Spouse and partner perception of the ability of a patient with breast cancer to cope with treatment and disease can improve the patient’s adjustment and can moderate the connection between functional status and adjustment.
Spousal Support and Adjustment to Disease
According to a recent study, in 72 husband-wife couples, congruence of perspectives on efficacy of the wife’s coping was minimal to modest (R= 0.207), yet additive and multiplicative models assessing the relationship between husbands’ and wives’ perspectives and how it affected adjustment to disease were significant.1
“[H]usbands have a unique perspective on their wives’ coping that contributed to their adjustment to cancer, albeit a small but positive contribution,” the authors noted.1
Researchers administered assessments for marital adjustment, self-efficacy for coping, and adjustment to breast cancer to 72 married, heterosexual couples in which the wife was undergoing treatment for breast cancer. This study used Karnofsky Performance Status (KPS), obtained from medical records.
Measurements of wives’ perceptions of self-efficacy (WSEC) reflected their own perception at their ability to cope, and measurements of husbands’ perceptions of self-efficacy (HSEC) reflected their perception of their wives’ ability to cope.
Models for Understanding Coping and Adjustment
Researchers then tested 3 different models to better characterize the relationship between WSEC and HSEC. The discrepancy model (WSEC – HSEC), which is used conventionally to support the idea that spousal congruence improves outcomes, assumes that the larger the difference between spousal perspectives, the more negative the effect on adjustment. The additive model (WSEC + HSEC) assumes a husband’s perspective independently contributes and positively affects adjustment. The multiplicative model (WSEC × HSEC) assumes a synergistic relationship between WSEC and HSEC affecting adjustment.
Controlling for age, income, education, marital adjustment, KPS, and stage, no relationship existed between the discrepancy score and wives’ adjustment to cancer (B = 0.089; 95% CI, –0.032 to 0.24); however, the overall regression met statistical significance (R2= 0.274; P =.003).
With the same controls as in the discrepancy model, a significant relationship existed between the additive model score and wives’ adjustment to cancer (B = 0.206; 95% CI, 0.105-0.325) and the multiplicative model score and wives’ adjustment to cancer (B = 0.001; 95% CI, 0.0001-0.001). Regressions were also significant for both the additive (R2= 0.397, P <.0001) and multiplicative models (R2= 0.385, P <.0001). These results suggest that more perceived coping efficacy from either partner results in improved adjustment.