COUPLES DEALING WITH CANCER--ANALYSIS AND INTERVENTION

DESCRIPTION: Social and emotional support provided by friends and family play a critical role in the adjustment of cancer patients to the myriad stressors encountered during the course of diagnosis and treatment. Spouses are particularly invaluable as sources of emotional support for patients. Unfortunately, the stress of illness can negatively affect close relationships such that the support provided by family can deteriorate, as the demands of the illness increase. Thus, at the very time when patients need support most, it becomes increasingly difficult for family and friends to meet these needs. The goal of the proposed research is to understand this social support process and to develop interventions to bolster the quality of close relationships during cancer treatment. The proposed research plans two studies. The first study seeks to examine support exchanges between women with breast cancer and their husbands to determine the interactional processes which convey support or criticism. These couples will be followed over the course of cancer treatment and six months after treatment is complete. Data on interactional styles, along with results from our questionnaire studies already completed, will aid in the design of an intervention program that includes spouses. Study 2 is a controlled clinical trial of a communication and coping skills intervention focused on the married couple designed to bolster the patient's well-being. Couples will be randomly assigned either to the intervention group or to standard psychosocial care. The group's content will target productive communication, particularly asking for and providing support' problem-solving skills; and coping with the illness and demands of treatment. Preliminary data suggest that poor communication between spouses is a key determinant of how well the patient, as well as the spouse, adjusts to and copes with the illness and treatment. The intervention will focus on teaching good communication and coping skills, which will enable the couples to avoid unproductive and damaging interactions. Patients and their partners will be assessed using questionnaire and observational methods pre-and post-intervention, and a six-month post-intervention follow-up will be conducted.