Daily partner responses have divergent effects on cancer patient’s fatigue interference and relationship satisfaction

Abstract

Background: Fatigue is an interfering symptom many cancer patients experience even after treatment completion. Support provided by the partner may help limit the negative effects of fatigue on daily life, but may erode the couple’s relationship. This study aimed to investigate the effects of different partner responses on the patient’s fatigue interference and relationship satisfaction. Methods: One-hundred-and-one post-treatment colorectal cancer patients (66% male, mean age 64 years) and their partners completed daily diaries for 14 days on perceived and provided partner responses (punishing, solicitous) and co-rumination (ruminating together about fatigue). Within-person multilevel modelling analyses were applied, with patient’s fatigue interference and relationship satisfaction as outcomes and daily fatigue and gender as control-variables. Findings: The within-person effect of co-rumination on fatigue interference was significant (b=0.25, p<0.01), that is cancer patients who reported higher than usual levels of daily co-rumination experienced higher fatigue interference. The main-effects of neither punishing (p=0.48) nor solicitous (p=0.82) responses on fatigue interference were significant. However, as expected, punishing responses predicted a decrease of relationship satisfaction during the day (b=-0.35, p<0.01) while solicitous responses (b=0.11, p<0.05) and co-rumination (b=0.10, p<0.05) predicted an increase in relationship satisfaction. Discussion: Co-rumination is beneficial for the spousal relationship, but increases the negative impact of fatigue on daily activities. Punishing responses were not found to decrease fatigue interference but seem to erode the couple’s relationship. In order to limit fatigue interference, partners should withdraw from co-rumination. Couples should be supported to apply strategies to discourage fatigue interference while maintaining a healthy relationship.