title: Late effects of cancer and hematopoietic stem-cell transplantation on spouses or partners compared with survivors and survivor-matched controls.
abstract: OBJECTIVE
  Little is known about the long-term effects of cancer and hematopoietic stem-cell transplantation (HCT) on spouses or partners. The purpose of this study was to examine the health-related quality of life and post-traumatic growth (PTG) of spouses/partners compared with survivors and controls and to identify factors associated with those outcomes.
  
  
  METHODS
  HCT survivor/partner pairs (n = 177), coupled continuously since HCT, were drawn from 40 North American transplantation centers. Married peer-nominated acquaintances (of survivors) served as controls (n = 133). Outcomes were measured a mean of 6.7 years after HCT (range, 1.9 to 19.4 years).
  
  
  RESULTS
  As expected, self-reported partner physical health was similar to controls and better than survivors (P < .001). However, partners reported more fatigue and cognitive dysfunction than controls (P < .001 for both), although less than survivors. Partners and survivors reported more depressive symptoms and sleep and sexual problems than controls (P < .001, P < .01, and P < .01, respectively). Odds of partner depression were nearly 3.5 times that of controls (P < .002). Depressed partners were less likely than depressed survivors to receive mental health treatment (P < .04). Partners reported less social support (P < .001), dyadic satisfaction (P < .05), and spiritual well-being (P < .05) and more loneliness (P < .05) than both survivors and controls. In contrast to survivors, partners reported little PTG (P < .001). Factors associated with partner outcomes included partner health problems, coping, female sex, social constraint, survivor depression, optimism, multiple life changes, and social support.
  
  
  CONCLUSIONS
  Spouses/partners experience similar emotional and greater social long-term costs of cancer and HCT than survivors without the potential compensatory benefits of PTG. Some of the factors associated with partner outcomes are amenable to intervention.
authors.affiliation: Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610-0277, USA. bishomm@medicine.ufl.edu
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Bishop
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Beaumont
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hahn
authors.forename: David
authors.initials: D
authors.lastname: Cella
authors.forename: Michael A
authors.initials: MA
authors.lastname: Andrykowski
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Brady
authors.forename: Mary M
authors.initials: MM
authors.lastname: Horowitz
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Sobocinski
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Rizzo
authors.forename: John R
authors.initials: JR
authors.lastname: Wingard
mesh_terms: D000328:Adult; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D011788:Quality of Life; D012747:Sexual Partners / Q000523:psychology*; D012944:Social Support; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*