The importance of sexuality, changes in erectile functioning and its association with self-esteem in men with localized prostate cancer: data from an observational study.

BACKGROUND: Treatment for localized prostate cancer (PCa) can cause long-term changes in erectile functioning. However, data on the importance of sexuality and possible consequences of altered erectile functioning on self-esteem in men with localized PCa are lacking. METHODS: Self-report questionnaires were completed by 292 men with PCa, initially managed with active surveillance (AS) or radical prostatectomy (RP). Independent t-tests were conducted to evaluate group differences. A sequential multiple regression model was fitted to analyze the associations between the importance of sexuality, changes in erectile functioning and impairment of self-esteem. Interaction effects were tested using simple slope analyses. RESULTS: Participants were 70 ± 7.2 years old and 66.5% rated sex as being "rather/very important". The two groups differed markedly in changes in erectile functioning, importance of sexuality and impairment of self-esteem (p < .001), with higher values in RP patients. Regression analysis showed that after adjustment for control variables and importance of sexuality, changes in erectile functioning were still associated with impairment of self-esteem (B = .668, SE = .069, p < .001). The interaction of changes in erectile functioning and importance of sexuality reached significance (B = .318, SE = .062, p < .001). CONCLUSIONS: RP patients report more changes in erectile functioning than AS patients. Moreover, in men with localized PCa, erectile functioning and self-esteem are closely related. Sexuality seems to be important for the majority of these men. Physicians should address the possibility of erectile dysfunction and its potential effects on psychological well-being before the treatment decision.

Which characteristics of planning matter? Individual and dyadic physical activity plans and their effects on plan enactment.

OBJECTIVE: Past research supports individual planning as an effective intervention strategy to increase physical activity in individuals. A similar strategy, dyadic planning, adds a planning partner who supports an individual's planning processes. Whether the two planning formats differ in terms of participants' entered plan content and whether and how different content characteristics are linked to plan enactment remains unknown. By investigating the content of generated plans, this study aimed at distinguishing plan characteristics of the two planning formats and examining their role as predictors of later plan enactment. METHODS: Secondary analyses of a three-arm RCT with German couples (data collection between 2013 and 2015). Couples were assigned to an individual (IPC, n = 114) or dyadic planning condition (DPC, n = 111) and formulated up to 5 physical activity plans for a target person. Couples assigned to a control condition were not included as they did not generate plans. The following characteristics were distinguished and coded for each plan: number of planned opportunities, presence of a planned routine, planned cue- or activity-related specificity, activity-related intensity, and chronological plan rank. One week before (T0) and two weeks following (T2) the intervention (T1), increase vs. no increase of the planned activity was coded as a dichotomous plan enactment variable. Multilevel logistic regressions were fit. RESULTS: Plan enactment was higher in dyadic than in individual planners. Findings indicated that routines (e.g., after work) were positively related to plan enactment, whereas a high specificity of when-cues (e.g., Friday at 6.30 p.m.) showed a negative relationship. None of the examined plan characteristics could explain differences in enactment between IPC and DPC. CONCLUSIONS: Linking health behaviours to other behavioural routines seems beneficial for subsequent plan enactment. Dyadic planning was linked with higher enactment rates than individual planning. However, as mechanisms underlying this effect remain unclear, they should be investigated further.

Predictors of dyadic planning: Perspectives of prostate cancer survivors and their partners.

OBJECTIVES: Extending individual planning of health behaviour change to the level of the dyad, dyadic planning refers to a target person and a planning partner jointly planning the target person's health behaviour change. To date, predictors of dyadic planning have not been systematically investigated. Integrating cognitive predictors of individual planning with four established predictor domains of social support provision, we propose a framework of predictors of dyadic planning. Including target persons' and partners' perspectives, we examine these predictor domains in the context of prostate cancer patients' rehabilitative pelvic floor exercise (PFE) following radical prostatectomy. DESIGN: Longitudinal data from 175 patients and their partners were analysed in a study with four post-surgery assessments across 6 months. METHODS: PFE-related dyadic planning was assessed from both partners together with indicators from four predictor domains: context, target person, partner, and relationship factors. Individual planning and social support served as covariates. RESULTS: Findings from two-level models nesting repeated assessments in individuals showed that context (patients' incontinence), target person (i.e., positive affect and self-efficacy), and relationship factors (i.e., relationship satisfaction) were uniquely associated with dyadic planning, whereas partner factors (i.e., positive and negative affects) were not. Factors predicting patients' and partners' accounts of dyadic planning differed. CONCLUSIONS: Resembling prior findings on antecedents of support provision in this context, partner factors did not prevail as unique predictors of dyadic planning, whereas indicators from all other predictor domains did. To establish predictive direction, future work should use lagged predictions with shorter intermeasurement intervals. Statement of contribution What is already known on this subject? Dyadic planning has been shown to be linked to health behaviour change. However, its role in behaviour regulation frameworks is not well investigated, especially regarding factors that might be predictive of dyadic planning. What does this study add? A framework of predictors of dyadic planning in the health behaviour change process is presented. The framework is investigated accounting for both planning partners' perspectives. Context, target person, and relationship factors were related to dyadic planning.

Effects of dyadic planning on physical activity in couples: A randomized controlled trial.

OBJECTIVE: Action planning can help translate physical activity intentions into action by linking situational cues with behavioral responses. Dyadic planning extends action planning and refers to target persons forming plans for their own behavior change together with partners. This study investigated whether a dyadic planning intervention could increase physical activity in target persons and their partners, whether these effects were moderated by relationship quality and mediated by action control, activity-specific received partner support, and control. METHOD: Couples (n = 338; target persons randomized) were randomly assigned to (a) a dyadic planning condition (DPC); (b) an individual planning condition (IPC), in which target persons planned and partners worked on a distractor task; or (c) a control condition (CC), in which couples worked on a distractor task. During 3 assessments up to 6 weeks postintervention, moderate (primary outcome) and vigorous activity were objectively measured; other variables were self-reported. Multilevel and path models were fit. RESULTS: There were no beneficial direct effects of the intervention for DPC target persons. Over time, DPC partners' vigorous activity increased, but decreased again. At lower relationship quality, DPC target persons' activity decreased, whereas IPC target persons' vigorous activity increased. Mediation hypotheses were not supported. Mutual influence models indicated positive effects of partners' on target persons' moderate activity in DPC and CC, whereas for IPC, negative effects of target persons' on partners' moderate activity emerged. CONCLUSIONS: Findings revealed the complexity of effects of dyadic planning on behavior change. Adding relationship quality to the equation clarified effects of DPC and IPC on physical activity. (PsycINFO Database Record

Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice.

The current article details a position statement and recommendations for future research and practice on planning and implementation intentions in health contexts endorsed by the Synergy Expert Group. The group comprised world-leading researchers in health and social psychology and behavioural medicine who convened to discuss priority issues in planning interventions in health contexts and develop a set of recommendations for future research and practice. The expert group adopted a nominal groups approach and voting system to elicit and structure priority issues in planning interventions and implementation intentions research. Forty-two priority issues identified in initial discussions were further condensed to 18 key issues, including definitions of planning and implementation intentions and 17 priority research areas. Each issue was subjected to voting for consensus among group members and formed the basis of the position statement and recommendations. Specifically, the expert group endorsed statements and recommendations in the following areas: generic definition of planning and specific definition of implementation intentions, recommendations for better testing of mechanisms, guidance on testing the effects of moderators of planning interventions, recommendations on the social aspects of planning interventions, identification of the preconditions that moderate effectiveness of planning interventions and recommendations for research on how people use plans.

Patients' preferences for selective versus complete excavation: A mixed-methods study.

OBJECTIVES: Despite increasing evidence supporting selective caries tissue removal, the technique is not adopted by most dentists, one possible reason being that patients might reject it. We aimed to assess patients' preferences for selective versus complete excavation, and to identify predictors of this preference. METHODS: A sequential mixed-methods approach was taken. First, semi-structured focus group discussions on two convenience samples were performed. Verbatim transcripts were evaluated using content-analysis to inform quantitative study design. The subsequent survey employed convenience, snow-ball and deviant-case sampling, yielding 150 respondents. The relevance of treatment attributes (risks of nerve damage, root-canal treatment, recurrent caries, restorative complications, treatment costs, aesthetic consequences) on patients' treatment preferences was measured using case-vignettes. Dental experience and anxiety as well as patients' personality and socio-demographic details were recorded. Association of predictor variables (age, gender, education, partnership status, personality items, dental experience, anxiety) with treatment preference was assessed using regression analysis. RESULTS: Focus group participants perceived complete excavation as reliable, but feared endodontic treatment. The vast majority of survey respondents (82.7%) preferred complete over selective excavation. The preference for selective excavation was significantly increased in patients with an emotionally stable personality (p<0.001), university entrance degree (p<0.001), none or little dental anxiety (p=0.044), few dentist changes in the past (p=0.025), and who accepted that sealed lesions could progress (p<0.002). CONCLUSION: Treatment attributes, socio-demographic characteristics, personality and dental experiences shape patients' preference towards caries excavation. CLINICAL SIGNIFICANCE: Clinical decision-making regarding carious tissue removal might be affected by dentists on both an informative and an empathic level.

Enabling or Cultivating? The Role of Prostate Cancer Patients' Received Partner Support and Self-Efficacy in the Maintenance of Pelvic Floor Exercise Following Tumor Surgery.

BACKGROUND: To manage incontinence following tumor surgery, prostate cancer patients are advised to perform pelvic floor exercise (PFE). Patients' self-efficacy and support from partners were shown to facilitate PFE. Whereas support may enhance self-efficacy (enabling function), self-efficacy may also cultivate support (cultivation function). PURPOSE: Cross-lagged inter-relationships among self-efficacy, support, and PFE were investigated. METHOD: Post-surgery patient-reported received support, self-efficacy, PFE, and partner-reported provided support were assessed from 175 couples at four times. Autoregressive models tested interrelations among variables, using either patients' or partners' reports of support. RESULTS: Models using patients' data revealed positive associations between self-efficacy and changes in received support, which predicted increased PFE. Using partners' accounts of support provided, these associations were partially cross-validated. Furthermore, partner-provided support was related with increases in patients' self-efficacy. CONCLUSION: Patients' self-efficacy may cultivate partners' support provision for patients' PFE, whereas evidence of an enabling function of support as a predictor of self-efficacy was inconsistent.

Gender differences in depression, but not in anxiety in people with epilepsy.

PURPOSE: Anxiety and depression are frequent comorbidities in people with epilepsy (PWE), but possible gender differences are often neglected. The aim of the present study was to analyze if men and women with epilepsy differ with regard to anxiety and depressive symptoms and to identify possible predictors. METHODS: Adult consecutive PWE (N=302; 53% women) completed self-report questionnaires, including the depression module of the Patient Health Questionnaire (PHQ-9), the anxiety module of the Hospital Anxiety and Depression Scale (HADS-A) and the subscales "medication effects" and "seizure worry" of the Patient-weighted Quality of Life in Epilepsy Inventory-31-P (QOLIE-31-P). RESULTS: There was no gender difference in extent of anxiety (p=.532), which was mainly due to higher anxiety levels in men compared to the general population. The gender difference in depressive symptoms was significant (p=.009), with female patients being more affected. The most important predictors for anxiety and depressive symptoms were detrimental effects of medication (QOL medication effects) and of seizure worry (QOL seizure worry). Moreover, these predictors were more closely associated with anxiety and depressive symptoms in men. CONCLUSION: Future intervention studies could show whether providing more information about the illness and medication effects may improve anxiety and depression. Our results suggest that such interventions should be tailored to the different needs of men and women.

Individual and dyadic planning predicting pelvic floor exercise among prostate cancer survivors.

UNLABELLED: [Correction Notice: An Erratum for this article was reported in Vol 60(3) of Rehabilitation Psychology (see record 2015-40319-001). Aleksandra Luszczynska's institutional affiliation was incorrectly set as Warsaw School of Social Sciences and Humanities. It should have been University of Social Sciences and Humanities. All versions of this article have been corrected.] OBJECTIVE: Radical prostatectomy, a standard treatment for localized prostate cancer, is often followed by a recommendation to initiate and maintain pelvic floor exercise (PFE), to control postsurgery urinary incontinence. Previous studies showed that planning facilitated the uptake and maintenance of a new behavior. Whereas individual planning addresses the setting of plans by 1 person, dyadic planning refers to creating plans together with a partner on when, where, and how the individual target person will perform a behavior. Individual and dyadic planning of PFE, their development over time, and their associations with PFE were investigated. RESEARCH METHOD: In a correlational study, 175 prostate-cancer patients provided data at 1, 3, 5, and 7 months following the onset of incontinence. Individual planning of PFE by patients and dyadic planning of PFE between patients and their partners, PFE, and incontinence were assessed by patients' self-reports. RESULTS: Two-level models with repeated assessments nested in individuals revealed stable levels of individual planning of PFE over time in patients with higher incontinence severity, whereas patients with receding incontinence showed decreases. Independent of incontinence severity, a curvilinear increase followed by a decrease of dyadic planning of PFE across time emerged. Sequential associations of both planning strategies with PFE were found. Whereas individual planning was steadily associated with PFE, associations between dyadic planning and PFE were nonsignificant in the beginning, but increased over time. CONCLUSIONS: Findings point to the importance of individual planning for the adoption and maintenance of PFE, with dyadic planning being relevant for PFE maintenance only.

Self-Directed Weight Loss Strategies: Energy Expenditure Due to Physical Activity Is Not Increased to Achieve Intended Weight Loss.

UNLABELLED: Reduced physical activity and almost unlimited availability of food are major contributors to the development of obesity. With the decline of strenuous work, energy expenditure due to spontaneous physical activity has attracted increasing attention. Our aim was to assess changes in energy expenditure, physical activity patterns and nutritional habits in obese subjects aiming at self-directed weight loss. METHODS: Energy expenditure and physical activity patterns were measured with a portable armband device. Nutritional habits were assessed with a food frequency questionnaire. RESULTS: Data on weight development, energy expenditure, physical activity patterns and nutritional habits were obtained for 105 patients over a six-month period from an initial cohort of 160 outpatients aiming at weight loss. Mean weight loss was -1.5 ± 7.0 kg (p = 0.028). Patients with weight maintenance (n = 75), with substantial weight loss (>5% body weight, n = 20) and with substantial weight gain (>5% body weight, n = 10) did not differ in regard to changes of body weight adjusted energy expenditure components (total energy expenditure: -0.2 kcal/kg/day; non-exercise activity thermogenesis: -0.3 kcal/kg/day; exercise-related activity thermogenesis (EAT): -0.2 kcal/kg/day) or patterns of physical activity (duration of EAT: -2 min/day; steps/day: -156; metabolic equivalent unchanged) measured objectively with a portable armband device. Self-reported consumption frequency of unfavorable food decreased significantly (p = 0.019) over the six-month period. CONCLUSIONS: An increase in energy expenditure or changes of physical activity patterns (objectively assessed with a portable armband device) are not employed by obese subjects to achieve self-directed weight loss. However, modified nutritional habits could be detected with the use of a food frequency questionnaire.

Associations of physical activity with depressiveness and coping in subjects with high-grade obesity aiming at bariatric surgery: a cross-sectional study.

BACKGROUND: Reduced physical activity is supposed to be associated with depressiveness and more passive coping patterns. For further evaluation of this assumed relation we studied energy expenditure due to physical activity - usually referred to as activity thermogenesis (AT) - together with depressiveness (clinical diagnosis, depression module of the Patient Health Questionnaire), and coping behaviours (Brief COPE Inventory) in 50 patients with high-grade obesity (42 ± 12 years; 9 with II° and 41 with III° obesity) aiming at bariatric surgery. METHODS: AT was assessed with a portable armband device (SenseWear™ armband). Depressiveness and coping were assessed using validated questionnaires. RESULTS: Weight-adjusted non-exercise AT and intensity of physical activity (metabolic equivalent) correlated inversely with body mass index (non-exercise AT: r = -0.32, P < 0.05; mean metabolic equivalent: r = -0.37, P < 0.01) but not with depressiveness. The coping strategies "support coping" and "active coping" showed significant inverse correlations to a) weight-adjusted non-exercise AT ("support coping": r = -0.34, P < 0.05; "active coping": r = -0.36, P < 0.05), b) weight-adjusted exercise-related AT ("support coping": r = -0.36, P < 0.05; "active coping": r = -0.38, P < 0.01) and c) intensity of physical activity (for mean metabolic equivalent: "support coping": r = -0.38, P < 0.01; "active coping": r = -0.40, P < 0.01; for duration of exercise-related AT: "support coping": r = -0.36, P < 0.05; "active coping": r = -0.38, P < 0.01). CONCLUSIONS: AT was not associated with depressiveness. Furthermore, supposed adaptive coping strategies of individuals aiming at bariatric surgery were negatively associated with AT.

Gender differences in social support in persons with epilepsy.

The present study focused on social support as a key feature of the enhancement and maintenance of mental health. So far, literature on gender differences in social support and its effects on the experience of stress in individuals with epilepsy is scarce. We hypothesized that in individuals with epilepsy, social support buffers detrimental effects of stressors (e.g., unpredictable occurrence of seizures) on mental health. Additionally, we explored the role of gender in this process. In 299 individuals with epilepsy, data from validated questionnaires on seizures in the last 3months, perceived support, social network size, and depressive symptoms were analyzed. Women reported higher depressive symptoms (t=2.51, p<.01) and higher perceived support (t=2.50, p<.01) than men. Women and men did not differ in social network size (t=-0.46, p=64), nor in experiencing seizures (χ(2)=0.07, p=.82). Regression analyses revealed no buffer effects. Perceived support was negatively associated with depressive symptoms (B=-0.49, p<.001, 95% CI [-0.67; -0.32]). With regard to depressive symptoms, social integration was slightly more beneficial for women (Bcond.=-0.06, p<.001; 95% CI [-0.09; -0.03]) than for men (Bcond.=-0.02, p=.09; 95% CI [-0.04; 0.01]). Findings present perceived support and social integration as general health resources in individuals with epilepsy regardless of previously experienced seizures. They also encourage further research on gender-specific effects in individuals with epilepsy and move towards recommendations for practitioners and gender-specific interventions. Future aims will be to enhance social integration in order to support adjustment to the chronic condition of epilepsy and to improve individuals' confidence in support interactions.

Calibrating Independence Goals and Partner Support: Couples Adjust to Functional Limitations after Tumor Surgery.

BACKGROUND: When patients recover from disease-related functional limitations, support received from partners may not always match patients' changing independence goals. The lines of defense (LoD) model proposes a hierarchy of independence goals (LoDs), ranging from minimising discomfort by disengagement (lowest LoD) to protection of self-reliance (highest LoD). Prostate cancer patients' LoDs were examined as moderators of the association between partner support and patients' and partners' affect during patients' recovery from postsurgical functional limitations. METHODS: Data from 169 couples were assessed four times within 7 months following patients' surgery. Patients reported on post-surgery functional limitations (i.e. incontinence), LoDs, affect, and received partner support. Partners reported on affect and support provided to patients. RESULTS: In patients endorsing lower LoDs, more received support was associated with less negative affect. Also, not endorsing high LoDs while receiving strong partner support was related to patients' lower negative and higher positive affect. Partners' support provision to patients tended to be associated with increases in partners' negative affect when patients had endorsed higher LoDs and with increases in positive affect when patients had endorsed lower LoDs. CONCLUSIONS: Matching patients' independence goals or LoDs with partners' support may be beneficial for patients' and partners' affect.

Healthy eating at different risk levels for job stress: testing a moderated mediation.

Health behavior, like fruit and vegetable consumption (FVC), is affected by unfavorable job conditions. However, there is little research to date that combines job stress models and health-behavior change models. This longitudinal study examined the contribution of risk factors associated with job stress to the intention-planning-FVC relationship. In the context of the Health Action Process Approach, action planning (when-where-how plans) and coping planning (plans to overcome anticipated barriers) have been shown to be successful mediators in the translation of health-related intentions into action. Risk factors for job stress are operationalized as the interaction of job demands and job resources in line with the Job Demands-Resources (JD-R) model. Two hundred seventy-two employees (mean age 41.2 years, 73.9% female) from different jobs completed measures of intention at baseline (t1), action planning and coping planning 2 weeks later (t2), and FVC another 2 weeks later (t3). Job demands and job resources were assessed at t1 and t2. A moderated mediation analysis indicated that risk factors for job stress moderate the translation of intention into action planning (B = -0.23, p < .05) and coping planning (B = -0.14, p < .05). No moderation effect of the planning-FVC relationship by risk factors for job stress was found. However, coping planning directly predicted FVC (B = 0.36, p < .001). Findings suggest that employees intending to eat healthily use action planning and coping planning when job demands exceed job resources. For increasing FVC, coping planning appears most beneficial.

Olfactory training is helpful in postinfectious olfactory loss: a randomized, controlled, multicenter study.

OBJECTIVES/HYPOTHESIS: The aim of this study was to evaluate the effects of olfactory training (OT) on olfactory function in patients with persistent postinfectious olfactory dysfunction (PIOD). STUDY DESIGN: Randomized, single-blind, controlled, multicenter crossover study. METHODS: Twelve tertiary university medical centers participated. Investigations were performed at three visits (baseline, after 18 weeks, and after 36 weeks), including only subjects with PIOD of <24-months duration. At each visit, participants received detailed assessment of olfactory function. Seventy subjects trained with high concentrations of four odors for 18 weeks; the other half (n = 74) trained with low concentrations of odors. For the following 18 weeks this regimen was switched. RESULTS: After 18 weeks, olfactory function improved in the high-training group in 18 of 70 participants (26%), whereas only 11/74 improved in the low-training group (15%). In subjects with a duration of olfactory dysfunction of <12 months, olfactory function improved in 15/24 participants (63%) of the high-training group and in 6/31 participants (19%) of the low-training group (P = .03). CONCLUSIONS: OT improves PIOD, and the use of odors at higher concentrations is beneficial to improvement. OT is a safe procedure and appears to be particularly useful in patients who start OT within 12 months after the onset of the disorder. OT is the first successful therapy regime in patients with PIOD. LEVEL OF EVIDENCE: 1b.

Intrinsic rewards, fruit and vegetable consumption, and habit strength: a three-wave study testing the associative-cybernetic model.

BACKGROUND: Habit formation is thought to lead to long-term maintenance of fruit and vegetable consumption. Habits develop through context-dependent repetition, but additional variables such as intrinsic reward of behaviour may influence habit strength. Drawing upon the Associative-Cybernetic Model, this exploratory study tested different pathways by which intrinsic reward may influence fruit and vegetable consumption habit strength. METHODS: In a three-wave study of fruit and vegetable intake in adults (N = 127) from the general population, intrinsic reward, intention, and self-efficacy were assessed at baseline, fruit and vegetable consumption and intrinsic reward two weeks later, and habit strength another two weeks later. Direct, indirect, and moderation effects of intrinsic reward on habit strength were tested simultaneously in a moderated mediation model. RESULTS: Intrinsic reward had a positive indirect effect on habit strength through its influence on the frequency of fruit and vegetable consumption. Further, the relationship between fruit and vegetable consumption and habit was stronger where consumption was considered more intrinsically rewarding. CONCLUSIONS: Findings highlight the potential relevance of intrinsic reward to habit. We suggest that intrinsic rewards from behaviour may not only facilitate habit via behaviour frequency, but also reinforce the relationship between behavioural repetition and habit strength.

The interplay of dyadic and individual planning of pelvic-floor exercise in prostate-cancer patients following radical prostatectomy.

This study broadens the current understanding of the role of planning by focusing on the interplay between individual and dyadic planning (i.e. making plans about the target person's behaviour together with a partner). Self-report data from N=141 prostatectomy-patients and their partners were assessed at three times within 1 year post-surgery. Direct and indirect effects of dyadic and individual planning on patients' pelvic-floor exercise (PFE) were tested. Proposed mediators were social support, social control, and action control. Cross-sectionally, the dyadic planning-PFE relationship was mediated by patients' received support and partners' provided social control. Longitudinally, mediators of dyadic planning were partners' provided social control and support. Effects of individual planning on PFE were mediated by action control at baseline only. Also, at lower levels of individual planning, patients' dyadic planning was more strongly associated with receipt of social control. Results underscore the importance of social factors in the planning process and its mechanisms in health-behaviour change.

The dual-effects model of social control revisited: relationship satisfaction as a moderator.

The dual-effects model of social control states that receiving social control leads to better health behavior, but also enhances distress in the control recipient. Associated findings, however, are inconsistent. In this study we investigated the role of relationship satisfaction as a moderator of associations of received spousal control with health behavior and affect. In a study with five waves of assessment spanning two weeks to one year following radical prostatectomy (RP), N=109 married or cohabiting prostate-cancer patients repeatedly reported on their pelvic-floor exercise (PFE) to control postsurgery urinary incontinence and affect as primary outcomes, on received PFE-specific spousal control, relationship satisfaction, and covariates. Findings from two-level hierarchical linear models with repeated assessments nested in individuals suggested significant interactions of received spousal control with relationship satisfaction predicting patients' concurrent PFE and positive affect. Patients who were happy with their relationships seemed to benefit from spousal control regarding regular PFE postsurgery while patients less satisfied with their relationships did not. In addition, the latter reported lower levels of positive affect when receiving much spousal control. Results indicate the utility of the inclusion of relationship satisfaction as a moderator of the dual-effects model of social control.

Dyadic planning of health-behavior change after prostatectomy: a randomized-controlled planning intervention.

In this study, we investigated the role of dyadic planning for health-behavior change. Dyadic planning refers to planning health-behavior change together with a partner. We assumed that dyadic planning would affect the implementation of regular pelvic-floor exercise (PFE), with other indicators of social exchange and self-regulation strategies serving as mediators. In a randomized-controlled trial at a German University Medical Center, 112 prostatectomy-patients with partners were randomly assigned to a dyadic PFE-planning condition or one of three active control conditions. Questionnaire data were assessed at multiple time points within six months post-surgery, measuring self-reported dyadic PFE-planning and pelvic-floor exercise as primary outcomes and social exchange (support, control) and a self-regulation strategy (action control) as mediating mechanisms. There were no specific intervention effects with regard to dyadic PFE-planning or pelvic-floor exercise, as two active control groups also showed increases in either of these variables. However, results suggested that patients instructed to plan dyadically still benefited from self-reported dyadic PFE-planning regarding pelvic-floor exercise. Cross-sectionally, received negative control from partners was negatively related with PFE only in control groups and individual action control mediated between self-reported dyadic PFE-planning and PFE for participants instructed to plan PFE dyadically. Longitudinally, action control mediated between self-reported dyadic PFE-planning and pelvic-floor exercise for all groups. Findings provide support for further investigation of dyadic planning in health-behavior change with short-term mediating effects of behavior-specific social exchange and long-term mediating effects of better self-regulation.

Predictors of support provision: a study with couples adapting to incontinence following radical prostatectomy.

OBJECTIVES: Four domains of predictors of support provision were tested in couples facing an illness-related stress context. Predictor domains of partners' support provision to patients adapting to incontinence following prostatectomy included stress factors, recipient factors, provider factors, and relationship factors. METHODS: Data from 109 patients and their female partners were analysed. Couples provided data on five measurement occasions from 2 weeks to 1 year postsurgery. Predictors included patient's incontinence (stress factor), patient's support mobilization, affect and general self-efficacy (recipient factors), partner's affect and general self-efficacy (provider factors), partners' average waking time spent together, both partners' relationship satisfaction and partner's received support from patient (as an indicator of reciprocal support; relationship factors). RESULTS: Provider factors were not reliably associated with support provision, neither was patient negative affect. Stress and relationship factors accounted for outcome variance in the expected directions. Among recipient factors, mobilization of support and patient self-efficacy were positively related with the outcome, whereas patient positive affect was negatively associated with support provision by partners. CONCLUSIONS: Findings on predictor domains are in line with other couple studies that used non-illness-related stress contexts. Resemblance of findings points to generalizability of predictions across stress contexts varying in content, controllability, and duration.