Illness representations and psychological symptoms of couples dealing with cancer: dyadic, interaction and perception-dissimilarity effects

Abstract

Background. The aim of this study was to examine the impact of the dyadic, interaction and dissimilarity effects of the illness representations of recently diagnosed cancer patients and their spouses on their psychological health. Methods. Cancer patients who received a formal diagnosis of cancer less than a month ago, and their spouses were invited to participate in the study. The final sample consisted of 298 individuals nested in 149 couples. Effects were examined with the Actor-Partner Interdependence Model (APIM). Findings. The findings revealed several actor (i.e., within person) effects. Personal control and emotional representations were related to patients’ and spouses’ psychological symptoms, while treatment control was also related to patients’ symptoms. Certain partner (i.e., between partners) effects were also found. Patients reported better psychological health when their spouses perceived cancer as a less burdensome and understandable condition, while spouses reported better psychological health when patients perceived their condition as more controllable. Furthermore, the negative association of patients’ psychological symptoms with their representations of illness coherence was weak at the higher and medium levels, and stronger at the lower levels of spouse corresponding representations. Patient-partner discrepancy in perceived illness consequences was associated with more psychological symptoms in patients. Discussion. Adaptation to cancer is a dyadic process within the context of which patient and partner psychological well-being is affected by each other’s understanding of illness. Thus, the parallel examination of the illness representations of both partners is needed from the early phases of the illness trajectory.