Abstract
BackgroundSupportive communication (e.g., protective buffering, PB) may impact individual and relational adjustment in patients following hematopoietic stem cell transplantation (HSCT) and their caregivers. Previous studies revealed that PB (i.e., hiding one’s concerns and denying one’s worries) has mixed effects, namely it is beneficial, costly or unrelated to dyadic adjustment. This study aimed to verify these findings by addressing some unresolved issues, i.e., examining (1) both individual and relational as well as both positive and negative indicators of adjustment, (2) the effect of within-dyad congruence (i.e., complementarity/similarity) in PB, and (3) within-dyad causal associations between PB and adjustment.MethodsTwo hundred patients (following first autologous or allogeneic HSCT) and their caregivers independently completed measures of daily PB, relationship satisfaction, relationship stress, and positive affect (PA) and negative affect (NA) for 28 consecutive evenings after discharge of patients.FindingsFor both patients and caregivers, the results showed a same-day association between daily PB and individual (positive and negative) and relational (positive and negative) adjustment indicators showing the advantage of PB. In terms of the dyad congruence, complementarity (one partner high and the other low) in daily PB was related to higher same-day relationship satisfaction for both patients and caregivers and lower same-day relationship stress in caregivers. The benefits from similarity (both patient and caregiver high or low in PB) had delayed effects, although only in patients. As far as the causal associations were concerned, day-to-day changes in PB preceded changes in daily adjustment. In caregivers, reverse causality was found, i.e., changes in adjustment predicted next-day changes in support.DiscussionContrary to previous studies, daily PB has a rather beneficial effect in dyads following HSCT. Patients seemed to have benefited the most from the similarity in daily PB fluctuation, while caregivers profited from complementarity. Causal associations between PB and adjustment within-dyad were also different. The findings may add to a better understanding of PB-adjustment relationship in dyads facing HSCT.
Highlights
Adjustment to cancer or other chronic diseases is a challenging process which involves the patient and his/her surroundings
Missing data analysis showed missing values were less than 11% and were slightly higher for caregivers (8.4% relationship stress, 9.1% relationship satisfaction, 9.3% negative affect (NA), 10% positive affect (PA), 10.9% protective buffering (PB)) than patients (7.2% relationship stress, 8.3% relationship satisfaction, 7.9% NA, 8% PA, 9.9% PB)
The missing pattern analysis indicated significant differences in the type of transplant between the participants who fully and partially completed the diary and daily relationship stress of patients
Summary
Adjustment to cancer or other chronic diseases is a challenging process which involves the patient and his/her surroundings. According to the most common definition of stress (Lazarus and Folkman, 1984), disease and its treatment may be perceived as a stressful situation. Based on Lazarus and Folkman (1984) stress and coping model, adjustment to stressful circumstances is a dynamic and time-varying process that requires coping efforts from an individual and availability of their personal and social resources. Referring to Lazarus and Folkman (1984) framework to stress, the ways of coping, resources (e.g., social support), and adjustment indicators in one dyad member may impact the same indicators and mechanisms in the other. Supportive communication (e.g., protective buffering, PB) may impact individual and relational adjustment in patients following hematopoietic stem cell transplantation (HSCT) and their caregivers. This study aimed to verify these findings by addressing some unresolved issues, i.e., examining (1) both individual and relational as well as both positive and negative indicators of adjustment, (2) the effect of within-dyad congruence (i.e., complementarity/similarity) in PB, and (3) within-dyad causal associations between PB and adjustment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
