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Marital quality and survivorship
Slowed recovery for breast cancer patients in distressed relationships
Article first published online: 24 OCT 2008
Copyright © 2008 American Cancer Society
Volume 115, Issue 1, pages 217–228, 1 January 2009
How to Cite
Yang, H.-C. and Schuler, T. A. (2009), Marital quality and survivorship. Cancer, 115: 217–228. doi: 10.1002/cncr.23964
- Issue published online: 29 DEC 2008
- Article first published online: 24 OCT 2008
- Manuscript Accepted: 24 JUL 2008
- Manuscript Revised: 22 JUL 2008
- Manuscript Received: 27 MAY 2008
- American Cancer Society. Grant Numbers: PBR-89, RSGPB-03-248-01-PBP
- Longaberger Company-American Cancer Society Grant for Breast Cancer Research. Grant Number: PBR-89A
- US Army Medical Research Acquisition Activity. Grant Numbers: DAMD17-94-J-4165, DAMD17-96-1-6294, DAMD17-97-1-7062
- National Institutes of Mental Health. Grant Number: 1 R01 MH51487
- National Cancer Institute. Grant Numbers: K05 CA098133, R01 CA92704
- General Clinical Research Center. Grant Number: M01-RR0034
- Ohio State University Comprehensive Cancer Center. Grant Number: P30 CA16058
Although marital distress has been implicated in difficulties with adjustment to a breast cancer diagnosis, its long-term effects, especially on physical recovery, are unknown.
Longitudinal data from newly diagnosed breast cancer patients (N = 100) who were married or cohabiting were used. Patients were assessed after diagnosis and surgery (baseline) and then reassessed every 4 or 6 months for the next 5 years. Women in stable, distressed relationships (n = 28) were compared with those in stable, nondistressed relationships (n = 72). Stress, health behavior, and health outcomes were examined using mixed-effects modeling.
Overall, marital distress was associated with slowed recovery trajectories and poor outcomes. At baseline, both groups had equivalent, high levels of stress, but diverged thereafter. Stress declined more slowly for the Distressed group, and by 5 years it remained significantly higher. Differential reductions in physical activity were also observed. With regard to health, the Distressed group was found to have a slower recovery in performance status and more symptoms/signs of illness and treatment side effects through 3 years. Finally, all the effects were observed above and beyond reductions occurring with depressive symptomatology, which was significantly higher in the Distressed group.
Marital distress is not only associated with worse psychologic outcomes for breast cancer survivors, but poorer health and a steeper decline in physical activity. These novel data demonstrate recovery trajectories for breast cancer survivors to be constrained for those also coping with ongoing difficulties in their marriage. Cancer 2009. © 2008 American Cancer Society.