title: The relative contributions of function, perceived psychological burden and partner support to cognitive distress in bladder cancer.
abstract: Bladder cancer is a genitourinary disease of increasing incidence. Despite improvements in treatment, outcomes remain equivocal with high recurrence rates. It is associated with poor psychosocial outcomes due to reduced functioning of the genitourinary system. The objective of these analyses was to query whether reported loss of function or the perception of psychological burden caused by this functional impedance was the key to understanding psychosocial outcomes.
  
  
  
  The sample comprised 119 participants with a confirmed diagnosis of bladder cancer. They completed a self-report questionnaire comprising the Bladder Cancer Index, Mini-mental Adjustment to Cancer Scale, Psychosocial Adjustment to Illness Scale and standard sociodemographic details. Simple mediation and serial mediation were used to explore the potential for psychological burden to mediate associations between loss of function and cognitive distress, and the potential additional contribution of positive partner support on these relationships. Age and duration of cancer were considered as covariates.
  
  
  
  Simple mediation demonstrated that the association between function and cognitive distress was fully mediated by perceived psychological burden. Serial mediation, which allowed for the addition of partner support, again demonstrated full mediation, with partner support being the key predictive variable.
  
  
  
  These analyses emphasise the importance of an appreciation of individuals' interpretation of the burden occasioned by bladder cancer and the role of a supportive partner. The implications for management discussions and support services in alleviating negative psychological outcomes in bladder cancer are highlighted. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: School of Nursing and Midwifery, Flinders University, Adelaide, Australia.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Heyes
authors.affiliation: School of Medicine, Flinders University, Adelaide, Australia.
authors.forename: Malcolm J
authors.initials: MJ
authors.lastname: Bond
authors.affiliation: School of Nursing and Midwifery, Flinders University, Adelaide, Australia.
authors.forename: Ann
authors.initials: A
authors.lastname: Harrington
authors.affiliation: School of Nursing and Midwifery, Flinders University, Adelaide, Australia.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Belan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003071:Cognition; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D011788:Quality of Life; D012747:Sexual Partners / Q000523:psychology*; D012938:Social Perception; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000523:psychology*