Dyadic Coping in Patients Undergoing Radiotherapy for Head and Neck Cancer and Their Spouses.
Dyadic Coping in Patients Undergoing Radiotherapy for Head and Neck Cancer and Their Spouses.
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DOI：
10.3389/fpsyg.2018.01780
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发表时间：
2018
影响因子：
3.8
通讯作者：
Wagner T
中科院分区：
文献类型：
--
作者：
Badr H;Herbert K;Bonnen MD;Asper JA;Wagner T
背景：头颈癌（HNC）对心理（即，抑郁、焦虑）和患者及其配偶的婚姻适应。双元应对指的是夫妻如何科普压力。它包括积极的行动，如分享实际或情感上的担忧（即，以问题和情绪为中心的压力沟通; PFSC，EFSC），以及参与以问题或情绪为中心的行动以相互支持（以问题和情绪为中心的二元应对; PFDC，EFDC）。它还包括消极行为，如回避（消极二元应对; NEGDC）。在对一项名为SHARE（配偶应对头颈部辐射经历）的基于夫妇的干预的随机试点试验的二次分析中，我们首先检查了患者和配偶的二元应对（以及对二元应对的满意度; SATDC）与他们自己/彼此的心理和婚姻调整之间的关联。接下来，我们研究了SHARE相对于常规医疗护理（UMC）对患者和配偶的二元应对的影响。最后，我们研究了二元应对的变化是否与患者和配偶的心理和婚姻适应的变化有关。方法和措施：30例HNC患者（80%男性）及其配偶（N = 60）在开始放疗（RT）前完成基线调查，并随机分配至SHARE或UMC组。RT后一个月，他们完成了随访调查。结果如下：基线多水平行为者-伙伴相互依赖模型显示，PFSC（效应量r =-0.32）和PFDC（r =-0.29）对抑郁症有显著的行为者效应。对于婚姻适应，PFSC、PFDC、EFDC和SATDC的演员效应显著（p < 0.05，r = 0.23至0.38）。NEGDC的演员效应（r =-0.35）和伴侣效应（r =-0.27）也很显著。发现中等至大的效应量有利于SHARE对PFSC（科恩d = 1.14）、PFDC（d = 0.64）、NEGDC（d =-0.68）和SATDC（d = 1.03）的影响。PFDC的改善与抑郁和焦虑的减少相关（p < 0.05）; SATDC的改善与焦虑和婚姻适应的改善相关（p < 0.05）。结论：SHARE干预改善了患者和配偶的积极应对，减少了消极应对。积极二元应对的增加也与心理和婚姻适应的改善有关。虽然研究结果是初步的，更多的研究如何将二元应对纳入肿瘤支持性护理干预似乎是必要的。
Background: Head and neck cancer (HNC) adversely affects the psychological (i.e., depression, anxiety) and marital adjustment of patients and their spouses. Dyadic coping refers to how couples cope with stress. It includes positive actions like sharing practical or emotional concerns (i.e., problem- and emotion-focused stress communication; PFSC, EFSC), and engaging in problem- or emotion-focused actions to support each other (problem- and emotion-focused dyadic coping; PFDC, EFDC). It also includes negative actions like avoidance (negative dyadic coping; NEGDC). In this secondary analysis of a randomized pilot trial of a couple-based intervention called SHARE (Spouses coping with the Head And neck Radiation Experience), we first examined associations between patients’ and spouses’ dyadic coping (and satisfaction with dyadic coping; SATDC) and their own/each other’s psychological and marital adjustment. Next, we examined the effects of SHARE relative to usual medical care (UMC) on patients’ and spouses’ dyadic coping. Finally, we examined whether changes in dyadic coping were associated with changes in patients’ and spouses’ psychological and marital adjustment. Methods and Measures: Thirty HNC patients (80% men) and their spouses (N = 60) completed baseline surveys prior to initiating radiotherapy (RT) and were randomized to SHARE or UMC. One month after RT, they completed follow-up surveys. Results: Baseline multilevel Actor-Partner Interdependence Models revealed significant actor effects of PFSC (effect size r = −0.32) and PFDC (r = −0.29) on depression. For marital adjustment, significant actor effects were found for PFSC, PFDC, EFDC, and SATDC (p < 0.05, r = 0.23 to 0.38). Actor (r = −0.35) and partner effects (r = −0.27) for NEGDC were also significant. Moderate to large effect sizes were found in favor of SHARE on PFSC (Cohen’s d = 1.14), PFDC (d = 0.64), NEGDC (d = −0.68), and SATDC (d = 1.03). Improvements in PFDC were associated with reductions in depression and anxiety (p < 0.05); and, improvements in SATDC were associated with improvements in anxiety and marital adjustment (p < 0.05). Conclusion: The SHARE intervention improved positive and decreased negative dyadic coping for patients and spouses. Increases in positive dyadic coping were also associated with improvements in psychological and marital adjustment. Although findings are preliminary, more research on ways to integrate dyadic coping into oncology supportive care interventions appears warranted.
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影响因子：
45.3
作者：
Gritz, ER;Carmack, CL;Abemayor, E
通讯作者：
Abemayor, E
影响因子：
5.4
作者：
Hodges, LJ;Humphris, GM;Macfarlane, G
通讯作者：
Macfarlane, G
DOI：
10.1002/hed.1049
发表时间：
2001-05-01
影响因子：
2.9
作者：
Epstein, JB;Robertson, M;Stevenson-Moore, P
通讯作者：
Stevenson-Moore, P
影响因子：
4.2
作者：
Badr, Hoda;Carmack, Cindy L.;Kashy, Deborah A.;Cristofanilli, Massimo;Revenson, Tracey A.
通讯作者：
Revenson, Tracey A.
影响因子：
2.1
作者：
Badr, Hoda;Herbert, Krista;Gupta, Vishal
通讯作者：
Gupta, Vishal