COUPLES ADJUSTMENT TO BREAST-CANCER AND BENIGN BREAST DISEASE - A LONGITUDINAL ANALYSIS

A comprehensive comparison of couples' adjustment to benign (n = 73 co uples) and malignant breast disease (n = 58 couples) at the time of di agnosis and at two follow-up assessments at 60 days and 1 year is repo rted. Specific objectives were to: (a) compare the concurrent stress, resources, appraisal, and patterns of adjustment of couples in the ben ign and malignant groups; (b) compare the psychosocial responses of pa tients versus spouses; and (c) determine the amount of correspondence in levels of adjustment reported by patients and their husbands over t ime. Multiple instruments with reported reliability and validity were used to measure study variables: Smilkstein Stress Scale, Dyadic Adjus tment Scale, Family APGAR, Social Support Questionnaire, Mishel Uncert ainty in Illness Scale, Beck Hopelessness Scale, Brief Symptom Invento ry, and Psychosocial Adjustment to Illness Scale. Mixed design analyse s of covariance (ANCOVA) were used to assess differences between and a mong couples and examine changes in study variables over time. Signifi cant differences were found in the resources, appraisal, and patterns of adjustment reported by couples in the benign and malignant groups. Couples facing breast cancer reported greater decreases in their marit al and family functioning, more uncertain appraisals, and more adjustm ent problems associated with the illness. In addition, there was a hig h degree of correspondence between the levels of adjustment reported b y women with breast cancer and their husbands over time. Couples who r eported high distress or a high number of role problems at diagnosis w ere likely to remain highly distressed at 60 days and 1 year. Study fi ndings underscore the importance of assisting couples, not just patien ts, to manage the adjustment difficulties associated with breast cance r. (C) 1998 John Wiley & Sons, Ltd.