Lim Jung-Won, Shon En-Jung
Author Affiliations: College of Social Welfare, Kangnam University, Yongin, Gyeonggi, Korea (Dr Lim); and Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH (Ms Shon).
Cancer Nurs. 2018 Mar/Apr;41(2):156-165. doi: 10.1097/NCC.0000000000000468.
Spouses' ability to care for survivors can be particularly challenging because patients and spouses are interdependent and mutually influence one another. Family functioning such as family cohesion and communication may play a primary role in improving the health-related quality of life (HRQOL) of couples, given that cancer can influence family dynamics.
The aims of this study were to investigate the mediating effect of family communication on the relationship between family cohesion and HRQOL and examine the moderating effect of sex on this relationship among cancer survivor-spouse dyads.
A total of 91 cancer survivors with a diagnosis of breast, colorectal, or prostate cancer and their spouses were recruited from the University Hospital Registry in Cleveland, Ohio. The dyadic data were analyzed using structural equation modeling with the actor-partner interdependence mediation model.
Findings demonstrated that the spouses' own perceived family communication mediated the associations between their own family cohesion and physical HRQOL and between the survivors' family cohesion and physical HRQOL. The spouse actor effects between family communication and HRQOL significantly differed by sex.
Enhancing family cohesion and communication within the family can improve the spouses' HRQOL. Findings regarding sex differences serve as a rationale for gender-based approaches to improving HRQOL in survivorship care in the family context.
Couple- and/or family-based interventions should be designed to enhance family cohesion and improve family communication skills for effective adjustments within couples and families. Supportive care within the family context can be promoted to address the diverse challenges of survivorship care.
配偶照顾幸存者的能力可能特别具有挑战性，因为患者和配偶相互依赖且相互影响。鉴于癌症会影响家庭动态，家庭功能，如家庭凝聚力和沟通，可能在改善夫妻的健康相关生活质量（HRQOL）方面发挥主要作用。
本研究的目的是调查家庭沟通在家庭凝聚力与HRQOL之间关系中的中介作用，并检验性别在癌症幸存者 - 配偶二元组中这种关系上的调节作用。
从俄亥俄州克利夫兰市大学医院登记处招募了91名被诊断患有乳腺癌、结直肠癌或前列腺癌的癌症幸存者及其配偶。使用具有actor - partner相互依赖中介模型的结构方程模型对二元数据进行分析。
研究结果表明，配偶自身感知的家庭沟通介导了他们自己的家庭凝聚力与身体HRQOL之间以及幸存者的家庭凝聚力与身体HRQOL之间的关联。家庭沟通与HRQOL之间的配偶actor效应在性别上存在显著差异。
增强家庭凝聚力和家庭内部沟通可以改善配偶的HRQOL。关于性别差异的研究结果为在家庭背景下的幸存者护理中采用基于性别的方法改善HRQOL提供了理论依据。
应设计基于夫妻和/或家庭的干预措施，以增强家庭凝聚力并提高家庭沟通技巧，以便在夫妻和家庭内部进行有效调整。可以促进家庭背景下的支持性护理，以应对幸存者护理的各种挑战。
