Patterns, relevance, and predictors of dyadic mental health over time in lung cancer

European Journal of Cardiovascular Nursing

Lee

2020

Although there has been increasing attention on a dyadic perspective of illness, contemporary dyadic research methods are still rarely utilized in cardiovascular disease. The focus of this paper is to describe the advantages of two types of multilevel dyadic models (the matched pairs model and the lesser known incongruence model). Data exemplars in a sample of heart failure family dyads are used to illustrate the distinct advantages of these two related multilevel dyadic models with particular emphasis on alignment with research questions. The more commonly known matched pairs model examines separate outcomes for each member of the dyad, controlling for the interdependent nature of the data. By re-parameterizing this model into a univariate dyadic outcomes model, researchers can address distinct, and sometimes more appropriate, research questions (e.g. incongruent appraisals of the illness experience). This paper promotes greater application of these methods in cardiovascular research to further understanding of the dyadic experience and more appropriately target interventions.

Section: Resultsmentioning

confidence: 99%

“…See Table 5 for extensions of each method as well as cited examples of each. 12,14,26,29,30,[40][41][42][43][44][45][46][47]…”

Section: Extensions Of the Modelsmentioning

confidence: 99%

Understanding the family care dyad: A comparison of two multilevel models

European Journal of Cardiovascular Nursing

Lee

2020

“…Survivor-, partner-, and couple-level determinants of fitting one pattern of change over the other(s) will be modeled using logistic, multinomial, or ordinal regression as appropriate. This integrated multi-level and mixture modeling approach has been used previously by this team [ 102 ], as it allows us to identify types of dyads and differentiate them based on individual and couple-level factors.…”

Section: Methodsmentioning

confidence: 99%

Study protocol for the Exercising Together© trial: a randomized, controlled trial of partnered exercise for couples coping with cancer

Winters-Stone

Dieckmann

et al. 2021

Trials

Self Cite

Background Most cancer survivors are married, and cancer strains the physical and mental health of each partner and their intimate relationship. We created a partnered strength training program, Exercising Together©, where the survivor and his/her partner exercise as a team in order to improve physical and mental health of both members of the couple as well as the quality of their relationship. We have not yet determined if Exercising Together© is similarly effective in couples coping with different types of cancer nor if training as a team has unique and added benefits over those derived from supervised group training and/or shared behavior change. The purpose of this study is to determine the unique benefits of Exercising Together© on physical, mental, and relational health in couples coping with breast, prostate, or colorectal cancer. Methods Survivors of prostate, breast and colorectal cancer (N = 294, 98 per cancer site) and their intimate, co-residing partners are recruited to participate in a single-blind, parallel group, randomized trial comparing three exercise groups that train twice per week for 6 months. Couples are randomized to one of three groups: (1) Exercising Together© where partners train as a team in a supervised group setting; (2) separate supervised group exercise classes for survivors or partners, respectively; (3) unsupervised home exercise program provided to each partner. The primary outcome is relationship quality (dyadic coping by the Dyadic Coping scale, emotional intimacy by the Dyadic Adjustment Scale, physical intimacy by the Physical Intimacy Behavior Scale, and symptom incongruence). Secondary outcomes are physical health (% body fat by DXA, serum fasting lipids (triglycerides, HDL, and LDL cholesterol), insulin resistance (HOMA-IR), resting blood pressure, C-reactive protein, TNF alpha, and physical functioning by the short Physical Performance Battery and SF-36) and mental health (depressive symptoms, anxiety, fear of recurrence) of each partner. Outcomes are collected at baseline, mid (3 months), post-intervention (6 months), and follow-up (12 months). Discussion Exercising Together© could shift the paradigm of survivorship care toward novel couple-based approaches that could optimize outcomes for each partner because their health is interdependent on each other and their relationship. Trial registration ClinicalTrials.govNCT03630354. Registered August 14, 2018

“…Methods such as MLM that explicitly focus on variability around the average are important tools that more realistically identify the diversity of our samples as do methods such as growth mixture modeling (GMM) and latent growth mixture modeling (LGMM) that have been used to identify subgroups (Ram & Grimm, 2009). Our team recently combined incongruence multilevel models and latent class mixture modeling to identify dyadic archetypes of symptom incongruent appraisals (Lee et al, 2017), archetypes of dyadic management of heart failure (Lee et al, 2015), and archetypes of dyadic health (Lee & Lyons, 2019). Finally, although a comprehensive discussion of power in MLM is beyond the scope of this article, given that the longitudinal incongruence model is simply an adaptation of the individual MLM, formulae for estimating power in MLM for repeated measures are applicable and focus on the within (number of waves of data collection) and between (number of dyads) variability (Raudenbush et al, 2004; Raudenbush & Xiao-Feng, 2001).…”

Section: Extensions Of the Modelmentioning

confidence: 99%

A Multilevel Modeling Approach to Examine Incongruent Illness Appraisals in Family Care Dyads Over Time

Lee

2020

J Fam Nurs

Self Cite

Over the past two decades, there has been movement toward a dyadic perspective of the illness experience. Although multilevel models have led to great insights into how dyads are affected by illness as family units, these models are still underutilized for understanding incongruent illness appraisals. Such incongruent appraisals can have implications for how the dyad collaborates to manage illness, the health of the dyad, and clinical outcomes. The focus of this article is to describe and promote the application of multilevel models to longitudinal dyadic data to understand incongruent illness appraisals over time. In particular, we present a data exemplar so researchers can apply these models to their own data and clinical questions to understand the ways care dyads converge and diverge in their appraisals and determine factors associated with such variability. We comment on the implications and extensions of these models for family nursing research and practice.