Dyadic concordance among prostate cancer patients and their partners and health-related quality of life: Does it matter?

Abstract

Serious and chronic illnesses occur within a family context, affecting not only the patient but also the spouse/partner, children and extended family network. Spouses/partners are likely to experience the greatest personal impact, and may influence patient adjustment. Also, the intimate relationship may be affected by the illness experience. This study examined whether dyadic concordance on the characteristics of prostate cancer (PC) was related to health-related quality of life (HRQOL), psychological distress and marital adjustment in PC patients and their female partners. Couples (N = 164) completed questionnaires on the appraisals of PC, and individual and dyadic adjustment. Patient and partner PC appraisal ratings were positively correlated. There was a general pattern of patients and partners in concordant dyads, versus those in dyads in which spouses maximised or minimised PC characteristics, reporting significantly better individual HRQOL outcomes, although there were several exceptions. Patient–partner appraisal (dis)agreement generally did not significantly predict dyadic adjustment. Overall, results suggest that dyadic disagreement is associated with worse HRQOL in couples facing PC.

Keywords:

• chronic illness
• prostate cancer
• appraisals
• coping
• spouses
• survivorship

Acknowledgements

This study was funded by an intramural grant from the UCSD Cancer Center Foundation, the National Cancer Institute Grant # R25CA65745 and the California Cancer Research Program Grant #1II0049. We would like to recognise the following San Diego health care professionals for their help in recruiting patients to this study: Christopher Amling, M.D., Israel Barken, M.D., the late Howard Fuerst, M.D., Jeffrey Gaines, M.D., Richard Hall, M.D., Robert Hathorne, M.D., Peter Johnstone, M.D., Linas Kazlo, M.D., Huathin Khaw, M.D., Robert Langer, M.D., Kenneth Nitahara, M.D., Fred Pardo, M.D., Jonathon Polikoff, M.D., Marianne Rochester, M.D., Carol Salem, M.D., Marilyn Sanderson, R.N., Kenneth Schimizu, M.D., Stephen Seagren, M.D., John Smiley, M.D., Thomas Szolar, M.D. and Linda Wasserman, M.D. We also wish to thank the following organisations for promoting the public's awareness of this study: American Cancer Society, Prostate Cancer Research & Education Forum, Informed Men's Support Group, and Wellness Community.

Notes

Note

1. The primary research question of interest presumes categorisation of couples (those who minimise, agree, maximise); however, dividing dyads into categories for mean comparison creates arbitrary boundaries and diminishes statistical power. We would like to thank two anonymous reviewers for suggesting alternate data analysis strategies.