| Objective1.To explore the dynamic changes of dyadic coping,post-traumatic growth and intimate relationship between breast cancer patients and their spouses at different evaluation time points;2.To analyze the correlation between the level of dyadic coping,post-traumatic growth and intimate relationship of breast cancer patients and their spouses at different assessment time points.MethodsThe convenience sampling method was used to select breast cancer patients and their spouses who received surgical treatment and needed chemotherapy in the breast surgery department of tertiary grade-A hospitals at Dalian from November 2019 to November 2020 as the research subjects.The general information questionnaire,the Lock-Wallace Marriage Adjustment Test(MAT),the Chinese Version of Dyadic Coping Inventory(CDCI)and the Post-Traumatic Growth Inventory(PTGI)were used to conduct a questionnaire survey in patients with breast cancer and their spouses.The evaluation time points were the day of admission(T1),the third day after surgery(T2),the day of admission of the first chemotherapy(T3),and the end of the fourth chemotherapy(T4).On the day of admission(T1),the husband and wife were introduced to the hospital and the environment of the department,the attending doctor and the responsible nurse,so as to relieve the patient’s tension at the beginning of admission.After that,the purpose and significance of the study are introduced to the participants.After obtaining the consent of the participants and signing the informed consent form,the researchers will issue questionnaires to the participants and fill in the questionnaires independently under the unified instructions.For the items that do not understand,the researchers can explain and fill in the questionnaires.Exchange contact information,such as phone number or We Chat,with the subject for future communication.At T2,T3 and T4,the patients and their spouses were kept in communication,and questionnaires were issued after health education and answering questions for the patients and their spouses.The Excel sheet was established to sort out the data in time,and the descriptive analysis,repeated measurement ANOVA,Pearson correlation analysis and multiple stepwise linear regression analysis were performed on the data with SPSS19.0.Results1 Dyadic coping and its dynamic changes in various dimensions in breast cancer patients and their spousesT1: The total dyadic coping score of breast cancer patients was(122.83±15.16);T2:The total score of dyadic coping was(130.91±20.55);T3: The total score of dyadic coping was(124.31±14.23);T4: The total score of dyadic coping was(122.71±14.47)points.T1: Total score of spousal dyadic coping was(123.90±16.84);T2: Total score of dyadic coping was(128.40±18.98);T3: The total score of dyadic coping was(124.91±13.70);T4: The total score of dyadic coping was(124.0±12.16).Repeated measurement ANOVA results showed that the total score of dyadic coping,supportive coping,delegated coping,common coping,spouse supportive coping and spouse common coping of breast cancer patients at different evaluation time points had statistical significance(P<0.05).There was statistical significance in the interaction between time and group for the change of the total scores of patients with different family per capita monthly income(P<0.05).2 Dynamic changes in post-traumatic growth of breast cancer patients and their spousesThe post-traumatic growth scores of breast cancer patients at different time points of evaluation were T1:(51.60±14.10)points,T2:(57.36±12.73)points,T3:(57.19±9.43)points,and T4:(60.07±9.35)points.The post-traumatic growth scores of the spouses were T1:(49.14±14.53)points,T2:(55.40±22.14)points,T3:(50.74±11.85)points,T4:(53.07 ± 11.44)points.The results of repeated measurement ANOVA showed that the total score of post-traumatic growth and the changes of each dimension of breast cancer patients at different evaluation time points had statistical significance(P<0.05),and the changes of spouse only new possibility and appreciation of life had statistical significance(P<0.05).There was statistical significance in the interaction between time and group(P<0.05)in the total post-traumatic growth score of spouses of different families with per capita monthly income.3 Dynamic changes of intimate relationship between breast cancer patients and their spousesThe intimate relationship scores of breast cancer patients at different time points were T1:(115.62±18.79),T2:(122.78±22.34),T3:(129.00±19.66),T4:(127.50±23.48);The intimate relationship scores of the spouses of breast cancer patients at different time points were T1:(118.29±16.32),T2:(122.86±16.89),T3:(128.93±14.63),T4:(122.02±16.02),all showed a trend of increasing first and then decreasing,and the changes of intimate relationship in each stage of both parties were statistically significant(P<0.001).4 An analysis of the relationship between dyadic coping,post-traumatic growth and intimate relationship in breast cancer patients and their spousesPearson correlation analysis results at different evaluation time points showed that T1: intimate relationship of breast cancer patients on admission day was significantly positively correlated with dyadic coping and post-traumatic growth of the couple(P<0.05).There was a significant positive correlation between spousal intimacy and their own dyadic coping(P<0.05),and a significant negative correlation between spousal intimacy and post-traumatic growth(P<0.05).T2: Patients’ intimate relationship was significantly positively correlated with their own dyadic coping and spouse’s intimate relationship(P<0.01),and negatively correlated with post-traumatic growth(P<0.05).Spousal intimacy was significantly negatively correlated with patients’ posttraumatic growth(P<0.05),and positively correlated with their own(P<0.01).T3:Patients’ intimate relationship was significantly positively correlated with their posttraumatic growth,spousal dyadic coping,and spousal intimate relationship(P<0.05);Spousal intimacy was correlated with the relationship between spousal dyadic coping and spousal post-traumatic growth(P<0.05)was significantly positive.T4: The intimate relationship of patients was significantly positively correlated with the dyadic coping,the post-traumatic growth and the intimate relationship with the spouse(P<0.05);Spousal intimacy was significantly positively correlated with dyadic coping and post-traumatic growth(P<0.05).5 The predictive effects of dyadic coping and post-traumatic growth on intimate relationship in breast cancer patients and their spousesThe relationship between breast cancer patients and others,personal strength,appreciation of life,negative coping,common coping and partner common coping had a certain positive predictive effect on patients’ intimate relationship(P<0.05),and the new possibility of self had a certain negative predictive effect on patients’ intimate relationship(P<0.05).Spouse’s own negative coping,common coping,personal strength,the relationship between patients and others,negative coping and supportive coping had a certain positive predictive effect on spouse’s intimate relationship(P<0.05),while spouse’s appreciation of life and patient’s personal strength had a certain negative effect on spouse’s intimate relationship(P<0.05).Conclusion1 The level of dyadic coping and post-traumatic growth changed dynamically at different assessment time points in patients with breast cancer,while the spouse tended to be stable.In addition,the intimate relationship between the husband and wife showed significant dynamic changes,and the medical staff should timely provide targeted intervention measures according to the characteristics of dyadic coping,post-traumatic growth and intimate relationship changes of patients with breast cancer and their spouses at different assessment time points;2 There was a significant positive/negative correlation between breast cancer patients and spouses of dyadic coping,post-traumatic growth and intimate relationship at different assessment time points,and patients and spouses of dyadic coping,posttraumatic growth and intimate relationship were correlated with each other;3 Dyadic coping,post-traumatic growth and other variables of patients with breast cancer and spouses can predict their intimate relationship positively or negatively.Therefore,it is suggested that medical staff should consider the husband and wife as a whole and implement intervention. |
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