Winters-Stone Kerri M, Lyons Karen S, Bennett Jill A, Beer Tomasz M
School of Nursing, Oregon Health & Science University, Mailcode: SN-ORD, Portland, OR, 97239, USA,
Support Care Cancer. 2014 May;22(5):1341-8. doi: 10.1007/s00520-013-2092-0. Epub 2013 Dec 17.
Prostate cancer survivors (PCSs) may experience persistent symptoms following treatment. If PCSs and spouses differ in their perceptions of symptoms, that incongruence may cause mismanagement of symptoms and reduced relationship quality. The purpose of this study was to examine symptom incongruence and identify the PCS and spouse characteristics associated with symptom incongruence in older couples coping with prostate cancer.
Participants in the study were older PCSs (>60 years) and their spouses (N=59 couples). Symptom incongruence was determined by comparing patient and spouse independent ratings of the severity of his cancer-related symptoms. Predictor variables included PCS age, time since diagnosis, PCS comorbidity, PCS and spouse depressive symptoms, and spouse caregiving strain.
PCS and spouse ratings of his symptom severity and the amount of incongruence over his symptoms varied significantly across couples. Overall, couples rated a moderate level of PCS symptom severity, but PCSs and their spouses significantly differed in their perceptions of PCS symptom severity with spouses rating severity higher (t=-2.66, df=51, p<0.01). PCS younger age and high spouse caregiver strain accounted for 29 % of incongruence in perceptions of PCS symptom severity.
This study is among the first to show that PCSs and spouses may perceive cancer-related persistent symptoms differently. Among this older sample, younger PCS age and spouse caregiver strain were associated with incongruence in symptoms perceptions in couples. These and other factors may inform future interventions aimed at preserving relationship quality in older couples who have experienced prostate cancer.
前列腺癌幸存者（PCSs）在治疗后可能会经历持续的症状。如果PCSs和其配偶对症状的认知存在差异，这种不一致可能会导致症状管理不当以及关系质量下降。本研究的目的是检查症状不一致情况，并确定在应对前列腺癌的老年夫妇中与症状不一致相关的PCSs和配偶特征。
本研究的参与者为年龄较大的PCSs（>60岁）及其配偶（N = 59对夫妇）。通过比较患者和配偶对其癌症相关症状严重程度的独立评分来确定症状不一致情况。预测变量包括PCSs的年龄、诊断后的时间、PCSs的合并症、PCSs和配偶的抑郁症状以及配偶的照料压力。
PCSs及其配偶对其症状严重程度的评分以及症状不一致程度在不同夫妇之间存在显著差异。总体而言，夫妇对PCSs症状严重程度的评分处于中等水平，但PCSs及其配偶对PCSs症状严重程度的认知存在显著差异，配偶评定的严重程度更高（t = -2.66，自由度 = 51，p < 0.01）。PCSs年龄较小和配偶照料压力较大占PCSs症状严重程度认知不一致的29%。
本研究首次表明PCSs和配偶对癌症相关的持续症状可能有不同的认知。在这个老年样本中，PCSs年龄较小和配偶照料压力与夫妇症状认知不一致有关。这些因素以及其他因素可能为未来旨在维护经历过前列腺癌的老年夫妇关系质量的干预措施提供参考。
