| Background. Prostate cancer and its treatments involve the most intimate relationships between patients and their partners, and negatively affect their QOL over time. The communication between patients and partners plays an integral role in their survivorship.;Aims. This study aimed to: (1) describe the changes over time in levels of dyadic communication between patients and partners who are coping with different phases of prostate cancer, and (2) examine whether communication mediates the relationships between selected bio-psychosocial factors and couples' QOL over time.;Methods. A modified Stress-Coping Model guided this secondary analysis of longitudinal data from a randomized clinical trial testing a family-based intervention to improve QOL in couples facing prostate cancer. To control for any intervention effects, only couples from the usual-care control group (N=134 dyads) were included. Patients and partners independently completed study instruments at baseline, and 4-, 8-, and 12-month follow-ups. Main study variables QOL and the level of dyadic communication were measured using the Functional Assessment of Chronic Illness Therapy-General scale (FACT-G) and Lewis Mutuality and Interpersonal Sensitivity Scale (MIS), respectively. Multilevel Modeling (MLM) was used to achieve research aims. Mediation effects were tested following Baron and Kenny's guidelines.;Results. The MLM analyses showed that (1) the role effect on the levels of dyadic communication was significant over time, and the effect of phase of illness on communication was significant at the time of diagnosis; (2) more communication was significantly associated with higher social support, less uncertainty, and fewer prostate cancer-specific hormonal symptoms; (3) higher QOL in couples was significantly related to patients' lower educational level, partners' older age, higher family income, and certain time-varying variables (i.e., higher social support, less uncertainty, fewer general symptoms in couples, and fewer prostate cancer-specific hormonal symptoms in patients); and (4) couples' communication partially mediated the relationships between time-varying factors and couples' QOL.;Conclusions. The results extend our knowledge about the communication between prostate cancer patients and partners and provide evidence that couples' QOL is affected by factors at intra-individual, intra-couple, and inter-couple levels. During cancer care, clinicians need to intervene effectively with both patients and their partners. |
