Objective
Couples facing metastatic breast cancer (MBC) must learn to cope with stressors that can affect both partners' quality of life as well as the quality of their relationship. Common dyadic coping involves taking a “we” approach, whereby partners work together to maintain their relationship while jointly managing their shared stress. This study prospectively evaluated whether common dyadic coping was associated with less cancer-related distress and greater dyadic adjustment for female MBC patients and their male partners.
Design
Couples (N = 191) completed surveys at the start of treatment for MBC (baseline), and 3 and 6 months later.
Main Outcome Measures
Cancer-related distress was assessed with the Impact of Events Scale; dyadic adjustment was assessed using the short-form of the Dyadic Adjustment Scale.
Results
Multilevel models using the couple as the unit of analysis showed that the effects of common positive dyadic coping on cancer-related distress significantly differed for patients and their partners. Whereas partners experienced slightly lower levels of distress, patients experienced slightly higher levels of distress. Although patients and partners who used more common negative dyadic coping experienced significantly greater distress at all times, the association was stronger for patients. Finally, using more common positive dyadic coping and less common negative dyadic coping was mutually beneficial for patients and partners in terms of greater dyadic adjustment.
Conclusion
Our findings underscore the importance of couples working together to manage the stress associated with MBC. Future research may benefit from greater focus on the interactions between patients and their partners to address ways that couples can adaptively cope together.
Objective
Informal caregivers (family and friends) of people with cancer are
often unprepared for their caregiving role, leading to increased burden or
distress. CHESS (Comprehensive Health Enhancement Support System) is a
web-based lung cancer information, communication and coaching system for
caregivers. This randomized trial reports the impact on caregiver burden,
disruptiveness and mood of providing caregivers access to CHESS versus the
Internet with a list of recommended lung cancer websites.
Methods
285 informal caregivers of patients with advanced non-small cell lung
cancer were randomly assigned to a comparison group that received Internet
or a treatment group that received Internet and CHESS. Caregivers were
provided a computer and Internet service if needed. Written surveys were
completed at pretest and during the intervention period bimonthly for up to
24 months. ANCOVA analyses compared the intervention’s effect on
caregivers’ disruptiveness and burden (CQOLI-C), and negative mood
(combined Anxiety, Depression, and Anger scales of the POMS) at six months,
controlling for blocking variables (site, caregiver’s race, and
relationship to patient) and the given outcome at pretest.
Results
Caregivers randomized to CHESS reported lower burden
[t (84) = 2.36, p = .021,
d= .39] and negative mood [t (86) =
2.82, p = .006, d= .44] than those in the
Internet group. The effect on disruptiveness was not significant.
Conclusions
Although caring for someone with a terminal illness will always exact
a toll on caregivers, eHealth interventions like CHESS may improve
caregivers’ understanding and coping skills and, as a result, ease
their burden and mood.
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