Intimacy, marital adjustment, and well-being in long-term survivors of childhood cancer

Abstract

The present study examined well-being and the contribution of intimacy and marital satisfaction to well-being in long-term survivors of childhood cancer (LTSCC). In addition, self-esteem, warmth and gregariousness were included to test for mediating effects. 207 adult LTSCC were assessed using the Rand Well-Being measure, Miller's Social Intimacy Scale, the Dyadic Adjustment Survey, Rosenberg Self-Esteem Scale, the NEO-PI Warmth and Gregariousness subscales, and the Marlowe-Crowne Social Desirability Scale (M-C) each of these is a well established and well validated self-report measure. Survivors scores on each of these measures were contrasted with those of a control group of adults who did not have a cancer history (N = 169). Each of the variables, as well as several sociodemographic and medical variables, were utilized in regression and path analyses to determine their ability to predict well-being. LTSCC reported significantly less overall well-being (F = 78.9, p < .000), significantly more anxiety (F = 194.2, p < .000) and depression (F = 1262.3, p < .000), and significantly less positive well-being (F = 18.6, p < .000), health (F = 137.0, p < .000), and self-control (F = 88.3, p < .000) than controls. Survivors reported significantly more intimacy (F = 5.1, p < .01), marital adjustment (F = 5.3, p < .01), self-esteem (F = 216.8, p < .001), warmth (F = 65.2, p < .001) and gregariousness (F = 113.3, p < .001) than controls. LTSCC also had higher scores on the M-C (F = 26.7, p < .001). An omnibus stepwise multiple regression analysis accounting for 27% of the variance, revealed that self-esteem and the interaction of warmth and intimacy were the best predictors of well-being. Group membership was a nonsignificant predictor of well-being. Finally, path analysis was employed and different models "fit" the LTSCC and the controls. The best path model (NET = .94) for the LTSCC indicates that well-being predicts intimacy. The best path model (NET = .98) for the controls, on the other hand, indicates that intimacy predicts well-being. These results are discussed in terms of developmental and social support theories. Interpretations of these results, strengths and weaknesses of the study, and implications for theory, application, and future research are discussed.