Behind closed doors: How advanced cancer couples communicate at home

Objective: Describe communication between patients with advanced cancer and their spouse/partner caregivers. Design: Prospective observational study. Sample: 83 advanced cancer patient–spouse caregiver couples. Methods: Couples completed surveys and recorded naturalistic communication for one day. Descriptive analysis was performed on self-report and observational communication data. Findings: Both patients and caregivers self-reported high likelihood of engaging in positive interactions. The majority of observed communication was logistical or social small-talk. Cancer and relationship talk was highly skewed; many couples had no talk in these domains. Conclusion: This study is one of the first to assess continuous naturalistic observation of communication in the homes of couples coping with advanced cancer. We found that routine aspects of daily life continue even when couples are facing important challenges. Implications for Psychosocial Providers: There appear to be few naturalistic cues encouraging couples to discuss potentially difficult topics. More work is needed to determine appropriate levels of communication.