Intimacy and relationship processes in couples' psychosocial adaptation to cancer

Understanding the patient-spouse communication experience during chemotherapy for gastric cancer based on the couple's adaptation to cancer intimacy model: a directed content analysis

PURPOSE

This study analyzes the communication experience between gastric cancer patients and their spouses regarding the disease. It also evaluates the impact of positive or negative communication on Psychological Adaptation and couples' Relationship Intimacy. The ultimate objective was to help nurses develop effective patient-spouse communication strategies that promote the psychological well-being of patients and their spouses.

METHOD

Based on The Relationship Intimacy Model of Couple Adaptation to Cancer, the study used purposive sampling to select participants, guided by the principle of maximum variation. Sixteen pairs of patients with gastric cancer and their spouse caregivers, hospitalized in the oncology department of a tertiary hospital in Jingjiang City, Jiangsu Province, between March and July 2023, were chosen for semi-structured face-to-face interviews. Within 24 h after each interview, the recorded data were transcribed and supplemented with field notes. Directed content analysis was used for qualitative content analysis.

RESULTS

The interview data revealed five themes and 12 subthemes: (1) Negative Spousal Communication, which includes (i) lack of awareness of proactive communication, (ii) lack of emotional interaction and patience in exchange, and (iii) substituting conflict for communication; (2) Positive Spousal Communication, which includes (i) appropriate communication topics, (ii) appropriate timing and approach, and (iii) integration with emotional support; (3) Protective Concealment, which includes (i) suppressing emotions and making compromises and (ii) avoiding taboo topics; (4) Negative Spousal Disease Communication, which may lead to reduced psychological adaptation and a decline in couples' relationship intimacy; and (5) Positive Spousal Disease Communication, which may enhance psychological adaptation and strengthen couples' relationship intimacy. During chemotherapy, gastric cancer patients and their spouses experienced positive, negative, and Protective Concealment communication patterns. Both psychological adaptation and relationship intimacy are significantly influenced by spousal disease communication.

CONCLUSIONS

For patients with gastric cancer and their spouses, nurses should focus on the importance of spousal disease communication during chemotherapy, take positive measures to mitigate one-side, conflictual communication and avoidance behaviors, and adopt appropriate communication cut-in content and timing to promote couple communication deeply, with the need to focus on physical and psychological stress of the protective concealment in couple.

Informing Psychosocial Care for Young Couples Coping with Early-Onset Breast Cancer: A Cross-Sectional Examination of Unmet Service Needs and Their Association with Psychological Distress in the First Year Post-Diagnosis

Objective: Young women diagnosed with breast cancer report greater psychological and physical morbidity than both older women and healthy peers. Similarly, young partners experience elevated cancer-related distress. Psychosocial oncology programs are not frequently attuned to the needs of young adult patients and may exclude their social networks. This marks a critical gap in psychosocial care delivery. The study investigated unmet service needs, psychological distress, and care preferences of young couples managing breast cancer in the first year post-diagnosis. Methods: Forty dyads (n = 80) of women aged 18-45 and their partners completed measures of anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), and a service use questionnaire adapted from previously published Adolescent and Young Adult (AYA) literature. The resulting 25 items assessed perceived care needs and service utilization across three domains: informational, emotional/supportive, and practical issues. Descriptive statistics, cross-tabulations, and bivariate correlations were computed. Actor and partner effects of unmet needs on mental health outcomes were investigated with generalized estimating equations (GEE). Results: Patients and partners were in their late thirties, mostly non-Hispanic White, married, highly educated, and employed. Approximately 60% of patients and 43%-66% of partners presented one or more unmet service needs, which correlated with greater distress. Unmet needs about information related to exercise, recurrence, nutrition, and symptom management were prevalent. Unmet supportive service needs of both patients and partners included age-appropriate programs, sexual health, and family counseling. Women reported practical needs for work/school accommodations, integrative care, financial issues and health coverage; while financial concerns, health insurance, and caregiving demands were priorities for partners. Conclusion: Young couples facing early-onset breast cancer experience large proportions of unmet service needs. These challenges were exacerbated by the lack of developmentally targeted psychosocial programs pertaining to informational, supportive, and practical care needs. Enhancing providers' understanding of the psychosocial issues affecting young couples' well-being, and the implementation of systematic procedures to detect and respond to their distress, is urgently needed.

Después del Cáncer: a qualitative exploration of navigating survivorship as a Latino couple following a breast cancer diagnosis

PURPOSE

Although Latino cancer inequities persist and result in poorer quality of life, limited research examines the psychological and relationship functioning impacts following a breast cancer diagnosis among Latino couples. Therefore, this study aimed to explore how breast cancer shapes Latino couples' relationships throughout the cancer care continuum.

METHODS

Focus groups and semi-structured interviews were conducted in 2022 with a purposive sample of Latina breast cancer survivors and their intimate partners. Interviews were audio recorded, transcribed, and coded using the Community-Engaged Rapid Analysis and Visualization Adaption methodological framework.

RESULTS

Most of the Latina breast cancer survivors were within 5 years of survivorship (58%) and over half of all participants reported being in a relationship for over 21 years. Results revealed that following a breast cancer diagnosis, Latina breast cancer survivors and intimate partners of a Latina breast cancer survivor have different primary fears, use different coping mechanisms, navigate unfamiliar challenges following the cancer-related treatment phases due to limited understanding and knowledge of cancer treatments, and can reinvent intimacy through supportive actions through the cancer care continuum.

CONCLUSION

This study illustrates Latino couple's individual and dyadic navigation processes following a breast cancer diagnosis and the unique cultural and contextual challenges that arise throughout survivorship.

IMPLICATIONS FOR CANCER SURVIVORS

Within Latino dyads, each individual may navigate through the cancer care continuum differently and may be influenced by different cultural norms. Culturally tailored interventions can improve emotional and functional adjustments for Latino couples, bettering their quality of life.

Efficacy of couple-based dyadic interventions on the relationship outcomes of couples with cancer: A systematic review and network meta-analysis

PURPOSE

To compare the effects of different couple-based dyadic interventions on patient-partner couple's relationship outcomes.

METHODS

A systematic search of the nine databases, Cochrane Library, MEDLINE, PubMed, Embase, Web of Science, CINHAL, PsyclINFO, China National Knowledge Infrastructure and WanFang was conducted from database inception to October 22, 2024 for randomized controlled trials (RCTs) of patients with cancer and their partners receiving couple-based dyadic interventions. The outcome indicators included couple relationship quality. The results were plotted and presented by Stata 14.0. The surface under the cumulative ranking area (SUCRA) was employed for intervention level estimation.

RESULTS

This study included 2519 patients with cancer and their partners from 25 RCTs. For patients with cancer, supportive care demonstrated the largest effect size in improving couples' relationships (standardized mean difference [SMD]: -0.69; 95% confidence intervals [CI]: -1.15,-0.23) and had the highest cumulative probability (SUCRA: 69.4%) compared to skills training. Mindfulness demonstrated the largest effect size for partners in improving relationships of couples (SMD: -0.51, 95% CI: -0.98,-0.05) and had the highest cumulative probability (SUCRA: 87.2%) compared to skills training.

CONCLUSIONS

Mindfulness represents the most promising couple-based dyadic intervention for improving relationship quality between partners of patients with cancer. However, no significantly effective interventions have been identified to enhance couple relationships for patients. Future research should consider the requirements of patients and partners who are the units, and develop more targeted programs to facilitate relationship adjustment. The results provide a low level of certainty, suggesting the need for further rigorous studies to validate these findings.

Self-disclosure and reproductive concerns among breast cancer female patients: the chain mediation model of couples' cancer-related communication problems and relationship intimacy

PURPOSE

Reproductive concerns are prevalent in the female breast cancer patient population and increase existential distress. Although self-disclosure significantly correlated reproductive concerns, the exact mechanism of action is unknown. Based on previous theoretical studies on couples' cancer-related communication problems and intimacy in couples, this study constructed a chain mediation model to investigate whether the two variables mediate the relationship between self-disclosure and reproductive concerns.

METHODS

A cross-sectional survey was conducted from August 2023 to July 2024 at Jiangxi Cancer Hospital. A total of 280 female breast cancer patients completed the Distress Disclosure Index, Couples' Cancer-Related Communication Problems Scale, Quality Relationship Index, and Reproductive Concerns After Cancer Scale. Data description and Pearson's correlation analysis were performed through SPSS 26.0 software. Serial mediation effect analysis and testing were performed through Hayes' Process 4.1 program.

RESULTS

Self-disclosure was found to be negatively associated with reproductive concerns and couples' cancer-related communication problems, but positively associated with intimacy. After controlling for sociodemographic variables, including age, matrimonial, number of children, and hormone receptor, the direct effect of self-disclosure on reproductive concerns was significant (Effect =  - 0.320; 95% CI, - 0.465 to - 0.178). In addition, three other indirect pathways of action were also significant: (1) through couples' cancer-related communication problems (Effect =  - 0.113; 95% CI, - 0.181 to - 0.045), (2) through intimate relationships (Effect =  - 0.110, 95% CI - 0.187 to - 0.043), and (3) through the chain-mediated effects of couples' cancer-related communication problems and intimacy (Effect =  - 0.025; 95% CI, - 0.054 to - 0.007). The total indirect effect of the three pathways of action was 43.66%.

CONCLUSIONS

Self-disclosure not only directly affects reproductive concerns in female breast cancer patients, but also indirectly through couples' cancer-related communication problems and intimacy, as well as sequential mediation of the two. Interventions targeting the above factors can help promote self-disclosure in female breast cancer patients, reduce couples' cancer-related communication problems, and improve intimacy, thereby alleviating reproductive concerns after cancer.

Association between communication patterns, benefit finding, and relationship satisfaction in stroke couples: an actor-partner interdependence mediation model

AIMS

To explore the mediating role of relationship satisfaction between communication patterns and benefit findings in stroke couples using the actor-partner interdependence mediation model.

METHODS AND RESULTS

A cross-sectional study was conducted from October 2022 to April 2023 in China. Based on the actor-partner interdependence mediation model, we used structural equation modelling to explore the mediating role of relationship satisfaction of stroke patients and their spouses in communication patterns and benefit findings. A total of 381 stroke couples (patients, 61.4% male, mean age 54.06; caregivers, mean age 53.58) were included in the data analysis. Actor effects showed that stroke couples' relationship satisfaction mediated each of their own three communication patterns (constructive communication, demand/withdraw communication, and mutual avoidance) and benefit findings. In addition, patients' relationship satisfaction mediated patient demand-spouse withdraw and spouses' benefit findings. Partner effect showed that patients' relationship satisfaction mediated the association between their own three communication patterns and spouses' benefit findings. Patients' relationship satisfaction mediated the association between patient demand-spouse withdraw and patients' benefit findings. Moreover, spouses' relationship satisfaction mediated the association between the two communication avoidance patterns exhibited by patients (spouse demand-patient withdraw and mutual avoidance) and the spouses' benefit findings.

CONCLUSION

The results have demonstrated a reciprocal influence on benefit findings between stroke patients and their spouses. The communication patterns within these couples have impacted not only their own benefit findings but also those of their spouses, with relationship satisfaction playing a mediating role.

Associations between health-related quality of life, infertility-related psychological well-being, and relationship quality in individuals with endometriosis: A cross-sectional study

BACKGROUND

Endometriosis is the most frequent gynecological diseases and accompanied by both physical and psychological symptoms. An increasing number of studies suggested acknowledging endometriosis as a systematic disease due to the multifactorial effects throughout the body. The chronic disease significantly impacts daily life, including romantic relationships. This study aimed to investigate the associations between health-related quality of life (HRQoL), infertility-related psychological well-being (IPW), constructive communication, and relationship quality in individuals with endometriosis.

METHODS

A total of 627 individuals with endometriosis participated in this online cross-sectional study. We measured HRQoL in all participants and IPW specifically in those who reported an unfulfilled wish for a child. Additionally, relationship quality and constructive communication were assessed. We used Pearson's product moment correlation to examine the association of HRQoL/IPW and relationship quality. Mediation analysis was used to assess the role of constructive communication in the association between HRQoL/IPW and relationship quality. In an explorative analysis, differences between subsamples with and without an unfulfilled wish for a child were analyzed.

RESULTS

Poorer HRQoL was associated with lower relationship quality overall (p = .002) and specifically with three subscales of relationship quality: worse sexuality (p = .016), increased mistrust towards the partner (p < .001), and restriction of freedom/independence (p = .003). There was no significant association between IPW and relationship quality. The mediation analysis including constructive communication as mediator showed a full mediation between HRQoL/IPW and relationship quality. The subsamples with and without an unfulfilled wish for a child differed in HRQoL but not in relationship quality or constructive communication.

CONCLUSION

The findings indicated an association between HRQoL in individuals with endometriosis and relationship quality. In addition, we observed a full mediation between HRQoL/IPW and relationship quality, when constructive communication was considered as a mediator. Therefore, constructive communication plays a key role in effectively managing the impact of the disease within a relationship. Individuals with endometriosis experiencing difficulties conceiving should have access to appropriate psychological counseling.

Couple communication in cancer: A tale of two conceptual models

Cancer poses significant challenges for patients and caregiving partners. Avoidant communication has been linked to poorer psychosocial adjustment to cancer. Two conceptual models have been proposed to account for this linkage: the social-cognitive processing and relationship intimacy models.

OBJECTIVE

To examine the utility of these models in explaining patient and partner psychological and relationship adjustment on a day-to-day basis using ecological momentary assessment.

METHOD

Patients with breast, colorectal, or lung cancer and their partners (286 dyads) were prompted twice daily for 14 days via smartphone to answer questions about communication with their partner, adjustment (psychological distress and relationship satisfaction), and hypothesized mediators (avoidant thoughts and intimacy). Data were collected from 2017 to 2020.

RESULTS

Participants responded to 92% of prompts and completed 91%. Results supported the relationship intimacy but not the social-cognitive processing model. On afternoons when participants (both patients and caregivers) held back or perceived avoidance or criticism from their partner, they reported less intimacy, as did their partners; this lowered intimacy, in turn, led to participants' (both patients' and caregivers') own lowered relationship satisfaction that evening and to patients' lowered relationship satisfaction through caregivers' lowered intimacy (one-tailed Bayesian ps < .025). When distress was the criterion, patients' holding back or perceived avoidance/criticism led to their own increased distress through their own decreased intimacy, and caregivers' holding back or perceived avoidance/criticism led to patients' increased distress through patients' lowered intimacy (one-tailed Bayesian ps < .005).

CONCLUSIONS

Findings offer implications for interventions designed to improve communication and enhance closeness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Understanding the patient-spouse communication experience during chemotherapy for gastric cancer: A qualitative study

PURPOSE

This study examines how patients with gastric cancer and their spouses communicate about the illness, assessing the impact of positive or negative communication on their psychological adaptation and the intimacy of their relationship as a couple.

METHOD

Employing The Relationship Intimacy Model of Couple Adaptation to Cancer, this study used purposive sampling with the principle of maximum variation to select participants. Sixteen pairs of patients with gastric cancer and their spouse caregivers, hospitalized in the oncology department of a tertiary hospital in Jingjiang City, Jiangsu Province, from March to July 2023, were chosen for semi-structured face-to-face interviews. The recorded data were transcribed within 24 h following each interview and supplemented with field notes. Directed content analysis was employed for the qualitative content analysis.

RESULTS

The interview data revealed three themes and six subthemes. Theme 1: The impact of negative patient-spouse communication, with the subthemes being (i) a decline in couples' relationship intimacy and (ii) reduced psychological adaptation. Theme 2: The impact of positive patient-spouse communication, with the subthemes being (i) enhanced couples' relationship intimacy and (ii) increased psychological adaptation. Theme 3: The impact of protective concealment, with the subthemes being (i) declined couples' relationship intimacy and psychological adaptation, and (ii) increased couples' relationship intimacy and psychological adaptation. Throughout the chemotherapy period, patients with gastric cancer and their spouses experienced both positive and negative forms of patient-spouse communication. This underscores the significance of acknowledging protective concealment within couples. Moreover, the study highlights how the dynamics of couples' relationship intimacy and psychological adaptation are influenced by both positive and negative communication patterns surrounding the illness.

CONCLUSIONS

For patients with gastric cancer and their spouses, it is crucial for nurses to emphasize the importance of spousal disease communication during chemotherapy. Efforts should be made to mitigate one-sided, conflictual communication and avoidance behaviors, and to adopt appropriate communication strategies in terms of content and timing to deeply promote couple communication. Additionally, there is a need to focus on the physical and psychological stress of protective concealment in couples.

Mutual communication intervention for colorectal cancer patient-spousal caregiver dyads: A randomized controlled trial

OBJECTIVE

Gender could impact the psychosocial outcomes and coping strategies of cancer patients and their spousal caregivers (SCs). This study aims to develop a gender-concerned program for colorectal cancer (CRC) couple-based mutual communication intervention (MCI) and to assess its effectiveness on the intra-couple relationship and the individual functions of the partners.

DESIGN

A randomized clinical trial with two study groups was utilized.

METHODS

A total of 144 CRC patients and their SCs were randomly assigned to either MCI or usual care (UC) groups, and all of them were required to complete the measurements at baseline and post-intervention. The primary outcome was for mutual communication, and the secondary outcomes included dyadic coping, relationship satisfaction, anxiety, depression, benefit finding and quality of life. The data were analysed by multi-level modelling.

RESULTS

The MCI program was feasible and acceptable for Chinese CRC couples and was effective for the improvement of the intra-couple relationship and the individual functions of each partner. CRC patients showed more improvement in mutual communication and dyadic coping than their SCs in the MCI group. Also, this intervention effectiveness was found to be independent of gender.

CONCLUSIONS

The MCI program is beneficial for Chinese CRC couple's adaptation outcomes. This suggests that clinical medical staff should consider the gender tendency during the implementation of interventions. More researches are needed to extend the application of the MCI program to different participants (e.g. patients with the diagnosis of other types of cancer and their SCs).

Development of the Partner Version of the Self-Efficacy to Communicate about Sex and Intimacy (SECSI-PV) Scale in the Context of Cancer Survivorship

PURPOSE

This study aimed to develop the Partner Version of the Self-Efficacy to Communicate about Sex and Intimacy (SECSI-PV) scale.

METHODS

Candidate items derived from the patient version of the instrument were refined with input from an expert panel specializing in sexual health, psychosocial oncology, and instrument development (n = 6). Partners (n = 17) of female cancer survivors participated in cognitive interviews to assess the revised scale's content validity.

RESULTS

Transcripts were analyzed qualitatively. Participants endorsed the items as relevant, clear, and appropriate.

CONCLUSIONS

The present work illustrates the iterative development of the SECSI-PV scale. The study highlights the importance of including partners in sexual health discussions and emphasizes the need for psychosocial interventions supporting partners' confidence communicating about sexuality and intimacy. Additional research is recommended to validate the instrument in larger samples encompassing cancer types that are not sex-based and partners from diverse backgrounds, including sexual and gender minority groups.

Dyadic coping and related factors among couples with colorectal cancer: A latent profile analysis

Objective

This study aimed to identify latent subgroups of dyadic coping (DC) among colorectal cancer (CRC) patients and their spousal caregivers, and to explore the factors associated with these subgroups.

Methods

We conducted a cross-sectional study involving 268 pairs of CRC patients and their spousal caregivers. Participants completed the General Information Questionnaire, the Dyadic Coping Inventory, the Cancer-Related Communication Problems Scale, and the Fear of Progress Questionnaire-Short Form. Latent profile analysis (LPA) of DC among CRC couples was performed using Mplus 8.3. We compared couple illness communication, fear of cancer recurrence (FCR), and demographic characteristics between the identified subgroups and conducted ordinal logistic regression analysis to examine factors associated with these subgroups.

Results

The 268 pairs of CRC patients and their spousal caregivers were classified into four subgroups based on their coping levels: low-DC group (12.3%), low common-DC group (7.1%), moderate-DC group (52.6%), and high-DC group (28.0%). Disease stage, couple illness communication, and spouse's FCR were significantly associated with the four subgroups.

Conclusions

There is considerable variability in DC levels among CRC patients and their spousal caregivers. Patients with advanced disease stages, inadequate communication between spouses, and severe RCR exhibit lower levels of DC. These findings provide a theoretical basis for nursing personnel to develop personalized intervention strategies tailored to the characteristics of these subgroups.

Symptoms, distress, finances, social support, resource utilization, and unmet care needs of patients with gynecological cancer

PURPOSE

This study explored the unmet care needs of gynecological cancer patients, including overall and subdomain needs (i.e., physical and daily living needs, psychological and emotional needs, care and support needs, and health-system and information needs), and related factors.

METHODS

In this cross-sectional study, gynecological cancer patients treated at a medical center in northern Taiwan were recruited. Data on demographics, symptoms, distress, finances, social support, resource utilization, and care needs were collected. Spearman's correlation and the Mann-Whitney U test were used for analysis.

RESULTS

This study of 118 cancer patients found that 73% had unmet psychological and emotional needs, followed by 54% with unmet health system and information needs. The most common physical symptoms were insomnia, fatigue, and pain, with 51.7% experiencing moderate or high levels of distress. Overall, the patients received considerable social support, both instrumental and emotional, primarily through medical information booklets (39.0%), cancer information websites (28.8%), and rehabilitative resources (20.3%). Factors associated with unmet care needs included younger age, non-ovarian cancer, symptoms (pain, fatigue, appetite loss, insomnia, dyspnea, nausea, and vomiting), distress, finances, social support, and the use of cancer information websites.

CONCLUSION

Psychological and emotional unmet needs is prevalent among patients with gynecological cancer; psychological support is crucial. Younger patients and those with non-ovarian cancer had more unmet care needs. These needs are linked to severe symptoms, distress, financial difficulties, limited social support, and low use of cancer information websites. Enhancing support for this population through targeted interventions is necessary.

From stress communication to depressive symptoms among couples facing vision impairment: The mediating role of dyadic coping

Vision impairment is considered one of the most common disability worldwide, can induce considerable stress for both patients and their spouses and may subsequently affect couples' psychological functioning. This study examined whether dyadic coping (DC) mediated the association between stress communication (SC) and depressive symptoms among couples coping with one partner's vision impairment. A total of 99 Swiss couples completed questionnaires assessing SC, various types of DC, and depressive symptoms. An Actor-Partner Interdependence Mediation Model was performed. Results showed that (1) the more one partner communicated stress, the less the other partner perceived negative DC and, consequently, the less the partner perceiving negative DC reported depressive symptoms; (2) the more partners communicated stress, the more they and their partners engaged in common DC and, consequently, the less the partner engaging in common DC reported depressive symptoms; (3) the more partners communicated stress, the less they and their partners engaged in protective buffering and, consequently, the less the partner engaging in protective buffering reported depressive symptoms. This pattern of associations occurred similarly for patients and their spouses. Our findings underline the interpersonal experience of vision impairment within couples and the importance of fostering explicit SC and common DC in psychosocial rehabilitation interventions directed at couples facing one partner's vision impairment.

Men in Marital Relationships with Women Undergoing Breast Cancer Treatment: A Qualitative Study

Objective

Sexual health is an essential part of overall health and well-being. Breast cancer affects the marital relationships and sexual activity of patients and their sexual partners. The present qualitative study was conducted to discover the experiences of women undergoing breast cancer treatment and their husbands regarding marital relationships after breast cancer.

Methods

Semi-structured interviews were conducted with the 37 women undergoing breast cancer, their husbands, and healthcare providers. Recorded interviews were transcribed and analyzed using a qualitative content analysis approach.

Results

Four categories of 'Utilization of couple-based approach,' 'Consequences of relationship breakdown,' and 'A need for the spouse's support and compassion' were revealed.

Conclusion

The present study showed that the husbands of women undergoing breast cancer treatment played a dual role in marital relationships. It seems that using couple-based approaches, such as mental and sexual health counseling, should be considered by healthcare providers.

Illness perception and intimate relationships in patients with cervical cancer: the mediating role of dyadic coping

BACKGROUND AND OBJECTIVES

A good intimate relationship (IR) can relieve the psychological distress of patients with cervical cancer and promote a sense of well-being during stressful times. Researchers have found that IR is related to illness perception (IP) and dyadic coping (DC). Therefore, this study aimed to (1) describe the IR of patients with cervical cancer, (2) identify the relationships and pathways among IP, DC and IR in patients with cervical cancer and (3) explore the mediating role of DC between IP and IR in cervical cancer patients.

METHODS

A total of 175 patients with cervical cancer were recruited at a tertiary hospital in China from September 2021 to January 2023. The data were collected through a general demographic and disease-related information questionnaire, the Locke-Wallace Marriage Adjustment Test, the Revised Illness Perception Questionnaire of Cervical Cancer and the Dyadic Coping Inventory.

RESULTS

The mean score for intimate relationships was 107.78 (SD = 23.99, range 30-154). Pearson's correlation analysis revealed that intimate relationships were positively correlated with IP (personal control) and DC (stress communication, supportive DC, delegated DC and common DC) and were negatively correlated with IP (consequence, timeline acute/chronic, timeline cyclical and emotional representation) and negative DC. As for the results of the structural equation model, DC fully mediated the influencing effects of both positive and negative IP on IR.

CONCLUSIONS

The level of IR of patients with cervical cancer in China should be improved. DC has a significant mediating effect on the link between the IP and IR.

Perceived stress, marital satisfaction, and prenatal depression among couples with gestational diabetes mellitus

OBJECTIVE

This study aimed to explore the prevalence of prenatal depression and to determine the dyadic relationship between perceived stress, marital satisfaction, and prenatal depression in pregnant women with gestational diabetes mellitus (GDM) and their partners.

BACKGROUND

GDM during pregnancy is a very stressful event for couples. However, previous studies have largely focused on pregnant women, with few including their partners.

METHODS

A cross-sectional study was conducted in Guangzhou, China, from 30 July to 2 December 2021. Three hundred fourteen couples with GDM completed the Perceived Stress Scale, Locke-Wallace Marital Adjustment Scale, and Edinburgh Postnatal Depression Scale. Dyadic analysis was conducted using the actor-partner interdependence mediation model.

RESULTS

The prevalence of depressive symptoms was 13.4% in pregnant women with GDM and 8.3% in their partners. Regarding the actor effects, perceived stress was positively associated with prenatal depression in pregnant women with GDM and their partners, respectively, and marital satisfaction acted as a mediating role. Regarding the partner effects, paternal perceived stress was negatively associated with maternal marital satisfaction, and maternal marital satisfaction mediated the association between paternal perceived stress and maternal prenatal depression.

CONCLUSIONS

Dyadic effects of perceived stress, marital satisfaction, and prenatal depression exist in couples with GDM.

Fear of progression among colorectal cancer patients: a latent profile analysis

PURPOSE

Fear of progression (FoP) leads to poor clinical outcomes in colorectal cancer patients. The study aimed to clarify the profiles and influencing factors of FoP among colorectal cancer patients.

METHODS

A cross-sectional study was conducted with 409 colorectal cancer patients. Convenience sampling method was used to select colorectal cancer patients hospitalized in a tertiary-level hospital in Nanjing as the survey subjects. General information questionnaire, Fear of Progression Questionnaire-Short Form, Distress Disclosure Index, and Social Support Rating Scale were used to collect the data. Latent profile analysis was used to explore the latent profiles of FoP in colorectal cancer patients. Additionally, the influencing factors of profiles were explored by Univariate Analysis and Binomial Logistic Regression Analysis.

RESULTS

Latent profile analysis identified two subgroups of fear of disease progression: the "fear low-risk profile (83%)", and the "severe fear profile (17%)." Patients with low age, low social support utilization, first hospital admission, severe healthcare burden, and preoperative bowel symptoms were prone to severe fear of disease progression.

CONCLUSIONS

There is some heterogeneity in the level of postoperative fear of disease progression in colorectal cancer patients. Doctors and nurses should focus on patients with severe fear and take targeted preventive and psychological care for patients' fear of disease progression as early as possible according to the distribution characteristics of different categories.

Marital Self-Disclosure Intervention for the Fear of Cancer Recurrence in Chinese Patients With Gastric Cancer: Protocol for a Quasiexperimental Study

BACKGROUND

Patients with gastric cancer experience different degrees of fear of cancer recurrence. The fear of cancer recurrence can cause and worsen many physical and psychological problems. We considered the "intimacy and relationship processes in couples' psychosocial adaptation" model.

OBJECTIVE

The study aims to examine the effectiveness of a marital self-disclosure intervention for improving the level of fear of cancer recurrence and the dyadic coping ability among gastric cancer survivors and their spouses.

METHODS

This is a quasiexperimental study with a nonequivalent (pretest-posttest) control group design. The study will be conducted at 2 tertiary hospitals in Taizhou City, Jiangsu Province, China. A total of 42 patients with gastric cancer undergoing chemotherapy and their spouses will be recruited from each hospital. Participants from Jingjiang People's Hospital will be assigned to an experimental group, while participants from Taizhou People's Hospital will be assigned to a control group. The participants in the experimental group will be involved in 4 phases of the marital self-disclosure (different topics, face-to-face) intervention. Patients will be evaluated at baseline after a diagnosis of gastric cancer and reassessed 2 to 4 months after baseline. The primary outcome is the score of the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) for patients. The secondary outcomes are the scores of the FoP-Q-SF for partners and the Dyadic Coping Inventory.

RESULTS

Research activities began in October 2022. Participant enrollment and data collection began in February 2023 and are expected to be completed in 12 months. The primary results of this study are anticipated to be announced in June 2024.

CONCLUSIONS

This study aims to assess a marital self-disclosure intervention for improving the fear of cancer recurrence in Chinese patients with gastric cancer and their spouses. The study is likely to yield desirable positive outcomes as marital self-disclosure is formulated based on evidence and inputs obtained through stakeholder interviews and expert consultation. The study process will be carried out by nurses who have received psychological training, and the quality of the intervention will be strictly controlled.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05606549; https://clinicaltrials.gov/study/NCT05606549.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/55102.

The effectiveness of couple-based interventions on the marital outcomes of women with genital and breast cancer and their partners: a systematic review and meta-analysis

BACKGROUND

Breast cancer and genital cancer are known as cancers that affect people's relationships with their partners. Women with such cancers are emotionally vulnerable and need more support from their partners. The present systematic review and meta-analysis evaluated the effectiveness of couple-based interventions on the marital outcomes of patients with these cancers and their intimate partners.

METHODS

To perform this systematic review, Google Scholar and databases such as PubMed, Web of Science, Cochrane, Scopus, SID (Scientific Information Database), and Magiran were searched systematically. The reviewed studies included randomized controlled trials and quasiexperimental studies in which the intervention group, couple-based interventions, and the control group received routine care, general education or no intervention for cancer treatment. In this study, the included participants were patients with breast cancer or genital cancer and their intimate partners. The primary outcomes considered in this study included patients' marital adjustment, patients' marital satisfaction, patients' marital intimacy, and patients' marital relationships. The secondary outcomes were partners' marital adjustment, partners' marital satisfaction, partners' marital intimacy, and partners' marital relationships. A meta-analysis was performed with Review Manager v. 5.3 software (The Nordic Cochrane Centre, Cochrane Collaboration, 2014; Copenhagen, Denmark). The intervention impacts on continuous outcomes were measured using standardized mean differences (SMDs) with 95% confidence interval because of the use of various scales to evaluate the outcomes. The quality of evidence presented in the included studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In the subgroup analysis, the studied outcomes were divided into two parts (theory-based and non-theory-based) in terms of the theoretical context of couple-based interventions.

RESULTS

From a total of 138 retrieved studies, 14 trials were eligible for inclusion in the study. The results of the meta-analysis showed that the patient's marital satisfaction increased significantly with couple-based interventions (SMD 0.46, 95% confidence interval 0.07 to 0.85; 7 trials, 341 patients, very low certainty) compared to the control group, but the evidence was uncertain. However, there were no significant differences between the groups in the partner's marital satisfaction, the patient's and partner's marital adjustment, and the patient's and partner's marital intimacy. Additionally, the results of the subgroup analysis showed that the couple-based interventions significantly increased the patient's marital adjustment (SMD 1.96, 95% CI 0.87 to 3.06; 4 trials, 355 patients, very low certainty), the partner's marital adjustment (SMD 0.53, 95% CI 0.20 to 0.86; 4 trials, 347 partners, very low certainty), the patient's marital satisfaction (SMD 0.89, 95% CI 0.35 to 1.43; 2 trials, 123 patients, very low certainty), and the partner's marital satisfaction (SMD 0.57, 95% CI 0.20 to 0.94; 2 trials, 123 partners, very low certainty) compared to the control group in theory-based studies. In. However, in non-theory-based studies, the results of the meta-analysis revealed no significant differences between the intervention and control groups.

CONCLUSIONS

The results of this study demonstrated the impact of couple-based interventions on the marital outcomes of patients with breast and genital cancers. Because of the very low confidence in the evidence, high-quality randomized trials with a sufficient sample size should be conducted considering the proper theoretical context.

Patients with advanced cancer and their spouses parenting minor children: The role of the relationship context in parenting concerns

OBJECTIVE

Patients with advanced cancer who parent minor children report parenting concerns and increased psychological distress. This cross-sectional study seeks to understand parenting-related issues in patients and spousal caregivers from a relationship perspective.

METHODS

Patients with a metastatic solid malignancy and their spouses independently completed cross-sectional assessments of psychological distress (Hospital Anxiety and Depression Scale), parenting concerns (Parenting Concern Questionnaire) and efficacy (Cancer-Related Parenting Self-Efficacy Scale), and relationship measures (DAS-7, Couples' Illness Communication Scale, and Family Relationship Index).

RESULTS

Of the 51 patients (57% female, 49% NHW, mean age 42 years) and spouses (43% female, 43% NHW, mean age of 42 years), approximately 50% couples endorsed psychological distress and were at risk for family dysfunction. Spouses reported significantly higher levels of parenting-related concerns (t = -2.0, p < 0.05) and anxiety (t = -2.8, p < 0.001) than patients. Parenting concerns were significantly associated with illness communication (r = -0.56, p < 0.001) and family function (r = -0.38, p < 0.001). Although the expected interactions between parenting concerns and relationship variables (i.e., illness communication, dyadic adjustment, and family function) were significant for depressive symptoms at p < 0.05, the associations were not in the expected direction. Relationship function buffered against depressive symptoms for those with low rather than high parenting concerns.

CONCLUSIONS

Not only patients but also spouses report cancer-related parenting concerns. The associations between parenting concerns and distress were stronger for spouses than patients. Dual caregiving appears to be a particularly stressful role. Because relationship function was associated with parenting concerns, we suggest that parent support programs that are couple-based and include both parenting-specific and relationship-specific content may be most effective in reducing distress for this vulnerable population.

Couples communication and cancer: Sequences and trajectories of behavioral affective processes in relation to intimacy

Cancer poses a set of physical and emotional challenges to the patient, spouse, and their relationship. One challenge for couples is discussing cancer-related concerns in a manner that facilitates intimacy. Current couple-based interventions have been shown to have mixed efficacy, and little is known about how they bring about improvements. This study aims to expand our understanding of dyadic communication and intimacy to adapt and/or develop more effective interventions for couples coping with cancer. To accomplish this goal, the present study examined affective and behavioral processes associated with intimacy using the valence-affective-connection (VAC) framework and observational coding methods. Participants were 134 couples in which a patient was diagnosed with breast, colorectal, or lung cancer. Couples completed a battery of questionnaires, including a self-report measure of intimacy. Couples also completed a 15-min videotaped interaction about a cancer topic of their choosing, which was observationally coded for communication behavior and affective expression. Couples coping with cancer who reported higher versus lower intimacy engaged in qualitatively different levels, types, and patterns of communication behavior and affective expression. Specifically, couples who reported lower relationship intimacy used negative approach behavior and hard negative affect more frequently and for longer periods of time and were more likely to use avoidance-based communication. Higher intimacy couples were less likely to sustain the use of negative behavior and affect and displayed more reciprocity of positive joining affect. The study highlights important considerations for couple-based interventions and research in the context of cancer. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The effect of a couple-based posttraumatic growth intervention in supporting couples coping with colorectal cancer: A randomized controlled study

OBJECTIVES

To promote posttraumatic growth (PTG) in colorectal cancer (CRC) couples, a couple-based PTG intervention was conducted, and the intervention had previously proved be feasible in CRC couples. The current study was conducted to validate the effects of intervention in CRC couples.

METHOD

This is a randomized controlled study that included 174 CRC couples. All participants were randomized to either the intervention (usual care plus 5-week PTG intervention, n = 87) or the control group (usual care, n = 87). Data were collected from CRC couple dyads at baseline and immediately post-intervention periods. Primary outcome refers to positive changes, and secondary outcomes include marital satisfaction, quality of life (QOL), and anxiety and depression. Multilevel modeling was applied to analyze the intervention effects.

RESULTS

Participants in the program showed increased PTG, marital satisfaction, and QOL both physically and mentally, and decreased levels of anxiety and depression over time. And spousal caregivers showed greater improvement in marital satisfaction and physical QOL compared with patients. In addition, significant intervention effects were shown in the participants' benefit finding, physical health and depressive symptoms.

CONCLUSION

The study confirmed the effect of the PTG intervention on CRC couples' benefit finding, physical health and depressive symptoms. However, this study only measured outcome variables at two time-points. Future studies should add follow-up assessments to evaluate long-term effects of the intervention in CRC couples.

REGISTRATION NUMBER

ChiCTR2300067809.

Dyadic association between mindfulness, family avoidance of communication about cancer and fear of cancer recurrence among breast cancer couples: A cross-sectional study

PURPOSE

The research focused on examining the dyadic relationship between mindfulness, fear of cancer recurrence (FCR), and family avoidance of communication about cancer (FACC) within breast cancer couples.

METHODS

This study utilized a cross-sectional approach to gather data from 249 breast cancer couples. Participants completed self-report measures assessing mindfulness, FCR, and FACC. The Actor-Partner Interdependence Mediation Model was applied to analyze how each individual's and their partner's mindfulness affected their own and their partner's FCR, as well as the mediating role of FACC in this relationship.

RESULTS

The study found that the average FCR score for breast cancer patients was (32.59 ± 10.05), while their spouses had a score of (34.39 ± 8.60). The bootstrap method showed that self-FACC as a mediator between mindfulness in breast cancer couples and their own FCR (patient: β = -0.044, P = 0.019; spouse: β = -0.046, P = 0.007). Patients' FACC influenced the connection between their mindfulness and spouses' FCR (β = -0.031, P = 0.030).

CONCLUSIONS

The findings highlight the potential for interventions that focus on mindfulness and communication enhancement to alleviate FCR and improve the overall well-being of breast cancer couples.

Couples and concealable chronic illness: Investigating couples' communication, coping, and relational well-being over time

Couples managing chronic illnesses-the leading causes of death and disability in the United States-can experience challenges in their daily lives and relationships. Both couple members have reported lower satisfaction, greater burden, and communication difficulties. Many of these illnesses are nonvisible or concealable, increasing fear and uncertainty when sharing illness information, and reducing self-disclosure. These challenges can leave couples vulnerable to dissatisfaction and distress. In this longitudinal study, we integrated dyadic coping frameworks to examine how couples' communication and coping predicted relational well-being over time. Couples, where one partner was diagnosed with a concealable chronic illness, completed three online surveys 6 months apart (n = 242 couples at baseline, 146 couples at 6 months, and 123 couples at 12 months). Couples were recruited from university settings. Actor-partner interdependence mediation models using within-person multilevel dyadic path modeling tested the theoretical model. For patient and partner actor effects, at times when they saw the illness as shared and something that they could manage together, the more they talked about the illness and used dyadic coping strategies (p < .001). In turn, when using dyadic coping strategies more often, patients and partners felt more satisfied, close, and sexually satisfied than they typically felt that year (p < .001). For cross-partner effects, when patients talked about the illness more than usual, their partners also used dyadic coping strategies more often (p = .01). Patients' open communication may not only benefit themselves but also their partners. This multifaceted approach offers new insight into promoting relational well-being while managing concealable chronic illness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Why do we feel close to a person who expresses gratitude? Exploring mediating roles of perceived warmth, conscientiousness, and agreeableness

The literature suggests that expressed gratitude improves the interpersonal relationship between a beneficiary and a benefactor. However, there is little research that has explored why thanking provides these positive effects, so this study investigated thanking mechanisms to explain reasons why people feel close to a beneficiary who expresses gratitude. This study also examines the effects of apologies, which are sometimes used to show gratitude in Japan. In this experimental study, 671 Japanese participants reported their perceived closeness, warmth, conscientiousness, and agreeableness to a hypothetical beneficiary who expressed gratitude, apologies, or both after a benefit was provided. The results revealed that benefactors who received a message indicating gratitude and both gratitude and apologies reported higher levels of closeness toward a beneficiary than those who received a message with only apologies and a message without either gratitude or apologies. A structural equation model further indicated that warmth and conscientiousness mediated the link between expressed gratitude/apologies and perceived closeness.

Mutual communication processes within Chinese colorectal cancer patient-spousal caregiver dyads: A qualitative study of taking gender into account

PURPOSE

Mutual communication within cancer couples is a complex process. More research is needed to explore the complex process of mutual communication and its nuances presented by various factors in different culture contexts. Gender, a factor embedded in marital relationships, is an important consideration. We thus aim to explore the mutual communication process within Chinese colorectal cancer couples and take gender into account.

METHODS

A qualitative study was conducted by interviewing 20 colorectal cancer patients and 15 spousal caregivers. Inductive thematic analysis was used to analyze the transcripts.

RESULTS

Three themes (mutual communication and support interaction, communication quality, and foundation of mutual communication and collaboration) were developed. Gender was found to have specific impact on emotional disclosure and communication challenges. A preliminary framework of "smile" was constructed to demonstrate the relationship among the three themes and the relationships between the three themes and dyads' psychosocial adaptation to colorectal cancer.

CONCLUSIONS

Study findings demonstrate complex mutual communication processes within colorectal cancer couples and the impact of gender. The findings will contribute to developing more effective colorectal cancer couple-based mutual communication interventions. Health practitioners are suggested to improve mutual communication within colorectal cancer couples in three aspects: relational topics, emotional disclosure and communication skills. Guiding couples to deal with each theme and the relationship among the themes simultaneously is helpful for them to return and smile to their normal life.

Intimacy and survivors of cancer with ostomies: findings from the Ostomy Self-management Training trial

BACKGROUND

Many people with abdominal or pelvic cancers require an ostomy during surgical treatment, which can cause significant issues with physical and emotional intimacy in relationships.

AIM

To evaluate the effect of a telehealth-based education program on intimacy over time for survivors of cancer with ostomies.

METHODS

We performed a secondary analysis of our multicenter randomized controlled trial to determine intimacy outcomes and to compare the effects of the Ostomy Self-management Training (OSMT) program vs usual care. Partnered patients were included who provided answers to the City of Hope Quality of Life-Ostomy survey for at least 2 time points during the study. We evaluated the effect of baseline information, such as gender on intimacy.

OUTCOMES

The primary outcome was intimacy, estimated by a composite score created from questions within the City of Hope Quality of Life-Ostomy survey.

RESULTS

Of 216 enrolled volunteers, 131 had a partner: 68 in the OSMT arm and 63 in the usual care arm. Of these, 48 were women and 83 were men. The tumor types represented in this study were colorectal (n = 69), urinary (n = 45), gynecologic (n = 10), and other (n = 7; eg, melanoma, liposarcoma). From the cohort, 87 answered the 5 composite intimacy score questions at 2 time points, including baseline. There was significant improvement over time in composite intimacy scores for participants in the OSMT arm vs the usual care arm.

CLINICAL IMPLICATIONS

Our OSMT intervention had a positive effect on factors that contribute to intimacy for survivors of cancer with ostomies, suggesting that a survivorship curriculum can improve their experiences after ostomy surgery.

STRENGTHS AND LIMITATIONS

OSMT allowed for discussion of intimacy and other sensitive topics, which can be challenging. These discussions demonstrate benefit to participants and can serve as frameworks for cancer treatment providers. The focus of this work on partnered participants provides insight into the interpersonal challenges of a life with an ostomy, but it may overlook the important perspectives of nonpartnered participants and the partners themselves. Furthermore, limited power prevented us from conducting subgroup analyses exploring the effects of factors such as gender and tumor type on intimacy.

CONCLUSION

At 6-month follow-up, the novel intimacy composite score indicated improvement for participants completing the OSMT intervention. Future research studies with higher power will validate this intimacy measurement and identify intimacy differences in similar populations based on tumor type.

Toward an Integrative Model of Intimacy, Sexual Satisfaction, and Relationship Satisfaction: A Prospective Study in Long-Term Couples

Sexual and relationship well-being are strongly intertwined in couple relationships. However, relationship quality is generally examined through relationship satisfaction only, neglecting the importance of sexual satisfaction as an aspect of relationship quality for many couples. Moreover, considering the role of interpersonal processes, such as intimacy, in relationship quality seems essential to better understand couples' optimal functioning. Although the Vulnerability-Stress-Adaptation Model posits bidirectional associations between interpersonal processes and relationship quality, few studies have tested such models. This dyadic study examined the longitudinal associations between the process of intimacy and sexual and relationship satisfaction in 145 long-term mixed-gender/sex couples. Participants completed online questionnaires three times over 13 months. A cross-lagged panel model revealed bidirectional associations between intimacy behaviors and both sexual and relationship satisfaction. Findings suggest that intimacy behaviors could foster both sexual and relationship satisfaction in couples, and that higher sexual and relationship satisfaction could also promote intimacy behaviors over time. These results highlight that satisfaction may not only be an outcome of positive interpersonal processes, but also a facilitator of these interpersonal processes over time. This study underscores the need to consider the complex interplay of interpersonal processes and satisfaction to foster relationship quality in long-term couples over time.

The psychosocial experiences of head and neck cancer caregivers following (chemo)radiotherapy: A systematic qualitative review and narrative synthesis

OBJECTIVE

Oropharyngeal cancer, a type of head and neck cancer (HNC), the incidence of which is increasing, often affects younger patients than traditional HNC, having distinct psychosocial consequences. Treatment side effects mean many rely on informal caregivers following (chemo)radiotherapy. The purpose of this review was to describe current understanding of the psychosocial experiences of these caregivers in the post-treatment phase.

METHODS

A systematic search for relevant studies between January 2010 and October 2022 in three electronic databases (CINAHL, MEDLINE and PsycINFO) was followed by citation searching. Inclusion criteria were developed to ensure studies explored caregivers' experiences during the post-treatment phase following oropharyngeal cancer (chemo)radiotherapy. Thematic analysis informed by the 'Cancer Family Caregiving Experience Model', identified stressors, appraisals and responses. Themes evolved through the synthesis of recurrent concepts across the studies and a narrative of psychosocial experiences and their impact upon caregiver well-being was developed.

RESULTS

Fifteen HNC papers which included exploration of the psychosocial experiences of oropharyngeal cancer caregivers following (chemo)radiotherapy were selected. Findings were synthesised to develop five themes: an emotional struggle, supporting nutrition, altered lifestyles, changes within relationships and support needs.

CONCLUSIONS

The completion of (chemo)radiotherapy signalled a transition for these caregivers as they undertook burdensome responsibilities. Experiences indicated that preparation for the role, assessment of needs, and targeted support is required. Additionally, caregivers' recognition by healthcare professionals as caring partners could help moderate this demanding experience.

Impact of Head and Neck Cancer Diagnosis and Treatment on Patient-Partner Intimacy

OBJECTIVE

To determine the effects of head and neck squamous cell carcinoma diagnosis and treatment on patient- and partner-perceived intimacy and to understand if a diagnosis of HPV-related head and neck squamous cell carcinoma influences patient-partner intimacy.

STUDY DESIGN

Prospective observational.

SETTING

Single tertiary care center.

METHODS

An investigator-developed questionnaire was used to prospectively survey patients and partners in 2 groups based on human papillomavirus (HPV) status: HPV+ and HPV- at diagnosis (visit 1) and after treatment (visit 2). Surveys were scored on a 60-point scale, and results were categorized as follows: loss of intimacy (0-30), stable relationship (31-41), or improvement in intimacy (42-60). Responses of couples who participated together were assessed for concordance. Responses were considered discordant if patient and partner scores equated to different levels of perceived intimacy. Median patient and partner scores were compared via Mann-Whitney U test, and concordance was assessed with a chi-square test.

RESULTS

Thirty-four patients and 28 partners completed surveys at visit 1 and 28 patients and 15 partners at visit 2. Median scores among patients and partners were similar at the first time point (HPV+, 45 vs 45, P = .64; HPV-, 42.6 vs 40.8, P = .29) and the second (HPV+, 44.5 vs 44, P = .87; HPV-, 40.2 vs 39.6, P = .90). Concordance rates between HPV+ and HPV- couples were 63% vs 44% (P = .43) for the first time point and 89% vs 50% (P = .24) for the second.

CONCLUSION

Patients and partners reported stable or improved intimacy at both time points, and most couples tended to agree on their levels of perceived intimacy. A diagnosis of HPV did not appear to significantly affect intimacy scores.

It's time to address fear of cancer recurrence in family caregivers: usability study of an virtual version of the Family Caregiver-Fear Of Recurrence Therapy (FC-FORT)

Background

Family caregivers of cancer survivors experience equal or greater levels of fear of cancer recurrence (FCR) than survivors themselves. Some interventions have demonstrated their ability to reduce FCR among cancer survivors and dyads (patient and caregivers). However, to date, no validated intervention exists to focus solely on family caregiver's FCR.

Objectives

This study aimed to (1) adapt the evidence-based in-person Fear Of Recurrence Therapy (FORT) for family caregivers (referred here in as FC-FORT) and to a virtual delivery format and (2) test its usability when offered virtually.

Methods

The adaptation of FC-FORT was overseen by an advisory board and guided by the Information Systems Research Framework. Following this adaptation, female family caregivers and therapists were recruited for the usability study. Participants took part in 7 weekly virtual group therapy sessions, a semi-structured exit interview and completed session feedback questionnaires. Therapists were offered a virtual training and weekly supervision. Fidelity of treatment administration was assessed each session. Quantitative data were analyzed using descriptive statistics. Exit interviews were transcribed verbatim using NVivo Transcription and coded using conventional content analysis. Results were presented back to the advisory board to further refine FC-FORT.

Results

The advisory board (n = 16) met virtually on 7 occasions to adapt FC-FORT (i.e., patient manuals, virtual format) and discuss recruitment strategies. Minor (e.g., revised text, adapted materials to virtual format) and major adaptations (e.g., added and rearranged sessions) were made to FC-FORT and subsequently approved by the advisory board. Four family caregivers and three therapists took part in the first round of the usability testing. Six family caregivers and the same three therapists took part in the second round. Overall, participants were very satisfied with FC-FORT's usability. Qualitative analysis identified 4 key themes: usability of FC-FORT, satisfaction and engagement with content, group cohesion, and impact of FC-FORT. All participants indicated that they would recommend FC-FORT to others as is.

Conclusions

Using a multidisciplinary advisory board, our team successfully adapted FC-FORT and tested its usability using videoconferencing. Results from this study indicate that the efficacy and acceptability of FC-FORT are now ready to be tested in a larger pilot study.

Concurrent and Prospective Associations Between Communicated Emotional Arousal and Adjustment Among Couples Coping With Cancer

BACKGROUND

The experience of cancer can create considerable emotional distress for patients and their committed partners. How couples communicate about cancer-related concerns can have important implications for adjustment. However, past research has primarily utilized cross-sectional designs and retrospective self-reports of couple communication. While informative, little is known about how patients and partners express emotion during conversations about cancer, and how these emotional patterns predict individual and relational adjustment.

PURPOSE

The current investigation examined how patterns of emotional arousal within couples' communication about cancer was associated with concurrent and prospective individual psychological and relational adjustment.

METHODS

At baseline, 133 patients with stage II- breast, lung, or colorectal cancer and their partners completed a conversation about a cancer-related concern. Vocally expressed emotional arousal (f0) was extracted from recorded conversations. Couples completed self-report measures of individual psychological and relational adjustment at baseline and at 4, 8, and 12 months later.

RESULTS

Couples who started the conversation higher in f0 (i.e., greater emotional arousal) reported better individual and relational adjustment at baseline. If the non-cancer partner had lower f0 relative to patients, this predicted worse individual adjustment across follow-up. Additionally, couples who maintained their level of f0 rather than decreasing later in the conversation reported improvements in individual adjustment across follow-up.

CONCLUSIONS

Elevated emotional arousal within a cancer-related conversation may be adaptive for adjustment, as it may reflect greater emotional engagement and processing of an important topic. These results may suggest ways for therapists to guide emotional engagement to enhance resilience in couples experiencing cancer.

Relationship satisfaction and self-esteem in patients with breast cancer and healthy women: the role of expected and actual personal projects support from the partner

BACKGROUND

For breast cancer patients, the partner's support for personal projects can serve as a means of adaptation. We aimed to investigate the associations between the intimate partner's personal project support and women's well-being.

METHODS

A sample of 274 Hungarian women (breast cancer patients n = 137, control n = 137) took part in the study. Expected and actually received autonomy-, directive- and emotional project support was assessed by the procedure of Personal Project Assessment. Well-being was measured by the Relationship Assessment Scale and the Rosenberg Self-Esteem Scale. For investigating the associations between project support and well-being in a multivariate way, structural equation modelling was used.

RESULTS

Except for autonomy support, participants expected more support than they received. A path model indicated multiple associations between types of project support and relationship satisfaction and self-esteem. The partner's emotional project support was predictive of women's relationship satisfaction and self-esteem, while directive support was predictive of self-esteem only. The associations showed similar patterns in the subgroups of patients with breast cancer and control.

CONCLUSIONS

Our results highlight the importance of involving women's subjective perspectives regarding the partner's project support while also have implications for praxis. Teaching women how to communicate their needs to their partner effectively (whether it is the need for autonomy or directive guidance) can help close the gap between expected and received support, which may in turn enhance relationship satisfaction and self-esteem.

The worse we feel, the more intensively we need to stick together: a qualitative study of couples' emotional co-regulation of the challenge of multimorbidity

Introduction

Being faced with multimorbidity (i.e., being diagnosed with at least two chronic conditions), is not only demanding in terms of following complicated medical regimes and changing health behaviors. The changes and threats involved also provoke emotional responses in the patients but also in their romantic partners. This study aims at exploring the ways of emotional co-regulation that couples facing multimorbidity express when interviewed together.

Method

N = 15 opposite sex couples with one multimorbid patient after an acute health crisis that led to hospitalization were asked in a semi-structured interview about how they found ways to deal with the health situation, what they would recommend to other couples in a similar situation, and how they regulated their emotional responses. Interviews were analyzed qualitatively following open, axial, and selective coding, as in the grounded theory framework.

Results

Emerging categories from the romantic partners' and the patients' utterances revealed three main categories: First, overlapping cognitive appraisals about the situation (from fighting spirit to fatalism) and we-ness (construing the couple self as a unit) emerged as higher order factor from the utterances. Second, relationship-related strategies including strategies aimed at maintaining high relationship quality in spite of the asymmetric situation like strengthening the common ground and balancing autonomy and equity in the couple were often mentioned. Third, some couples mentioned how they benefit from individual strategies that involve fostering individual resources of the partners outside the couple relationship (such as cultivating relationships with grandchildren or going outdoors to nature).

Discussion

Results underline the importance of a dyadic perspective not only on coping with disease but also on regulating the emotional responses to this shared challenging situation. The utterances of the couples were in line with earlier conceptualizations of interpersonal emotion regulation and dyadic perspectives on we-disease. They broaden the view by integrating the interplay between individual and interpersonal regulation strategies and underline the importance of balancing individual and relational resources when supporting couples faced with chronic diseases.

Marital satisfaction, partner communication, and illness acceptance among couples coping with breast cancer: A dyadic approach

OBJECTIVE

Associations between marital satisfaction and illness acceptance are mediated by different factors. This study examines whether partner communication mediates relationships between marital satisfaction and illness acceptance among couples coping with breast cancer within a dyadic approach.

METHODS

One hundred and thirty-six couples were examined: 136 women with a diagnosis of breast cancer and their 136 spouses without a history of cancer. Questionnaires measuring marital satisfaction, partner communication, and illness acceptance were used. SEM analysis was applied to examine mediation effects.

RESULTS

For the patients, marital satisfaction was positively associated with supportive self-communication, supportive partner communication, and illness acceptance. For the spouses, marital satisfaction was positively correlated with supportive self-communication and supportive partner communication, yet, it was negatively correlated with deprecating communication of both self and partner. The associations between marital satisfaction and illness acceptance were mainly mediated by supportive communication (self and partner).

CONCLUSIONS

An examination of partner communication within a dyad is crucial for understanding relationships between marital satisfaction and illness acceptance in breast cancer patients. These relationships predominantly depend on the supportive communication of cognitive and emotional information between the spouses.

Obstacles and facilitators of cancer-related dyadic efficacy experienced by couples coping with non-metastatic cancers

Introduction

Cancer-related dyadic efficacy is an individual's confidence to work together with a partner to conjointly manage the effects of cancer and its treatment. In other health contexts, higher levels of dyadic efficacy have been associated with fewer symptoms of psychological distress and higher ratings of relationship satisfaction. The aim of the current study was to explore patient and partner perspectives on what obstructs and facilitates cancer-related dyadic efficacy.

Methods

These aims were accomplished through a secondary analysis of data collected as a part of a collective qualitative case study. Participants (N = 17 participants) were patients undergoing treatment or recently completed treatment (within 6 months) for a non-metastatic cancer and their partners. To enable in-depth discussions among participants, data was collected through five focus groups. Participants described obstacles and facilitators of dyadic efficacy as dimensions of a common influence. Consistent with these descriptions, reflexive thematic analysis was used to identify influences on cancer-related dyadic efficacy and their subsequent obstructive and facilitative dimensions.

Results

Four main categories of influence with the potential to obstruct or facilitate cancer-related dyadic efficacy were identified along with their subthemes: appraisals of the couple relationship (quality and togetherness), communication (pattern and interest in information), coping (strategy and evaluation), and responses to change (in tasks and roles and sex life). Eight obstructive and seven facilitative dimensions of these subthemes were described.Discussion: This first analysis of obstacles and facilitators of couples' cancer-related dyadic efficacy capitalized on the experiential expertise of individuals with cancer and their partners. These thematic results are instructive for the design of dyadic efficacy-enhancing interventions for couples coping with cancer.

The independent prognostic effect of marital status on non-small cell lung cancer patients: a population-based study

Background

Previous studies had demonstrated that marital status was an independent prognostic factor in multiple cancers. However, the impact of marital status on non-small cell lung cancer (NSCLC) patients was still highly controversial.

Method

All NSCLC patients diagnosed between 2010-2016 were selected from the Surveillance, Epidemiology and End Results (SEER) database. To control the confounding effect of related clinicopathological characteristics, propensity score matching (PSM) was conducted between married and unmarried groups. In addition, independent prognostic clinicopathological factors were evaluated via Cox proportional hazard regression. Moreover, nomograms were established based on the clinicopathological characteristics, and the predictive accuracy was assessed by calibration curves. Furthermore, decision curve analysis (DCA) was used to determine the clinical benefits.

Results

In total, 58,424 NSCLC patients were enrolled according to the selection criteria. After PSM, 20,148 patients were selected into each group for further analysis. The married group consistently demonstrated significantly better OS and CSS compared to unmarried group [OS median survival (95% CI): 25 (24-26) vs. 22 (21-23) months, p < 0.001; CSS median survival (95% CI): 31 (30-32) vs. 27 (26-28) months, p < 0.001]. Moreover, single patients were associated with the worst OS [median survival (95% CI): 20 (19-22) months] and CSS [median survival (95%CI): 24 (23-25) months] among unmarried subgroups. Besides, unmarried patients had a significantly worse prognosis compared to married patients in both univariate and multivariate Cox proportional hazard regressions. Furthermore, married group was associated with better survival in most subgroups. To predict the 1-, 3- and 5-year OS and CSS probabilities, nomograms were established based on age, race, sex, gender, marital status, histology, grade, TNM stage. The C-index for OS and CSS were 0.759 and 0.779. And the calibration curves showed significant agreement between predictive risk and the observed probability. DCA indicated nomograms had consistently better predict performance.

Conclusion

This study demonstrated that unmarried NSCLC patients were associated with significantly worse OS and CSS compared to married NSCLC patients. Therefore, unmarried patients need not only closer surveillance, but also more social and family support, which may improve patients' adherence and compliance, and eventually improve the survival.

Discrepancies in dyadic coping: associations with distress and quality of life in couples facing early stage dementia

Objectives

Due to an aging population, the number of persons living with dementia (PWDs) is increasing worldwide. Romantic partners, as informal caregivers (IC) of PWDs, are often adopting additional tasks. The concept of dyadic coping (DC) addresses how couples cope with stress together. For dyadic coping to be successful, efforts of both partners should be equal. The current study examines how discrepancies in PWDs and ICs perspectives on DC relate to distress and quality of life in each partner within couples facing early stage dementia (ESD).

Methods

A total of 37 mixed-sex couples including one partner with ESD completed self-report questionnaires. Discrepancies in reciprocity (comparing provided or received levels of DC between partners), equity (each partner balancing own levels received and provided), and congruence (the agreement about levels of DC exchanged between partners) and their covariation with distress and quality of life (QoL) of each partner were measured.

Results

Both partners indicated a discrepancy in reciprocity: PWDs reported receiving more DC than ICs reported receiving, which was associated with higher QoL in PWDs and lower QoL in ICs. Inequities were found in ICs only, who reported receiving less DC, than providing. No relation between inequities and distress or QoL was found. ICs reported more incongruencies than PWDs did, which was associated with higher QoL and less depression in partners.

Discussion

A redivision of tasks and roles in the early stage of dementia is associated with different experiences and views between partners. Whereas ICs take over most household and care tasks within the couple, their effort was considered less helpful by PWDs than by ICs. A high care burden is associated with a compromised quality of ICs' social life and living conditions. The clinical implications of the results are discussed.

Psychological recovery and well-being of spouses of patients with prostate cancer 5 years after primary treatment in Finland: a follow-up survey

OBJECTIVE AND SETTING

To study longitudinally cancer-related experiences of spouses of patients with prostate cancer and the predictors of their psychological recovery and quality of life (QOL) by following the participants of our previous survey at primary cancer treatment in a university hospital.

DESIGN

A 5-year longitudinal cohort design.

PARTICIPANTS AND PROCEDURE

A follow-up questionnaire was mailed to the female spouses/partners who participated in our previous survey (n=104). We quantitatively explored the spouses' prostate cancer-related experiences since the previous survey and measured their current psychological symptom distress and well-being/QOL. Seventy-seven (74%) of the initial participants responded.

OUTCOMES

The main outcome measures were the spouses' psychological recovery (psychological symptoms at the initial survey vs currently) and well-being/QOL (depressive symptoms, domains of QOL) at 5 years. We analysed their predictors with regression analyses.

RESULTS

The treatment had been prostatectomy in 70% of the patients. Psychological distress had alleviated in 76% of spouses (p<0.001) and emotional changes decreased (p=0.02), but a deteriorating impact on the partnership (from 4% to 16%) and on sex life ('strong impact' from 23% to 37%) had increased. The outcomes were inversely associated with negative depression-related psychological symptoms and emotional changes either initially or at follow-up. However, some early experiences also predicted the outcomes when other factors were controlled for. Prostate cancer-related information received by the spouses from several sources (leaflets/handouts, TV/radio, internet) predicted better recovery and well-being/QOL, whereas the patients' prostate cancer and treatment-related symptoms (pain, irritability/anger, bowel dysfunction) predicted poorer recovery and well-being/QOL in spouses.

CONCLUSIONS

A major negative impact of prostate cancer was experienced by the spouses still 5 years after primary treatment. Early prostate cancer-related experiences predicted long-term psychological recovery and QOL. Responding to the early information needs of spouses and effective symptom management for the patients are likely to enhance the spouses' long-term recovery and well-being.

Psychosocial Care Needs of Women with Breast Cancer: Body Image, Self-Esteem, Optimism, and Sexual Performance and Satisfaction

As breast cancer is on the rise, it is essential to understand the consequences of the diagnosis for patients. This article investigates whether there are differences in different psychosocial variables in Spanish women with breast cancer according to the type of surgery the patients underwent and in comparison with a control group. A study was carried out in the north of Spain in which 54 women participated (27 women were the control group, and 27 women who had been diagnosed with breast cancer). The results of the study indicate that women with breast cancer have lower self-esteem and worse body image, sexual performance, and sexual satisfaction than women in the control group. No differences were found in optimism. These variables do not differ according to the type of surgery the patients underwent. The findings confirm the need to work on these variables in women diagnosed with breast cancer in psychosocial intervention programs.

"A kaleidoscope of relationships" - cervical cancer survivors' perspectives on their intimate relationships: A qualitative study

OBJECTIVE

Cervical cancer is known to affect survivors' intimate relationships, as well as their communication and coping. Yet little is known about the perspectives of these survivors on their intimate relationships in the context of their needs during and after medical treatment. Additionally, only a few studies have focused on survivors' perceived needs or on existing psychosexual support. Understanding these perceptions can help provide a tailored response and improve dyadic interventions. The aim of this study was to examine cervical cancer survivors' perspectives on their intimate relationships during and after their treatment.

METHOD

The present study adopted a qualitative-phenomenological approach. In-depth, semi-structured interviews were conducted with 15 survivors of cervical cancer between the ages of 38 and 44 who were diagnosed at stages I-II and were treated with radiotherapy or chemo-radiotherapy and surgery. Data collection continued until saturation of concepts was reached. The results underwent thematic analysis.

RESULTS

Analysis of the findings revealed two key themes: (1) Together and apart in the shadow of cervical cancer. This theme focuses on the recovery period as a potential opportunity for changing and improving the couple relationship, such that men no longer withdraw but rather provide their partners with needed support and encouragement. (2) Changes in sexual life and couple intimacy. This theme focuses on changes in sexual relations, which have become a burden, painful, and something to avoid.

SIGNIFICANCE OF RESULTS

The study provides a comprehensive picture of intimate relationships during and after cervical cancer treatment and highlights the women's needs and desires for support from their intimate partners. The discussion notes that oncology providers can better facilitate supportiveness on the part of cervical cancer partners by offering better couple-oriented education and interventions to promote couple communication.

Spouse caregivers' identification of the patient as their primary support person is associated with better patient psychological well-being

Examine the impact of the primary-support person (PSP) role on advanced cancer patient and spouse caregiver psychological well-being, above and beyond the effects of relationship satisfaction.

Secondary analysis of cross-sectional questionnaire data.

88 advanced cancer patient/spouse-caregiver dyads.

Patients and caregivers independently completed measures assessing depression, anxiety, perceived stress, and relationship satisfaction, and identified their PSP. Patient and caregiver psychological well-being outcomes were regressed on patient and caregiver PSP variables in an actor-partner interdependence model.

Half of patients identified their caregiver as PSP; 9% of caregivers identified their patient as PSP. When caregivers identified their patient as PSP, the patient reported better outcomes. No associations were seen for patient identification of caregiver as PSP or caregiver well-being.

Clinicians can encourage patients to find ways to continue to focus on their relationship with the caregiver and help caregivers connect with other sources of support.

Effect of intimacy and dyadic coping on psychological distress in pancreatic cancer patients and spousal caregivers

Aims

The aim of this study was to investigate the effect of intimacy and dyadic coping on anxiety and depression in patients with pancreatic cancer and their spousal caregivers.

Methods

This study conducted from October 2021 to June 2022, included 277 pancreatic cancer patients and their spousal caregivers. This research used actor-partner interdependence mediation model to explore the relationship of intimacy, dyadic coping, and psychological distress among pancreatic cancer patients and their spousal caregivers.

Results

The results of this study showed that there were two actor effects: the satisfaction of intimate relationship between pancreatic cancer patients and their spouse caregivers had a positive predictive effect on their dyadic coping (β = 1.787, p < 0.001) and (β = 1.587, p < 0.001). The dyadic coping of pancreatic cancer patients and their spouse caregivers had a negative predictive effect on their own anxiety and depression (β = -0.253, p < 0.001) and (β = -0.293, p < 0.001). The results of this study showed that there was a partner effect: intimate relationship satisfaction of pancreatic cancer patients had a positive predictive effect on dyadic coping of their spousal caregivers (β = 0.574, p < 0.05).

Conclusion

This study demonstrates the interdependence of pancreatic cancer patients and their spousal caregivers in coping with the disease. The healthy intimate relationship and effective dyadic coping styles are essential to alleviating disease pressure and lowering the psychological burden on cancer families.

Social Wellbeing in Cancer Survivorship: A Cross-Sectional Analysis of Self-Reported Relationship Closeness and Ambivalence from a Community Sample

Improvements in early screening and treatment have contributed to the growth of the number of cancer survivors. Understanding and mitigating the adverse psychosocial, functional, and economic outcomes they experience is critical. Social wellbeing refers to the quality of the relationship with partners/spouses, children, or significant others. Close relationships contribute to quality of life and self-management; however, limited literature exists about social wellbeing during survivorship. This study examined positive and negative self-reported changes in a community sample of 505 cancer survivors. Fourteen items assessed changes in communication, closeness with partner/children, stability of the relationship, and caregiving burden. An exploratory factor analysis was conducted using a robust weighted least square procedure. Differences by sociodemographic and clinical characteristics were investigated. Respondents were mostly male, non-Hispanic white, and ≥4 years since diagnosis. Two factors, labeled Relationship Closeness and Ambivalence, emerged from the analysis. Women, younger survivors, individuals from minority groups, and those with lower income experienced greater negative changes in social wellbeing. Variations by treatment status, time since diagnosis, and institution were also reported. This contribution identifies groups of cancer survivors experiencing affected social wellbeing. Results emphasize the need to develop interventions sustaining the quality of interpersonal relationships to promote long-term outcomes.

Quality of sexual life and associated factors: a cross-sectional survey of Chinese breast cancer patients

PURPOSE

This study aimed to explore Chinese breast cancer patients' quality of sexual life (QSL) and factors associated with QSL.

METHODS

The questionnaires in this cross-sectional study include the general information questionnaire, cognition and assessment of sexual health questionnaire, Self-acceptance Questionnaire (SAQ), Medical Coping Modes Questionnaire (MCMQ), and Quality of Sexual Life Questionnaire (QSLQ); 201 breast cancer patients were required to complete the questionnaires assessing characteristic information, cognition and assessment of sexual health, QSL, self-acceptance, and coping style. Finally, hierarchical regression was used to analyze the factors associated with QSL in Chinese breast cancer patients.

RESULTS

The mean age (at the time of the survey) of the breast cancer patients was 48.31±9.15. The mean score of the QSLQ (range 28-140) was 75.14±16.57. Hierarchical regression analysis showed that the associated factors of breast cancer patients' QSL included age (at the time of the survey), education level, type of surgery, cognition and assessment of sexual health, self-acceptance, and avoidance and acceptance-resignation coping styles, that independent variables explained 60.4% of the variance.

CONCLUSION

The QSL among Chinese breast cancer patients needs to be improved. Our findings indicated that breast cancer patients with older age, lower education level, or modified radical mastectomy have poor QSL. Breast cancer patients learn correct information about sexual health, enhance self-acceptance, and reduce acceptance-resignation, and avoidance coping could be intervention strategies to improve their QSL.

Couple-Based Communication Interventions for Cancer Patient-Spousal Caregiver Dyads' Psychosocial Adaptation to Cancer: A Systematic Review

(1) Background: Effective communication among couples in which one has been diagnosed with cancer is critical to improve their psychosocial adaptation to cancer. The objective of this review was to explore the characteristics and measurement outcomes of existing couple-based communication interventions in the cancer context. (2) Methods: Eight electronic databases were searched from database initiation to August 2022 to identify eligible articles. Hand searching was also performed on the included articles' reference lists and authors. (3) Results: A total of 14 intervention studies were eligible to be included in this review. Cancer couples with distress or communication problems before intervention were more likely to benefit from the couple-based communication interventions. Positive outcomes were reported, including an improvement in relationship functioning (including mutual communication, intimacy, and relationship satisfaction) and individual functioning (including a decline of anxiety, depression and cancer-related concerns, and an increase in psychological adjustment and quality of life). (4) Conclusions: These findings supported the importance of improving mutual communication behaviors to promote cancer patient-spousal caregiver dyads' psychosocial adaptation to cancer. While most included studies were conducted in western countries and the sample size was relatively small, more research is warranted to develop more efficacious couple-based communication interventions.

Perception of disease, dyadic coping, and the quality of life of oncology patients in the active treatment phase and their life partners: an approach based on the actor-partner interdependence model

Objective

The aim of this study based on the Systemic Transactional Model was to examine the relationship between dyadic coping and (1) disease perception and (2) quality of life of a sample of cancer patients and their life partners.

Method

This cross-sectional study included 138 oncological dyads. The following questionnaires were used: Stress Appraisal Measure, Dyadic Coping Inventory, and European Organisation for Research and Treatment of Cancer QLQ-C30. Data collected was analysed by applying the actor-partner interdependence model.

Results

The perception of the disease as a threat as well as its centrality significantly negatively influences the positive forms of dyadic coping whilst the perception of the disease as a challenge has a significant positive influence on them. Dyadic coping does not influence symptoms but has significant influences on global health/quality of life.

Conclusion

This study has highlighted new information regarding how couples cope with cancer. The results encourage the inclusion of the perception of the disease and dyadic coping in interventions that aim to improve the quality of life of cancer patients and their life partners.

Sexual quality of life following a cancer diagnosis: a qualitative study

Sexual quality of life (SQoL) challenges are prevalent and persistent for people with a cancer diagnosis. Using a qualitative design, this study investigated the impact of a cancer diagnosis on SQoL in participants (N = 18) with a current or past cancer diagnosis of various sites and severity. Thematic analysis identified three themes: gender attachment, vulnerability, and growth vs. fixed mindset. The theme of gender attachment related to the impact of understanding SQoL based on heteronormative definitions of masculinity and femininity. The second theme of vulnerability suggested that pre-existing relational or personal challenges can amplify the impact of a cancer diagnosis on SQoL. The third theme of growth vs. fixed mindset explored how cognitive flexibility and optimism can support SQoL, while a rigid and pessimistic mindset can exacerbate SQoL challenges. The findings of this study build on the traditional medical understanding of SQoL and can inform SQoL support in cancer care settings.