A Couples Approach to Enhance Breast Cancer Survirorship

描述(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，以及夫妇之间的关系都有重大和持久的影响。乳腺癌经常导致患者和伴侣的情绪困扰，患者的身体形象、角色功能和性功能的紊乱，以及患者和伴侣之间的不适应模式，所有这些都会影响患者的适应和夫妻关系的正常运作。我们研究的最终目标是帮助一方患有癌症的夫妇提高他们相互帮助的能力，既解决关注的领域，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名为CanThrive的新开发的、基于认知行为的夫妇干预的有效性。292名最近被诊断患有早期乳腺癌的妇女及其伴侣将被随机分配到三种情况之一：(1)CanThrive，向夫妇传授经过充分验证的特定关系技能，以提高他们就癌症相关问题进行有效沟通和解决问题的能力，保持令人满意的性功能，并最大限度地实现积极互动；(2)癌症教育，向夫妇提供有关乳腺癌及其治疗的信息；或(3)照常治疗，即夫妇不接受任何积极干预。在治疗前后以及在6个月和12个月的随访中进行的评估包括患者对与丈夫的沟通、丈夫的支持、性适应和自我图式、利益发现、情绪和情绪健康、社会角色功能、疼痛、疲劳和身体健康的报告；以及丈夫对与患者的沟通、患者的支持、性功能、利益发现、情绪和心理健康的评分。患者还完成关于感知到的伴侣支持、情绪、症状和角色功能的日常日记。在每一次评估中，夫妇们还会进行三次与癌症相关的视频对话，这些对话将根据伴侣支持和沟通技能的维度进行评级。这项研究可能会在我们理解人际关系技能和伴侣参与在癌症患者适应中的作用方面取得重大进展。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的储备。

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.