Marital Adjustment in Patients with Cancer: Association with Psychological Distress, Quality of Life, and Sleep Problems
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Subjects and Procedures
2.3. Outcome Measures
2.3.1. Marital Adjustment
2.3.2. Quality of Life
2.3.3. Depressive Symptomatology
2.3.4. Suicidal Ideation
2.3.5. Anxiety
2.3.6. Sleep Problems
2.4. Statistical Analysis
3. Results
3.1. Study Sample
3.2. Differences between Patients with Good versus Poor Marital Adjustment
3.3. The Impact of Demographic, Clinical, and Psychosocial Characteristics on Marital Adjustment
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total Sample n = 130 | |
---|---|
Sociodemographic Characteristics | |
Age in years, mean ± SD | 57.9 ± 12.4 |
Female sex, n (%) | 68 (52.3) |
Educational status, n (%) | |
No school | 16 (12.3) |
Primary school | 49 (37.7) |
secondary school | 36 (27.7) |
University | 29 (22.3) |
Employment status, n (%) | |
Works only at home | 15 (11.3) |
Works outside home | 20 (15.4) |
Unemployed | 8 (6.2) |
Retired | 31 (23.8) |
Temporary sick leave | 26 (20.9) |
Permanent sick leave | 22 (16.9) |
Other | 8 (6.2) |
Clinical Characteristics | |
Time since diagnosis, n (%) | |
<1 year | 85 (65.4) |
≥1 year | 45 (34.6) |
Tumor type, n (%) | |
Breast | 33 (25.4) |
Colon | 31 (23.9) |
Other gastrointestinal tumors * | 29 (22.3) |
Lung | 10 (7.7) |
Other | 27 (20.8) |
Surgical intervention, n (%) | 88 (67.7) |
Comorbid conditions, n (%) | 57 (43.8) |
Quality of life and Psychosocial Outcomes | |
LWMAT, mean ± SD | 117.1 ± 23.9 |
SF-12 PCS, mean ± SD | 39.3 ± 9.6 |
SF-12 MCS, mean ± SD | 42.1 ± 11.8 |
BDI-II, mean ± SD | 13.4 ± 9.3 |
Severity of depression, n (%) | |
Minimal | 74 (56.9) |
Mild | 23 (17.7) |
Moderate | 25 (19.2) |
Severe | 8 (6.2) |
Suicidal ideation, n (%) | 18 (13.9) |
BAI, mean ± SD | 15 ± 11.9 |
Severity of anxiety, n (%) | |
Normal (0–9) | 49 (37.7) |
Mild–moderate (10–18) | 36 (27.7) |
Moderate–severe (19–29) | 28 (21.5) |
Severe (30–63) | 17 (13.1) |
ISI, mean ± SD | 10.3 ± 6.8 |
Severity of insomnia, n (%) | |
No clinically significant insomnia (0–7) | 53 (40.8) |
Subthreshold insomnia (8–14) | 45 (34.6) |
Clinical insomnia of moderate severity (15–21) | 24 (18.5) |
Severe clinical insomnia (22–28) | 8 (6.2) |
Good Marital Adjustment n = 110 | Poor Marital Adjustment n = 20 | p-Value | |
---|---|---|---|
Sociodemographic Characteristics | |||
Age in years, median (IQR) | 58.5 (50–67) | 57 (52–65.5) | 0.55 |
Female sex, n (%) | 58 (52.7) | 10 (50) | 0.82 |
Educational status, n (%) | 0.33 | ||
No school | 11 (10) | 5 (25) | |
Primary school | 42 (38.2) | 7 (35) | |
secondary school | 32 (29.1) | 4 (20) | |
University | 25 (22.7) | 4 (20) | |
Employment status, n (%) | 0.76 | ||
Works only at home | 12 (10.9) | 3 (15) | |
Works outside home | 18 (16.4) | 2 (10) | |
Unemployed | 7 (6.4) | 1 (5) | |
Retired | 25 (22.7) | 6 (30) | |
Temporary sick leave | 24 (21.8) | 2 (10) | |
Permanent sick leave | 18 (16.4) | 4 (20) | |
Other | 6 (5.5) | 2 (10) | |
Clinical Characteristics | |||
Time since diagnosis, n (%) | 0.11 | ||
<1 year | 75 (68.2) | 10 (50) | |
≥1 year | 35 (31.8) | 10 (50) | |
Tumor type, n (%) | 0.16 | ||
Breast | 30 (27.8) | 3 (15) | |
Colon | 27 (24.5) | 4 (20) | |
Other gastrointestinal tumors | 24 (21.8) | 5 (25) | |
Lung | 10 (9.1) | 0 | |
Other | 19 (17.3) | 8 (40) | |
Surgical intervention, n (%) | 70 (63.6) | 18 (90) | 0.02 |
Comorbid conditions, n (%) | 44 (40) | 13 (65) | 0.04 |
Quality of life and Psychosocial Outcomes | |||
SF-12 PCS, mean ± SD | 39.9 ± 9.7 | 36.2 ± 8.9 | 0.11 |
SF-12 MCS, mean ± SD | 43.7 ± 11.8 | 33.3 ± 7.6 | <0.001 * |
BDI-II, mean ± SD | 12.3 ± 8.2 | 19.9 ± 12.2 | 0.003 * |
Severity of depression, n (%) | 0.002 | ||
Minimal (0–13) | 68 (61.8) | 6 (30) | |
Mild (14–19) | 21 (19.1) | 2 (10) | |
Moderate (20–28) | 16 (14.6) | 9 (45) | |
Severe (29–63) | 5 (4.5) | 3 (15) | |
Suicidal ideation, n (%) | 12 (10.9) | 6 (30) | 0.03 |
BAI, mean ± SD | 14 ± 11.3 | 20.8 ± 14.2 | 0.04 * |
Severity of anxiety, n (%) | 0.008 | ||
Normal (0–9) | 45 (40.9) | 4 (20) | |
Mild–moderate (10–18) | 29 (26.4) | 7 (35) | |
Moderate–severe (19–29) | 26 (23.6) | 2 (10) | |
Severe (30–63) | 10 (9.1) | 7 (35) | |
ISI, mean ± SD | 9.6 ± 6.5 | 14.4 ± 7 | 0.008 * |
Severity of insomnia, n (%) | 0.001 | ||
No clinically significant insomnia (0–7) | 48 (43.6) | 5 (25) | |
Subthreshold insomnia (8–14) | 42 (38.2) | 3 (15) | |
Clinical insomnia of moderate severity (15–21) | 15 (13.6) | 9 (45) | |
Severe clinical insomnia (22–28) | 5 (4.6) | 3 (15) |
Univariate Estimates | Multivariable Estimates # | |||||
---|---|---|---|---|---|---|
B (95% CI) | F-Statistic (p-Value *) | Adjusted R2 | B (95% CI) | F-statistic (p-Value *) | Adjusted R2 | |
Surgical Intervention | −8.77 (−17.1, −0.89) | 5.56 (0.019) | 0.034 | −6.6 (−15.2, 1.4) | 2.72 (0.03) | 0.051 |
SF-12 MCS | 0.34 (0.013, 0.66) | 5.52 (0.02) | 0.033 | 0.31 (−0.016, 0.64) | 3.09 (0.02) | 0.061 |
SF-12 PCS | 0.13 (−0.28, 0.56) | 1.24 (0.26) | 0.019 | 0.08 (−0.33, 0.52) | 2.09 (0.09) | 0.032 |
BDI-II | −0.63 (−1.04, −0.21) | 7.65 (0.006) | 0.049 | −0.60 (−1.01, −0.19) | 3.48 (0.01) | 0.071 |
Positive suicidal ideation | −17.5 (−29.1, −5.5) | 9.79 (0.002) | 0.063 | −17.7 (−29.2, −5.9) | 4.21 (0.003) | 0.091 |
BAI | −0.45 (−0.76, −0.12) | 8.07 (0.005) | 0.052 | −0.35 (−0.69, −0.01) | 3.11 (0.02) | 0.061 |
ISI | −1.02 (−1.6, −0.49) | 10.45 (0.001) | 0.068 | −0.88 (−1.5, −0.32) | 3.67 (0.007) | 0.076 |
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Ruiz-Marin, C.M.; Molina-Barea, R.; Slim, M.; Calandre, E.P. Marital Adjustment in Patients with Cancer: Association with Psychological Distress, Quality of Life, and Sleep Problems. Int. J. Environ. Res. Public Health 2021, 18, 7089. https://doi.org/10.3390/ijerph18137089
Ruiz-Marin CM, Molina-Barea R, Slim M, Calandre EP. Marital Adjustment in Patients with Cancer: Association with Psychological Distress, Quality of Life, and Sleep Problems. International Journal of Environmental Research and Public Health. 2021; 18(13):7089. https://doi.org/10.3390/ijerph18137089
Chicago/Turabian StyleRuiz-Marin, Carmen Maria, Rocio Molina-Barea, Mahmoud Slim, and Elena P. Calandre. 2021. "Marital Adjustment in Patients with Cancer: Association with Psychological Distress, Quality of Life, and Sleep Problems" International Journal of Environmental Research and Public Health 18, no. 13: 7089. https://doi.org/10.3390/ijerph18137089