An observational study of social control, mood, and self-efficacy in couples during treatment for head and neck cancer

Objective: Head and neck cancer (HNC) patients experience debilitating side effects, including abnormally reduced salivation and difficulty swallowing. Intensive self-care protocols are prescribed to control side effects and minimise discomfort, but non-adherence rates are high. Although spouses are in a prime position to encourage adherence, studies have yet to examine how spouse social control (i.e. attempts to influence patient behaviour to support adherence) affects HNC patient mood and self-efficacy for engaging in these self-care routines. Methods: One-hundred twenty-five HNC couples, where the patient (86% male) was undergoing radiotherapy, were recorded in the laboratory as they discussed a cancer-related issue that the patient identified as being a topic of concern. Results: Sixty-eight couples discussed side effects and spouses engaged in social control in 61 of these discussions. Although oral complications and pain were frequently identified by patients as being topics of concern, dental/oral care and pain management were some of the least likely self-care behaviours to be targeted by spouses, who focused primarily on encouraging patients to maintain their weight and hydration. Although spouses engaged in an almost equal number of positive and negative control attempts, only positive control was significantly (p < .05) associated with patient positive mood and self-efficacy. Conclusion: HNC couples may benefit from programmes that emphasise the regular practise of self-care routines to control oral side effects, pain and nutrition/hydration problems. Likewise, programmes that encourage spouses to maximise their use of positive social control may also boost patients’ mood during treatment and empower them to engage in recommended self-care behaviours.