Couple Communication in Cancer: A Multi-Method Examination

对于患者及其亲密伴侣来说，癌症带来了重大的身体和情感挑战， 对个人和夫妻双方都有负面影响。越来越多的证据表明， 有效沟通的能力，或缺乏这种能力，在双方的心理调整中起着重要作用。 个人及其关系的质量。已经提出了两个关键的概念模型来解释 沟通困难如何导致较差的结果：社会认知处理模型和 亲密关系模型这些模式包含影响结果的不同机制和过程， 因此，对干预的影响有很大的不同。然而，迄今为止， 对每个模型提出的机制进行审查，限制了科学的进步， 制定基于理论的干预措施。拟议项目的目的是测试和比较 这些模型使用全面和严格的方法。该项目由一个 二元观点，包括检查患者和伴侣的感知和行为， 交流他们对癌症的担忧并相互回应。我们提出了一个纵向多- 审查沟通过程的方法，包括：（a）标准的自我报告问卷 评估在一年的过程中在多个时间点收集的过程和结果变量;（B） 生态瞬时评估，对参与者的报告进行真实的抽样;以及（c）基于实验室的 几个对话，我们将从中获得沟通行为和声音的观察措施 情绪激动的指标所提出的方法将解决以往研究的局限性 包括横截面设计和对自我报告措施的唯一依赖。目标样本包括 共434例晚期乳腺癌或结直肠癌患者及其伴侣。这项研究的目的是： (1)检验社会认知加工和亲密关系模型在解释 患者和伴侣的心理和关系调整，因为他们发生在日常的基础上，并在 （2）检查模型对不同亚组（男性与女性， 患者与合作伙伴）;（3）检查评估沟通的各种方法的效用 （自我报告问卷与EMA与观察性测量），通过检查 来自这些不同测量策略的基线指数预测一年随访时的调整。 这项研究的发现有可能推进关系科学和我们对人际关系的理解。 人际沟通影响患者和伴侣对癌症适应的过程。我们 长期目标是利用结果为理论、测量以及设计和实施提供信息， 旨在优化患者和伴侣福祉的有效干预措施。

For patients and their intimate partners, cancer poses significant physical and emotional challenges that can negatively impact both individuals and the couple as a whole. Accumulating evidence suggests that couples' ability to communicate effectively, or lack thereof, plays a major role in the psychological adjustment of both individuals and the quality of their relationship. Two key conceptual models have been proposed to account for how communication difficulties lead to poorer outcomes: the social-cognitive processing model and the relationship intimacy model. These models posit different mechanisms and processes affecting outcomes, and thus have substantially different implications for intervention. To date, however, there has been little empirical examination of the mechanisms proposed by each model, limiting advancement of the science as well as the development of theory-based interventions. The purpose of the proposed project is to test and compare the utility of these models using comprehensive and methodologically rigorous methods. The project is guided by a dyadic perspective that includes examination of both patient and partner perceptions and behaviors in communicating their cancer-related concerns and responding to one other. We propose a longitudinal multi- method approach to examining communication processes including: (a) standard self-report questionnaires assessing process and outcome variables collected at multiple time points over the course of one year; (b) ecological momentary assessments (EMA) to sample participant reports in real time; and (c) laboratory-based couple conversations from which we will derive observational measures of communication behavior and vocal indices of emotional arousal. The proposed methodology will address limitations of previous research including cross-sectional designs and a sole reliance on self-report measures. The targeted sample includes a total of 434 patients with advanced breast or colorectal cancer and their partners. The aims of the study are: (1) to examine the overall fit of the social-cognitive processing and relationship intimacy models in explaining patient and partner psychological and relationship adjustment as they occur on a day-to-day basis and over the course of one year; (2) to examine the fit of the models for different subgroups (males versus females, and patients versus partners); and (3) to examine the utility of the various methods of assessing communication (self-report questionnaires versus EMA versus observational measures) by examining the degree to which baseline indices from these different measurement strategies predict adjustment at one-year follow up. Findings from this study have the potential to advance relationship science and our understanding of the processes through which interpersonal communication affects patient and partner adaptation to cancer. Our long-term goal is to use the results to inform theory, measurement, and the design and implementation of efficacious interventions aimed at optimizing both patient and partner well-being.