In-home conversations of couples with advanced cancer: Support has its costs.
In-home conversations of couples with advanced cancer: Support has its costs.
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DOI：
10.1002/pon.5416
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发表时间：
2020-08
期刊：
影响因子：
3.6
通讯作者：
Heyman RE
中科院分区：
文献类型：
--
作者：
Reblin M;Otto AK;Ketcher D;Vadaparampil ST;Ellington L;Heyman RE
本研究的目的是用观察方法描述晚期癌症患者及其配偶照顾者之间自然沟通的质量。我们还使用行动者-伴侣相互依赖模型评估了患者和护理者沟通行为与心理和身体健康之间的关系。作为前瞻性观察研究的一部分，收集了81对夫妇的数据。晚期癌症患者及其配偶照顾者完成了人口统计、身体健康和情感健康问卷。在“日常生活”录音中捕捉到的癌症和人际关系的交流使用Gottman的转向系统进行编码，以评估引起注意和回应的质量。引起注意的出价通常是信息性的（低出价），反应大多是积极和努力的（转向）；患者和护理人员在沟通行为上没有显著差异。更努力地吸引注意力（高出价）与更积极、更努力的反应相关。患者沟通行为与护理者情绪健康显著相关，而护理者沟通行为与自身情绪健康和患者身体健康显著相关。虽然患者可能会从护理人员在家中更积极、更投入的沟通中受益，但关注和参与患者的情绪劳动可能会对护理人员自己的健康造成损害。这项工作有助于了解晚期癌症患者及其配偶照顾者的日常交流情况，以及这种交流如何影响身心健康。我们的研究结果为制定基于夫妻的社会心理干预指南提供了基础。
The goal of this study was to describe the quality of naturalistic communication between patients with advanced cancer and their spouse caregivers using observational methods. We also assessed the association between patient and caregiver communication behaviors and psychological and physical health using the actor-partner interdependence model. Data on 81 dyads were gathered as part of a prospective observational study. Patients with advanced cancer and their spouse caregivers completed demographic, physical health, and emotional well-being questionnaires. Cancer and relationship communication captured in “day-in-the-life” audio recordings were coded using Gottman’s Turning System to assess the quality of bids for attention and responses. Bids for attention were most often informational (Low Bids) and responses were mostly positive and effortful (Turn Towards); patients and caregivers did not significantly differ in communication behavior. More effortful bids for attention (High Bids) were associated with more positive and effortful responses. Patient communication behaviors were significantly associated with caregiver emotional well-being, whereas caregiver communication behaviors were significantly associated with their own emotional well-being and patient physical health. While patients may benefit from caregivers’ more positive and engaged communication at home, the emotional labor of focusing on and engaging the patient may take a toll on caregivers’ own well-being. This work contributes to the understanding of what everyday communication looks like for patients with advanced cancer and their spouse caregivers and how this communication may impact physical and psychological health. Our findings provide a foundation to develop guidelines for psychosocial couple-based interventions.
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