Dyadic Analysis to Explain Distress in Couples

描述(由申请人提供)：现有的文献表明，个性、评估和应对构成了一个模型，可以解释乳腺癌患者及其伴侣痛苦变化的很大一部分。然而，这种差异的很大一部分仍然无法解释。一起研究患者和伴侣的文献表明，其中一个人的痛苦和应对会影响另一个人的痛苦和应对，尽管我们还不清楚是通过什么机制。这项拟议的研究有望确定影响患者和伴侣痛苦的变量，并解释配偶一方如何影响另一方。在这项拟议的研究中，我们将确定认知压力模型中的变量在多大程度上改善了模型的预测能力，而不是传统的不包括并元/配偶变量的模型。我们将为患者和他们的伴侣确定这一点，以努力更好地理解乳腺癌的诊断是如何导致夫妇长期存在的心理困扰的。为了实现这些目标，将招募60名被诊断患有乳腺癌并接受辅助化疗的已婚或有伴侣的妇女及其伴侣。他们将通过邮件收到一份评估小组。将对乳腺癌、乐观、应对策略(以问题为中心的应对、以情绪为中心的应对、以关系为中心的应对以及情绪表达和处理应对)和痛苦(情绪状态的概况)进行初步评估。在控制了任何必要的人口统计学和疾病变量之后，将使用使用SAS PROC混合的多级建模的参与者伙伴相互依赖模型来确定模型变量组之间的关系。我们预计，在我们的分析中包括伴侣变量将比只包括个人变量在统计上更显著地预测陷入困境的变量。这项拟议研究的结果将为临床实践和一项更大规模的纵向研究提供参考，以确定干预措施的重要变量，以减少患者和伴侣在整个癌症经历中的心理发病率。

DESCRIPTION (provided by applicant): Extant literature shows that personality, appraisals and coping comprise a model that explains a significant proportion of the variance in distress in patients with breast cancer and their partners. However, much of the variance remains unexplained. Literature that examines patients and partners together shows that the distress and coping of one influence the distress and coping of the other, although we have yet to understand through which mechanisms. The proposed research is expected to identify variables that affect distress in patients and partners and explain how one spouse impacts the other. In the proposed study, we will determine the extent to which the variables from a cognitive stress model modified to include a dyadic component improve the model's predictive ability over the traditional model that does not include dyadic/spouse variables. We will determine this for both for patients and for their partners in an effort to better understand how a diagnosis of breast cancer leads to potentially long-standing psychological distress in couples. In order to reach these goals, 60 married or partnered women, diagnosed with breast cancer and undergoing adjuvant chemotherapy treatment, and their partners will be recruited. They will be sent an assessment battery through mail. Primary appraisals of the breast cancer, optimism, coping strategies (problem-focused coping, emotion-focused coping, relationship-focused coping, and emotional expression and processing coping) and distress (Profile of Mood States) will be assessed. The Actor Partner Interdependence Model using multilevel modeling with SAS PROC MIXED will be used to determine relationships among groups of variables from the model after controlling for any necessary demographic and disease variables. We expect that including partner variables in our analyses will result in more statistically significant variance predicted in distress than including only the individual's variables. Findings from the proposed study will inform clinical practice and also a larger, longitudinal study to determine variables important for interventions to reduce psychological morbidity for patients and partners throughout the cancer experience.