title: Intimacy processes and psychological distress among couples coping with head and neck or lung cancers.
abstract: OBJECTIVE
  Couples coping with head and neck and lung cancers are at increased risk for psychological and relationship distress given patients' poor prognosis and aggressive and sometimes disfiguring treatments. The relationship intimacy model of couples' psychosocial adaptation proposes that relationship intimacy mediates associations between couples' cancer-related support communication and psychological distress. Because the components of this model have not yet been evaluated in the same study, we examined associations between three types of cancer-related support communication (self-disclosure, perceived partner disclosure, and protective buffering), intimacy (global and cancer-specific), and global distress among patients coping with either head and neck or lung cancer and their partners.
  
  
  METHODS
  One hundred and nine patients undergoing active treatment and their partners whose average time since diagnosis was 15 months completed cross-sectional surveys.
  
  
  RESULTS
  For both patients and their partners, multilevel analyses using the actor-partner interdependence model showed that global and cancer-specific intimacy fully mediated associations between self- and perceived partner disclosure and distress; global intimacy partially mediated the association between protective buffering and distress. Evidence for moderated mediation was found; specifically, lower levels of distress were reported as a function of global and cancer-specific intimacy, but these associations were stronger for partners than for patients.
  
  
  CONCLUSIONS
  Enhancing relationship intimacy by disclosing cancer-related concerns may facilitate both partners' adjustment to these illnesses.
authors.affiliation: Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA. Sahron.Manne@fccc.edu
authors.forename: Sharon
authors.initials: S
authors.lastname: Manne
authors.forename: Hoda
authors.initials: H
authors.lastname: Badr
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003863:Depression / Q000523:psychology; D005191:Family Characteristics; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D012650:Self Disclosure; D012747:Sexual Partners; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological