An observational study of social control, mood, and self-efficacy in couples during treatment for head and neck cancer

Abstract

OBJECTIVE Head and neck cancer (HNC) patients experience debilitating side effects, including abnormally reduced salivation and difficulty swallowing. Intensive self-care protocols are prescribed to control side effects and minimize discomfort, but non-adherence rates are high. Although spouses are in a prime position to encourage adherence, studies have yet to examine how spouse social control (i.e., attempts to influence patient behavior to support adherence) affects HNC patient mood and self-efficacy for engaging in these self-care routines. METHODS One-hundred twenty-five HNC couples where the patient (86% male) was undergoing radiotherapy were recorded in the laboratory as they discussed a cancer-related issue that the patient identified as being a topic of concern. RESULTS Sixty-eight couples discussed side-effects and spouses engaged in social control in 61 of these discussions. Although oral complications and pain were frequently identified by patients as being topics of concern, dental/oral care and pain management were some of the least likely self-care behaviors to be targeted by spouses, who focused primarily on encouraging patients to maintain their weight and hydration. Although spouses engaged in an almost equal number of positive and negative control attempts, only positive control was significantly (p<.05) associated with patient positive mood and self-efficacy. CONCLUSION HNC couples may benefit from programs that emphasize the regular practice of self-care routines to control oral side effects, pain, and nutrition/hydration problems. Likewise, programs that encourage spouses to maximize their use of positive social control may also boost patients’ mood during treatment and empower them to engage in recommended self-care behaviors.

Unmet needs and relationship challenges of head and neck cancer patients and their spouses

“…Social control is a term that comes from the social/health psychology literature that refers to attempts to influence behavior to support adherence (Lewis, Gladstone, Schmal, & Darbes, 2006). In a recent observational study, spouses’ positive social control (e.g., reminding, offering to help, positive reinforcement) was associated with greater HNC patient positive mood and self-efficacy for symptom management (Badr, Yeung, Lewis, Milbury, & Redd, 2015). Programs that teach spouses to engage in more positive social control and to minimize negative social control may help to ease spousal tension over self-care.…”

Development of a survivorship needs assessment planning tool for head and neck cancer survivors and their caregivers: a preliminary study

“…While national guidelines direct survivorship visits to be held at end of treatment [47], our findings highlighted that HNC survivors may not be ready for this visit until they have completed their initial recovery period. However, because caregivers preferred earlier intervention, it is possible that a dynamic delivery approach for HNC dyadic survivorship care (e.g., addressing some high-priority caregiver needs at the end of treatment and holding a clinic visit for both survivors and caregivers later in the recovery period) may be ideal so both survivor and caregiver needs can be met in a timely fashion [48–50]. …”

Social network, autonomy, and adherence correlates of future time perspective in patients with head and neck cancer

“…The long‐term goal of controlling disease progression in HNC not only requires adherence to a demanding multifaceted treatment regimen but also includes coming to terms with high levels of treatment toxicity. Both might interfere with individuals' more short‐term goals, such as fulfilling immediate needs (eg, reduce pain) or preferences (eg, regulate emotions) …”