a Department of Health Outcomes & Behavior , Moffitt Cancer Center , Tampa , FL , USA.
b Psychology Department , Brigham Young University , Provo , UT , USA.
Psychol Health Med. 2018 Jun;23(5):548-554. doi: 10.1080/13548506.2017.1381747. Epub 2017 Oct 6.
The shared social context created in a marriage may be important in motivating engagement in health behaviors, but spousal influence may not be uniformly applied. Our goal was to examine how spouses discuss health behaviors relevant for colorectal cancer (CRC) risk-reduction to better understand how spouses exert or fail to exert influence. In this pilot study, first degree relatives of CRC patients and their spouses completed demographic and self-reported health questionnaires. After a genetic counseling session regarding risk and risk reduction, couples engaged in a semi-structured discussion task to discuss lifestyle choices they currently undertake or could undertake to reduce risk. Demographic and health data was analyzed using descriptive statistics. Using a directed content analysis based on the transtheoretical model of behavior change, we coded discussion transcripts for depth and direction of talk for seven behavioral CRC risk factors. Spouses engaged in several strategies to reduce their risk for CRC, and problem-solved together to increase these preventative efforts. All couples mentioned diet and exercise as important factors in CRC risk; however, other risk factors received less attention. Despite evidence of support and encouragement, spouses ignored, minimized, or negated the importance of some health behaviors. Spousal influence could be an important tool to improve participation in health behaviors, but more guidance may be necessary to hold couples accountable to evidence-based guidelines to reduce risk. Health care providers should address couples as a unit to assess and address health behaviors.
婚姻中共同的社会背景可能对激励人们参与健康行为很重要，但配偶的影响可能并不统一。我们的目标是研究配偶之间如何讨论与降低结直肠癌（CRC）风险相关的健康行为，以更好地理解配偶如何施加或未能施加影响。在这项初步研究中，CRC 患者的一级亲属及其配偶完成了人口统计学和自我报告的健康问卷。在进行了关于风险和降低风险的遗传咨询后，夫妇们参与了一个半结构化的讨论任务，讨论他们目前正在采取或可以采取哪些生活方式选择来降低风险。使用描述性统计方法分析人口统计学和健康数据。我们使用基于行为改变跨理论模型的定向内容分析，为七个行为 CRC 风险因素的讨论记录进行了深度和方向的编码。配偶们采取了几种策略来降低他们患 CRC 的风险，并共同解决问题以增加这些预防措施。所有夫妇都提到饮食和运动是 CRC 风险的重要因素；然而，其他风险因素则受到较少关注。尽管有支持和鼓励的证据，但配偶们忽视、最小化或否定了一些健康行为的重要性。配偶的影响可能是提高健康行为参与度的重要工具，但可能需要更多的指导，以使夫妇对基于证据的指南负责，以降低风险。医疗保健提供者应该将夫妇作为一个整体来评估和解决健康行为问题。
