title: Testicular cancer: a longitudinal pilot study on stress response symptoms and quality of life in couples before and after chemotherapy.
abstract: OBJECTIVE
  The current study was designed to longitudinally examine stress response symptoms (SRS) and quality of life (QoL) in couples confronted with disseminated testicular cancer. The objectives were to examine couples' patterns of adjustment over time and possible differences in adjustment between the patient and his partner.
  
  
  METHODS
  Couples completed the Impact of Event Scale and the QoL subscales physical functioning, social functioning, and mental health of the RAND-36 before chemotherapy (T1), after completion of chemotherapy (T2), and 1 year later (T3).
  
  
  RESULTS
  Before chemotherapy 26% of the patients and 50% of partners reported clinically elevated levels of SRS. Patients reported lower physical and social functioning at T2 compared to T1 and T3. Partners reported an improvement in social functioning over the year and no changes in physical functioning or mental health. No relationships between patients and partners' functioning were found. One year after diagnosis, QoL of patients and partners was similar to that of reference groups, and patients even reported better physical functioning than the reference group. SRS of patients and partners were negatively related at T1, and patients and partners' social functioning were positively related at T2.
  
  
  CONCLUSIONS
  According to stress response levels, the period before the start of chemotherapy was most stressful for couples. Adjustment patterns differ between testicular cancer patients and their partners with patients reporting lowered QoL after completion of chemotherapy. QoL of couples returned to normal levels 1 year after diagnosis. The effect of disseminated testicular cancer on the QoL of patients and their partners seems to be temporary. A minority may need clinical attention for severe SRS.
authors.affiliation: Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, P.O. Box 30001, Groningen, 9700 RB, The Netherlands.
authors.forename: Marrit A
authors.initials: MA
authors.lastname: Tuinman
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Hoekstra
authors.forename: Dirk Th
authors.initials: DT
authors.lastname: Sleijfer
authors.forename: Joke
authors.initials: J
authors.lastname: Fleer
authors.forename: Damon J
authors.initials: DJ
authors.lastname: Vidrine
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Gritz
authors.forename: Josette E H M
authors.initials: JE
authors.lastname: Hoekstra-Weebers
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D009426:Netherlands; D010865:Pilot Projects; D011788:Quality of Life; D012107:Research Design; D018434:Sickness Impact Profile; D012917:Social Adjustment; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin