Perceptions of marital quality and quality of life among cancer patients and their spouses: Current and retrospective evaluations

In recent years the health and medical professions have recognized the importance of assessing the patient\u27s subjective appraisal of life satisfaction as an integral part of provision of care. Quality of life research conducted on cancer patients has stressed the significance of investigating the social support resources available to patients within their marriage relationship. The majority of these studies, however, have been exploratory and assessed the relationships between primarily demographic and diagnostic data. In this study particular aspects of marriage quality were empirically defined, particular patterns of relationships between personality and marital quality variables were tested and, finally, current and retrospective marital relationship evaluations were provided by subjects and analyzed in a group of pre-illness/advanced-illness comparisons. The personality variable employed was level of ego development. Marital quality was defined along three criteria: interactional style, level of intimacy, and coping with problems. The present investigation included 50 couples with a mean age of 59 for patients and 58 for spouses. Data from a matched comparison group was analyzed in an attempt to preliminarily check for the generalizability of the findings. Generalizability remains limited, though, due to population restrictions which arose from the sampling methods chosen. Other limitations included statistical and procedural shortcomings. This study produced two major findings. First, patient and spouse predictors of overall quality of life from among the marriage quality variables were disparate: patients endorsed affiliation as the major predictor of quality of life, while the spouses endorsed marital adjustment as the major predictor of quality of life. Second, patients at the post-conformist level of ego development were found to constitute a subset of subjects who were most likely to report perceived marital enhancement between time periods in the pre-illness/advanced-illness comparisons. No reliable changes in perceptions of marital quality were reported by conformist patients or by either conformist or post-conformist spouses. Clinical implications for maximizing differential treatment opportunities for conformists versus post-conformists and patients versus spouses are discussed. Finally, recommendations for future research incorporating the study\u27s findings are proposed