Dyadic coping among breast cancer patients treated with radiotherapy

Background: Cancer poses a major stressor for patients and their partners. Understanding dyad coping is useful for determining if one partner's involvement is beneficial or harmful to the other. We sought to evaluate whether dyadic coping enhances resilience in the context of other risk and protective factors for coping with serious illness. Methods: An IRB-approved questionnaire was offered to breast cancer patients and their spouses. Consent was obtained from 21 dyads who were queried prior to initiation of breast irradiation and within 2 weeks of completing treatment. The nature of dyadic coping (positive or negative), level of posttraumatic stress, functional impairment, depression, and markers of resiliency were assessed for each partner at the beginning and conclusion of therapy. Results: Depression was significantly higher in patients than in their spouses (df = 1, 13; F = 6.13; p = 0.028). Over the course of the radiotherapy, partner's depression improved while the patient's depression worsened (df=1,13; F=5.46; p=0.030). The patient's negative dyadic coping assessment before radiation therapy was positively associated with depression (? = 0.78; df = 31.3; t = 2.15; p = 0.04), as well as the partner's depression (? = 0.92; df = 31.3; t = 2.52; p = 0.017) and posttraumatic stress (? = 0.74; df = 31.7; t = 2.10; p = 0.04). Patient's pre-radiation negative dyadic coping was negatively associated with the partner's flexibility (? = -.21; df = 19; t = -2.28; p = 0.03) and self efficacy (? = 0.46; df = 21.8; t = 2.96; p = 0.007) at completion of therapy. Positive dyadic coping assessment was not associated with negative coping behaviors on the part of either the patient or partner. Conclusions: The results of this pilot study support interventions incorporating dyadic support to enhance the resilience of patients and partners. Intervention should promote flexibility and self-efficacy while providing tools for altering negative dyadic coping patterns. No significant financial relationships to disclose.