Date on Master's Thesis/Doctoral Dissertation

5-2016

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Cooperating University

University of Kentucky

Department

Social Work

Degree Program

Social Work, PhD

Committee Chair

Kayser, Karen

Committee Co-Chair (if applicable)

Collins, Wanda Lott

Committee Member

Collins, Wanda Lott

Committee Member

Karam, Eli

Committee Member

Mark, Kristen

Committee Member

Moon, Heehyul

Author's Keywords

psychosocial oncology; breast cancer; couples, younger women, partners; dyadic coping

Abstract

Background Despite the extensive literature available about the psychosocial adaptation to breast cancer, the experience of younger women and their partners has been mostly neglected by the research. While younger couples have been identified at higher risk because of less collaborative behaviors, higher vulnerability to distress, and poorer quality of life, in most contributions couples are treated as a homogeneous group. This study was then designed to examine the differential impact of the illness on younger dyads, by comparing them to a group of older couples. A significant gap in the literature about dyadic coping was also addressed, which is the understanding of how dyadic coping originates and it is associated with higher quality of life. Methods Participants have been recruited among newly diagnosed women with early-stage breast cancer, for a total of 86 couples. Patients below the age of 45 and their partners were considered younger couples and compared to the remaining 51 older couples. The Actor Partner Interdependence Model (APIM) was used to examine actor and partner effects of mutuality on dyadic coping. A simple mediation model tested whether dyadic coping mediates the relationship between mutuality and quality of life. Summary of Findings Younger women reported significantly worse quality of life, with worse functioning in physical, social and emotional domains than older patients. Similarly, younger partners experienced higher illness intrusiveness, worse emotional well-being, and maladaptive dyadic coping. Younger couples’ positive and negative coping styles were the result of both actor and partner effects of mutuality, indicating higher interdependence in their relationship. Finally, negative dyadic coping mediated the relationship between mutuality and quality of life for younger patients and older partners. Conclusions Younger couples’ adaptation to breast cancer is significantly compromised not only because of the more negative impact of the illness on the individual’s well-being, but also as a result of higher reciprocal influence of mutuality in predicting both adaptive and maladaptive dyadic coping behaviors. Future studies should continue to examine the developmental trajectory of dyadic coping over the life-span and psychosocial interventions should be developed to promote positive adaptation to cancer in a time of higher vulnerability.

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