We are in this together - Aren't we? Congruence of common dyadic coping and psychological distress of couples facing breast cancer

Coping equally: Equity of dyadic coping and depressive symptoms among adolescent couples

INTRODUCTION

Many adolescents are in their first romantic relationship; at the same time, depressive symptoms generally increase during this developmental stage. In adults, equity of support in romantic relationships is associated with less depressive symptoms-especially in female partners, who are generally on "the losing side" of support transactions with male partners. This study examines whether equity of dyadic coping is associated with depressive symptoms in adolescent mixed-gender couples. We disentangle equity of positive and negative dyadic coping, as differential effects might arise.

METHODS

Self-report data on dyadic coping and depressive symptoms were gathered from 124 mixed-gender couples aged between 16 and 21 years living in Switzerland between 2011 and 2013. Equity of dyadic coping was quantified by calculating the difference between received dyadic coping and provided dyadic coping for each partner separately. These difference scores and the overall level of dyadic coping were used to predict depressive symptoms in both partners using an Actor-Partner-Interdependence Model.

RESULTS

For female adolescents, we found the expected curvilinear association between equity of negative dyadic coping behaviors and depressive symptoms (actor effect). Additionally, the female perception of equity of positive dyadic coping was correlated with less depressive symptoms in male partners (partner effect). For male adolescents, receiving more positive dyadic coping than they provided was associated with more depressive symptoms (actor effect).

DISCUSSION

In female partners, results resembled those in adult mixed-gender couples. In male partners, results changed depending on the direction of inequity-possibly due to gender role development.

Coping with family function changes: A qualitative study of couples facing advanced lung cancer

Objective

This study aimed to explore the experiences of couples with advanced lung cancer in coping with changes in their family functioning.

Methods

This study included patients with advanced lung disease and their spouses who were hospitalized in a tertiary hospital in Shanghai, China. Data were collected through interviews that focused on three key areas: (1) patient coping, (2) spousal coping, and (3) dyadic coping. Semi-structured qualitative interviews were conducted in Chinese and analyzed using Braun-Clarke thematic analysis.

Results

A total of 15 couples participated in the study (12 male and 3 female patients). The average age of the patients was 63.73 years, and that of their partners was 63.20 years. Marriage duration ranged from 25 to 53 years. Three distinct themes emerged from the data: individual patient coping was expressed in four areas: struggle, acceptance of reality, cherishing the present and regaining hope, and rebuilding family life; spousal coping was expressed in three areas: acceptance and understanding of the patient, providing active support, and adjusting roles and sharing of family responsibilities; and dyadic coping was expressed in three areas: cognitive consistency of changes in family functioning, stress communication, and family adjustment and adaptation based on shared cognition. A relationship diagram of patients with advanced lung cancer and their spouses in coping with post-cancer changes in family functioning was constructed.

Conclusions

Post-cancer coping with changes in family functioning in couples with advanced lung cancer is a continuous developmental and gradual evolutionary process, and there is a close relationship between the two that influences each other. Early assistance for couples to form consistent cognition and communicate effectively with the stress caused by the disease can help improve the family functioning of both partners and, in turn, improve the quality of life of patients. Therefore, it is recommended that clinicians conduct family- or couple-centered intervention studies aimed at improving the post-cancer quality of life of patients with advanced lung cancer.

The experiences of men on active surveillance for prostate cancer and their significant others: A qualitative synthesis

BACKGROUND

Active surveillance (AS) for prostate cancer (PCa) is a monitoring pathway for men with low-grade, slow growing PCa and aims to delay or avoid active treatment by treating only in the case of disease progression. Experiences of this pathway vary but living with an untreated cancer can have a negative psychological impact on both the patient and their significant other (SO). Literature suggests partners are the primary source of support for men on AS, and therefore it is important to consider SO experiences alongside those of the patient. To the best of our knowledge this is the first UK-based qualitative review looking specifically at experiences of AS for both men with PCa and their SOs.

METHODS

MEDLINE (Ovid), EMBASE, PsychINFO, CINAHL and Cochrane Library were searched for literature reporting qualitative experiences of AS for PCa for either men on AS or SOs (or both). 2769 records were identified and screened, with 28 meeting the eligibility criteria. Qualitative data were synthesised and included men on AS (n = 428), and SOs (n = 51).

RESULTS

Experiences of the AS pathway vary but reports of uncertainty and anxiety were present in the accounts of both men on AS and SOs. SOs are intertwined throughout every part of the PCa journey, and couples presented as a unit that were on AS together. Both patients and SOs expressed a need for more support, and highly valued peer support. Despite this finding, men expressed a dislike towards 'support groups'.

CONCLUSIONS

Increased recognition in clinical practice of SO involvement in AS is needed. Further research is required to explore the specific types of support that would be most acceptable to this population to address the unmet support needs uncovered in this review.

Common dyadic coping and its congruence in couples facing breast cancer: The impact on couples' psychological distress

OBJECTIVE

Psychological distress is prevalent in couples facing breast cancer. Couples often deal with breast cancer as a unit instead of as individuals. Couple's dyadic coping is important for their adjustment to breast cancer; however, little is known about how couple's coping congruence influences their distress. This study examined how common dyadic coping (CDC) and coping congruence impact psychological distress in couples facing breast cancer.

METHODS

Baseline data were analyzed from 343 women with recently diagnosed early-stage breast cancer and their partners who participated in a randomized clinical trial. Psychological distress was indicated by depressed mood and state anxiety. Common dyadic coping was measured by a self-report scale. Coping congruence was assessed by the absolute difference between a woman's and her partner's CDC scores.

RESULTS

Higher CDC scores were associated with lower psychological distress in both women and partners. In the CDC subscales, women who suffered less scored higher on open communication, sharing a positive outlook, and lower on avoidance coping. Partners who suffered less scored higher on open communication, sharing a positive outlook, spending time talking, and lower on avoidance coping. Greater congruence in CDC was associated with lower psychological distress in women and their partners. Congruence in sharing a positive outlook benefited both members of the dyad; congruence in avoidance coping significantly benefited patients; congruence in open communication significantly benefited partners.

CONCLUSIONS

CDC and its congruence in specific areas have potential benefit to couple's psychological distress when facing breast cancer. Health care providers could consider enhancing couple's CDC and coping congruence to improve their adjustment.

Self-efficacy as mediators of the association between dyadic coping and quality of life among spousal caregiver of patients with cervical cancer

Objective

This study aims to explore the influence of dyadic coping (DC) on the quality of life (QoL) of spousal caregivers for patients with cervical cancer and to investigate the mediating role of self-efficacy in this relationship.

Methods

A convenience sample of 206 spouses of cervical cancer patients from five hospitals in Jiangsu Province, China, was included in the study. The participants completed three instruments: the 12-item Short-Form Health Survey, the General Self-Efficacy Scale, and the Dyadic Coping Inventory. Structural Equation Modeling (SEM) was used to analyze the mediating effect of self-efficacy in the DC and QoL relationship.

Results

The study found a positive correlation between self-efficacy and DC. Self-efficacy partially mediated the impact of DC on QoL, accounting for 16% of the total effect. Self-efficacy played a mediating role in facilitating the indirect positive effects of DC on QoL.

Conclusions

Spousal caregivers of cervical cancer patients frequently experience a relatively low QoL. The results suggest that interventions aimed at enhancing DC among spousal caregivers should incorporate strategies to improve self-efficacy, given its mediating role in the positive relationship between DC and QoL.

Predictive Models of Psychological Distress, Quality of Life, and Adherence to Medication in Breast Cancer Patients: A Scoping Review

Purpose

An interplay of clinical and psychosocial variables affects breast cancer patients' experiences and clinical trajectories. Several studies investigated the role of socio-demographic, clinical, and psychosocial factors in predicting relevant outcomes in breast cancer care, thus developing predictive models. Our aim is to summarize predictive models for specific psychological and behavioral outcomes: psychological distress, quality of life, and medication adherence. Specifically, we aim to map the determinants of the outcomes of interest, offering a thorough overview of these models.

Methods

Databases (PubMed, Scopus, Embase) have been searched to identify studies meeting the inclusion criteria: a breast cancer patients' sample, development/validation of a predictive model for selected psychological/behavioral outcomes (ie, psychological distress, quality of life, and medication adherence), and availability of English full-text.

Results

Twenty-one papers describing predictive models for psychological distress, quality of life, and adherence to medication in breast cancer were included. The models were developed using different statistical approaches. It has been shown that treatment-related factors (eg, side-effects, type of surgery or treatment received), socio-demographic (eg, younger age, lower income, and inactive occupational status), clinical (eg, advanced stage of disease, comorbidities, physical symptoms such as fatigue, insomnia, and pain) and psychological variables (eg, anxiety, depression, body image dissatisfaction) might predict poorer outcomes.

Conclusion

Predictive models of distress, quality of life, and adherence, although heterogeneous, showed good predictive values, as indicated by the reported performance measures and metrics. Many of the predictors are easily available in patients' health records, whereas others (eg, coping strategies, perceived social support, illness perceptions) might be introduced in routine assessment practices. The possibility to assess such factors is a relevant resource for clinicians and researchers involved in developing and implementing psychological interventions for breast cancer patients.

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.

Blaming in Women with Breast Cancer Subjected to Intimate Partner Violence: A Hermeneutic Phenomenological Study

Objective

The present study was conducted to determine the blaming experiences of women with breast cancer subjected to intimate partner violence (IPV).

Methods

This hermeneutic phenomenological study explored blaming experiences of women with breast cancer subjected to IPV. Nine women with a mean age of 47.5 years referred to oncology hospitals in Tabriz (Iran) were interviewed using semi-structured in-depth interviews. Data analysis was performed based on Van Manen's thematic analysis method.

Results

The main theme emerged from the data is "blaming as a shifting cognitive judgment" with three subthemes of patient blaming partner, partner blaming patient, and self-blame.

Conclusions

The findings of the present study revealed that cognitive judgment shifting could be emerged as different types of blaming in the patients with breast cancer exposed to IPV. It is suggested that oncology nurses heed the psychological needs of women with breast cancer through holistic nursing considering couple and family-centered care.

Becoming a secondary actor of one's own life: A qualitative study of the experiences of informal caregivers in the care of people with chronic pain

INTRODUCTION

The physical limitations experienced by people with chronic pain (CP) produce a greater need for care and assistance, most of which is provided by an informal caregiver (IC). Despite the key role ICs play in the everyday lives of individuals living with CP, knowledge about their experiences and needs is limited. We aimed to address this limitation by exploring the experiences of IC of people with CP.

METHODS

This is a qualitative descriptive study using semistructured interviews. Participants were 12 ICs purposively chosen from the Unit of Pain at the University Hospital in Cádiz. Individual interviews were recorded, transcribed verbatim and analysed following thematic analysis.

RESULTS

We developed one overarching theme 'Becoming a secondary actor of one's own life' and three themes: 1. Key elements that shape a caregiver's experiences; 2. It's the hand that life dealt me; 3. The burden of being a caregiver and coping strategies.

CONCLUSIONS

This study's findings highlight how the CP impacts IC lives. Being an IC for a relative with CP became the most important role in the IC's life, to the point of casting a shadow over their own needs. Besides, participants felt not having other options but to keep going with that role. Yet, the context was essential in shaping the experiences as caregivers and the burden derived from caregiving. In this line, differences related to gender roles were found in the narratives of participant women and men.

PATIENT OR PUBLIC CONTRIBUTION

Participants were purposively chosen from the Unit of Pain at the University Hospital 'Puerta del Mar' who attended the consultation accompanying their relatives. All the eligible participants were approached by the clinician. After this initial approach by the clinician, one of the researchers met the potential participant and they went to a quieter place in a clinical setting for the interview, before which the participant was shown a letter with more comprehensive information about the study and its aim. The participants were left alone to read and think carefully before giving their written informed consent. Participation was voluntary and the subjects received no financial contribution for their time.

Couples facing the “honeymoon period” of Parkinson's disease: A qualitative study of dyadic functioning

INTRODUCTION

The public health issue of the Parkinson's disease (PD) has led to a great deal of research that has highlighted the individual challenges faced by the person with the Parkinson's disease (PwPD) and the caregiving spouse. Few studies, however, have sought to understand the functioning of couples facing PD, by differentiating each stage, each of which has its own issues. In particular, the "honeymoon period", characterized by a symptomatic respite allowed by the effectiveness of treatments for motor symptoms, has been poorly documented, especially at the dyadic level.

DESIGN AND METHOD

This qualitative study, based on Interpretative Phenomenological Analysis, aimed to understand the experience of couples and their functioning at this stage. Fifteen couples participated in separate semi-structured interviews for each partner. The analyses highlighted four dyadic dynamics, which call into question the relevance of the term "honeymoon" to describe the experience of couples.

RESULTS

While some couples appear to adjust by means of flexible functioning and a positive reinterpretation of this experience, other dyads oscillate between rigid hyperprotection in the face of perceived distress or a vicious circle of control/avoidance and, in some cases, gradually slipping towards the erosion of the relationship.

DISCUSSION

These results show that the relational difficulties suffered by partners at this stage should be taken into account as soon as possible after the diagnosis. Strengthening the communication and the togetherness between partners, as well as working on dyadic emotional regulation, are particularly relevant options for these couples.

Exploring influencing factors in breast cancer survivors’ experience in Lebanon

Background

The research objective was to investigate social and cultural factors affecting breast cancer survivors’ experiences in Lebanese.

Methods

A snowball sampling of 20 breast cancer survivors participated in the study. Semi-structured open-ended interviews were used to collect data.

Results

The results showed that family support and religious beliefs were the primary supporting sources for breast cancer survivors. On the other hand, their body image and children were the major concerns. Thus, family and religious beliefs were needed to overcome breast cancer’s daily burden.

Conclusion

Women with breast cancer perceived their cancer experience through their social roles, reflecting a concern for image and role preservation.

Coupling with COVID: The Role of Dyadic Coping in Relationship Satisfaction and Psychological Distress during the COVID-19 Pandemic

Models of dyadic coping suggest that facing a stressful situation, such as the COVID-19 pandemic, with one's partner to meet their needs is associated with positive outcomes. This study explored dyadic coping and its association with relationship satisfaction and distress in the time of the COVID-19 pandemic. Data were collected online from 564 participants. Participants completed measures of dyadic coping, relationship satisfaction, COVID anxiety, and OCD, and asked to describe their experience in an open-ended question. Results showed that experiences were quite polarized. Significant gender differences and differences for couples with/without children were noted for distress and relationship satisfaction. There was a significant interaction between dyadic coping and relationship satisfaction for women when predicting COVID OCD; however, post-hoc analysis showed that this interaction was only significant for women with children. The potential exponential burden that female couple members may face during COVID-19 as well as implications for intervention, are discussed.

Couples Coping With Hematological Cancer: Support Within and Outside the Couple - Findings From a Qualitative Analysis of Dyadic Interviews

Objective

Cancer affects the patients as well as their partners. Couples use different strategies to cope with cancer and the associated burden: individual coping, dyadic coping, and support from the social network and from professional health care. The aim of this qualitative dyadic interviews is to gain a deeper and more differentiated understanding of the support system inside and outside of the couple.

Methods

Ten heterosexual couples (patients: seven men and three women) with different ages (patients: range = 22-75; spouses: range = 22-74), different hematological cancer (e.g., acute myeloid leukemia, non-Hodgkin's lymphoma) and cancer stages (initial diagnosis or relapse) participated in the study. Semi-structured dyadic interviews were conducted. Data of the verbatim transcripts were systematically coded and analyzed following structuring content analysis.

Results

Three main categories (individual coping, dyadic coping, and outside support) and ten subcategories about coping and support strategies in hematological cancer patients and their spouses could be identified. All couples described cohesion in relationship as an essential common dyadic coping strategy. Most strategies were focused on the patient's wellbeing. Furthermore, couples reported different common plans for the future: while some wanted to return to normality, others were reaching out for new goals.

Conclusion

Couples used various coping and support strategies, that differed in type and frequency between patients and spouses. Most of the strategies were perceived as beneficial, but some also triggered pressure. Overall, spouses seem to need more psychological support to improve their own wellbeing.

Dyadic coping and its association with emotional functioning in couples confronted with advanced cancer: Results of the multicenter observational eQuiPe study

Objective

How patients and their partners cope with advanced cancer as a couple, may impact their emotional functioning (EF). The aim of this study was to assess dyadic coping (DC) of couples confronted with advanced cancer and its association with EF.

Methods

Actor‐partner interdependence models were used to analyze baseline data of 566 couples facing advanced cancer participating in an observational study on quality of care and life. Measures included the DC Inventory and the European Organization for Research and Treatment of Cancer quality of life questionnaire (EOQLQ‐C30).

Results

Negative DC (mean 86–88) was most often used and common DC (both mean 66) was least often used. We found small to moderate interdependence (r = 0.27−0.56) between patients' and partners' DC perceptions. Compared to partners, patients were more satisfied with their DC (p < 0.001). Partners' satisfaction with DC was positively associated with their own (B = 0.40, p < 0.001) and patients' (B = 0.23, p = 0.04) EF. We found positive actor (patients B = 0.37 B = 0.13, p = 0.04) and partner (both B = 0.17, p < 0.05) associations for negative DC in patients and partners. Partners' supportive DC was negatively associated with patients (B = −0.31, p = 0.03) and partners' EF (B = −0.34, p = 0.003).

Conclusions

This study highlight the importance of DC (especially from the partners' perspective) for EF in advanced cancer but also identifies differences in the experience of patients and their partners. Future research is needed to understand the mechanisms of such relations and the common and unique support options that may facilitate adjustment in patients with advanced cancer and their partners.

Active Engagement, Protective Buffering, and Depressive Symptoms in Young-Midlife Couples Surviving Cancer: The Roles of Age and Sex

OBJECTIVE

Cancer researchers have found midlife couples to have poorer outcomes compared to older couples due to the off-time nature of the illness for them. It is unknown if young couples (aged 18-39), who are under-represented in cancer studies and overlooked for supportive programs, are at further risk. This study explored the moderating roles of survivor age and sex on the associations between active engagement and protective buffering and depressive symptoms in couples surviving cancer.

METHODS

The exploratory study comprised 49 couples (aged 27-58) 1-3 years post-diagnosis. Multilevel modeling was used to explore the moderating roles of survivor age and sex, controlling for interdependent data.

RESULTS

Approximately, 37% of survivors and 27% of partners met clinical criteria for further assessment of depression, with 50% of couples having at least one member meeting the criteria. Survivors and their partners did not significantly differ on depressive symptoms, active engagement, or protective buffering. Male survivors reported significantly higher levels of active engagement by their partners than female survivors and female survivors reported significantly higher levels of protective buffering by their partners than male survivors. We found some evidence to suggest that survivor age and sex may play moderating roles between active engagement and protective buffering and depressive symptoms. Older partners and female survivors appeared to experience more positive effects from engaging in positive dyadic behaviors than younger partners and male survivors.

CONCLUSION

Findings not only confirm the important role of dyadic behaviors for couples surviving cancer together, but also the important roles of survivor age and sex may play in whether such behaviors are associated with lower levels of depressive symptoms. Future research that examines these complex associations over time and across the adult life span in diverse populations is needed.

« We-ness, we-disease » : impact sur la résilience sexuelle des couples confrontés au cancer du sein

Cet article présente notre travail de recherche, effectué en vue de l’obtention du Diplôme interuniversitaire de sexologie.

Objectif :L’objectif de notre étude est d’observer le lien entre le sens du « we-ness, we-disease » et la résilience sexuelle du couple confronté au cancer du sein.

Matériel et méthodes : La méthodologie a été qualitative et observationnelle. Cinq couples ont été inclus dans l’étude, et ont chacun participé à un entretien de couple. Les retranscriptions verbatim des entretiens ont été analysées grâce à la « We-ness Coding Scale » (Reid) et à une analyse de contenu thématique de la vie intime et sexuelle.

Résultats : Pour trois couples, l’analyse de contenu des entretiens montre un lien entre un niveau élevé du sens du « we-disease » et la résilience sexuelle du couple. Pour les deux autres couples, nous n’observons pas de lien entre le niveau du sens du « we-disease » et la résilience sexuelle. Des antécédents individuels — propres à la patiente et à son partenaire — et dyadiques, pourraient en partie expliquer nos observations.

Conclusion : De futures recherches, menées avec des échantillons de population plus conséquents, pourraient permettre d’étudier plus précisément le lien entre le sens du « we-ness, we-disease » et un modèle de résilience sexuelle des couples, après un cancer du sein.

Psychosocial Impact of Multiple Sclerosis on Couples: Relationship Between Anxiety, Depression, and Stress Communication of Both Partners

Background:

Multiple Sclerosis (MS) influences the relationships of affected couples, whereby the disease-related stress can lead to a deterioration of communication. This, in turn, makes it difficult for the couples to cope successfully. To support couples affected by MS for coping with the disease, the first step in developing an intervention is to examine whether this situation also applies in the Swiss context.

Methods:

A cross-sectional study was conducted to examine the psychosocial situation of couples where 1 partner has MS, regarding anxiety, depression, and stress communication. The Hospital Anxiety and Depression Scales (HADS-D) were used to assess depression and anxiety in both partners of 462 couples, while their stress communication was assessed using questions formulated according to the corresponding subscales of the Dyadic Coping Inventory (DCI). A comparison of the assessments of both partners was performed using the Mann-Whitney U test. Furthermore, the relationship between their stress communication and the severity of anxiety and depression was calculated using Spearman’s rank correlation.

Results:

Life partners rated the stress communication of their partners with MS significantly higher than the partners with MS themselves. Moreover, life partners could not distinguish whether their partners with MS expressed a sense of burden or a need for support. These findings indicate that the stress communication skills of both partners show potential for optimization. Health status regarding depression and anxiety revealed the following: 34.2% of the persons with MS and 34% of their life partners experienced clinically high levels of anxiety (HADS-D/A ≥ 8.0), and 31.4% of those with MS and 20.2% of the life partners showed clinically high levels of depression (HADS-D/D ≥ 8.0).

Conclusion:

In the Swiss context, psychosocial intervention, which includes communication training for both partners, might be effective in improving the health status regarding depression and anxiety as well as the stress communication.

Breast cancer and social relationship coping efficacy: validation of the Greek version

The Social Relationship Coping Efficacy scale (SRCE) was designed to assess cancer patients' efficacy for maintaining social support and social relationships. The purpose of the study was to confirm the psychometric quality and utility of a Greek-language version of the (SRCE) scale. The study included 116 women with breast cancer, who underwent surgery at a public hospital In Greece. The SRCE scale was translated using standard procedures and then culturally adapted for use in Greece. Psychometric evaluation of the SRCE-Greek scale included reliability, structural validity and convergent validity analyses. The SRCE-Greek scale demonstrated strong internal consistency (Cronbach a 0.87), and split-half reliability (Spearman-Brown, 0.747; Guttman, 0.742). The structural construct validity was confirmed with factor analysis using principal axis factor analysis. Construct validity was further supported with convergent validity with the Family Crisis Oriented Personal Evaluation Scales (F-COPES) (Acquiring Social Support, Reframing) and Family Support scale. The Greek language SRCE has strong internal consistency reliability and construct validity, as well as satisfactory convergent validity. Results provide support for the use of the SRCE-GR as a research and clinical instrument for the assessment of breast cancer patient's self-efficacy with regard to maintaining and enhancing close social relationships and social support.

A literature review of the relationship between dyadic coping and dyadic outcomes in cancer couples

PURPOSE

Couples are usually affected by cancer as patient-partner dyads, and they may react as a unit rather than as individuals, i.e., dyadic coping. This paper aims to comprehensively summarise the relationship between dyadic coping and dyadic outcomes (relationship satisfaction, quality of life, and psychological adjustment) in cancer couples, and provide valuable evidence to guide future research.

METHOD

A systematic search of five online databases, e.g., Cochrane Library, Embase, Medline, PubMed, and PsycINFO, was conducted to identify cancer couple-based studies published in English or Chinese from January 1990 to March 2021. A manual search was also performed on the article reference lists.

RESULTS

Twenty-eight studies met the inclusion criteria. We found that communication, supportive dyadic coping, delegated dyadic coping and common dyadic coping might strengthen marital bonds, alleviate couples' stress, and facilitate mental health, but on the other hand, they possibly increase patients' and/or partners' physical or psychological burden. Negative dyadic coping and protective buffering were related to lower relationship satisfaction, worse quality of life, and more depressive symptoms. Patients reported more self-emotional disclosure, common dyadic coping, and negative dyadic coping than partners, while partners showed more holding back, supportive dyadic coping, delegated dyadic coping, and protective buffering. Moreover, patients were more susceptible to dyadic coping strategies.

CONCLUSIONS

This review provides a comprehensive overview of the relationship between dyadic coping and dyadic outcomes. Based on the available evidence, the development of personalised interventions for improving dyadic coping is required to help couples live better with cancer.

Challenges experienced and resources identified by young to midlife couples 1-3 years post-cancer diagnosis

OBJECTIVE

The purpose of this study was to explore what young to midlife couples viewed as their strengths as a couple and the greatest challenges in their experience with cancer 1-3 years post-diagnosis.

METHODS

We used qualitative content analysis to extract common themes from open-ended questions from 42 cancer survivors and their partners (aged 27-58). Patterns of themes by age and gender of the survivor were also explored.

RESULTS

Couples described both positive and negative impacts of the cancer experience: (1) strengthened the relationship, bringing couples closer together; (2) brought emotional strain to many areas of life, especially for partners; (3) created positive changes in lifestyle and new priorities for the couple; (4) created strain in the couple's relationship and intimacy; and (5) altered the role of family in supporting the couple. Couples also described four key strengths in dealing with the cancer experience: (1) drawing strength from shared love and mutuality; (2) communicating openly, even about the difficult stuff; (3) working together as a team to support each other; and (4) drawing strength from shared values and goals. Couples reported unmet needs related to the emotional and relational strain of the cancer experience, managing longer term survivor symptoms, fertility and physical intimacy, and lack of support or attention to the partner who often assumed the role of care partner.

CONCLUSIONS

Themes are discussed in light of current dyadic concepts and importance of couple-based interventions.

Relationship Dynamics among Couples Dealing with Breast Cancer: A Systematic Review

Most studies have been concerned with the experiences and needs of women with breast cancer and spouses/partners separately. In this review, the relationship dynamics that characterize the couple’s experience of breast cancer treatment were investigated. Findings will inform both researchers and professionals in the area of oncology. A systematic literature search was performed in CINAHL, PsychINFO, MEDLINE, Scopus and Web of Science. A checklist for qualitative and observational studies was used to evaluate the methodological quality of the studies. Seventeen studies were included, and the synthesis of the literature revealed five domains that characterized the dyadic process: dyadic coping strategies, psychosocial support, communication, the couple’s sexual life and spirituality. The included studies provide the basis for knowledge and awareness about the experience of couples with cancer, the specific dimensions enacted during the breast cancer treatment path and the type of responses that are associated with a positive couple’s adjustment to the disease.

Relationships between dyadic coping, intimate relationship and post-traumatic growth in patients with breast cancer: A cross-sectional study

AIM

To investigate the relationships and pathways between dyadic coping, intimate relationship and post-traumatic growth (PTG) in Chinese patients with breast cancer.

DESIGN

A cross-sectional study.

METHODS

Between November 2019 and November 2020, 133 patients with breast cancer who received therapy in tertiary grade-A hospitals at Dalian, China completed questionnaires including demographic and clinical questionnaires, Locke-Wallace Marriage Adjustment Test, Chinese version of the Dyadic Coping Inventory and Chinese version of the Post-traumatic Growth Inventory. Structural equation modelling was used to analyse the pathways.

RESULTS

Dyadic coping was positively interrelated with PTG and intimate relationship (r = .355, p < .01; r = .213, p < .05); intimate relationship was negatively interrelated with PTG (r = -.207, p < .05). The structural equation model demonstrated adequate fit. Dyadic coping and intimate relationship directly affected PTG (β = .469, p < .05; β = -.309, p < .05). Dyadic coping indirectly affected PTG through intimate relationship (β = -.066, p < .05).

CONCLUSIONS

Dyadic coping was a stimulus factor, but intimate relationship was an obstructive factor in enhancing PTG for the Chinese patients with breast cancer. Furthermore, intimate relationship may have significant mediating effects in the link between dyadic coping and PTG. Strategies that improve dyadic coping level and avoid excessive intimacy relationships between couples contribute to the development of PTG among patients with breast cancer.

IMPACT

The research provides new ideas and intervention entry points for global nurses and psychotherapists so that they can enact and implement targeted PTG intervention plans for patients with breast cancer worldwide.

Quality of intimate relationships, dyadic coping, and psychological health in women with endometriosis: Results from an online survey

OBJECTIVE

To explore the associations between intimate relationships, psychological health, and endometriosis-related variables such as pelvic pain and infertility.

METHODS

In this cross-sectional study, data were collected with an online survey delivered through Qualtrics and posted on the Facebook page and website of a patient association (Associazione Progetto Endometriosi-APE) in August 2020. The survey was composed of a researcher-made questionnaire and four validated questionnaires assessing relational satisfaction (adapted Quality of Marriage Index), dyadic coping (Dyadic Coping Questionnaire), and psychological health (Hospital Anxiety and Depression Scale and Rosenberg Self-Esteem Scale).

RESULTS

Participants were 316 women (age: 35.9 ± 6.7) with endometriosis, who reported being in an intimate relationship from at least one year. A greater perceived negative impact of the disease on past and current intimate relationships was associated with poorer psychological health, lower relational satisfaction and worse dyadic coping. Women who perceived their partner as more informed about endometriosis, more informed about and interested in their health conditions, and more likely to accompany them to the medical appointments, showed greater relational satisfaction and dyadic coping. Relational satisfaction and dyadic coping were associated with psychological health. A greater perceived negative impact of endometriosis on intimate relationships was associated with more severe pelvic pain (especially dyspareunia).

CONCLUSION

Endometriosis has a negative impact on intimate relationships, which is associated with poorer psychological health. For the women with the disease, partner's support is important, and our findings suggest that effort should be made to involve both members of the couple in multidisciplinary treatment.

Equity of Dyadic Coping in Patients with Depression and Their Partners

Introduction: For couples, depression can position diagnosed partners to receive dyadic coping and mates to primarily provide support. We examine whether inequities in dyadic coping covary with depressive symptoms. Methods: Using data from 62 mixed-gender couples with one partner diagnosed with major depression (60% female), we computed differences between provided and received dyadic coping reported by both partners. With Response Surface Analyses we examined the associations with depressive symptoms. Results: In patients, lower equity of dyadic coping was associated with more depressive symptoms, regardless of whether the patient felt underbenefitted or overbenefitted. In partners, dyadic coping was negatively associated with depressive symptoms while equity of dyadic coping showed no significant associations. Patients and partners both reported providing more dyadic coping than they received. Discussion: Inequities in dyadic coping covary with depressive symptoms in patients, beyond main effects of dyadic coping, justifying the inclusion of couples in treatment for depression.

Disability as an Interpersonal Experience: A Systematic Review on Dyadic Challenges and Dyadic Coping When One Partner Has a Chronic Physical or Sensory Impairment

Chronically disabling health impairments affect an increasing number of people worldwide. In close relationships, disability is an interpersonal experience. Psychological distress is thus common in patients as well as their spouses. Dyadic coping can alleviate stress and promote adjustment in couples who face disabling health impairments. Much research has focused on dyadic coping with cancer. However, other health problems such as physical and sensory impairments are also common and may strongly impact couple relationships. In order to promote couples' optimal adjustment to impaired health, the identification of disability-related relationship challenges is required. Furthermore, ways in which dyadic coping with these challenges may benefit couples could inform researchers and practitioners how to support couples in coping with health impairments. Accordingly, the aims of this study were to systematically review dyadic challenges and dyadic coping when one partner has a chronically disabling physical or sensory impairment. Out of 873 articles identified through database searches, 36 studies met inclusion criteria. The disability-related dyadic challenges identified in the review were changed roles and responsibilities within the couple, altered communication, compromised sexual intimacy, and reduced social participation. These challenges were reported to burden both partners and the couple relationship. Dyadic adjustment benefitted from a we-perspective, i.e., when couples viewed the disability as a shared challenge and engaged in conjoint dyadic coping. The results suggest that patient/care recipient and partner/caregiver roles should be de-emphasized and that disability should be recognized as an interpersonal experience.