title: The daily impact of pain from metastatic breast cancer on spousal relationships: a dyadic electronic diary study.
abstract: Women with metastatic breast cancer (MBC) experience high levels of emotional distress and pain. Although individuals often rely on their intimate partners to provide physical and emotional support when they are in pain, the daily impact of pain on the spousal relationship in the context of advanced cancer is unclear. To understand how relationships are affected by pain, 57 MBC patients and their partners completed electronic diary assessments 6 times a day for 14 days. Patients and partners rated the patient's pain, their own mood (circumplex adjectives), the provision/receipt of social support, and the degree to which cancer interfered with their relationship. Multilevel mediation models with the couple as the unit of analysis were estimated. Partners and patients reported greater relationship interference when patients experienced more pain and less aroused (i.e., more tired, less peppy, less active) mood. Greater tired mood during the day accounted for 17% and 82% of the association between patients' morning pain and their evening ratings of emotional and physical support from their partners, respectively. Partners did not directly respond to patients' pain by providing emotional or physical support; however, they were more likely to provide support when patients experienced more tired and less active mood as a consequence of their pain. Results suggest that one way that pain may wear on couples' relationships is through its adverse effects on patients' daily mood. They also suggest that partners may base their provision of support on their perception of the adverse effects of pain on patients' aroused mood.
authors.affiliation: Department of Oncological Sciences, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1130, New York, NY 10029, USA Department of Psychology, 110 Wolf Hall, University of Delaware, Newark, DE 19716-2577, USA St. Louis Behavioral Medicine Institute, 1129 Macklind Ave, St. Louis, MO 63110, USA Department of Behavioral Science, The University of Texas, M.D. Anderson Cancer Center, P.O. Box 301439, Unit 1330, Houston, TX 77230-1439, USA Department of Anesthesiology and Pain Medicine, Box 356540, University of Washington, School of Medicine, Seattle, WA 98195, USA.
authors.forename: Hoda
authors.initials: H
authors.lastname: Badr
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Laurenceau
authors.forename: Leslie
authors.initials: L
authors.lastname: Schart
authors.forename: Karen
authors.initials: K
authors.lastname: Basen-Engquist
authors.forename: Dennis
authors.initials: D
authors.lastname: Turk
mesh_terms: D000339:Affect; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D010146:Pain / Q000209:etiology / Q000523:psychology*; D012944:Social Support; D018454:Spouses / Q000523:psychology*