancer, with the resulting relationship becoming a vehicle through which women regained self-esteem. CONCLUSIONS The process of dating and starting a new intimate relationship had the potential to restore women's self and bodily esteem previously diminished by breast cancer. The reconfiguration of self-esteem following breast cancer is thus experienced as an ongoing process that begins with diagnosis and continues well into the new relationship.
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Affiliation(s)
- Darya Kurowecki
- Department of Psychology, York University, Toronto, ON, Canada
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17
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Moreira H, Canavarro MC. Psychosocial adjustment and marital intimacy among partners of patients with breast cancer: a comparison study with partners of healthy women. J Psychosoc Oncol 2013; 31:282-304. [PMID: 23656256 DOI: 10.1080/07347332.2013.778934] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This cross-sectional study investigated the psychosocial adjustment of 70 partners of patients with breast cancer by comparing their emotional adjustment and quality of life (QoL) with 70 partners of women without cancer. The role of marital intimacy in their adjustment and the moderating effect of group type were analyzed. The partners of patients with breast cancer presented higher levels of anxious and depressive symptomatology; poor social, psychological, general and physical QoL; and higher levels of intimacy. The moderation analysis showed that higher levels of intimacy predicted lower levels of depression and anxiety and greater QoL only among the partners of cancer patients.
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Affiliation(s)
- Helena Moreira
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
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18
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Moser MT, Künzler A, Nussbeck F, Bargetzi M, Znoj HJ. Higher emotional distress in female partners of cancer patients: prevalence and patient-partner interdependencies in a 3-year cohort. Psychooncology 2013; 22:2693-701. [DOI: 10.1002/pon.3331] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 05/13/2013] [Accepted: 05/13/2013] [Indexed: 01/06/2023]
Affiliation(s)
| | - Alfred Künzler
- Clinical Psychology; University of Bern; Bern Switzerland
- Division of Hematology/Oncology; Cantonal Hospital Aarau; Aarau Switzerland
- Onco-Psychology; Psychiatric Services Aargau; Switzerland
| | - Fridtjof Nussbeck
- Department of Psychology; University of Zurich; Zurich Switzerland
- Department of Psychology; University of Bielefeld; Bielefeld Germany
| | - Mario Bargetzi
- Division of Hematology/Oncology; Cantonal Hospital Aarau; Aarau Switzerland
| | - Hans J. Znoj
- Clinical Psychology; University of Bern; Bern Switzerland
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19
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Miller LE. Uncertainty management and information seeking in cancer survivorship. HEALTH COMMUNICATION 2013; 29:233-243. [PMID: 23682727 DOI: 10.1080/10410236.2012.739949] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Uncertainty is a common experience among people coping with chronic illness. For many individuals, managing information is used as a means of coping with illness-related uncertainty. In-depth interviews with 60 cancer survivors and partners were conducted. Many of the participants in this study reported feeling uncertain about the challenges awaiting them in cancer survivorship and reported experiencing various information behaviors and challenges relating to their uncertainty management. These results have important implications for health care providers and imply that continued care and information provision, after cancer treatment is complete, would facilitate adaptive survivorship.
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Affiliation(s)
- Laura E Miller
- a School of Communication Studies, University of Tennessee
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20
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Shaw EK, Scott JG, Ferrante JM. The Influence of Family Ties on Men’s Prostate Cancer Screening, Biopsy, and Treatment Decisions. Am J Mens Health 2013; 7:461-71. [DOI: 10.1177/1557988313480226] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Extensive research has focused on understanding family dynamics of men with prostate cancer. However, little qualitative work has examined the role of family ties on men’s prostate cancer decisions across the spectrum of screening, diagnosis, and treatment. Using data from a larger study, we qualitatively explored the influence of family ties on men’s prostate cancer decisions. Semistructured interviews were conducted with men ages ≥50 ( N = 64), and data were analyzed using a grounded theory approach and a series of immersion/crystallization cycles. Three major themes of spousal/family member influence were identified: (a) spousal/family member alliance marked by open communication and shared decision making, (b) men who actively opposed spouse/family member pressure and made final decisions themselves, and (c) men who yielded to spouse/family member pressure. Our findings provide insights into men’s relational dynamics that are important to consider for the shared decision-making process across the prostate cancer spectrum.
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Affiliation(s)
- Eric K. Shaw
- Mercer University, Savannah, GA, USA
- The Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - John G. Scott
- Northeastern Vermont Regional Hospital, St. Johnsbury, VT, USA
| | - Jeanne M. Ferrante
- The Cancer Institute of New Jersey, New Brunswick, NJ, USA
- UMDNJ-Robert Wood Johnson Medical School, Somerset, NJ, USA
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21
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Mokuau N, Braun KL, Daniggelis E. Building family capacity for Native Hawaiian women with breast cancer. HEALTH & SOCIAL WORK 2012; 37:216-224. [PMID: 23301435 PMCID: PMC3954100 DOI: 10.1093/hsw/hls033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Revised: 03/23/2012] [Accepted: 04/10/2012] [Indexed: 05/28/2023]
Abstract
Native Hawaiian women have the highest breast cancer incidence and mortality rates when compared with other large ethnic groups in Hawai'i. Like other women, they rely on the support of their families as co-survivors. This project explored the feasibility and effects of a culturally tailored educational intervention designed to build family capacity by improving the knowledge and skills of the woman and her family in dealing with breast cancer, particularly in the latter stage of recovery care. Twenty-nine Native Hawaiian women with breast cancer, along with a close family member, were randomly assigned to the intervention (n = 15) or a wait-list control group (n = 14). The authors assessed the knowledge, self-efficacy, and coping skills of women and their family members and the recovery care behaviors of the women at baseline and at four months (after the intervention or control period). The intervention group made significant improvements in self-efficacy and coping; the wait-list control group did not. Evaluation of the intervention suggests that it was well received by participants. This work has relevance for social workers wanting to design and test culturally appropriate interventions for minority groups.
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Affiliation(s)
- Noreen Mokuau
- Myron B. Thompson School of Social Work, University of Hawaii at Manoa, Honolulu, HI 96822, USA.
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Abstract
OBJECTIVE Informal caregivers (ICs) are relatives, friends, and partners who have a significant relationship with and provide assistance (i.e., physical, emotional) to a patient with a life- threatening, incurable illness. The multidimensional burden that results from providing care to a patient with cancer is well documented, and as a result, a growing number of psychosocial interventions have been developed specifically to address this burden. The purpose of the present study was to characterize the state of the science of psychosocial interventions for informal cancer caregivers. METHOD A comprehensive systematic review of interventions for cancer caregivers was conducted via an electronic literature search of publications between 1980 and January 13, 2011. A final sample of 49 interventions was reviewed in detail. RESULTS The interventions, which varied in terms of modality and patient population, fell into the following eight categories: psychoeducation, problem-solving/skills building interventions, supportive therapy, family/couples therapy, cognitive-behavioral therapy, interpersonal therapy, complementary and alternative medicine interventions, and existential therapy. Benefits and disadvantages of each of the categories are discussed, with special attention given to studies that produced null findings. SIGNIFICANCE OF RESULTS Beyond specific techniques, structured, goal-oriented, and time-limited interventions that are integrative appear to be the most feasible and offer the greatest benefits for ICs of cancer patients. Future studies are needed to examine the specific benefits and challenges of delivering interventions in alternative modalities (Internet, Skype) so that the needs of a greater number of ICs may be addressed.
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Drabe N, Wittmann L, Zwahlen D, Büchi S, Jenewein J. Changes in close relationships between cancer patients and their partners. Psychooncology 2012; 22:1344-52. [DOI: 10.1002/pon.3144] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 07/02/2012] [Accepted: 07/05/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Natalie Drabe
- Department of Psychiatry and Psychotherapy; University Hospital Zurich; Zurich Switzerland
| | - Lutz Wittmann
- Department of Psychiatry and Psychotherapy; University Hospital Zurich; Zurich Switzerland
| | - Diana Zwahlen
- Department of Medical Oncology; University Hospital of Berne ‘Insel’; Berne Switzerland
| | - Stefan Büchi
- Clinic for Psychotherapy and Psychosomatics ‘Hohenegg’; Meilen Switzerland
| | - Josef Jenewein
- Department of Psychiatry and Psychotherapy; University Hospital Zurich; Zurich Switzerland
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Porter LS, Baucom DH, Keefe FJ, Patterson ES. Reactions to a partner-assisted emotional disclosure intervention: direct observation and self-report of patient and partner communication. JOURNAL OF MARITAL AND FAMILY THERAPY 2012; 38 Suppl 1:284-295. [PMID: 22765340 DOI: 10.1111/j.1752-0606.2011.00278.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Partner-assisted emotional disclosure is a couple-based intervention designed to help patients disclose cancer-related concerns to their spouses-partners. We previously found that, compared with an education/support control condition, partner-assisted emotional disclosure led to significant improvements in relationship quality and intimacy for couples in which the patient initially reported holding back from discussing cancer-related concerns (Porter et al., 2009, Cancer, 115, 4326-4338). The purpose of this study was to examine the process data from couples who participated in the disclosure sessions including (a) observational ratings of couples' communication during the sessions; (b) couples' ratings of their communication during the sessions; and (c) associations between participants' observed communication and their baseline psychological/relationship functioning. As rated by trained observers, couples' communication was in the moderate range of adaptive skills. Self-report data indicated that participants had positive perceptions of their communication. Observational and self-report ratings were weakly associated. Patients reporting lower levels of relationship quality, higher levels of holding back, and higher partner avoidance at baseline were rated by observers as more expressive during the sessions. Overall, these findings suggest that the intervention was acceptable to couples and was particularly helpful for patients who had difficulty talking with their partners on their own without skills training.
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Affiliation(s)
- Laura S Porter
- Psychiatry and Behavioral Sciences/Medical Psychology, Duke University Medical Center, Durham, North Carolina 27709, USA.
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Abstract
AbstractThe thesis advanced in this essay is that couple relationship interventions are central to effective therapy with many adult clients. I begin by reviewing a body of evidence that demonstrates the significance of couple relationships in the lives of most adults. A range of circumstances are described in which effective therapy with adults needs to address the couple relationship, even when the couple relationship is not mentioned as a presenting issue. It is concluded that individual psychological adjustment often is best understood when conceptualised within the intimate interpersonal context of the couple relationship.
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Donovan-Kicken E, Tollison AC, Goins ES. The nature of communication work during cancer: advancing the theory of illness trajectories. HEALTH COMMUNICATION 2011; 27:641-652. [PMID: 22168391 DOI: 10.1080/10410236.2011.629405] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
More theory development about interpersonal communication during cancer is needed so that scholarship can be advanced and practical applications of findings can be best disseminated and applied. We proposed an evidence-based extension to the theory of illness trajectories based on findings from a qualitative study of cancer survivors' (n = 40) experiences with communication. Grounding our analysis in respondents' descriptions of the demands, obligations, and preparatory activities involved in discussing their cancer, we theorized the construct of communication work, which focuses on the labor and resources devoted to managing talk during cancer and living with illness. Findings are discussed in terms of how this conceptualization presents new opportunities for research and practice.
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Affiliation(s)
- Erin Donovan-Kicken
- Department of Communication Studies , University of Texas at Austin, 1 University Station, Austin, TX 78712, USA.
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Les effets de l’expression émotionnelle sur l’ajustement au cancer : une revue systématique de la littérature. PSYCHO-ONCOLOGIE 2011. [DOI: 10.1007/s11839-011-0328-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Thornton AA, Perez MA, Oh S, Crocitto L. A prospective report of changes in prostate cancer related quality of life after robotic prostatectomy. J Psychosoc Oncol 2011; 29:157-67. [PMID: 21391068 DOI: 10.1080/07347332.2010.548669] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this prospective, longitudinal study the authors examined changes in cognitive, emotional, and interpersonal components of prostate cancer-related quality of life in 71 men who underwent robotic-assisted prostatectomy for prostate cancer. They identified significant changes across several quality-of-life domains from presurgery to 3-months and 1-year postsurgery. Although some components of quality of life returned to baseline by one year postsurgery, decrements in sexual intimacy, sexual confidence, and masculine self-esteem were enduring. These data can be used to guide patients in their expectations for quality of life following robotic prostatectomy and highlight the need for multidisciplinary approaches aimed at improving men's sexual adjustment after this procedure.
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Affiliation(s)
- Andrea A Thornton
- Divisions of Psychology and Behavioral Sciences, City of Hope, Duarte, CA, USA.
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Zimmermann T, Herschbach P, Wessarges M, Heinrichs N. Fear of progression in partners of chronically ill patients. Behav Med 2011; 37:95-104. [PMID: 21895427 DOI: 10.1080/08964289.2011.605399] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Fear of progression (FoP) is one of the most prevalent symptoms in cancer patients. This chronic disease does not only have a profound impact on patients, but also on their spouses. The aim of this study was to evaluate the psychometric properties of a spouse FoP questionnaire (FoP-Q-SF/P) in 227 partners of chronically ill patients (breast cancer, prostate cancer, and diabetes mellitus) in Germany. Estimates of reliability were high (α = 0.88). The original one-factor structure of the FoP-Q-SF for patients was replicated. We used the Hamilton Anxiety and Depression Scale, Impact of Event Scale-revised, Short Form-8 Health Survey, Quality of Marriage Index, Partnership Questionnaire, and Dyadic Coping Inventory to validate the FoP-Q-SF/P. Significant positive correlations were found for anxiety, hyperarousal and intrusion (r > .61) as well as for depression and avoidance (r > .51). Partners of patients with cancer reported significantly higher levels of FoP than did partners of patients with diabetes mellitus. The FoP-Q-SF/P is a reliable and valid instrument that can be recommended for further use in research and clinical care.
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Affiliation(s)
- Tanja Zimmermann
- University of Braunschweig, Institute of Psychology, Braunschweig, Germany.
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Cleary V, Hegarty J, McCarthy G. Sexuality in Irish Women With Gynecologic Cancer. Oncol Nurs Forum 2011; 38:E87-96. [DOI: 10.1188/11.onf.e87-e96] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ezer H, Chachamovich JLR, Chachamovich E. Do men and their wives see it the same way? Congruence within couples during the first year of prostate cancer. Psychooncology 2011; 20:155-64. [DOI: 10.1002/pon.1724] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Bishop MM, Curbow BA, Springer SH, Lee JA, Wingard JR. Comparison of lasting life changes after cancer and BMT: perspectives of long-term survivors and spouses. Psychooncology 2010; 20:926-34. [PMID: 20690114 DOI: 10.1002/pon.1812] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 06/14/2010] [Accepted: 06/15/2010] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This qualitative follow up of long-term (>5 years) cancer survivor and spouse participants from a large, previous study of quality of life after blood and marrow transplantation (BMT) was designed to gain a deeper understanding of lasting life changes they experienced. METHODS Thirty spouse-survivor pairs, an average of 13 years post-BMT, were individually interviewed to identify lasting life changes. Participants were asked about their most significant long-lasting change since cancer/BMT, most significant positive change and negative change, and whether the experience had affected them and their spouse differently. RESULTS Spouses and survivors spontaneously identified both positive and negative changes. Spouses reported a higher proportion of negative changes (24%) than did survivors (15%), and survivors a higher proportion of positive changes (85%) than spouses (76%). For both groups, the most frequent positive change was in 'perspective/outlook on life' and negative change was 'lingering health effects,' although survivors mentioned the latter twice as often as did spouses. Spouses were more likely to talk about changes in the first-person plural (we, us) that were largely emotional or in relation to the survivor, whereas survivors spoke of changes in the first-person singular (I, me) that occurred to them directly and were largely physical. CONCLUSIONS Although both spouses and survivors described similar negative and positive long-lasting changes that continued an average of 13 years post-BMT, they reported differences in the ways they were impacted by the experience, which was reflected in the language they used. Implications for future studies, family education, and couples-based interventions are discussed.
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Affiliation(s)
- Michelle M Bishop
- Department of Medicine, Division of Hematology/Oncology, University of Florida, FL 32610-0277, USA.
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Murray SA, Kendall M, Boyd K, Grant L, Highet G, Sheikh A. Archetypal trajectories of social, psychological, and spiritual wellbeing and distress in family care givers of patients with lung cancer: secondary analysis of serial qualitative interviews. BMJ 2010; 340:c2581. [PMID: 20538635 PMCID: PMC2883691 DOI: 10.1136/bmj.c2581] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2010] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess if family care givers of patients with lung cancer experience the patterns of social, psychological, and spiritual wellbeing and distress typical of the patient, from diagnosis to death. DESIGN Secondary analysis of serial qualitative interviews carried out every three months for up to a year or to bereavement. SETTING South east Scotland. PARTICIPANTS 19 patients with lung cancer and their 19 family carers, totalling 88 interviews (42 with patients and 46 with carers). RESULTS Carers followed clear patterns of social, psychological, and spiritual wellbeing and distress that mirrored the experiences of those for whom they were caring, with some carers also experiencing deterioration in physical health that impacted on their ability to care. Psychological and spiritual distress were particularly dynamic and commonly experienced. In addition to the "Why us?" response, witnessing suffering triggered personal reflections in carers on the meaning and purpose of life. Certain key time points in the illness tended to be particularly problematic for both carers and patients: at diagnosis, at home after initial treatment, at recurrence, and during the terminal stage. CONCLUSIONS Family carers witness and share much of the illness experience of the dying patient. The multidimensional experience of distress suffered by patients with lung cancer was reflected in the suffering of their carers in the social, psychological, and spiritual domains, with psychological and spiritual distress being most pronounced. Carers may need to be supported throughout the period of illness not just in the terminal phase and during bereavement, as currently tends to be the case.
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Affiliation(s)
- Scott A Murray
- Primary Palliative Care Research Group, Centre for Population Health Sciences: General Practice Section, University of Edinburgh, Edinburgh EH8 9DX.
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Zwahlen D, Hagenbuch N, Jenewein J, Carley MI, Buchi S. Adopting a family approach to theory and practice: measuring distress in cancer patient-partner dyads with the distress thermometer. Psychooncology 2010; 20:394-403. [PMID: 20878839 DOI: 10.1002/pon.1744] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Revised: 02/08/2010] [Accepted: 02/16/2010] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Significant others are central to patients' experience and management of their cancer illness. Building on our validation of the Distress Thermometer (DT) for family members, this investigation examines individual and collective distress in a sample of cancer patients and their matched partners, accounting for the aspects of gender and role. METHOD Questionnaires including the DT were completed by a heterogeneous sample of 224 couples taking part in a multisite study. RESULTS Our investigation showed that male patients (34.2%), female patients (31.9%), and male partners (29.1%) exhibited very similar levels of distress, while female partners (50.5%) exhibited much higher levels of distress according to the DT. At the dyad level just over half the total sample contained at least one individual reporting significant levels of distress. Among dyads with at least one distressed person, the proportion of dyads where both individuals reported distress was greatest (23.6%). Gender and role analyses revealed that males and females were not equally distributed among the four categories of dyads (i.e. dyads with no distress; dyads where solely the patient or dyads where solely the partner is distressed; dyads where both are distressed). CONCLUSION A remarkable number of dyads reported distress in one or both partners. Diverse patterns of distress within dyads suggest varying risks of psychosocial strain. Screening patients' partners in addition to patients themselves may enable earlier identification of risk settings. The support offered to either member of such dyads should account for their role- and gender-specific needs.
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Affiliation(s)
- Diana Zwahlen
- Department of Psychiatry, University Hospital of Zurich, Zurich, Switzerland.
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Syse A, Loge JH, Lyngstad TH. Does childhood cancer affect parental divorce rates? A population-based study. J Clin Oncol 2009; 28:872-7. [PMID: 20038725 DOI: 10.1200/jco.2009.24.0556] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Cancer in children may profoundly affect parents' personal relationships in terms of psychological stress and an increased care burden. This could hypothetically elevate divorce rates. Few studies on divorce occurrence exist, so the effect of childhood cancers on parental divorce rates was explored. PATIENTS AND METHODS Data on the entire Norwegian married population, age 17 to 69 years, with children age 0 to 20 years in 1974 to 2001 (N = 977,928 couples) were retrieved from the Cancer Registry, the Central Population Register, the Directorate of Taxes, and population censuses. Divorce rates for 4,590 couples who were parenting a child with cancer were compared with those of otherwise similar couples by discrete-time hazard regression models. Results Cancer in a child was not associated with an increased risk of parental divorce overall. An increased divorce rate was observed with Wilms tumor (odds ratio [OR], 1.52) but not with any of the other common childhood cancers. The child's age at diagnosis, time elapsed from diagnosis, and death from cancer did not influence divorce rates significantly. Increased divorce rates were observed for couples in whom the mothers had an education greater than high school level (OR, 1.16); the risk was particularly high shortly after diagnosis, for CNS cancers and Wilms tumors, for couples with children 0 to 9 years of age at diagnosis, and after a child's death. CONCLUSION This large, registry-based study shows that cancer in children is not associated with an increased parental divorce rate, except with Wilms tumors. Couples in whom the wife is highly educated appear to face increased divorce rates after a child's cancer, and this may warrant additional study.
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Affiliation(s)
- Astri Syse
- Cancer Registry of Norway, PO Box 5313, Majorstua, N-0304 Oslo, Norway.
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Bergman J, Gore JL, Saigal CS, Kwan L, Litwin MS. Partnership and outcomes in men with prostate cancer. Cancer 2009; 115:4688-94. [PMID: 19626653 DOI: 10.1002/cncr.24544] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Being in a supportive relationship may have improved the health-related quality of life (HRQOL) of men with prostate cancer, if the support was strong and positive. In the current study, the authors sought to examine the impact of partnership status on the mental health of men treated for localized prostate cancer. METHODS Participants had clinically localized prostate cancer and chose treatment with radical prostatectomy (n=307), external-beam radiotherapy (n=78), or brachytherapy (n=91). The authors prospectively assessed subject characteristics and HRQOL outcomes and evaluated associations between partnership outcomes and HRQOL measures. Two multivariate linear regression models were then created, 1 for baseline HRQOL outcomes and 1 for change in HRQOL from baseline to 12 months, with partnership status as the main predictor and subject characteristics as covariates. RESULTS Partnership status was not found to be associated with either baseline physical or mental health, but partnered participants had less bowel bother (P=.02) and a lower fear of recurrence (P=.03) at baseline than did unpartnered subjects. Men with fewer comorbid conditions scored better across almost all baseline HRQOL domains. Primary treatment type was significantly associated with changes in physical HRQOL, with men undergoing radical prostatectomy describing better changes in physical health than those treated with brachytherapy (P=.04) or those receiving external-beam radiotherapy (P<or=.01). CONCLUSIONS Physical and mental health was found to be comparable in the study cohort of partnered and unpartnered men treated for prostate cancer. The universally high socioeconomic status of the current study cohort may mitigate differences in HRQOL by partnership status.
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Affiliation(s)
- Jonathan Bergman
- Department of Urology, University of California at Los Angeles, Los Angeles, California 90095-1738, USA.
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Porter LS, Keefe FJ, Baucom DH, Hurwitz H, Moser B, Patterson E, Kim HJ. Partner-assisted emotional disclosure for patients with gastrointestinal cancer: results from a randomized controlled trial. Cancer 2009; 115:4326-38. [PMID: 19731357 DOI: 10.1002/cncr.24578] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND For patients with cancer who are married or in an intimate relationship, their relationships with their partners play a critical role in their adaptation to illness. However, cancer patients and their partners often have difficulty in talking with each other about their cancer-related concerns. Difficulties in communication ultimately may compromise both the patient-partner relationship and the patient's psychological adjustment. The current study tested the efficacy of a novel partner-assisted emotional disclosure intervention in a sample of patients with gastrointestinal (GI) cancer. METHODS One hundred thirty patients with GI cancer and their partners were assigned randomly to receive 4 sessions of either partner-assisted emotional disclosure or a couples cancer education/support intervention. Patients and partners completed measures of relationship quality, intimacy with their partner, and psychological distress before randomization and at the end of the intervention sessions. Data were analyzed using multilevel modeling. RESULTS Compared with an education/support condition, the partner-assisted emotional disclosure condition led to improvements in relationship quality and intimacy for couples in which the patient initially reported higher levels of holding back from discussing cancer-related concerns. CONCLUSIONS Partner-assisted emotional disclosure is a novel intervention that builds on both the private emotional disclosure and the cognitive-behavioral marital literature. The results of this study suggested that this intervention may be beneficial for couples in which the patient tends to hold back from discussing concerns. The authors concluded that future research on methods of enhancing the effects of partner-assisted emotional disclosure is warranted.
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Affiliation(s)
- Laura S Porter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA.
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Gazendam-Donofrio S, Hoekstra H, van der Graaf W, van de Wiel H, Visser A, Huizinga G, Hoekstra-Weebers J. Parent-child communication patterns during the first year after a parent's cancer diagnosis. Cancer 2009; 115:4227-37. [DOI: 10.1002/cncr.24502] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Goldzweig G, Andritsch E, Hubert A, Walach N, Perry S, Brenner B, Baider L. How relevant is marital status and gender variables in coping with colorectal cancer? A sample of middle-aged and older cancer survivors. Psychooncology 2009; 18:866-74. [DOI: 10.1002/pon.1499] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Goldzweig G, Hubert A, Walach N, Brenner B, Perry S, Andritsch E, Baider L. Gender and psychological distress among middle- and older-aged colorectal cancer patients and their spouses: An unexpected outcome. Crit Rev Oncol Hematol 2009; 70:71-82. [DOI: 10.1016/j.critrevonc.2008.07.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Revised: 07/10/2008] [Accepted: 07/17/2008] [Indexed: 01/02/2023] Open
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Zwahlen D, Hagenbuch N, Carley MI, Recklitis CJ, Buchi S. Screening cancer patients' families with the distress thermometer (DT): a validation study. Psychooncology 2009; 17:959-66. [PMID: 18203146 DOI: 10.1002/pon.1320] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although family members of cancer patients are at great risk of experiencing psychological distress, clinical tools to assist with recognizing and intervening with appropriate psychosocial care are sparse. This study reports on the first validation of the distress thermometer (DT) as a screening instrument for symptoms of depression and anxiety in family members of cancer patients. The DT was administered with the Hospital Anxiety and Depression Scale (HADS) in a sample of 321 family members. Receiver operating characteristics (ROC) demonstrated that the DT has good diagnostic utility relative to the HADS (area under the curve= 0.88 relative to the HADS anxiety scale; 0.84 relative to the HADS depression scale, respectively). The ROC curves indicate that using a cut-off of 4/5 maximizes sensitivity (86.2% HADS anxiety scale; 88.2% HADS depression scale) and specificity (71.2% HADS anxiety scale; 67.6% HADS depression scale); however, the alternative lower cut-off of 3/4 increases sensitivity (94.1% for both scales) and hence reduces the risk of missing distressed family members (specificity is 62.9% for HADS anxiety scale; 59.1% for HADS depression scale). The results offer validation of the DT for screening family members of cancer patients and support its use for clinical assessment. Distress screening with DT for family members of cancer patients is a promising and efficient approach to integrating family members in the program of care and provides the first step toward meeting their unmet needs with referral for supportive services.
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Affiliation(s)
- Diana Zwahlen
- Department of Psychiatry, University Hospital of Zurich, Switzerland
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Kim Y, Wellisch DK, Spillers RL. Effects of psychological distress on quality of life of adult daughters and their mothers with cancer. Psychooncology 2009; 17:1129-36. [PMID: 18318454 DOI: 10.1002/pon.1328] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION As the population continues to age, adult daughters are more likely to be involved in caregiving. Given the fact that sharing emotional experiences is common in female relationships, (dis)similarity between mothers with cancer and their adult caregiving daughters is expected. However, the extent to which the (dis)similarity in psychological distress influences the quality of life of each person remains unknown. METHOD This study aims at addressing this concern, using a total of 98 mother-daughter dyads participating in the American Cancer Society's Study of Cancer Survivors-I and Quality of Life Survey for Caregivers. RESULTS Using the Actor Partner Interdependence Model, the results showed that although each person's psychological distress is the strongest predictor of their own quality of life, a mother's distress also plays a significant role in the daughter's quality of life. Specifically, when mothers experienced greater levels of psychological distress, the daughters reported better mental health but poorer physical health. CONCLUSIONS Our findings on the disproportionately strong association between psychological distress of mothers with cancer and their adult caregiving daughters' quality of life suggest that caregiving daughters may benefit from programs designed to assist them to cope better with their mothers' psychological distress when both are living with cancer.
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Affiliation(s)
- Youngmee Kim
- Behavioral Research Center, American Cancer Society, 250 Williams St., NW, Atlanta, GA 30303, USA.
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Syse A, Aas GB. Marriage after cancer in older adulthood. J Cancer Surviv 2009; 3:66-71. [DOI: 10.1007/s11764-008-0078-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Accepted: 12/27/2008] [Indexed: 11/29/2022]
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Mitschke DB. Coping with prostate cancer in Asian-American, Native Hawaiian, and Caucasian families. SOCIAL WORK IN HEALTH CARE 2009; 48:192-206. [PMID: 19197774 DOI: 10.1080/00981380802580513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Prostate cancer is the most commonly diagnosed invasive cancer among men in the United States. In order to explore the coping experience of men and their families facing prostate cancer, a qualitative analysis of written responses to open-ended questions related to roles during the illness experience, closeness of relationships, and coping strategies was conducted with a sample of 100 Caucasian, Asian, and Native Hawaiian participants. Results indicate that family members and friends are essential to coping with the effects of the disease, and also that spouses, children, and friends fulfill unique and important roles in facing the illness experience.
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Affiliation(s)
- Diane B Mitschke
- School of Social Work, University of Texas at Arlington, Arlington, Texas 76019, USA.
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Hodges LJ, Humphris GM. Fear of recurrence and psychological distress in head and neck cancer patients and their carers. Psychooncology 2008; 18:841-8. [DOI: 10.1002/pon.1346] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Development in quality of relationship between the significant other and the lung cancer patient as perceived by the significant other. Eur J Oncol Nurs 2008; 12:430-5. [PMID: 18845476 DOI: 10.1016/j.ejon.2008.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Revised: 05/22/2008] [Accepted: 07/09/2008] [Indexed: 11/20/2022]
Abstract
AIM To prospectively explore the quality of the relationship between significant others and patients during lung cancer, based on the perceptions of the significant others. METHOD In a sample of 91 significant others, longitudinal data were collected during the first year after diagnosis, and explored on group level and as individual patterns over time. RESULTS Relational quality was skewed towards high quality, although 30% of the significant others reported low levels close to diagnosis. Forty-eight percent reported stability in the quality of their relationship during the disease trajectory. Within this group, 36% reported low levels of relational quality. Fifty-two percent reported change in quality of relationship and four typical patterns of change were identified. Two showed approximate linear changes in either a positive direction (15%) or a negative direction (49%), and two showed non-linear changes with a temporary ascending curve (11%) or a descending curve (26%). This implies that a change towards low levels of relational quality was most common. CONCLUSION The present results show that illness may be a trigger for change in relational quality, which may have implications for future family-centred practice and research, since previously high relational quality has been linked to improved emotional well-being.
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Abstract
INTRODUCTION Finding a life partner is of great importance for persons' life satisfaction, but cancer's potential impact on family life is not well described. Cancer's impact on marriage formation rates was therefore explored. METHOD Data on the entire unmarried Norwegian population aged 17-44 in 1974-2001 (N = 2.2 million) come from the Cancer Registry and the Central Population Register. Marriage rates for 12,100 persons diagnosed with cancer were compared to marriage rates for otherwise similar persons using discrete-time hazard regression models. RESULTS Men with cancer had a marriage probability that was five percent higher (OR 1.05, CI 1.01-1.11) than cancer-free men. No cancer forms reduced men's marriage rates, and significantly elevated rates were seen after skin and testicular cancer (OR 1.16 and 1.11). Cancer did not impact significantly on women's overall marriage rate (OR 0.95, CI 0.90-1.00), but pronounced deficiencies were seen after brain and breast cancer (OR 0.62 and 0.74). Skin cancer elevated women's marriage rate (OR 1.27). Male cancer survivors with children were more likely to marry than their female counterparts. Significant increases in cancer survivors' marriage rates were observed over time. CONCLUSION Marrying after cancer is more common today than previously, and only slight overall differences were observed in cancer survivors' marriage rates relative to those of the cancer-free population. However, while brain and breast cancer in women is associated with reduced marriage rates, testicular cancer is associated with increased rates. The differences observed between common cancer forms in young adults deserve further exploration. IMPLICATIONS FOR CANCER SURVIVORS In general, marriage rates in survivors of most types of cancer are very similar to those in the population as a whole. Women with brain and breast cancer have lower marriage rates than their cancer-free counterparts. While it is necessary to identify exactly why this was observed, the information can alert those with these cancers to the potential impact on marriage and thus work to reduce the possible effect, if desired.
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Affiliation(s)
- Astri Syse
- Cancer Registry of Norway, Oslo, Norway.
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