Department of Oncological Sciences, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1130, New York, NY 10029, USA Department of Psychology, 110 Wolf Hall, University of Delaware, Newark, DE 19716-2577, USA St. Louis Behavioral Medicine Institute, 1129 Macklind Ave, St. Louis, MO 63110, USA Department of Behavioral Science, The University of Texas, M.D. Anderson Cancer Center, P.O. Box 301439, Unit 1330, Houston, TX 77230-1439, USA Department of Anesthesiology and Pain Medicine, Box 356540, University of Washington, School of Medicine, Seattle, WA 98195, USA.
Pain. 2010 Dec;151(3):644-654. doi: 10.1016/j.pain.2010.08.022. Epub 2010 Sep 15.
Women with metastatic breast cancer (MBC) experience high levels of emotional distress and pain. Although individuals often rely on their intimate partners to provide physical and emotional support when they are in pain, the daily impact of pain on the spousal relationship in the context of advanced cancer is unclear. To understand how relationships are affected by pain, 57 MBC patients and their partners completed electronic diary assessments 6 times a day for 14 days. Patients and partners rated the patient's pain, their own mood (circumplex adjectives), the provision/receipt of social support, and the degree to which cancer interfered with their relationship. Multilevel mediation models with the couple as the unit of analysis were estimated. Partners and patients reported greater relationship interference when patients experienced more pain and less aroused (i.e., more tired, less peppy, less active) mood. Greater tired mood during the day accounted for 17% and 82% of the association between patients' morning pain and their evening ratings of emotional and physical support from their partners, respectively. Partners did not directly respond to patients' pain by providing emotional or physical support; however, they were more likely to provide support when patients experienced more tired and less active mood as a consequence of their pain. Results suggest that one way that pain may wear on couples' relationships is through its adverse effects on patients' daily mood. They also suggest that partners may base their provision of support on their perception of the adverse effects of pain on patients' aroused mood.
患有转移性乳腺癌（MBC）的女性经历着高度的情绪困扰和疼痛。尽管当个体感到疼痛时，他们通常依赖亲密伴侣提供身体和情感支持，但在晚期癌症背景下，疼痛对配偶关系的日常影响尚不清楚。为了了解疼痛如何影响关系，57 名 MBC 患者及其伴侣在 14 天内每天完成 6 次电子日记评估。患者和伴侣评估了患者的疼痛、自己的情绪（双形容词）、社会支持的提供/接收情况，以及癌症对关系的干扰程度。以夫妻为单位的多层次中介模型进行了估计。当患者感到更疼痛和情绪更不振（即更疲倦、更没精打采、更不活跃）时，伴侣和患者报告了更多的关系干扰。白天的疲倦情绪解释了患者清晨疼痛与他们晚上对伴侣情感和身体支持的评分之间的关联的 17%和 82%。伴侣并没有直接通过提供情感或身体支持来回应患者的疼痛；然而，当患者由于疼痛而感到更加疲倦和不活跃时，他们更有可能提供支持。研究结果表明，疼痛可能会影响夫妻关系的一种方式是通过其对患者日常情绪的不良影响。研究结果还表明，伴侣可能会根据他们对疼痛对患者唤醒情绪的不良影响的感知来提供支持。
