title: Cancer and quality of life in spousal dyads: spillover in couples with and without cancer-related health problems.
abstract: OBJECTIVE
  Poor health of one spouse can adversely influence the partner's health outcomes ("spillover"). This study aimed to estimate quality of life spillover among spouses and to determine how presence of cancer influenced these effects.
  
  
  METHODS
  We examined data on husband-wife dyads with cancer-related health problems, medical events, or disabilities (n = 910) and matched comparison dyads from the 2004-2012 Medical Expenditures Panel Survey, a population-based survey of the USA. Mental and physical health-related quality of life and depressed mood were reported at two time points (T1 and T2, 11 months apart on average). Dyadic multilevel models evaluated the cross-lagged impact of HRQoL and depressed mood at T1 on spouses' HRQoL at T2, controlling for sociodemographics and health conditions.
  
  
  RESULTS
  Small but statistically significant spillover was observed for mental and physical HRQoL among couples with cancer. Spillover occurred from both the spouse to the survivor and from survivor to spouse. Depressed mood, in particular, showed stronger spillover effects from the spouse to the survivor than the inverse. Similar effects were not observed in dyads without cancer.
  
  
  CONCLUSIONS
  Screening for and treating poor HRQoL and depressed mood concurrently in both cancer survivors, and their spouses may positively influence HRQoL outcomes. Future research is needed to further elucidate these findings and determine whether a concurrent approach to psychosocial care in survivors and their spouses may improve long-term outcomes.
authors.affiliation: National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA. Kristin.litzelman@nih.gov.
authors.forename: Kristin
authors.identifier: http://orcid.org/0000-0002-5542-6434
authors.initials: K
authors.lastname: Litzelman
authors.affiliation: National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
authors.forename: Paige A
authors.initials: PA
authors.lastname: Green
authors.affiliation: National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
authors.forename: K Robin
authors.initials: KR
authors.lastname: Yabroff
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011788:Quality of Life; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: Caregivers; Depressed mood; Dyadic; Quality of life; Spillover