a Department of Medical Social Sciences , Northwestern University Feinberg School of Medicine , Chicago , IL , USA.
b Department of Population Health Science and Policy , Icahn School of Medicine at Mount Sinai , New York , NY , USA.
Acta Oncol. 2019 May;58(5):708-714. doi: 10.1080/0284186X.2018.1563714. Epub 2019 Feb 11.
Fear of cancer recurrence (FCR) in patients and their spouses is associated with reduced quality of life, but little is known about longitudinal dyadic associations of FCR between them. This study examined (i) the trajectory of FCR from pre-treatment to 12 months later; (ii) dyadic associations of FCR over time; and (iii) whether cancer treatment type predicted later FCR among prostate cancer patients and their spouses. Sixty-nine patients and 71 spouses of patients with localized prostate cancer completed a FCR measure at baseline (pre-treatment), 6 months and 12 months later (post-treatment). A repeated measures linear mixed model was used to examine FCR trajectories. Actor-partner interdependence models (APIMs) were conducted on the 52 couples with complete data to examine actor and partner effects and treatment type on subsequent FCR. Patients and spouses reported moderate FCR levels over time, though spouses' FCR was significantly higher than patients' FCR ( < .001). FCR declined significantly for both groups over time ( < .001). APIMs demonstrated significant actor effects in baseline to 6 month, and 6-12 month models. Surgery was significantly associated with lower spouse FCR at 6 months, and radiation with lower patient FCR at 12 months. This is the first study to have concurrently examined FCR longitudinally in prostate cancer patients and spouses. Patients' and spouses' FCR declined from pre- to post-treatment, with spouses experiencing greater FCR than patients over time. FCR in patients and spouses did not appear to impact one another over time. Treatment type impacted FCR in patients and spouses differently.
患者及其配偶对癌症复发的恐惧（FCR）与生活质量下降有关，但人们对他们之间 FCR 的纵向对偶关联知之甚少。本研究考察了（i）从治疗前到 12 个月后 FCR 的轨迹；（ii）随时间推移的 FCR 对偶关联；以及（iii）癌症治疗类型是否预测前列腺癌患者及其配偶的后续 FCR。69 名患者和 71 名患者配偶在基线（治疗前）、6 个月和 12 个月后（治疗后）完成了 FCR 测量。使用重复测量线性混合模型来检查 FCR 轨迹。对 52 对具有完整数据的夫妻进行了演员-伙伴相互依存模型（APIM），以检查演员和伙伴效应以及治疗类型对随后的 FCR 的影响。患者及其配偶报告说，随着时间的推移，他们的 FCR 水平适中，但配偶的 FCR 明显高于患者的 FCR（<0.001）。随着时间的推移，两组的 FCR 都显著下降（<0.001）。APIM 在基线到 6 个月和 6-12 个月的模型中显示出显著的演员效应。手术在 6 个月时与配偶较低的 FCR 显著相关，而放射治疗在 12 个月时与患者较低的 FCR 显著相关。这是首次同时在前列腺癌患者及其配偶中纵向检查 FCR 的研究。患者和配偶的 FCR 从治疗前到治疗后下降，随着时间的推移，配偶的 FCR 比患者的 FCR 更高。患者和配偶的 FCR 似乎不会随着时间的推移相互影响。治疗类型对患者和配偶的 FCR 影响不同。
