Department of Health Psychology.
Department of Psychological and Brain Sciences.
Health Psychol. 2019 Dec;38(12):1096-1106. doi: 10.1037/hea0000803. Epub 2019 Oct 3.
Fatigue is a prevalent and long-lasting symptom among patients with cancer that is known to be worsened by patients' catastrophizing thoughts about their fatigue. Spouses are also burdened by patient fatigue, which may lead them to catastrophize as well. Based on the dyadic coping literature, this study hypothesized that patient and spouse catastrophizing translate into worse fatigue through co-rumination-couples' communications dwelling on the negative aspects of fatigue (H1). While maladaptive for fatigue, co-rumination also was expected to foster couple relationship satisfaction (H2).
Posttreatment patients with cancer and their spouses ( = 101 dyads) completed daily diaries for 14 days. Patients reported on their momentary fatigue severity. Both couple members reported on their catastrophizing about the patients' fatigue, co-rumination, and their momentary relationship satisfaction. Multilevel structural equation modeling was applied to test within-person actor- and partner-effects between catastrophizing, co-rumination, and changes in fatigue (H1) and between co-rumination and changes in relationship satisfaction (H2).
Whereas patient catastrophizing was directly related to their fatigue ( = 0.52, 95% credibility interval [CI] [0.09, 0.95]), as hypothesized, the effect of spouse catastrophizing on patient fatigue was mediated through co-rumination (indirect effect = 0.32, 95% CI [0.07, 0.60]). Unexpectedly, patient- and spouse-reported co-rumination were unrelated to both couple members' relationship satisfaction.
Spouse catastrophizing contributes to patient fatigue severity through couples' ruminative communications. Co-rumination was not related to relationship satisfaction. Reducing patient and spouse catastrophizing and fostering adaptive dyadic communication in daily life could be targets for future interventions aiming to relieve fatigue in patients after completion of cancer treatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
疲劳是癌症患者中普遍存在且持久的症状，已知患者对疲劳的灾难性思维会使疲劳恶化。配偶也因患者的疲劳而负担过重，这可能导致他们也产生灾难性思维。基于对偶应对的文献，本研究假设患者和配偶的灾难性思维通过共同反刍——夫妻双方对疲劳的消极方面进行讨论的沟通方式——转化为更严重的疲劳（H1）。虽然对疲劳不利，但共同反刍也有望促进夫妻关系满意度（H2）。
治疗后的癌症患者及其配偶（=101 对）完成了 14 天的日常日记。患者报告了他们的即时疲劳严重程度。夫妻双方都报告了他们对患者疲劳的灾难性思维、共同反刍以及他们即时的关系满意度。多层次结构方程模型用于检验患者和配偶之间的个体内效应（H1）和共同反刍与关系满意度变化之间的个体内效应（H2）。
正如假设的那样，患者的灾难性思维与他们的疲劳直接相关（=0.52，95%置信区间[CI] [0.09，0.95]），而配偶的灾难性思维对患者疲劳的影响是通过共同反刍介导的（间接效应=0.32，95% CI [0.07，0.60]）。出乎意料的是，患者和配偶报告的共同反刍与夫妻双方的关系满意度均无关。
配偶的灾难性思维通过夫妻之间的反刍性沟通导致患者的疲劳严重程度增加。共同反刍与关系满意度无关。减少患者和配偶的灾难性思维，并在日常生活中培养适应性的对偶沟通，可能是针对癌症治疗完成后缓解患者疲劳的未来干预措施的目标。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
