Relationship-Focused Support, Body Image, and Quality of Life in Older Couples Coping with Skin Cancer

For older couples facing a skin cancer diagnosis, the experience is stressful, not only for the individual with the diagnosis, but also for the healthy partner. Couples may use various types of coping and styles of support to deal with the stress, including relationship-focused support, which addresses the needs and coping efforts of both partners in response to and in conjunction with one another. The current study examined associations between perceptions of three styles of relationship-focused partner support, namely active engagement, protective buffering, and overprotection, and body image of the partner with skin cancer and quality of life of the partner with skin cancer and the healthy partner. Using data collected from 30 older couples (Mage = 70; SD = 7.25) with diagnoses of melanoma (n = 14; 47%) or nonmelanoma (n = 16, 53%), linear regression models, adjusted for the stressor appraisal by both partners, revealed that when partners with skin cancer reported receiving higher active engagement support, they were more likely to have a positive body image (B [unstandardized] = 35.54, p = .04). A significant interaction was found between active engagement support used by both partners (B = -8.78, p = .05), indicating that active engagement from healthy partners appears to benefit the body image of the partner with skin cancer when they themselves use less active engagement support. Both protective buffering and overprotection support were not associated with body image. Multivariate actor-partner interdependence models (APIM) assessed the relationships between support received by each partner and its association with their quality of life (actor effects) and their partner's quality of life (partner effects). Results suggest that active engagement support perceived by either partner was not associated with quality of life. In contrast, overprotection perceived by partners with skin cancer was significantly associated with their quality of life (actor effect: B = -10.81, p < .001), but was not associated with the healthy partners' quality of life. Additionally, protective buffering perceived by healthy partners was associated with their own quality of life (actor effect; B = -6.91, p = .05) as well as their partner with skin cancer's quality of life (partner effect; B = -8.15, p = .01). Nuances based on the sex of the person with skin cancer, type of skin cancer, the stage of skin cancer and couple's appraisal of the stressors of skin cancer are also discussed.

Findings suggest that actively engaging with the stressors of skin cancer can contribute to positive views of one's body, whereas ignoring or avoiding conversations about skin cancer and overprotection provided by healthy partners might lead to poorer quality of life for both partners. These findings illustrate the influence of healthy partners, highlighting that how they give support when their partner is facing a skin cancer diagnosis may affect the overall quality of the couple relationship and couple outcomes.