Lyons Karen S, Miller Lyndsey M, McCarthy Michael J
Oregon Health & Science University, Portland, USA
University of Utah, Salt Lake City, USA.
J Fam Nurs. 2016 Nov;22(4):493-514. doi: 10.1177/1074840716675976. Epub 2016 Oct 31.
Given the high symptom burden and low survivability of lung cancer, patients and their spouses have been found to experience poor mental health. The current study examined the roles of dyadic appraisal and dyadic coping on the mental health of 78 couples living with non-small cell lung cancer. Multilevel modeling revealed that spouses, on average, reported significantly worse mental health than patients. Dyadic appraisal and dyadic coping played important roles in predicting mental health, controlling for known developmental and contextual covariates. Dyadic appraisal of the patient's pain and fatigue was significantly associated with spouse mental health, albeit in opposite directions. Dyadic coping significantly predicted patient mental health. The study underlines the need to incorporate routine screening of both patient and spouse mental health, and highlights the complex role of appraisal within the couple in a life-threatening context. Viewing the couple as a unit, rather than separate individuals, raises important awareness about the role of disparate illness appraisals and coping strategies within the dyad on the health of both members. Nurses are particularly well situated to engage in a collaborative family-focused approach to the couple with cancer that promotes communication and health.
鉴于肺癌的高症状负担和低生存率，已发现患者及其配偶心理健康状况不佳。本研究调查了二元评估和二元应对方式对78对非小细胞肺癌患者夫妻心理健康的影响。多层次模型显示，平均而言，配偶报告的心理健康状况明显比患者差。在控制已知的发展和背景协变量的情况下，二元评估和二元应对方式在预测心理健康方面发挥了重要作用。对患者疼痛和疲劳的二元评估与配偶心理健康显著相关，尽管方向相反。二元应对方式显著预测了患者的心理健康。该研究强调了对患者和配偶心理健康进行常规筛查的必要性，并突出了在危及生命的情况下夫妻间评估的复杂作用。将夫妻视为一个整体，而不是单独的个体，提高了人们对二元组中不同疾病评估和应对策略对双方健康作用的重要认识。护士特别适合采用以家庭为中心的协作方法来照顾患癌夫妻，以促进沟通和健康。
