Effective communication plays a major role in the psychological adjustment and quality of the relationship of couples coping with cancer, yet only a few communicative behaviors have been examined in the context of a cancer diagnosis and treatment. This study sought to expand the extant literature by describing a wider range of communicative behaviors (beyond the frequently researched withdraw, disclosure/holding back, and avoidance behaviors) through an observable measure, as previous research has relied heavily on self-report. Couples (134 cancer patients and their caregiving partners) were video-taped discussing a cancer-related concern in the laboratory. Discussions were coded separately for patients and caregivers using the Asymmetrical Behavioral Coding System which captures 22 communicative behaviors. These behaviors contribute to four higher-level scales: positive approach, negative approach, positive avoidance, and negative avoidance. Area under the curve was calculated to describe each factor. The most frequently observed behavior was positive approach, followed by negative avoidance, negative approach, and positive avoidance.

Paired samples t-test analyses examining the factors by moderating variables revealed that women engaged in more positive approach behaviors than did men; men engaged in more avoidant behaviors (both positive and negative) than did women; and caregivers engaged in more avoidant behaviors (both positive and negative) than did patients.

Findings are consistent with prior research in the field and suggest consideration of tailoring possible future interventions. Further investigation is needed to assess possible interactional effects to ultimately help couples better communicate about the challenges associated with cancer treatment and recovery.

Hematopoietic cell transplantation (HCT) is a treatment for hematologic malignancies. The procedure poses multiple medical risks ranging from infection to graft-versus-host disease. Patients must designate a full-time informal caregiver, typically a family member. Caregivers assume multiple medical and logistical responsibilities. Distress and burden are common. Psychosocial interventions, including narrative-based interventions, may offer support for caregivers. This thesis makes use of data collected as part of a digital storytelling intervention for HCT caregivers. Participants were 6 caregivers of HCT survivors who participated in a 3-day digital storytelling workshop, culminating in the creation of a personal story about their experience as a caregiver in the form of a video with narration in their own voice. Linguistic Inquiry and Word Count (LIWC, 2015) was used to characterize content of the stories. Compared to norms (base rates of word usage provided by the LIWC developers), caregivers used more first-person plural pronouns. Such use of we-talk may indicate caregiver-patient dyadic strength given other research linking we-talk to communal coping. Counter to prediction, caregivers did not differ from norms with respect to use of negative affect words or cognitive process words. They did, however, use more biological process words (to be expected given their focus on health) and more words indicative of affiliation (understandable in light of their interpersonal connection to the patient and supportive care role). Further research is needed to examine potential change in linguistic content across the HCT trajectory (from pre-transplant through long-term survivorship), also to compare caregiver and patient stories.

Almost sixty percent of adults within the United States are in a married or committed, cohabiting relationship. This study sought to examine the trajectory of relationship satisfaction over 14 consecutive days employing an ecological momentary assessment (EMA) method. Daily reports of relationship satisfaction were collected via a smartphone application developed from the LifeData platform. Phone-based interview questions posed one week after the 14-day EMA period afforded evaluation of usability and acceptability, in preparation for a much larger study of couples coping with cancer. Twenty-seven adults in a married or committed, cohabitating relationship served as participants, recruited from researchmatch.org. (These individuals were not coping with cancer.) Participants received a smartphone notification between 7:30pm and 8:30pm each day, with 45 minutes to begin recording their responses. A single item from the Dyadic Adjustment Scale (item #31) was used to assess relationship satisfaction. Findings revealed a marginally significant increase in satisfaction over the course of 14 days (b = 0.04, t = 1.85, p = .077). In addition, an intraclass correlation (ICC) value of 0.59 indicated larger between-person variability than within-person variability, suggesting that satisfaction varies more from one individual to another than it does within individuals over time. Finally, plots of mean relationship satisfaction by the standard deviation of relationship satisfaction showed lower variability in day-to-day satisfaction among those who were on average more satisfied with their relationship compared to those who were on average less satisfied. Feedback regarding convenience and ease of the application indicated favorable attitudes towards smartphone-based data collection.

Prior research has found an association between individual's resports of emotion dysregulation and experiences of stress; however, little work has been done to examine these constructs in the context of romantic relationships. To address this gap in the literature, the present study investigated the proposed association between individual reports of emotion dysregulation and experiences of internal stress. Additionally, data taken from couples' real-time conversations examined how reports of emotion dysregulation were associated with feelings about one's partner following an internal stress conversation. Data from 44 heterosexual romantic couples was used at two time points, baseline and momentary interaction data. Results did not show support for an association between emotion dysregulation and internal stress, however some support was found for an association between emotion dysregulation and negative feelings felt due to one's partner after a stressful conversation. Implications for future research are discussed.

Chemotherapy refers to the use of chemical agents to inhibit or stop the growth of rapidly dividing cancer cells. There are many side effects of systemic chemotherapy, which are caused because the drug not only kills cancer cells but healthy cells as well (American Cancer Society, 2017). Common side effects include fatigue, hair loss, bruising/ bleeding, infection, anemia, nausea and vomiting, appetite changes, constipation, diarrhea, oral sores, nerve and muscle pain, dry skin and color change, kidney dysfunction, weight loss, cognitive difficulties, mood changes, sexual dysfunction, and fertility problems (American Cancer Society, 2017). Research shows that complementary and alternative medicine (CAM) may help relieve some of the side effects of chemotherapy. Examples of CAM include herbal medicine, dietary supplements, acupuncture, yoga, Tai Chi, massage, electromagnetic therapy, meditation, biofeedback, music, dance, and guided imagery (Johns Hopkins Medicine, 2017). The aim of this creative project was to design a third-party website to provide information to patients undergoing chemotherapy and their family members regarding the use of CAM for the treatment of chemotherapy-induced side effects. Rationale for this project stemmed from a preliminary research step. We analyzed and coded for presence or absence of CAM-specific information on the websites of 20 National Cancer Institute-designated comprehensive cancer centers across the United States. Fifty percent of websites were double-coded. Inter-rater reliabilities (kappa values) for coding of the presence or absence of specific CAM therapies ranged from 0.38 for acupuncture to 1.00 for exercise and yoga, expressive arts, and herbs (mean kappa = 0.75). Fourteen of the 20 websites mentioned meditation or mindfulness; 13 mentioned nutrition; 12 mentioned acupuncture; 11 mentioned exercise or yoga; 11 mentioned massage; 8 mentioned expressive arts; and 3 mentioned herbs. Frequencies for presence of either a description of the specific CAM therapy or an explanation of how the therapy works were lower. We then conducted a literature review using PUBMED to find peer-reviewed research on the efficacy of the previously described seven CAM therapies. The literature search focused on systematic reviews and meta-analyses published within the past 10 years. Based on the literature obtained, we created summaries of the scientific evidence for each CAM therapy. This information is now provided on our third-party website in tabular form with summative statements. The website describes in lay language: chemotherapy, chemotherapy side effects, CAM, seven specific CAM therapies, and evidence for the efficacy or lack thereof of each. Per the American Nurses Association (2015), it is our responsibility to advocate for our patients through education and holistic treatment. The role of the nurse is to educate the patient about treatment options; however, it is not within the nurse's scope of practice to prescribe a treatment. As such, this website should not be viewed as a prescription for CAM therapies, but instead as a user-friendly and easily accessible resource for informed decision-making regarding the adjunctive use of CAM therapies.

Complementary and alternative medicine (CAM), also known as integrative medicine, is an important intervention used for holistic care of patients. It is patient-centered care, addressing multiple aspects of one's health ranging from physical and psychosocial to spiritual influences. CAM has been successful in patients' symptom and stress management, and has grown substantially in recent decades, especially in oncology nursing. Despite widespread use and their support for CAM therapies, nurses' lack of CAM knowledge and vocabulary are barriers to communication with patients. Also, little is known about the student nurses' awareness of CAM and the college instructors' opinions on the intervention, which are crucial in developing the college nursing education on integrative medicine. The purpose of this study was to describe the college nursing students' knowledge and their instructors' perspectives on integrative medicine and oncology care, and compared the data of the two populations. Convenience and snowball sampling were used to recruit participants from the community in College of Nursing and Health Innovation (CONHI) at Arizona State University (ASU). Five students (M age = 20.6 years; 80% female) and five nursing instructors (M age = 56.8 years; 100% female) were invited to 60-90 minute in-depth interviews on perceptions and knowledge of CAM. Four major themes emerged from the interviews: (1) Insufficient awareness and knowledge of CAM; (2) education and information needs on CAM; (3) positive attitudes toward CAM; and (4) importance of nurses' roles in CAM. Implications for nursing included need for more structured and efficient CAM in nursing programs; early exposure and education of college nursing students on CAM; and academic relationships between nursing instructors and students.