Couple Communication in Cancer: A Multi-Method Examination

对于患者和他们的亲密伴侣来说，癌症带来了巨大的身体和情感挑战， 对个人和夫妻作为一个整体都会产生负面影响。越来越多的证据表明，夫妻之间的 有效沟通的能力或缺乏，在双方的心理调整中都起着重要作用 个人及其关系的质量。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-认知加工模型和 关系亲密模型。这些模型假定了影响结果的不同机制和过程，以及 因此，对干预的影响有很大不同。然而，到目前为止，几乎没有经验性的 审查每个模型提出的机制，限制科学的进步以及 发展以理论为基础的干预措施。拟议项目的目的是测试和比较 使用全面和方法严谨的方法对这些模型进行实用。该项目由一个 二元视角，包括检查患者和伴侣的看法和行为 交流他们与癌症相关的担忧，并相互回应。我们提出了一种纵向多层次的 审查沟通过程的方法，包括：(A)标准的自我报告问卷 评估一年期间在多个时间点收集的过程和结果变量；(B) 生态瞬时评估(EMA)，实时采样参与者报告；和(C)以实验室为基础 两个对话，我们将从这些对话中得出交流行为和声音的观察测量 情绪唤醒指数。拟议的方法将解决先前研究的局限性。 包括横截面设计和完全依赖自我报告措施。目标样本包括 共有434名晚期乳腺癌或结直肠癌患者及其伴侣参加。研究的目的是： (1)考察社会认知加工模型和关系亲密度模型在解释问题上的整体适合性 患者和伴侣的心理和关系调整，因为它们发生在日常基础上和在 为期一年的课程；(2)检查不同亚组(男性与女性，以及 患者与伴侣)；以及(3)检查评估沟通的各种方法的效用 (自我报告问卷与EMA和观察性指标)，通过检查以下程度 这些不同测量策略的基线指数预测一年后的调整。 这项研究的发现有可能促进关系科学和我们对 人际沟通影响患者和伴侣对癌症的适应的过程。我们的 长期目标是使用结果为理论、测量以及设计和实施提供信息 有效的干预措施，旨在优化患者和伴侣的福祉。

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.