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

dc.contributor.authorKozimor, Laura Michelleen
dc.contributor.committeechairSavla, Jyoti S.en
dc.contributor.committeememberRoberto, Karen A.en
dc.contributor.committeememberZvonkovic, Anisaen
dc.contributor.committeememberBlieszner, Rosemaryen
dc.contributor.departmentAdult Learning and Human Resource Developmenten
dc.date.accessioned2019-12-25T07:00:48Zen
dc.date.available2019-12-25T07:00:48Zen
dc.date.issued2018-07-02en
dc.description.abstractFor 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.en
dc.description.abstractgeneralThe experience of facing a skin cancer diagnosis is stressful, both for a person with the diagnosis, but also for his or her romantic partner. As an increasing number of older adults will experience a skin cancer diagnosis at some point in their lifetimes, partially due to the link between cumulative sun exposure and age, it is important to understand how couples provide support to one another. This study examined three styles of support, active engagement, protective buffering, and overprotection that partners can use to support one another, and how the support partners perceive can be related to the body image of the person with skin cancer and quality of life of both the partners. Thirty couples, with an average age of 70 years, participated in this study. One partner in each couple had received a diagnosis of either melanoma (N = 14; 47%) or nonmelanoma (n = 16, 53%) in the previous two years. Findings showed that when partners with skin cancer reported receiving higher active engagement support, they were more likely to have better body image, especially when they were using less active engagement support themselves. Neither protective buffering nor overprotection support were associated with body image. Next, this study examined whether support from one’s partner is associated with his or her quality of life (actor effects) and with the partner’s quality of life (partner effects). Receiving active engagement support was not associated with quality of life for either partner. Conversely, protective buffering perceived by healthy partners was associated with poorer quality of life for themselves and their partners. Similarly, overprotection support perceived by partners with skin cancer was associated with poorer quality of life of themselves. Findings from this study suggest that if couples can actively engage with the stressors of the skin cancer diagnosis such as through open discussions about their fears or worries, the partner with skin cancer may experience a positive view of his or her body. In contrast, avoiding or ignoring concerns about the skin cancer may not be related to body image, but can have a negative impact on the relationship. This study also highlights the important impact healthy partners can have when facing skin cancer. While receiving active engagement support was not related to partners’ quality of life, receiving protective buffering and overprotection support from healthy partners was associated with poorer quality of life for both partners. How the healthy partner provides support appears to affect both people, and may also be important for the couple’s relationship quality.en
dc.description.degreePh. D.en
dc.format.mediumETDen
dc.identifier.othervt_gsexam:15143en
dc.identifier.urihttp://hdl.handle.net/10919/96215en
dc.publisherVirginia Techen
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.subjectRelationship-Focusen
dc.subjectActive Engagementen
dc.subjectProtective Bufferingen
dc.subjectOverprotectionen
dc.subjectSkin Canceren
dc.subjectChronic Illnessen
dc.subjectCouplesen
dc.subjectOlder Adultsen
dc.titleRelationship-Focused Support, Body Image, and Quality of Life in Older Couples Coping with Skin Canceren
dc.typeDissertationen
thesis.degree.disciplineHuman Developmenten
thesis.degree.grantorVirginia Polytechnic Institute and State Universityen
thesis.degree.leveldoctoralen
thesis.degree.namePh. D.en

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