Götze Heide, Friedrich Michael, Brähler Elmar, Romer Georg, Mehnert Anja, Ernst Jochen
Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
Support Care Cancer. 2017 Jan;25(1):255-264. doi: 10.1007/s00520-016-3411-z. Epub 2016 Sep 13.
With increasing age at pregnancy, the likelihood of cancer affecting a family with children under 18 is rising and the issue of parents with cancer is gaining importance. Here, we examined the level of anxiety and depression, social support, and partnership satisfaction of cancer patients with children under 18 years and their partners as well as the dyadic patient-partner relationship concerning psychological distress and predictor variables.
We used a longitudinal survey, recruiting patients with children under legal age and their partners (t1 = post therapy, t2 = 6 months after t1, t3 = 12 months after t1). Patients and partners completed the Hospital Anxiety and Depression Scale (HADS), the Oslo 3-item Social Support Scale (OSS-3), and the Abbreviated Dyadic Adjustment Scale (ADAS). We surveyed 161 cancer patients and 115 partners by mail (t1). Anxiety and depression were compared to German normative data. Dyadic relationships of three variables (social support, partnership satisfaction, and employment) and the psychological distress of 81 patient-partner dyads were analyzed with a structural equation model to estimate the actor-partner interdependence model.
After cancer therapy, 28.3 % of the patients and 46.2 % of their partners had moderate to high levels of anxiety and 17.9 % and 23.1 % had moderate to high levels of depression, respectively. Partners' levels of anxiety (p = 0.002) and depression (p = 0.018) had decreased significantly over the 1-year period post therapy. We found no changes in patients' anxiety (p = 0.444) and depression (p = 0.636) over time. Anxiety and depression did not differ on pair level (p = 0.120-0.928). The level of anxiety in patients and partners was significantly higher than that in the general population (p < 0.001-0.006). The analyses of the dyadic relationships showed a positive effect of social support on psychological distress of the patient (beta = -0.206, p < 0.2). Social support (beta = -0.448, p < 0.001), employment (beta = -0.509, p < 0.01), and satisfaction with partnership (beta = -0.448, p < 0.001) showed a positive impact on psychological well-being of the partner.
A cancer experience within a family is a large burden for both patients and partners, highlighting the high incidence of anxiety. The results indicate that couples coping with cancer tend to react as an emotional system rather than as individuals. Patients' reintegration in employment is as important as encouraging partners in their working activities. The findings underline the importance of continuing social support for patients and their partners.
随着怀孕年龄的增加，癌症影响有18岁以下子女家庭的可能性在上升，患癌父母的问题日益受到关注。在此，我们研究了有18岁以下子女的癌症患者及其伴侣的焦虑和抑郁水平、社会支持及伴侣关系满意度，以及患者 - 伴侣二元关系中的心理困扰和预测变量。
我们采用纵向调查，招募法定年龄以下子女的患者及其伴侣（t1 = 治疗后，t2 = t1后6个月，t3 = t1后12个月）。患者和伴侣完成医院焦虑抑郁量表（HADS）、奥斯陆3项社会支持量表（OSS - 3）和简化二元调节量表（ADAS）。我们通过邮件对161名癌症患者和115名伴侣进行了调查（t1）。将焦虑和抑郁与德国常模数据进行比较。用结构方程模型分析81对患者 - 伴侣二元组的三个变量（社会支持、伴侣关系满意度和就业）的二元关系以及心理困扰，以估计行为者 - 伴侣相互依存模型。
癌症治疗后，28.3%的患者及其46.2%的伴侣有中度至高度焦虑，分别有17.9%和23.1%有中度至高度抑郁。伴侣的焦虑水平（p = 0.002）和抑郁水平（p = 0.018）在治疗后的1年期间显著下降。我们发现患者的焦虑（p = 0.444）和抑郁（p = 0.636）随时间没有变化。焦虑和抑郁在二元组水平上没有差异（p = 0.120 - 0.928）。患者和伴侣的焦虑水平显著高于一般人群（p < 0.001 - 0.006）。二元关系分析显示社会支持对患者心理困扰有积极影响（β = -0.206，p < 0.2）。社会支持（β = -0.448，p < 0.001）、就业（β = -0.509，p < 0.01）和伴侣关系满意度（β = -0.448，p < 0.001）对伴侣的心理健康有积极影响。
家庭中的癌症经历对患者和伴侣都是巨大负担，凸显了焦虑的高发生率。结果表明，应对癌症的夫妻倾向于作为一个情感系统而非个体做出反应。患者重新融入工作与鼓励伴侣参与工作活动同样重要。研究结果强调了持续为患者及其伴侣提供社会支持的重要性。
