Pathways to psychological wellbeing for patients with bladder cancer and their partners-in-care.

Purpose: The goal of the current analyses was to describe pathways through which Psychological Wellbeing might be better understood for clinical participants with bladder cancer and their partners. This was achieved by applying Roy's Adaptation Model that provides a framework with which to understand responses to challenging circumstances that has proved useful in the study of a range of chronic conditions.

Methods: The sample comprised 119 patients with a diagnosis of bladder cancer, and 103 supportive partners. Participants completed a self-report questionnaire comprising the Bladder Cancer Index, Mini-Mental Adjustment to Cancer Scale, Psychosocial Adjustment to Illness Scale, and sociodemographic details. For each sample, structural equation modelling was used to determine goodness of fit, guided by Roy's Adaptation Model.

Results: For patients, increasing age and disease duration, the negative appraisal of health care, perceived poor functioning and elevated burden of disease provided pathways to Psychological Wellbeing. For partners, increasing age, being male, a negative health care experience, and perceived burden of disease were significant. However, for both groups a positive evaluation of family and social support was the key indicator of lower Psychological Wellbeing.

Conclusions: The models presented describe a suite of issues that could inform a nursing model of care to enhance the experience of living with bladder cancer for both patients and their supportive partners.