Carmack Taylor Cindy L, Badr Hoda, Lee Ji H, Fossella Frank, Pisters Katherine, Gritz Ellen R, Schover Leslie
Department of Behavioral Science Unit 1330, The University of Texas M. D. Anderson Cancer Center, P.O. Box 301439, Houston, TX, 77230-1439, USA,
Ann Behav Med. 2008 Oct;36(2):129-40. doi: 10.1007/s12160-008-9062-7. Epub 2008 Sep 17.
Lung cancer morbidity and mortality may increase the risk for distress in couples facing this malignancy.
We examined the prevalence of psychological and relationship distress in lung cancer patients and their spouses, predictors of psychological distress for both, and whether relationship satisfaction moderated the relation between patient and spouse distress.
Participants (169 patients and 167 spouses) completed questionnaires provided during clinic appointments at baseline (within one month of treatment initiation) and through the mail 3 and 6 months later. Analyses were from the baseline data.
In total, 34.6% of patients and 36.4% of spouses reported psychological distress. Patient and spouse distress were correlated, depending on the symptom examined. Only 10.9% of patients and 14.1% of spouses reported distressed spousal relationships. Distress predictors for patients included less positive social interaction support, more behavioral disengagement and self-distraction coping, and the spouse reporting less use of humor for coping. Predictors for spouses included more behavioral disengagement and substance use coping, more blaming the patient for causing the cancer, and the patient using more behavioral disengagement coping. Relationship satisfaction moderated the association between each partner's distress.
Psychosocial counseling for lung cancer patients should include spouses and target decreasing individual distress and enhancing relationship satisfaction.
肺癌的发病率和死亡率可能会增加面临这种恶性肿瘤的夫妻出现困扰的风险。
我们研究了肺癌患者及其配偶心理和关系困扰的患病率、双方心理困扰的预测因素，以及关系满意度是否调节了患者与配偶困扰之间的关系。
参与者（169名患者和167名配偶）在基线时（治疗开始后一个月内）的门诊预约期间以及3个月和6个月后通过邮寄方式完成问卷调查。分析基于基线数据。
总体而言，34.6%的患者和36.4%的配偶报告有心理困扰。患者和配偶的困扰存在相关性，具体取决于所检查的症状。只有10.9%的患者和14.1%的配偶报告配偶关系困扰。患者的困扰预测因素包括较少积极的社会互动支持、更多的行为脱离和自我分心应对方式，以及配偶报告较少使用幽默应对。配偶的预测因素包括更多的行为脱离和物质使用应对方式、更多地责怪患者导致癌症，以及患者使用更多的行为脱离应对方式。关系满意度调节了每个伴侣困扰之间的关联。
肺癌患者的心理社会咨询应包括配偶，并旨在减少个体困扰并提高关系满意度。
