Keywords

Cancer, Coping, Dyadic, Mediation, Oncology, Pain, Partner relationship, Quality of life, Structural equation modeling

 

Authors

  1. Morgan, Mary Ann PhD, FNP
  2. Small, Brent J. PhD
  3. Donovan, Kristine A. PhD, MBA
  4. Overcash, Janine PhD, GNP
  5. McMillan, Susan PhD, ARNP

Abstract

Background: A diagnosis of cancer affects not only the patient but also his/her spouse/partner. In addition to facing a life-threatening illness, changes in role and financial threats can impact the dyad.

 

Objective: This dyadic study examined the effects of financial concerns and pain on the quality of life (QOL) of cancer patients and their partners. The partner relationship and the partners' coping style were explored for mediating the couples' outcomes.

 

Methods: Participants consisted of 177 dyads with both sexes as patients and partners in committed, heterosexual relationships. Patients had a mix of cancer diagnoses and were in various phases of treatment. Each participant completed 4 of the same instruments. Partners also completed coping and financial concerns measures, and patients completed pain and symptom distress measures.

 

Results: Pathway analysis, using structural equation modeling, examined the effects of pain and financial concerns on relationship quality, partners' coping style, and QOL for the dyad. Partners' coping style affected only their own QOL (0.16; P = .05). Pain had a significantly negative direct effect (-0.51; P = .05) on patients' QOL and no direct relationship to the partner's QOL. Financial concerns affected the QOL of both patients (-0.13; P = .05) and partners (-0.36; P = .05). The relationship mediated a decrease in patient pain from -0.51 to -0.58, a significant total effect (P = .05).

 

Conclusions: The partners' relationship lessened pain's negative effect. Financial concerns were a significant issue for both dyad members, but the quality of the relationship was not compromised.

 

Implications for Practice: Patients' pain may be affected by the quality of the marital relationship.