Longitudinal Analysis of a Model to Predict Quality of Life in Prostate Cancer Patients and their Spouses
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ORIGINAL ARTICLE
Longitudinal Analysis of a Model to Predict Quality of Life in Prostate Cancer Patients and their Spouses Trace S. Kershaw, Ph.D. & Darlene W. Mood, Ph.D. & Gail Newth, M.S.N., R.N. & David L. Ronis, Ph.D. & Martin G. Sanda, M.D. & Ulka Vaishampayan, M.D. & Laurel L. Northouse, Ph.D., R.N.
Published online: 16 September 2008 # The Society of Behavioral Medicine 2008
Abstract Background/Purpose This study examined a stress-coping model to assess whether baseline antecedent variables predicted subsequent appraisal and how that appraisal predicted coping and quality of life for prostate cancer patients and their spouses. Methods In a sample of 121 prostate cancer patient/spouse dyads, we assessed baseline antecedent variables (selfefficacy, current concerns, age, socioeconomic status, social support, communication, symptoms, phase of illness), 4-month follow-up appraisal (negative appraisal, hopelessness, uncertainty), and 8-month follow-up coping and Grant support: R01CA90739 from NCI (L. Northouse PI). T. S. Kershaw (*) School of Public Health, Yale University, New Haven, CT, USA e-mail: [email protected] D. W. Mood : U. Vaishampayan College of Nursing, Wayne State University, Detroit, MI, USA G. Newth : D. L. Ronis : L. L. Northouse School of Nursing, University of Michigan, Ann Arbor, MI, USA D. L. Ronis Ann Arbor Veterans Administration Health Services Research and Development Center of Excellence, Ann Arbor, MI, USA M. G. Sanda Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA U. Vaishampayan Karmanos Cancer Center, Detroit, MI, USA
mental and physical quality of life. Patients and spouses were assessed in a single integrated path model using structural equation modeling. Results The stress-coping model accounted for a significant amount of variance in mental and physical quality of life at 8 months for patients (40% and 34%, respectively) and spouses (43% and 24%, respectively). Appraisal mediated the effect of several antecedent variables on quality of life. In addition, several partner effects (e.g., spouse variables influencing patient outcomes) were found. Conclusions Prostate cancer patients need interventions that assist them to manage the effects of their disease. The stress-coping model suggests skills in several areas that could be improved. Programs need to include spouses because they also are negatively affected by the disease and can influence patient outcomes. Keywords Prostate cancer . Quality of life . Stress-coping model
Introduction Prostate cancer is the most common cancer affecting men in the US; it is estimated that 218,890 men were diagnosed with prostate cancer and approximately 27,000 died of prostate cancer in 2007 [1]. In light of this incidence, there is a need for more theory-driven research that prospectively examines the mechanisms that influence the mental and physical quality of life of prostate cancer patients and their spouses. This research could improve programs aimed at increasing the mental and physical functioning of
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