Abstract
Goals of work
Prostate cancer, the most common life-threatening cancer among American men, increases risk of psychosocial distress and negatively impacts quality of life for both patients and their spouses. To date, most studies have examined the relationship between patient coping and distress; however, it is also likely that what the spouse does to cope, and ultimately how the spouse adjusts, will affect the patient’s adjustment and quality of life. The present study examined the relationships of spouse problem-solving coping, distress levels and patient distress in the context of prostate cancer. The following mediational model was tested: Spouses’ problem-solving coping will be significantly inversely related to patients’ levels of distress, but this relationship will be mediated by spouses’ distress levels.
Patients and methods
One hundred seventy-one patients with prostate cancer and their spousal caregivers were assessed for mood; spouses were assessed for problem-solving coping skills. Structural equation modeling was used to test model fit.
Main results
The model tested was a good fit to the data. Dysfunctional spousal problem-solving was a significant predictor of spouse distress level but constructive problem-solving was not. Spouse distress was significantly related to patient distress. Spouse dysfunctional problem-solving predicted patient distress, but this relationship was mediated by spouse distress. The same mediational relationship did not hold true for constructive problem-solving.
Conclusions
Spouse distress mediates the relationship between spouse dysfunctional coping and patient distress. Problem-solving interventions and supportive care for spouses of men with prostate cancer may impact not only spouses but the patients as well.
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Acknowledgements
The authors would like to acknowledge all the couples who agreed to participate in this study and who shared very intimate details about their lives with us. The following institutions, organizations, and health providers in San Diego County were very generous with their time and effort in helping us recruit for this study: American Cancer Society; Kaiser Permanente; Naval Medical Center San Diego; Informed Prostate Cancer Support Group; Oncology Therapies of Vista; Prostate Cancer Research and Education Foundation; Radiation Medical Group; San Diego Prostate Cancer Support Group; Solana Beach Presbyterian Church; The Wellness Community San Diego; UCSD Rebecca and John Moores Cancer Center; UCSD Selenium and Vitamin E Cancer Prevention Trial (SELECT); UCSD Stein Institute for Research in Aging; Veterans Health Administration San Diego. The following were key figures in recruitment: Christopher Amling, M.D; Israel Barken, M.D; Donald Fuller, M.D.; Robert W. Hathorn, M.D.; Peter Johnstone, M.D.; Mehdi Kamarei, M.D.; Francisco Pardo, M.D.; Marilyn Sanderson, R.N.; Carol Salem, M.D., Joseph Schmidt, M.D; Stephen Seagren, M.D.; Kenneth Shimizu, M.D; Clayton Smiley, M.D.; and Reverend Doctor Tom Theriault. The authors would also like to acknowledge all the undergraduate and graduate students who contributed time, energy, and hard work in completing this research project. This project was made possible from funding from the National Cancer Institute R2564745 and the California Cancer Research Program (CCRP) 99–00556V-10049.
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Ko, C.M., Malcarne, V.L., Varni, J.W. et al. Problem-solving and distress in prostate cancer patients and their spousal caregivers. Support Care Cancer 13, 367–374 (2005). https://doi.org/10.1007/s00520-004-0748-5
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DOI: https://doi.org/10.1007/s00520-004-0748-5