Links Between Communication and Relationship Satisfaction Among Patients With Cancer and Their Spouses: Results of a Fourteen-Day Smartphone-Based Ecological Momentary Assessment Study.
Abstract
Cancer treatment poses significant challenges not just for those diagnosed with the
disease but also for their intimate partners. Evidence suggests that couples' communication
plays a major role in the adjustment of both individuals and in the quality of their
relationship. Most descriptive studies linking communication to adjustment have relied
on traditional questionnaire methodologies and cross-sectional designs, limiting external
validity and discernment of temporal patterns. Using the systemic-transactional model
of dyadic coping as a framework, we examined intra- and inter-personal associations
between communication (both enacted and perceived) and relationship satisfaction (RS)
among patients with stage II-IV breast or colorectal cancer and their spouses (N =
107 couples). Participants (mean age = 51, 64.5% female patients, and 37.4% female
spouses) independently completed twice-daily ecological momentary assessments (EMA)
via smartphone for 14 consecutive days. Items assessed RS and communication (expression
of feelings, holding back from expression, support and criticism of partner, and parallel
ratings of partner behavior). Linear mixed models employing an Actor Partner Interdependence
Model were used to examine concurrent, time-lagged, and cross-lagged associations
between communication and RS. Expressing one's feelings was unassociated with RS.
Holding back from doing so, in contrast, was associated with lower RS for both patients
and spouses in concurrent models. These effects were both intrapersonal and interpersonal,
meaning that when individuals held back from expressing their feelings, they reported
lower RS and so too did their partner. Giving and receiving support were associated
with one's own higher RS for both patients and spouses in concurrent models, and for
patients in lagged models. Conversely, criticizing one's partner and feeling criticized
were maladaptive, associated with lower RS (own and in some cases, partner's). Cross-lagged
analyses (evening RS to next-day afternoon communication) yielded virtually no effects,
suggesting that communication may have a stronger influence on short-term RS than
the reverse. Findings underscore the importance of responsive communication, more
so than expression per se, in explaining both concurrent and later relationship adjustment.
In addition, a focus on holding back from expressing feelings may enhance the understanding
of RS for couples coping with cancer.
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https://hdl.handle.net/10161/21883Published Version (Please cite this version)
10.3389/fpsyg.2018.01843Publication Info
Langer, Shelby L; Romano, Joan M; Todd, Michael; Strauman, Timothy J; Keefe, Francis
J; Syrjala, Karen L; ... Porter, Laura S (2018). Links Between Communication and Relationship Satisfaction Among Patients With Cancer
and Their Spouses: Results of a Fourteen-Day Smartphone-Based Ecological Momentary
Assessment Study. Frontiers in psychology, 9(OCT). pp. 1843. 10.3389/fpsyg.2018.01843. Retrieved from https://hdl.handle.net/10161/21883.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Francis Joseph Keefe
Professor in Psychiatry and Behavioral Sciences
I am Director of the Duke Pain Prevention and Treatment Research Program, an active
NIH funded clinical research program focused on developing new and more effective
ways of assessing and treating patients having acute and persistent pain. I have
been active in nationally and internationally in shaping the pain research agenda.
For the past 10 years I served as Editor in Chief of PAIN the premier journal in pain
research. I also have served as the Chair of a number of NIH Study
Laura Streamo Porter
Professor in Psychiatry and Behavioral Sciences
My research focuses on developing and evaluating behavioral interventions to help
patients and their family members cope with the symptoms and psychological demands
associated with chronic and life-limiting illness.
Timothy J. Strauman
Professor of Psychology and Neuroscience
FOR POTENTIAL STUDENTS (fall 2024 class):
Dr. Timothy Strauman and Dr. Ann Brewster will be seeking to admit a student for Fall
2024 who will be an important member of their collaborative projects. Dr. Brewster
is an intervention scientist and a faculty member in Duke’s Social Science Research
Institute. The collaborative projects focus on creating, testing, and implementing
school-based therapeutic and preventive interventions for adolescents at risk for
negative academic and me
Syed Yousuf Zafar
Adjunct Professor in the Department of Medicine
Dr. Zafar is a gastrointestinal medical oncologist and Associate Professor of Medicine,
Public Policy, and Population Health Science at the Duke Cancer Institute and Duke-Margolis
Center for Health Policy. He serves as Director of Healthcare Innovation at the Duke
Cancer Institute. Dr. Zafar also serves as Clinical Associate Director of Duke Forge
(Health Data Science Center). Dr. Zafar is considered an international expert in identifying
and intervening upon the financial burden of cancer ca
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