Development Of Couple’s Communication Quality Scale In Gynecological Cancer Patients And Its Relationship With Family Resilience

PurposeThis study was conducted to develop a culturally appropriate communication quality scale for couples with gynecologic cancer,using the Communication Theory of Resilience as a guide,and to test the reliability and validity of the scale to provide a reliable assessment tool for related studies.Using the developed scale,we investigated the communication quality of couples with gynecologic cancer in China,examined the actor-partner effects between the communication quality of couples with gynecologic cancer and family resilience using the actor-partner interdependence model,and explored the specific dyadic communication process that could help improve family resilience,to provide guidance for the subsequent construction of a family resilience intervention program for couples with gynecologic cancer using the couple communication patterns as the target of intervention.Methods1.Guided by the Communication Theory of Resilience,the first draft of the Couple’s Communication Quality Scale for gynecologic cancer patients was formed by literature review and Delphi expert correspondence method.From May to August 2021,360 cases of gynecological cancer patients in a tertiary hospital in Shandong Province were conveniently selected for the survey,and the scale entries were screened using item analysis and exploratory factor analysis.After forming the formal scale,385 cases of gynecologic cancer patients in a tertiary hospital in Shandong Province were facilitated to be selected for formal testing from August to November 2021,and the formal scale was tested for reliability and validity.2.From April to November 2022,354 couples of gynecological cancer couples in a tertiary hospital in Shandong Province were selected conveniently for a cross-sectional survey.The study instruments were the General Information Questionnaire,the Couples’Communication Quality Scale for Gynecological Cancer Patients,and the Family Hardiness Index.A distinguishable actor-partner interdependence model was used to investigate the actor-partner effects between dyadic communication quality and family resilience in couples with gynecologic cancer.Results1.The formal Couples’ Communication Quality Scale for Gynecological Cancer Patients was composed of 34 items from 5 dimensions of"self-disclosure","perceived response","stress coping","normalcy crafting" and "constructive action",with a cumulative variance contribution rate of 68.181%.The Cronbach’s a coefficient of the scale was 0.949,the split-half reliability coefficient was 0.766,the retest reliability coefficient was 0.898,and the criterion validity coefficient was 0.696.The results of the confirmatory factor analysis showed that the model fit was good,and the fitness indexes were:CMIN/DF=1.778,RMSEA=0.047,CFI=0.956,IFI=0.956,TLI=0.952,NFI=0.905.2.Gynecologic cancer couples reported moderate levels of couple communication quality and family resilience,with spouses reporting better couple communication quality and family resilience compared to patients.On the scores of the five subscales of couple communication quality,patients reported lower scores than spouses on the perceived response and stress coping(both P<0.001)and higher scores on self-disclosure(P<0.05),while the differences in scores on the remaining subscales were not statistically significant(both P>0.05).3.In the dyadic analysis,paired patterns of both gynecologic cancer patients and spouses were mixed.There were significant actor effects for each subscale of couple’communication quality on family resilience for both patient and spouse,with the exception of perceived response(for which only patient-actor effects were observed).In addition,four significant partner effects were found:spouses’ self-disclosure(β=0.301,P<0.001),stress coping(β=0.097,P=0.006),and constructive action(β=0.124,P<0.001)were positively associated with patients’ family resilience,while patients’ normalcy crafting(β=0.093,P=0.041)positively predicted the family resilience of the spouse.Conclusions1.The Couple’ Communication Scale for Gynecologic Cancer Patients has good reliability and validity and can accurately measure the quality of communication between couples in the context of gynecologic cancer,identify communication needs,and provide important information for implementing individualized assessment and interventions in the course of future clinical practice.2.The couple’ communication quality and family resilience reported by gynecologic cancer couples were both moderate,with much room for improvement.In addition,there were differences in the quality of couple communication and family resilience reported by patients and spouses,with spouses scoring higher than patients,highlighting the need to capture the patient and spouse assessment perspectives separately.3.Our study provides preliminary evidence for the impact of couple communication in gynecologic cancer on family resilience.The findings highlight the need for interventions and strategies based on couple communication.Developing dyadic-level interventions that encourage spouses to foster a supportive family communication environment,may have a positive impact on family resilience in couples and ultimately facilitate family adaptation and adjustment to cancer.