Cancer patients often face difficulties disclosing their cancer-related feelings and concerns to their spouses or intimate partners. This may ultimately compromise patients' adjustment as well as the quality of their relationship with their partner. Emotional disclosure (ED) is a central component of the emotional support that partners provide to each other. In addition, having individuals engage in private ED about stressful experiences in a laboratory setting has been found to produce psychological and physical benefits. However, the potential benefits of facilitating ED between cancer patients and their partners have not been addressed. The proposed study seeks to evaluate the efficacy of a new partner-assisted emotional disclosure protocol. 200 patients with advanced gastrointestinal cancer and their partners will be randomly assigned to one of two conditions: 1) Partner-assisted emotional disclosure which systematically trains patients and partners in strategies to facilitate the patients' disclosure and gives the patient the opportunity to talk about their cancer-related concerns to the partner, or 2) Cancer education which provides patients and partners with information about cancer and its treatment. Assessment measures to be collected before and after treatment and at 8-weeks follow-up will include patients' reports of psychological adjustment, physical and functional well being, quality of communication with the partner, level of intimacy and quality of relationship with the partner; partners' ratings of psychological adjustment, caregiver strain, quality of communication, and level of intimacy and quality of relationship with the patient; and physician ratings of the patient's illness severity and documentation of medical treatments and frequency of medical visits. If partner-assisted ED is effective, future studies could evaluate this protocol in other cancer populations (e.g., breast cancer, prostate cancer). Future studies could also compare partner-assisted ED to a private ED protocol and identify individuals who are most likely to benefit from each approach. This study may lead to major advances in our understanding of the role of emotional disclosure and emotional support in the adjustment of cancer patients. If successful, it may enlarge our repertoire of methods for effectively increasing social support and enhancing the well being of both cancer patients and their partners.
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