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Objective Because partners are an important and unpaid resource in cancer care, understanding how destructive, controlling or interfering partner behaviors influence women's cancer care may be particularly relevant for health care providers seeking to provide cancer care and enhance recovery. Using a new measure of partner interfering behaviors in cancer care (PIB-C), we investigated whether women with a recent cancer diagnosis who additionally endorsed any PIB-C would report (a) more symptoms of depression and stress, and (b) lower Functional Assessment of Cancer Therapy (FACT-G) and lower Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-SP) scale scores indicating poorer quality of life (QOL). Methods Women aged 18–79 included in cancer registries as having an incident, primary, biopsy-confirmed cancer in the past 12 months were eligible for this study. Consenting women completed a phone interview 9–12 months following cancer diagnosis between 2009 and 2015. Interviews provided data to measure outcomes (perceived stress and depressive symptoms, FACIT-SP and FACT-G scores), partner supportive and interfering behaviors, and other potentially confounding factors. Results Of the 2376 women in a relationship at cancer diagnosis, 14.7% endorsed one or more of 14 PIB-C items. Women endorsing any PIB-C item reported more symptoms of depression and stress and lower FACT-G and FACIT-SP scores than partnered women reporting no PIB-C even when controlling for partner supportive behaviors and lifetime intimate partner violence. Increasing PIB-C scores were also correlated, in a dose–response pattern, with these same outcomes. Conclusions Partner interfering behaviors during cancer care impact patients' QOL across multiple domains. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

Purpose The aim of this study was to evaluate the psychometric properties of complementary and novel measures of partner interfering and partner supportive behaviors in cancer care (PIB-C and PSB-C). Methods Structured telephone interviews were conducted with 378 women (aged 18–79) in partnered relationships and recruited from the Kentucky Cancer Registry. Psychometric analyses of PIB-C and PSB-C were used to determine scale reliability, and scale construct and predictive validity (correlations with indicators of partner abuse, symptoms of depression, anxiety, and stress after cancer). Results Cronbach's alpha and split-half calculations indicated excellent internal consistency of the 20-item PIB-C (0.936 and 0.87, respectively) and 12-item PSB-C (0.930 and 0.89). Three thematic clusters for the PIB-C and two for the PSB-C were identified through factor analyses. Regarding construct validity, higher PIB-C and lower PSB-C scores were associated with a measure of psychological impacts from abuse. Predictive validity was suggested through (1) lower PSB-C associated with depression, (2) higher PIB-C associated with anxiety, and (3) higher perceived stress associated with higher PIB-C/lower PSB-C scores. Conclusion Both PIB-C and PSB-C have strong psychometric properties and distinguish partner behaviors more likely to negatively impact women's depression, anxiety, and stress during cancer care/recovery. Use of these measures may assist clinical teams in comprehensively assessing women patients' home environment to best ensure cancer care/recovery. Copyright © 2015 John Wiley & Sons, Ltd.

Objective Healthy People 2020 identifies elimination of health disparities as a key aim. Rural residence is associated with disparities in cancer screening, physical morbidity, and survival. The present study aimed to identify potential disparities in mental health (MH) outcomes (e.g., anxiety and depression symptoms, distress) in lung cancer (LC) survivors associated with ruralness of residence. Methods Lung cancer survivors (LC group; n = 193; mean age = 63.1 years; mean time since diagnosis = 15.6 months) were recruited from the population-based SEER Kentucky Cancer Registry. LC survivors completed a telephone interview and questionnaire assessing MH outcomes. U.S. Department of Agriculture Rural–Urban Continuum Codes were used to identify Rural (n = 117) and Urban (n = 76) LC survivors. A healthy comparison (HC) group was recruited (n = 152) and completed a questionnaire assessing MH outcomes. Results Across six MH indices, Rural LC survivors reported poorer MH relative to Urban LC survivors with a mean effect size (ES) of 0.43 SD in unadjusted analyses and 0.29 SD in analyses adjusted for education and physical comorbidity. Comparison of the LC and HC groups revealed significant Ruralness × Group interactions for five of six MH indices. The Rural LC group reported poorer MH than the Rural HC group with a mean ES of 0.51 SD. The MH of Urban LC and HC groups did not differ (mean ES = 0.00 SD). Conclusions Rural residence is a risk factor for poorer MH outcomes for LC survivors. The MH of Rural LC survivors may be more negatively impacted by cancer diagnosis and treatment than the MH of Urban LC survivors. Copyright © 2013 John Wiley & Sons, Ltd.

Background Reports of ‘growth’ following cancer diagnosis and treatment are common and are considered evidence for the transformative potential of the cancer experience. However, reports of growth are also common in the general population. This study sought to identify the unique, ‘value-added’ with regard to the nature and magnitude of growth represented by the cancer experience. Methods Lung cancer (LC) survivors (n = 190; mean 15 months post-diagnosis) completed the Posttraumatic Growth Inventory (PTGI), reporting changes occurring ‘as a result of having cancer’. Community-based, healthy controls (HC) (n = 152) completed the PTGI, reporting changes occurring ‘in the past year’. Results Reports of growth were common in both the LC and HC groups. However, the LC group reported greater total PTGI scores (effect size (ES) = 0.39 SD) and greater growth for 3 of 5 subscales (ESs 0.34–0.48 SD). The LC group was more likely to report any degree of change for 11 of 21 PTGI items (mean odds ratio (OR) across 21 items = 1.92) and were more likely to report ‘moderate’ to ‘very great’ change for eight of 21 items (mean OR = 1.75). The LC group was more likely to report growth in the areas of social relationships and appreciation for life. Conclusions In sum, the growth evidenced by LC survivors after diagnosis quantitatively and qualitatively differs from growth reported by the general population over a similar period. Estimates of the value-added by the cancer experience suggest a magnitude representing at least the lower range of clinical significance. Copyright © 2013 John Wiley & Sons, Ltd.

Objective Because partners are an important and unpaid resource in cancer care, understanding how destructive, controlling or interfering partner behaviors influence women's cancer care may be particularly relevant for health care providers seeking to provide cancer care and enhance recovery. Using a new measure of partner interfering behaviors in cancer care (PIB‐C), we investigated whether women with a recent cancer diagnosis who additionally endorsed any PIB‐C would report (a) more symptoms of depression and stress, and (b) lower Functional Assessment of Cancer Therapy (FACT‐G) and lower Functional Assessment of Chronic Illness Therapy‐Spiritual Well‐being (FACIT‐SP) scale scores indicating poorer quality of life (QOL). Methods Women aged 18–79 included in cancer registries as having an incident, primary, biopsy‐confirmed cancer in the past 12 months were eligible for this study. Consenting women completed a phone interview 9–12 months following cancer diagnosis between 2009 and 2015. Interviews provided data to measure outcomes (perceived stress and depressive symptoms, FACIT‐SP and FACT‐G scores), partner supportive and interfering behaviors, and other potentially confounding factors. Results Of the 2376 women in a relationship at cancer diagnosis, 14.7% endorsed one or more of 14 PIB‐C items. Women endorsing any PIB‐C item reported more symptoms of depression and stress and lower FACT‐G and FACIT‐SP scores than partnered women reporting no PIB‐C even when controlling for partner supportive behaviors and lifetime intimate partner violence. Increasing PIB‐C scores were also correlated, in a dose–response pattern, with these same outcomes. Conclusions Partner interfering behaviors during cancer care impact patients' QOL across multiple domains. © 2016 The Authors. Psycho‐Oncology Published by John Wiley & Sons Ltd.

The aim of this study was to evaluate the psychometric properties of complementary and novel measures of partner interfering and partner supportive behaviors in cancer care (PIB-C and PSB-C).Structured telephone interviews were conducted with 378 women (aged 18-79) in partnered relationships and recruited from the Kentucky Cancer Registry. Psychometric analyses of PIB-C and PSB-C were used to determine scale reliability, and scale construct and predictive validity (correlations with indicators of partner abuse, symptoms of depression, anxiety, and stress after cancer).Cronbach's alpha and split-half calculations indicated excellent internal consistency of the 20-item PIB-C (0.936 and 0.87, respectively) and 12-item PSB-C (0.930 and 0.89). Three thematic clusters for the PIB-C and two for the PSB-C were identified through factor analyses. Regarding construct validity, higher PIB-C and lower PSB-C scores were associated with a measure of psychological impacts from abuse. Predictive validity was suggested through (1) lower PSB-C associated with depression, (2) higher PIB-C associated with anxiety, and (3) higher perceived stress associated with higher PIB-C/lower PSB-C scores.Both PIB-C and PSB-C have strong psychometric properties and distinguish partner behaviors more likely to negatively impact women's depression, anxiety, and stress during cancer care/recovery. Use of these measures may assist clinical teams in comprehensively assessing women patients' home environment to best ensure cancer care/recovery. Copyright © 2015 John WileySons, Ltd.

Healthy People 2020 identifies elimination of health disparities as a key aim. Rural residence is associated with disparities in cancer screening, physical morbidity, and survival. The present study aimed to identify potential disparities in mental health (MH) outcomes (e.g., anxiety and depression symptoms, distress) in lung cancer (LC) survivors associated with ruralness of residence.Lung cancer survivors (LC group; n = 193; mean age = 63.1 years; mean time since diagnosis = 15.6 months) were recruited from the population-based SEER Kentucky Cancer Registry. LC survivors completed a telephone interview and questionnaire assessing MH outcomes. U.S. Department of Agriculture Rural-Urban Continuum Codes were used to identify Rural (n = 117) and Urban (n = 76) LC survivors. A healthy comparison (HC) group was recruited (n = 152) and completed a questionnaire assessing MH outcomes.Across six MH indices, Rural LC survivors reported poorer MH relative to Urban LC survivors with a mean effect size (ES) of 0.43 SD in unadjusted analyses and 0.29 SD in analyses adjusted for education and physical comorbidity. Comparison of the LC and HC groups revealed significant Ruralness × Group interactions for five of six MH indices. The Rural LC group reported poorer MH than the Rural HC group with a mean ES of 0.51 SD. The MH of Urban LC and HC groups did not differ (mean ES = 0.00 SD).Rural residence is a risk factor for poorer MH outcomes for LC survivors. The MH of Rural LC survivors may be more negatively impacted by cancer diagnosis and treatment than the MH of Urban LC survivors.

Reports of 'growth' following cancer diagnosis and treatment are common and are considered evidence for the transformative potential of the cancer experience. However, reports of growth are also common in the general population. This study sought to identify the unique, 'value-added' with regard to the nature and magnitude of growth represented by the cancer experience.Lung cancer (LC) survivors (n = 190; mean 15 months post-diagnosis) completed the Posttraumatic Growth Inventory (PTGI), reporting changes occurring 'as a result of having cancer'. Community-based, healthy controls (HC) (n = 152) completed the PTGI, reporting changes occurring 'in the past year'.Reports of growth were common in both the LC and HC groups. However, the LC group reported greater total PTGI scores (effect size (ES) = 0.39 SD) and greater growth for 3 of 5 subscales (ESs 0.34-0.48 SD). The LC group was more likely to report any degree of change for 11 of 21 PTGI items (mean odds ratio (OR) across 21 items = 1.92) and were more likely to report 'moderate' to 'very great' change for eight of 21 items (mean OR = 1.75). The LC group was more likely to report growth in the areas of social relationships and appreciation for life.In sum, the growth evidenced by LC survivors after diagnosis quantitatively and qualitatively differs from growth reported by the general population over a similar period. Estimates of the value-added by the cancer experience suggest a magnitude representing at least the lower range of clinical significance.