Human Development and Family Studies, School of Human Ecology, University of Wisconsin at Madison, Madison, Wisconsin.
Cancer. 2021 Apr 1;127(7):1146-1153. doi: 10.1002/cncr.33345. Epub 2020 Dec 8.
Spouses of cancer survivors are at an increased risk of poor mental health outcomes but are known to underuse supportive services. The objective of the current study was to determine how the health and health care use of cancer survivors were associated with depression and anxiety-related health care use in their spouses.
The current observational study used data from the Medical Expenditure Panel Survey to identify married individuals with a cancer-related medical event or disability ("cancer survivors"), and linked health and health care use data across spousal dyads. Spouses reporting a prescription for an antidepressant or antianxiety medication or any psychotherapy were flagged as having used mental health care. Correlates of use were assessed, with a focus on the health and health care use of the cancer survivor.
Greater than 25% of the spouses of cancer survivors used mental health care over the approximately 2.5 years of follow-up. Controlling for their own predisposing, enabling, and need characteristics, spouses were found to be less likely to use mental health care if the cancer survivor reported more health conditions or elevated depressed mood compared with dyads in which the survivor reported low distress and depression. Spouses were nearly 3 times more likely to use mental health care if the cancer survivor themselves had used mental health care (odds ratio, 2.98; 95% confidence interval, 2.17-4.09).
The findings of the current study enhance understanding of how health outcomes are intertwined in families with cancer, and reinforce the importance of a family-centered approach to cancer care that facilitates psychosocial care.
The health and well-being of cancer survivors and their spouses are intertwined. The results of the current study demonstrated that this interrelationship extends to mental health care related to depression and anxiety. Spouses of cancer survivors were found to be less likely to receive mental health care when the survivor had more health care needs. Spouses were nearly 3 times more likely to receive care if the survivor also was receiving mental health care. Caregiving spouses may face more challenges finding the time, money, or energy to engage in their own self-care. However, providing supportive care to one partner may help the other partner access care as well.
癌症幸存者的配偶心理健康状况较差的风险增加，但他们已知对支持性服务的利用率较低。本研究的目的是确定癌症幸存者的健康和医疗保健使用情况如何与配偶的抑郁和焦虑相关的医疗保健使用情况相关。
本观察性研究使用医疗支出面板调查（Medical Expenditure Panel Survey）的数据，确定有癌症相关医疗事件或残疾的已婚个体（“癌症幸存者”），并在配偶对子中链接健康和医疗保健使用数据。报告开有抗抑郁药或抗焦虑药处方或任何心理治疗的配偶被标记为使用了心理健康保健。评估了使用的相关性，重点是癌症幸存者的健康和医疗保健使用情况。
在大约 2.5 年的随访期间，超过 25%的癌症幸存者的配偶使用了心理健康保健。在控制了自己的倾向、使能和需求特征后，如果癌症幸存者报告的健康状况更多或情绪低落程度较高，与幸存者报告的压力较小和抑郁程度较低的配偶相比，配偶使用心理健康保健的可能性较小。如果癌症幸存者自己使用了心理健康保健，配偶使用心理健康保健的可能性几乎增加了 3 倍（优势比，2.98；95%置信区间，2.17-4.09）。
本研究的结果增强了对癌症家庭中健康结果相互交织的理解，并强调了以家庭为中心的癌症护理方法的重要性，该方法促进了心理社会护理。
癌症幸存者及其配偶的健康和幸福是相互交织的。本研究的结果表明，这种相互关系延伸到与抑郁和焦虑相关的心理健康保健。当幸存者有更多的医疗保健需求时，配偶接受心理健康保健的可能性较小。如果幸存者也接受心理健康保健，配偶接受护理的可能性几乎增加了 3 倍。照顾配偶的人可能会面临更多的挑战，例如找不到时间、金钱或精力来照顾自己。然而，为一个伴侣提供支持性护理也可能帮助另一个伴侣获得护理。
