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.
['Reblin|Maija|M|0000-0003-3108-465X', 'Otto|Amy K|AK|0000-0003-3712-6435', 'Ketcher|Dana|D|', 'Vadaparampil|Susan T|ST|', 'Ellington|Lee|L|', 'Heyman|Richard E|RE|']
D000223:Adaptation, Psychological D000328:Adult D000368:Aged D017028:Caregivers D017281:Cost of Illness D005260:Female D006801:Humans D008297:Male D008603:Mental Health D008875:Middle Aged D009369:Neoplasms D011446:Prospective Studies D011788:Quality of Life D012649:Self Concept D012944:Social Support D018454:Spouses D011795:Surveys and Questionnaires
couples cancer communication caregivers behavior observation naturalistic study oncology quality of life