Objective Prostate cancer (PC) and its treatment often result in chronic, negative side‐effects that affect both patients and their romantic partners. Illness uncertainty is a chronic stressor that impacts PC patients and their partners and, if left unmanaged, predicts decreased interpersonal functioning and quality of life (QOL) after treatment is complete. This study explored associations among psychosocial constructs, measured from both partners during the first year following a PC diagnosis, to better understand both partners' experiences and identify potential intervention targets for improving QOL. Methods Couples (N = 165) in which one partner was undergoing treatment for PC were recruited from the Duke University Medical Center of Urology. Patients and their partners were surveyed at four time points: diagnosis and 1‐, 6‐, and 12‐months post treatment. An Actor‐Partner Interdependence Model (APIM) framework was used to examine associations among perceived partner support, nonsupportive behaviors, illness uncertainty, relationship satisfaction, and physical and mental QOL. Results Partners feeling more supported at diagnosis was related to patients feeling more supported at 6 months. When patients' illness uncertainty decreased between diagnosis and 1 month, partners reported feeling more supported and engaging in fewer nonsupportive behaviors at 6‐months post‐treatment. Finally, partners' reports of support at 6 months predicted patients' 12‐month ratings of physical and mental QOL and relationship satisfaction. Conclusions Findings highlight psychological interdependence between PC patients and their partners. Future interventions to improve long‐term QOL in couples facing PC may benefit by targeting both partner support and illness uncertainty.
This systematic review explored ways in which doctoral-level clinical and counseling psychology graduate students are trained to build competency in self-care. The study aimed to examine which research methodologies have been utilized to examine self-care training, techniques and content of self-care training, and outcomes and effectiveness of self-care training methods. Twenty-one self-care competency training articles were identified. Results from the systematic review revealed most studies to date are quantitative (47.62%), followed by nonempirical (23.81%), mixed methods (14.29%), and qualitative (14.29%). Among quantitative studies, cross-sectional designs were most common (50%). Five themes of self-care training content were identified: culture of self-care, personal therapy, intervention, workbook/training tool, and mentorship/supervision. Five true outcome studies were identified and included outcomes such as frequency of use of self-care behaviors, self-care competency, wellness, stress, and mindfulness. Preliminary foundational evidence for effectiveness of self-care training methods is discussed. Recommendations are made for future research as well as suggestions at the policy level that incorporate several methods to train the self-care competency across training programs. Trainees and clinicians who practice self-care may then be able to avoid common pitfalls such as burnout, stress, and distress, and thereby function better in their roles as psychologists. Public Significance StatementThis study suggests that there are five types of self-care training that have been studied and implemented within the doctoral-level clinical and counseling psychology student population: creating a culture of self-care, personal therapy, intervention, workbook/training tool, and mentorship/supervision. Though the research on training effectiveness is in its early stages, results of the current systematic review describe preliminary evidence for training type effectiveness, with interventions and creating a self-care culture demonstrating the most promise. This study provides an overview of the state of research examining how to train the self-care competency. Considering self-care is an American Psychological Association mandated ethical standard, it is important to establish empirical evidence for how to and what to train regarding self-care with the dual goals of preventing burnout and protecting patient welfare.
Background Hematopoietic stem cell transplantation (HSCT) is an aggressive medical procedure which significantly impacts the shared emotional well-being of patients and family caregivers (FC). Prior work has highlighted the significant overlap in well-being among patients and FCs; however, how this interdependence may change over the course of HSCT has received less attention. Methods We conducted secondary analyses of a supportive intervention delivered to 154 FCs of HSCT patients and examined relationships at baseline, 6 weeks, 3 and 6 months post-HSCT. Actor Partner Interdependence Modeling examined patient quality of life (QOL) and FC anxiety/depression. Results The data did not fit a multigroup approach limiting our ability to test intervention effects; however, bivariate analyses indicated FC depression significantly correlated to patient QOL at baseline (r = − .32), 6 weeks (r = − .22) and 6 months post-HSCT (r = − .34; p’s < .05); whereas FC anxiety was only correlated with patient QOL at the first two timepoints (p’s < .05). There was an unexpected, partner effect such that worse patient QOL at 6-weeks significantly related to lower FC depression at 3-months (B = .193; p = .026) and changed direction with patient QOL at 3-months being related to more FC depression at 6-months (B = − .187; p = .001). Conclusions These findings highlight the significant, yet nuanced, interdependence of patient QOL and FC well-being during HSCT. Specifically, greater interdependence was observed between patient QOL and FC depression compared to FC anxiety, suggesting potential treatment targets for patients and their families. Trial was registered at ClinicalTrials.gov Identifier: NCT02037568; first registered: January 16, 2014; https://clinicaltrials.gov/ct2/show/NCT02037568
Purpose Physical activity is associated with improved health outcomes for cancer survivors and their romantic partners, yet it is unclear if joint exercise programs for survivor-partner dyads are acceptable. This study examined demographic, relationship, exercise, and cancer history correlates of survivors’ and their romantic partners’ couples-based exercise beliefs and their preferences for program designs. Methods All participants (survivors n =209, partners n =155, couples n =143) completed an online survey. Correlations and linear regression analyses were used to examine correlates of participants’ importance of and interest in couples-based exercise and their likelihood of joining a couples-based exercise program. Intraclass correlations estimated shared variance at the couple level. Results Most participants believed that couples-based exercise was highly important (51.8%) and were interested in a couples-based exercise program (61.5%), but fewer survivors believed their partner would be interested or would likely join a couples-based program. Across all outcomes, partner support for exercise was most strongly associated with participants’ couples-based exercise beliefs ( r = 0.19–0.54, p <.05), and couples were significantly aligned in their beliefs ( ρ =0.20–0.31, p <.01). Participants were interested in exercise programs involving exercising together (67.3%) as well as exercising separately while sharing activity data on an app or website (48.0%). Conclusions This novel understanding of couples-based exercise beliefs provides a strong foundation upon which future exercise programs may be designed for survivors and their romantic partners. Impact for Cancer Survivors Survivors’ adoption and maintenance of exercise may be enhanced by the inclusion of romantic partners in exercise programs, and partners’ inclusion is appealing to couples.
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