Department Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, Florida, USA.
College of Nursing, University of Utah, Salt Lake City, Utah, USA.
Psychooncology. 2020 Aug;29(8):1280-1287. doi: 10.1002/pon.5416. Epub 2020 Jun 8.
The goal of this study was to describe the quality of naturalistic communication between patients with advanced cancer and their spouse caregivers using observational methods. We also assessed the association between patient and caregiver communication behaviors and psychological and physical health using the actor-partner interdependence model.
Data on 81 dyads were gathered as part of a prospective observational study. Patients with advanced cancer and their spouse caregivers completed demographic, physical health, and emotional well-being questionnaires. Cancer and relationship communication captured in "day-in-the-life" audio recordings were coded using Gottman's Turning System to assess the quality of bids for attention and responses.
Bids for attention were most often informational (Low Bids) and responses were mostly positive and effortful (Turn Towards); patients and caregivers did not significantly differ in communication behavior. More effortful bids for attention (High Bids) were associated with more positive and effortful responses. Patient communication behaviors were significantly associated with caregiver emotional well-being, whereas caregiver communication behaviors were significantly associated with their own emotional well-being and patient physical health.
While patients may benefit from caregivers' more positive and engaged communication at home, the emotional labor of focusing on and engaging the patient may take a toll on caregivers' own well-being. This work contributes to the understanding of what everyday communication looks like for patients with advanced cancer and their spouse caregivers and how this communication may impact physical and psychological health. Our findings provide a foundation to develop guidelines for psychosocial couple-based interventions.
本研究旨在使用观察方法描述晚期癌症患者与其配偶照顾者之间自然交流的质量。我们还使用演员-伙伴相互依存模型评估了患者和照顾者沟通行为与心理和身体健康之间的关联。
作为前瞻性观察研究的一部分，收集了 81 对的数据。晚期癌症患者及其配偶照顾者完成了人口统计学、身体健康和情绪健康问卷。使用戈特曼的转向系统对“日常生活”录音中的癌症和关系沟通进行编码，以评估注意力请求和响应的质量。
注意力请求主要是信息性的（低请求），响应主要是积极的和费力的（转向）；患者和照顾者的沟通行为没有显著差异。更费力的注意力请求（高请求）与更积极和费力的响应相关。患者的沟通行为与照顾者的情绪健康显著相关，而照顾者的沟通行为与他们自己的情绪健康和患者的身体健康显著相关。
虽然患者可能从照顾者在家中更积极和投入的沟通中受益，但关注和参与患者可能会对照顾者的幸福感造成影响。这项工作有助于理解晚期癌症患者及其配偶照顾者的日常沟通方式以及这种沟通如何影响身体和心理健康。我们的研究结果为制定基于心理社会的夫妻干预指南提供了基础。
