Submission
| Title: | Breast cancer survivors’ satisfying marriages predict better psychological and physical health: A longitudinal comparison of satisfied, dissatisfied, and unmarried women |
| Co-Authors: |
Shrout, Rosie, Purdue University; Megan E. Renna, University of Southern Mississippi; Annelise A. Madison, Ohio State University; Catherine M. Alfano, Norwell Health Cancer Institute; Stephen P. Povoski, Ohio State University; Adele M. Lipari, Ohio State University; Doreen M. Agnese, Ohio State University; William B. Farrar, Ohio State University; William E. Carson III, Ohio State University; & Janice K. Kiecolt-Glaser, Ohio State University |
Abstract
Background/Significance/Rationale: Breast cancer survivors who experience psychological and physical symptoms after treatment have an increased risk for comorbid disease development, reduced quality of life, and premature mortality. Identifying factors that reduce or exacerbate their symptoms may enhance their long-term health and physical functioning. This study examined how survivors’ marital status and marital satisfaction—key health determinants—impacted their psychological and physical health trajectories to understand when, and for whom, marriage offers health benefits.
Methods: Breast cancer survivors (n=209, stages 0–IIIC) completed a visit before treatment and two visits 6 and 18 months after treatment. Questionnaires assessed their marital status and satisfaction when applicable, and their psychological (stress) and physical (fatigue) health at each visit. Analyses adjusted for participant age, comorbidities, cancer treatment and stage, BMI, and menopause status.
Results/Findings: Married survivors—both those in satisfying and dissatisfying marriages—experienced improvements in their psychological and physical symptoms after treatment, with satisfied survivors reporting the greatest improvements. Unmarried survivors’ psychological and physical symptoms did not change over time, instead remaining elevated 18 months after treatment ended. Satisfied women also had better psychological and physical health after treatment ended than their dissatisfied and unmarried peers, while women in dissatisfying marriages were no better off than those who were unmarried.
Conclusions/Discussion: Although marriage was associated with improved health, the gains were most notable when survivors’ marriages were satisfying. The quality of survivors’ marriages, rather than the marriage itself, provided the most psychological and physical health benefits.
Translational/Human Health Impact: Satisfying marriages help promote breast cancer survivors’ health. In addition to assessing marital status throughout treatment, these findings highlight the need to screen survivors’ marital satisfaction and refer dissatisfied couples to counseling when appropriate. This research demonstrates the importance of linking survivors to necessary resources and helping unmarried and dissatisfied survivors strengthen their nonmarital support systems.
