title: Longitudinal analysis of a model to predict quality of life in prostate cancer patients and their spouses.
abstract: OBJECTIVE
  This study examined a stress-coping model to assess whether baseline antecedent variables predicted subsequent appraisal and how that appraisal predicted coping and quality of life for prostate cancer patients and their spouses.
  
  
  METHODS
  In a sample of 121 prostate cancer patient/spouse dyads, we assessed baseline antecedent variables (self-efficacy, current concerns, age, socioeconomic status, social support, communication, symptoms, phase of illness), 4-month follow-up appraisal (negative appraisal, hopelessness, uncertainty), and 8-month follow-up coping and mental and physical quality of life. Patients and spouses were assessed in a single integrated path model using structural equation modeling.
  
  
  RESULTS
  The stress-coping model accounted for a significant amount of variance in mental and physical quality of life at 8 months for patients (40% and 34%, respectively) and spouses (43% and 24%, respectively). Appraisal mediated the effect of several antecedent variables on quality of life. In addition, several partner effects (e.g., spouse variables influencing patient outcomes) were found.
  
  
  CONCLUSIONS
  Prostate cancer patients need interventions that assist them to manage the effects of their disease. The stress-coping model suggests skills in several areas that could be improved. Programs need to include spouses because they also are negatively affected by the disease and can influence patient outcomes.
authors.affiliation: School of Public Health, Yale University, New Haven, CT, USA. trace.kershaw@yale.edu
authors.forename: Trace S
authors.initials: TS
authors.lastname: Kershaw
authors.forename: Darlene W
authors.initials: DW
authors.lastname: Mood
authors.forename: Gail
authors.initials: G
authors.lastname: Newth
authors.forename: David L
authors.initials: DL
authors.lastname: Ronis
authors.forename: Martin G
authors.initials: MG
authors.lastname: Sanda
authors.forename: Ulka
authors.initials: U
authors.lastname: Vaishampayan
authors.forename: Laurel L
authors.initials: LL
authors.lastname: Northouse
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D017028:Caregivers / Q000523:psychology; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D011471:Prostatic Neoplasms / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D018454:Spouses / Q000523:psychology*