Department of Psychiatry, Center for Palliative Care, The Ohio State University, Columbus, OH 43210–1222, USA.
Brain Behav Immun. 2012 Feb;26(2):228-33. doi: 10.1016/j.bbi.2011.07.237. Epub 2011 Jul 23.
Spouses of cancer patients are at-risk for poor psychological and physical health as they cope with the complex nature of the disease and fears of losing their partner. Moreover, spouses often serve as patients' primary informal caregivers, a group that evidences poor outcomes across a variety of domains. The present study examines the relative contributions of cancer recurrence - a cancer-specific stressful event - and the subjective experience of cancer-specific stress (IES) in a sample of male spouses of breast cancer survivors. We hypothesized that stress would contribute to poorer physical health and compromised immune function. Spouses (recurrence; n=16) of patients who were coping with their first recurrence were matched to spouses of patients with no evidence of disease (disease-free; n=16). Self-reported physical health (physical symptoms and fatigue) and immune function [T-cell blastogenic response to the mitogens Concanavalin A (ConA) and phytohemagglutanin (PHA) and T3 monoclonal antibody (T3 Mab)] were included as outcomes. Results indicated that patient recurrence status was not a significant unique predictor of physical health or immune function; rather, among all spouses, cancer-specific stress symptoms were associated with increased physical symptoms and altered T-cell blastogenesis. These data suggest that the health implications of caregiving for spouses of cancer survivors is more strongly linked to their subjective experience of cancer as stressful, rather than simply the patients' disease status.
癌症患者的配偶在应对疾病的复杂性和对失去伴侣的恐惧时，存在心理健康和身体健康状况不佳的风险。此外，配偶通常是患者的主要非正式照顾者，这一群体在多个领域的预后都较差。本研究考察了癌症复发（癌症特有的应激事件）和癌症特异性应激的主观体验（IES）在乳腺癌幸存者男性配偶样本中的相对贡献。我们假设压力会导致身体健康状况恶化和免疫功能受损。正在应对首次复发的患者的配偶（复发组；n=16）与没有疾病证据的患者的配偶（无疾病组；n=16）相匹配。作为结果，纳入了自我报告的身体健康（身体症状和疲劳）和免疫功能[T 细胞对有丝分裂原伴刀豆球蛋白 A（ConA）和植物血凝素（PHA）和 T3 单克隆抗体（T3Mab）的有丝分裂原反应的 Blastogenic 反应]。结果表明，患者的复发状况并不是身体健康或免疫功能的显著唯一预测因素；相反，在所有配偶中，癌症特异性应激症状与身体症状增加和 T 细胞有丝分裂原反应改变有关。这些数据表明，照顾癌症幸存者配偶的健康影响与其主观的癌症应激体验更密切相关，而不仅仅是患者的疾病状况。
