Making a treatment decision for breast cancer: Associations among marital qualities, couple communication, and breast cancer treatment decision outcomes.

摘要

The aim of this dissertation was to explain how marital qualities and couple communication influence treatment decision outcomes for a hypothetical diagnosis of breast cancer. I addressed this issue by integrating the relational turbulence model, functional theory, and literature on information exchange in small groups to develop specific predictions about the associations among relationship characteristics, couple communication, and treatment decision outcomes. Specifically, I hypothesized that decision-making quality would be positively associated with completing the fundamental tasks specified by functional theory (H1) and information sharing (H2), but negatively associated with information bolstering or discounting (H3b). Also, I predicted that information bolstering or discounting would be negatively associated with decision satisfaction (H3a). In addition, I reasoned that relational uncertainty (H4) would be negatively associated with fulfilling the functional theory tasks, information sharing, and information bolstering or discounting, but a partner's interference in everyday activities (H5) would be positively associated with these behaviors.;This dissertation employed a cross-sectional, two-group observational study design to test my hypotheses. Specifically, I had 113 marital dyads and committed domestic partners (N = 226) respond individually to a number of communication and relationship measures. Then, couples were assigned to either the functional theory condition or the control condition and were to make a decision about a treatment for a hypothetical diagnosis of breast cancer. Finally, individuals reflected on their treatment selection interactions. This research design allowed me to examine how mechanisms identified by the relational turbulence model and functional theory shape dyadic decision making.;Although the findings for the associations among relational turbulence, communication functions, and information exchange between partners were not always consistent with my predictions, the results provided initial support for the use of marital qualities and couple communication as predictors for treatment decision outcomes. Results showed that couples who developed criteria generally perceived the quality of their decisions to be lower, but couples who assessed solutions perceived the quality of their decision to be higher. Although not statistically significant (.05 p .10), couples in which females shared more information were more likely to choose mastectomy surgery, rather than lumpectomy surgery. Also, individuals' bolstering was positively associated with subjective decision quality, but only approached a significantly positive association with decision satisfaction. Couples in which males bolstered more tended to choose mastectomy surgery, rather than lumpectomy surgery. Female relationship uncertainty positively predicted developing criteria, whereas male relationship uncertainty negatively predicted developing solutions. When information sharing was the outcome, female relationship uncertainty positively predicted male information sharing. Finally, a male's perceptions of partner interference negatively predicted female bolstering, and the path between male's perceptions of partner interference and male bolstering approached significance.;This dissertation makes theoretical contributions to the relational turbulence model and functional theory by demonstrating how relationship characteristics and couple communication contribute to treatment decision outcomes. For example, because partners in this study role-played being diagnosed with breast cancer or having a partner who was diagnosed with breast cancer, I was able to explore how relational uncertainty or a partner's interference might influence communication from different vantage points. In addition, this dissertation provides preliminary evidence that suggests relationship circumstances among group members might shape if a group is able to address the fundamental tasks put forth by functional theory.