title: Appraisals, perceived dyadic communication, and quality of life over time among couples coping with prostate cancer.
abstract: Little research has examined how prostate cancer patients' and their spouses' appraisals of illness and quality of life (QOL) interact with one another. This study examined the interdependent relationships between their appraisals of illness and QOL and if their perceived dyadic communication mediated these relationships.
  
  
  
  We used the Actor-Partner Interdependence Mediation Model (APIMeM) approach to conduct a secondary analysis of longitudinal data from 124 prostate cancer patient-spouse dyads. We examined actor effects (each person's influence on his/her own outcomes) and partner effects (each person's influence on his/her partner's outcomes). Appraisals of illness, perceived dyadic communication, and QOL were measured using Appraisal of Illness Scale, Lewis Mutuality and Interpersonal Sensitivity Scale, and Functional Assessment of Chronic Illness Therapy General Scale, respectively. Analyses controlled for effects of prostate cancer symptoms and demographic factors.
  
  
  
  Among actor effects, spouses with more negative appraisals at baseline perceived worse dyadic communication 4 months later (p < .05) and worse QOL 8 months later (p < .001). Patients and spouses who perceived more dyadic communication at 4 months had better QOL at 8 months (p < .01). Among partner effects, there was only weak evidence for an association between patient perceived dyadic communication at 4 months and better spouse QOL at 8 months of follow-up (p = .05). No mediation effects were found.
  
  
  
  Patients' and spouses' appraisals of the illness and their dyadic communication were associated with their long-term QOL. Interventions that reduce negative appraisals of illness and promote dyadic communication may improve QOL for both patients with prostate cancer and their spouses.
authors.affiliation: School of Nursing, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, 27599, USA. lsong@unc.edu.
authors.forename: Lixin
authors.initials: L
authors.lastname: Song
authors.affiliation: Gillings School of Global Public Health, UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Rini
authors.affiliation: School of Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA.
authors.forename: Katrina R
authors.initials: KR
authors.lastname: Ellis
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, MI, 48109, USA.
authors.forename: Laurel L
authors.initials: LL
authors.lastname: Northouse
mesh_terms: D000223:Adaptation, Psychological; D005191:Family Characteristics; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*
keywords: Actor-Partner Interdependence Mediation Model (APIMeM); Appraisal; Path analysis; Perceived dyadic communication; Prostate cancer; Quality of life