A Couples Approach to Enhance Breast Cancer Survirorship

描述（由申请人提供）：乳腺癌的诊断和治疗不仅对患者，而且对患者的配偶或伴侣以及夫妻关系都有重大而持久的影响。乳腺癌经常导致患者和伴侣的情绪困扰，患者的身体形象，角色功能和性功能紊乱，以及患者和伴侣之间的互动模式不适应，所有这些都影响了患者的调整和夫妻关系的功能。我们研究的最终目标是帮助那些一方患有癌症的夫妇提高他们相互帮助的能力，既解决他们关心的领域，又最大限度地发挥生活的积极方面。这项拟议的研究评估了一种新开发的、以认知行为为基础的夫妇干预措施的效果，该干预措施被称为“茁壮成长”。292名最近被诊断为早期乳腺癌的女性及其伴侣将被随机分配到以下三种情况中的一种：(1)CanThrive，该项目向夫妇传授经过验证的特定关系技巧，以提高他们有效沟通和解决癌症相关问题的能力，保持令人满意的性功能，并最大限度地促进积极互动；(2)癌症教育，向夫妇提供有关乳腺癌及其治疗的信息；(3)照旧治疗，夫妻不接受积极干预。在治疗前后以及随访6个月和12个月时进行的评估包括患者与丈夫的沟通、丈夫的支持、性调整和自我图式、获益发现、情绪和情感健康、社会角色功能、疼痛、疲劳和身体健康的报告；以及丈夫对与病人沟通，病人支持，性功能，获益发现，情绪和心理健康的评分。患者还完成关于感知伴侣支持、情绪、症状和角色功能的日常日记。此外，在每次评估中，夫妇们都会进行三次与癌症有关的谈话录像，并根据伴侣的支持和沟通技巧进行评分。这项研究可能会导致我们对关系技巧和伴侣参与在癌症患者适应中的作用的理解取得重大进展。如果成功，它将扩大我们有效提高癌症患者及其伴侣福祉的方法。

DESCRIPTION (provided by applicant): The diagnosis and treatment of breast cancer has a significant and enduring impact not only on the patient, but also on the patient's spouse or partner, and the couple's relationship as well. Breast cancer frequently leads to emotional distress for both the patient and partner, disturbances in the patient's body image, role functioning, and sexual functioning, and maladaptive patterns of interaction between the patient and partner, all of which impact both the patient's adjustment and the couple's relationship functioning. The ultimate goal of our research is to help couples in which one partner has cancer improve their ability to assist each other, both to address areas of concern and to maximize positive aspects of life. The proposed study evaluates the efficacy of a newly developed, cognitive-behavioral couple-based intervention entitled CanThrive. 292 women recently diagnosed with early stage breast cancer and their partners will be randomly assigned to one of three conditions: (1) CanThrive, which teaches couples well-validated specific relationship skills to improve their ability to communicate effectively and problem-solve about cancer-related issues, maintain satisfactory sexual functioning, and maximize positive interactions; (2) Cancer Education which provides couples with information about breast cancer and its treatment; or (3) Treatment-As-Usual, in which couples receive no active intervention. Assessment conducted before and after treatment and at 6 and 12 months follow-up includes patients' reports of communication with the husband, support from the husband, sexual adjustment and self-schema, benefit finding, mood and emotional well being, social role functioning, pain, fatigue, and physical well being; and husbands' ratings of communication with the patient, support from the patient, sexual functioning, benefit finding, mood, and psychological well being. Patients also complete daily diaries regarding perceived partner support, mood, symptoms, and role function. Also at each evaluation, couples engage in three videotaped cancer-related conversations that will be rated on dimensions of partner support and communication skills. This study may lead to major advances in our understanding of the role of relationship skills and partner involvement in the adjustment of cancer patients. If successful, it will enlarge our repertoire of methods for effectively enhancing the well being of both cancer patients and their partners.