In‐home conversations of couples with advanced cancer: Support has its costs

OBJECTIVE: The goal of this study was to describe the quality of naturalistic communication between patients with advanced cancer and their spouse caregivers using observational methods. We also assessed the association between patient and caregiver communication behaviors and psychological and physical health using the actor-partner interdependence model. METHODS: Data on 81 dyads were gathered as part of a prospective observational study. Patients with advanced cancer and their spouse caregivers completed demographic, physical health, and emotional well-being questionnaires. Cancer and relationship communication captured in “day-in-the-life” audio recordings were coded using Gottman’s Turning System to assess the quality of bids for attention and responses. RESULTS: Bids for attention were most often informational (Low Bids) and responses were mostly positive and effortful (Turn Towards); patients and caregivers did not significantly differ in communication behavior. More effortful bids for attention (High Bids) were associated with more positive and effortful responses. Patient communication behaviors were significantly associated with caregiver emotional well-being, whereas caregiver communication behaviors were significantly associated with their own emotional well-being and patient physical health. CONCLUSIONS: While patients may benefit from caregivers’ more positive and engaged communication at home, the emotional labor of focusing on and engaging the patient may take a toll on caregivers’ own well-being. This work contributes to the understanding of what everyday communication looks like for patients with advanced cancer and their spouse caregivers and how this communication may impact physical and psychological health. Our findings provide a foundation to develop guidelines for psychosocial couple-based interventions

Partner Support

The term partner support traditionally refers to the process of responding with helping acts (behavioral as well as psychological) to a difficulty or problem of one\u2019s partner in a couple relationship. More recently, this definition was extended as to include responses apt to sustain the partner when facing positive events and life opportunities as well. Historically, from the interest for general social support, researchers have recognized the relevant role of the specific relationships on the effects produced by social support. Couple relationship scholars, in particular, have drawn attention on the fact that intimate partners are especially important sources of support, who cannot be easily substituted. Indeed, social epidemiology has often used marital status as a measure of social support availability

Marital Adjustment

The definition of this construct is one of the most controversial topics in the literature. On the basis of various contributions, marital adjustment can be defined as a multidimensional indicator of the quality of marital relationship. Evolution of the Construct Marital adjustment is one of the most studied dimensions in the couple and family research literature. According to Spanier (1976, p. 15), already by the 1970s, marital adjustment was \u201cprobably the most frequently investigated dependent variable in the field\u201d. Also during the last 30 years, family researchers and scholars have maintained a strong interest on marital adjustment, as an outcome (Shriner 2009). The literature on marital adjustment reveals a variety of factors that are related to the dyadic adjustment (e.g., individual aspects like personality traits, irrational beliefs, and dysfunctional emotions Abbasi 2017; Filipovi\u107 et al. 2016 and relational aspects like romantic attachment and dyadic coping (Young et al. 2017). Over the last decade, a substantial number of studies have focused on the role of personality traits in predicting the quality of adult romantic relationships (Abbasi 2017; Lampis et al. 2018; Rusu et al. 2019)

Cultural Considerations in the Context of Romantic Relationships

It is estimated that about one-third of couples experience distress or discord at some point in the course of their relationship. The early literature of marriage and committed relationships focused nearly exclusively on White, heterosexual, non-Hispanic couples, but over the past couple of decades, there has been increased focus on the dynamics and specific needs of couples from different ethnic backgrounds as well as same-sex couples. In this chapter, we summarize some of the major challenges and threats to relationship well-being for African American, Hispanic American, Asian American, Native American, and same-sex couples. Some of the challenges discussed in this chapter include racism and discrimination, financial strain and work stress, acculturation, and negative historical or societal influences. We also have tried to highlight important areas of strength for couples that therapists can help clients enhance, including religiosity and spirituality and support from family or friends