Graduation Year

2008

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Nursing

Major Professor

Susan C. McMillan, Ph.D.

Committee Member

Kristine Donovan, Ph.D.

Committee Member

Janine Overcash, A.R.N.P., Ph.D.

Committee Member

Brent Small, Ph.D.

Keywords

Gender, Coping, Distress, Interference, Dyadic analysis

Abstract

A diagnosis of cancer, regardless of type or site, raises much fear and loss of control for patients and their spouses. While being married is associated with lower mortality from a wide range of illnesses, including cancer, the quality of marital interactions and the relationship is the stronger predictor of health outcomes, rather than marital status. When people are faced with their greatest life challenges, they attach great importance to the behavior of their intimate partner, with trust being a key component of relationship quality, thus lending stability, and emotional and practical support. The purpose of this study was to examine vulnerable cancer patients with pain and their partners. The quality of the patient/partner relationships and the partners' coping styles were evaluated as mediators in a Structural Equation Model (SEM) latent path analysis with the outcome measures of quality of life for the individuals. Stress, coping and outcome theory guided the questions for the study. Much of the previous dyadic research that has been done on couples when one member has a diagnosis of cancer has centered on disease specific populations. This study was the first to examine the couples' relationships from a symptom defining population. Therefore, a broad range of ages, patients with different cancer diagnoses and both genders in the roles of patients and caregivers was the population studied. Coping was explored as a dyadic process that includes transactional appraisal of stressors that mediates the subsequent effects on quality of life outcomes. Multivariate analysis was used to determine covariates to be included in the SEM based on a review of the literature. There was no evidence of coping as a mediator. The participants in this study had good quality relationships, and this did serve as a positive mediator on the outcomes for the patient. Recommendations for future research and nursing practice, including the use of a single item global assessment of relationship quality, that nurses can incorporate in their practice is discussed.

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