title: The role of patient pain and physical function on depressive symptoms in couples with lung cancer: a longitudinal dyadic analysis.
abstract: Drawing on the Developmental-Contextual Model (Berg & Upchurch, 2007), we examined the association between changes in patient physical health (pain severity and physical function) and changes in depressive symptoms in couples with lung cancer over a 12-month period. Patients and their spouses or partners (n = 77) were recruited using rapid case ascertainment and completed five waves of data collection (baseline, 3, 6, 9, and 12 months). Multilevel modeling was used to examine aggregate and time-varying effects of patient physical health on depressive symptoms. Results indicated that for patients and spouses, patient-rated mean pain severity was significantly positively associated with patient and spouse depressive symptoms and patient-rated mean physical function was significantly negatively associated with patient and spouse depressive symptoms. More importantly, increases in patient pain severity and declines in patient physical function were significantly associated with increases in patient depressive symptoms. However, only declines in patient physical function were significantly associated with increases in spouse depressive symptoms. These time-varying effects remained even when controlling for patient gender, patient age, patient stage of disease, spouse physical health, and relationship quality. Findings suggest the importance of examining the changing illness context on the couple as a unit and the complexity of interpersonal processes in the presence of a life-threatening illness.
authors.affiliation: School of Nursing, Oregon Health & Science University.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Lyons
authors.affiliation: School of Nursing, Oregon Health & Science University.
authors.forename: Jill A
authors.initials: JA
authors.lastname: Bennett
authors.affiliation: School of Nursing, Oregon Health & Science University.
authors.forename: Lillian M
authors.initials: LM
authors.lastname: Nail
authors.affiliation: Knight Cancer Institute, Oregon Health & Science University.
authors.forename: Erik K
authors.initials: EK
authors.lastname: Fromme
authors.affiliation: School of Nursing, Oregon Health & Science University.
authors.forename: Nathan
authors.initials: N
authors.lastname: Dieckmann
authors.affiliation: Psychology Department, University of Massachusetts.
authors.forename: Aline G
authors.initials: AG
authors.lastname: Sayer
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000367:Age Factors; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008393:Marriage / Q000523:psychology; D008875:Middle Aged; D008960:Models, Psychological; D010146:Pain / Q000523:psychology*; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology; D012737:Sex Factors; D018454:Spouses / Q000523:psychology; D013223:Statistics as Topic