Perceived communication barriers with spouses among young adult patients with cancer and their association with psychological distress.

Abstract

Psychological distress is prevalent among young adult (YA) patients with cancer, yet the role of couples' communication in this specific population remains underexplored. This study aimed to investigate the status of couples' communication and examine its independent association with depression and anxiety in YA patients with cancer. A cross-sectional survey was conducted among YA patients with cancer. Participants completed the Cancer-Related Communication Problems Scale, PHQ-9 (depression), and GAD-7 (anxiety). Hierarchical linear regression analyses were performed to determine the association between communication barriers and psychological outcomes after controlling for demographic and clinical variables. A total of 202 married YA patients with cancer participated in this study. The mean age was 34.69 &#xb1; 4.11 years (Range: 22-39 years). Participants reported a mild level of overall communication barriers (Total Score Mean &#xb1; SD: 13.41 &#xb1; 3.93; Range: 1-22). The mean anxiety and depression scores were 6.43 &#xb1; 5.16 (Range: 0-21) and 6.97 &#xb1; 5.47 (Range: 0-27). The top five specific barriers were difficulty with partner understanding of body image changes (Item 11, Mean &#xb1; SD = 1.46 &#xb1; 0.69), difficulty discussing worsening conditions (Item 13, Mean &#xb1; SD = 1.30 &#xb1; 0.68), difficulty sharing worries about treatment effectiveness (Item 9, Mean &#xb1; SD = 1.28 &#xb1; 0.71), avoidance of discussing sexual experience (Item 15, Mean &#xb1; SD = 1.11 &#xb1; 0.72) and selective disclosure to protect the spouse (Item 14, Mean &#xb1; SD = 1.07 &#xb1; 0.70). Univariate analysis indicated that unemployment and female sex were significantly associated with higher depression scores (<i>P</i> &lt; 0.05), while no demographic variables were significantly associated with communication barriers. After adjusting for sex and unemployment status, communication barriers remained independently associated with depression (<i>B</i> = 0.26, 95% CI: 0.08, 0.44<i>, P</i> = 0.008), but not with anxiety (<i>P</i> &gt; 0.05). Communication barriers were independently associated with depressive symptoms, but not anxiety, after adjustment for sex and employment status. These item-level findings suggest that body image and intimacy may be key topics for future dyadic communication interventions. Future psychosocial interventions may consider addressing open spousal dialogue about body image and sexual concerns in this population.