Langer Shelby L, Romano Joan M, Todd Michael, Keefe Francis J, Syrjala Karen L, Bricker Jonathan B, Burns John, Bolger Niall, Porter Laura S
Edson College of Nursing and Health Innovation, Arizona State University.
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine.
Health Psychol. 2024 Dec;43(12):875-885. doi: 10.1037/hea0001396. Epub 2024 Sep 19.
Cancer poses significant challenges for patients and caregiving partners. Avoidant communication has been linked to poorer psychosocial adjustment to cancer. Two conceptual models have been proposed to account for this linkage: the social-cognitive processing and relationship intimacy models.
To examine the utility of these models in explaining patient and partner psychological and relationship adjustment on a day-to-day basis using ecological momentary assessment.
Patients with breast, colorectal, or lung cancer and their partners (286 dyads) were prompted twice daily for 14 days via smartphone to answer questions about communication with their partner, adjustment (psychological distress and relationship satisfaction), and hypothesized mediators (avoidant thoughts and intimacy). Data were collected from 2017 to 2020.
Participants responded to 92% of prompts and completed 91%. Results supported the relationship intimacy but not the social-cognitive processing model. On afternoons when participants (both patients and caregivers) held back or perceived avoidance or criticism from their partner, they reported less intimacy, as did their partners; this lowered intimacy, in turn, led to participants' (both patients' and caregivers') own lowered relationship satisfaction that evening and to patients' lowered relationship satisfaction through caregivers' lowered intimacy (one-tailed Bayesian s < .025). When distress was the criterion, patients' holding back or perceived avoidance/criticism led to their own increased distress through their own decreased intimacy, and caregivers' holding back or perceived avoidance/criticism led to patients' increased distress through patients' lowered intimacy (one-tailed Bayesian s < .005).
Findings offer implications for interventions designed to improve communication and enhance closeness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
癌症给患者及其护理伙伴带来了重大挑战。回避型沟通与对癌症较差的心理社会适应有关。已提出两种概念模型来解释这种联系：社会认知加工模型和关系亲密度模型。
使用生态瞬时评估来检验这些模型在日常解释患者及其伴侣的心理和关系适应方面的效用。
乳腺癌、结直肠癌或肺癌患者及其伴侣（286对）在14天内每天通过智能手机被提示两次，以回答有关与伴侣沟通、适应（心理困扰和关系满意度）以及假设的中介因素（回避想法和亲密度）的问题。数据收集于2017年至2020年。
参与者对92%的提示做出了回应，完成率为91%。结果支持关系亲密度模型，但不支持社会认知加工模型。在下午，当参与者（患者和护理者）克制自己或察觉到伴侣的回避或批评时，他们报告的亲密度较低，其伴侣也是如此；这种亲密度的降低反过来导致参与者（患者和护理者）当晚自己的关系满意度降低，并且通过护理者亲密度的降低导致患者关系满意度降低（单尾贝叶斯s <.025）。当以困扰为标准时，患者的克制或察觉到的回避/批评通过自身亲密度的降低导致其自身困扰增加，而护理者的克制或察觉到的回避/批评通过患者亲密度的降低导致患者困扰增加（单尾贝叶斯s <.005）。
研究结果为旨在改善沟通和增进亲密感的干预措施提供了启示。（PsycInfo数据库记录（c）2024美国心理学会，保留所有权利）
