title: Problem-solving and distress in prostate cancer patients and their spousal caregivers.
abstract: OBJECTIVE
  Prostate cancer, the most common life-threatening cancer among American men, increases risk of psychosocial distress and negatively impacts quality of life for both patients and their spouses. To date, most studies have examined the relationship between patient coping and distress; however, it is also likely that what the spouse does to cope, and ultimately how the spouse adjusts, will affect the patient's adjustment and quality of life. The present study examined the relationships of spouse problem-solving coping, distress levels and patient distress in the context of prostate cancer. The following mediational model was tested: Spouses' problem-solving coping will be significantly inversely related to patients' levels of distress, but this relationship will be mediated by spouses' distress levels.
  
  
  METHODS
  One hundred seventy-one patients with prostate cancer and their spousal caregivers were assessed for mood; spouses were assessed for problem-solving coping skills. Structural equation modeling was used to test model fit.
  
  
  RESULTS
  The model tested was a good fit to the data. Dysfunctional spousal problem-solving was a significant predictor of spouse distress level but constructive problem-solving was not. Spouse distress was significantly related to patient distress. Spouse dysfunctional problem-solving predicted patient distress, but this relationship was mediated by spouse distress. The same mediational relationship did not hold true for constructive problem-solving.
  
  
  CONCLUSIONS
  Spouse distress mediates the relationship between spouse dysfunctional coping and patient distress. Problem-solving interventions and supportive care for spouses of men with prostate cancer may impact not only spouses but the patients as well.
authors.affiliation: Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120-4913, USA. Cmko@ucsd.edu
authors.forename: Celine M
authors.initials: CM
authors.lastname: Ko
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Malcarne
authors.forename: James W
authors.initials: JW
authors.lastname: Varni
authors.forename: Scott C
authors.initials: SC
authors.lastname: Roesch
authors.forename: Rajni
authors.initials: R
authors.lastname: Banthia
authors.forename: Helen L
authors.initials: HL
authors.lastname: Greenbergs
authors.forename: Georgia Robins
authors.initials: GR
authors.lastname: Sadler
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D016009:Chi-Square Distribution; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D011471:Prostatic Neoplasms / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*