title: New frontiers in couple-based interventions in cancer care: refining the prescription for spousal communication.
abstract: BACKGROUND
  The diagnosis and treatment of cancer is a life-altering experience that signals profound changes in a person's life. However, most people do not experience cancer in isolation or cope alone. Despite the fact that partners (i.e. spouses, significant others) provide emotional support and play a critical role in caregiving, cancer exacts a heavy toll on them and challenges their relationship with the patient by altering established communication patterns and roles. In recognition of this, a burgeoning literature involving couple-based interventions to improve patient and partner quality of life and adaptation has emerged. However, questions remain regarding how we can improve these interventions to exact greater impact on patient and partner outcomes.
  
  
  METHODS
  A narrative review of the literature on couples' communication processes in cancer was conducted in order to describe knowledge gaps and directions for future research.
  
  
  RESULTS
  Most couple-based interventions have included a communication skills training component because communication is an important process through which couples make sense of cancer, engage in social support, negotiate role changes and coordinate coping responses. However, scholars still know very little about what they should instruct couples to talk about, how often they should talk and when talking (or not talking) is beneficial (and for whom - the patient, partner, or both).
  
  
  CONCLUSIONS
  In order push this field forward, we need to develop a more nuanced view of couples' communication that acknowledges that there are multiple ways to talk, different aspects of the cancer experience to talk about, and preexisting communication patterns and preferences for different couples that may influence the utility of talk. Interventions that replace the unilateral and generic prescription to talk openly about cancer with targeted questions that prompt reflection on couples' unique strengths, preexisting communication patterns and support resources may thus help bolster the impact of couple-based interventions on patient and partner quality of life.
authors.affiliation: a Department of Medicine , Baylor College of Medicine , Houston , Texas , USA.
authors.forename: Hoda
authors.initials: H
authors.lastname: Badr
mesh_terms: D000223:Adaptation, Psychological; D003142:Communication; D030881:Disclosure; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D012944:Social Support; D018454:Spouses