Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Ulm, Ulm, Germany.
Comprehensive Cancer Center Ulm (CCCU), University Medical Center Ulm, Ulm, Germany.
Psychooncology. 2021 Jul;30(7):1041-1050. doi: 10.1002/pon.5631. Epub 2021 Mar 9.
Patients and spouses use various support strategies to deal with cancer and its associated burden. Support can be perceived within the dyad [perceived dyadic coping (PDC)] or from others [perceived social support (PSS)]. The present study investigates the association of PDC and PSS with depression and anxiety symptoms experienced by hematooncological dyads.
A total of 330 hematooncological dyads participated in the study. Dyadic Coping Inventory (DCI) including perceived stress communication and four PDC strategies (supportive, negative, delegated, common), ENRICHED Social Support Instrument (ESSI) and Patient Health Questionnaire-4 (PHQ-4) are used for assessment. To take nonindependence of patient's and spouse's variables into account, data are analyzed with the Actor-partner-interdependence model (APIM).
Hematological cancer patients and their spouses reported a similar level of depression and anxiety symptoms. Perceived negative dyadic coping (DC) was adversely related with both patient's and spouse's outcomes (all p < 0.01) and perceived positive DC was adversely related with depression symptoms in both and anxiety symptoms in spouses (all p < 0.05). More PSS was associated with less depression and anxiety symptoms in both (all p < 0.05), and spouse's PSS (b = -0.04, p < 0.05) was significantly associated with patient's depression symptoms.
This study highlights the association between perceived negative DC, perceived positive DC and PSS with depression and anxiety symptoms. Focus should be on enhancement of PSS especially in spouses, as they experience a comparable amount of psychosocial distress and have considerable impact on the patient's wellbeing.
患者及其配偶使用各种支持策略来应对癌症及其相关负担。支持可以在夫妻之间感受到[感知夫妻应对(PDC)]或来自他人[感知社会支持(PSS)]。本研究调查了 PDC 和 PSS 与血液肿瘤夫妻双方抑郁和焦虑症状的关系。
共有 330 对血液肿瘤夫妻参与了这项研究。使用了夫妻应对量表(DCI),包括感知压力沟通和四种 PDC 策略(支持、消极、委托、共同)、充实社会支持量表(ESSI)和患者健康问卷-4(PHQ-4)进行评估。为了考虑患者和配偶变量的非独立性,使用 Actor-partner-interdependence model(APIM)分析数据。
血液癌症患者及其配偶报告的抑郁和焦虑症状水平相似。感知的消极夫妻应对(DC)与患者和配偶的结果都呈负相关(均 p<0.01),感知的积极 DC 与患者和配偶的抑郁症状呈负相关,与配偶的焦虑症状呈负相关(均 p<0.05)。更多的 PSS 与患者和配偶的抑郁和焦虑症状减少有关(均 p<0.05),配偶的 PSS(b=-0.04,p<0.05)与患者的抑郁症状显著相关。
本研究强调了感知的消极 DC、感知的积极 DC 和 PSS 与抑郁和焦虑症状的关系。应重点关注增强 PSS,特别是在配偶中,因为他们经历了相当程度的心理社会困扰,并对患者的幸福感有相当大的影响。