Publication Date

2012-06-26

Availability

Open access

Embargo Period

2012-06-26

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Psychology (Arts and Sciences)

Date of Defense

2011-05-27

First Committee Member

Youngmee Kim

Second Committee Member

Frank J. Penedo

Third Committee Member

Michael H. Antoni

Fourth Committee Member

Sara Czaja

Fifth Committee Member

John E. Lewis

Abstract

Improvements in public awareness and in regular screening for prostate cancer (PC) have resulted in dramatic increases in survival for men diagnosed with localized stage disease. However, this has resulted in a significant, and growing, population of men, who are now placed in the difficult position of having to find ways to cope with the physical and mental challenges that can develop following their diagnosis. Existing literature suggests that positive social support can act to help PC survivors adjust physically and mentally to the disease. Historically, the social support construct has been separated into two primary forms: 1) structural support, which describes the quantity and framework of an individual’s support network and 2) functional support, which describes the quality of the support that the individual perceives. Several salient sources of support have been identified, with the individual’s spouse most often noted as being the primary caregiver for PC survivors. Although the long-term task of caregiving for a PC survivor can be especially challenging, little research has investigated the adjustment process of spousal caregivers of PC survivors. The limited research which has evaluated quality of life outcomes in these populations has primarily done so independently of one another, rather than considering the two groups as a dyadic unit. The current study proposed to address several key limitations of our current knowledge by: 1) document the levels and relationships among physical and mental quality of life and sources of social support in the understudied populations of PC survivors and their spousal caregivers and 2) evaluate the effects of different sources of social support on physical and psychological quality of life in a dyadic model that considers both survivor and caregiver functioning. Results from the current study suggest that both the PC survivor and his spousal caregiver report lower than normative levels of significant other support, while the spousal caregiver reported lower than normative levels of family and friend support, as well. The specified actor-partner interdependence model indicated that for the PC survivor his perceptions of significant other support were significantly related to his level of physical quality of life (β=.33, p<.05) and his perceptions of friend support were significantly related to his level of mental quality of life (β=.43, p<.05). For the spousal caregiver, her perceptions of friend support were significantly associated with her level of mental quality of life (β=.38, p<.05). The introduction of age into the model, as a co-variate of physical and mental quality of life, did not affect the relationships between sources of support and quality of life. However, the introduction of age and number of medical co-morbidities into the model, as co-variates of physical and mental quality of life, caused the relationship between PC survivor significant other support with his physical quality of life to become non-significant. These results indicate that unique sources of social support have implications in the adjustment process for PC survivors and their spousal caregivers and are valuable targets for future psychosocial intervention work designed to influence their quality of life.

Keywords

prostate cancer; spousal caregiver; dyadic adjustment; quality of life; cancer survivorshop; actor-partner interdependence model

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