Adaptation of wives to prostate cancer following diagnosis and 3 months after treatment: a test of family adaptation theory.
BACKGROUND
Prostate cancer challenges not only the men with the disease, but also their partners. Existing studies have focused on the relationship between type of treatment and sexual and urinary function in men, with recent qualitative work suggesting that men and their spouses have differing responses to the illness. Factors predicting women's adaptation to prostate cancer have not been examined.


OBJECTIVE
Using a model derived from family stress and adaptation theory, this study examined (1) the contribution of urinary and sexual symptoms, sense of coherence, marital resources and situational appraisal to wives' global adaptation (PAIS) and emotional adaptation (POMS), and (2) the role of situational appraisal as a mediator between the set of independent variables and PAIS and POMS.


METHODS
In a prospective, correlational design, data were collected from 70 women following their partners' diagnosis and again 3 months later.


RESULTS
Using a path analysis approach, between 30% and 62.7% of the variance in global adjustment and mood disturbance was explained across model tests. Sense of coherence was a strong and consistent predictor. Appraisal acted as a mediator only at time 2, mediating the effect of symptom distress on global adaptation. Change in sense of coherence and change in family resources predicted global adaptation and emotional adaptation at time 2, and predicted the change between time 1 and 2 in those variables.


CONCLUSIONS
The findings suggest nursing interventions that mobilize and build wives' sense of the manageability, meaningfulness and comprehensibility of life events, and that foster cohesion and flexibility within the marital relationship. Interventions that mitigate the impact of urinary symptoms and the appraisal of threat in the illness event are also indicated. Additional model-testing studies based on family adaptation theory with patients and family members in other types of cancer would help build nursing knowledge for interventions in cancer.
Ezer
Hélène
H
School of Nursing, McGill University, Montreal, Canada H3A 2A7. helene.ezer@mcgill.ca
Ricard
Nicole
N
Bouchard
Louise
L
Souhami
Luis
L
Saad
Fred
F
Aprikian
Armen
A
Taguchi
Yoshi
Y
D000223:Adaptation, Psychological; D000359:Aftercare / Q000523:psychology; D000368:Aged; D000704:Analysis of Variance; D001294:Attitude to Health; D007172:Erectile Dysfunction / Q000209:etiology; D005192:Family Health; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D011582:Psychological Theory; D011792:Quebec; D012044:Regression Analysis; D012307:Risk Factors; D012944:Social Support; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology; D014555:Urination Disorders / Q000209:etiology