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Almont T, Sougué PO, Houpert R, Beaubrun-Renard M, Montabord C, Joachim C, Véronique-Baudin J, Bouhnik AD, Bendiane MK, Mancini J, Huyghe É. Communication and sexual function and frequency in breast cancer patients 2 years after diagnosis: results from the VICAN 2 study. J Sex Med 2024; 21:333-341. [PMID: 38410031 DOI: 10.1093/jsxmed/qdae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 12/18/2023] [Accepted: 12/30/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND Breast cancer treatments may have impacts on several aspects of sexual health, including psychological, psychosexual, physiological, physical, and relational. AIM In this study we sought to assess sexual function and sexual frequency in breast cancer patients 2 years after diagnosis. METHODS We selected all breast cancer participants from the the French national VIe après le CANcer 2 (VICAN 2) longitudinal study. Data sources included patient and medical questionnaires, along with medico-administrative databases. OUTCOMES Outcomes assessed were the dimensions of sexual function and frequency from the Relationship and Sexuality Scale and communication about sexuality with healthcare providers. RESULTS Out of 1350 participating women, 60.2% experienced a decrease in sexual desire, 61.4% reported a lower frequency of intercourse, and 49.5% faced decreased ability to orgasm. In contrast, 64.8% had engaged in sexual intercourse in the previous 2 weeks, 89.5% were "Somewhat" to "Very much" satisfied with the frequency of intimate touching and kisses with their partner, and 81.6% expressed satisfaction with their intercourse frequency. However, a mere 15% of women discussed sexuality with the healthcare providers. Independent factors associated with increased communication about sexuality included age younger than 50 years (OR = 1.90 95% CI [1.28-2.82], P = .001), being in a partner relationship (OR = 2.53 95% CI [1.28-2.82], P = .003), monthly income above 1,500 euros (OR = 1.73 95% CI [1.15-2.60], P = .009), and absence of diabetes (OR = 6.11 95% CI [1.39-26.93], P = .017). CLINICAL TRANSLATION The study findings underscore the need for continuing education in oncosexology and dedicated sexual health interventions that should involve a holistic approach that takes into consideration age, treatments, relationship status, and whether the patient has diabetes. STRENGTHS AND LIMITATIONS Strengths of the study are the sample size, the national representativeness, and data reliability. However, the cross-sectional design could introduce potential recall, recency, or social desirability biases. Also, social determinants influencing sexual health, such as ethnicity or geographic locations, have not been considered in the analyses. CONCLUSIONS This study revealed that sexual disorders persist 2 years after a breast cancer diagnosis, with a noticeable communication gap regarding sexuality between patients and medical teams. These findings underscore the necessity for tailored sexual health interventions, particularly designed for women who are single, older aged, and diabetes patients.
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Affiliation(s)
- Thierry Almont
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
| | - Prisca Ouowéné Sougué
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Rémi Houpert
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Murielle Beaubrun-Renard
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Christelle Montabord
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Clarisse Joachim
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Jacqueline Véronique-Baudin
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
| | - Anne-Déborah Bouhnik
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
| | - Marc-Karim Bendiane
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
- Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, 270 Boulevard de Sainte Marguerite, 13009 Marseille, France
- ORS PACA, Observatoire Régional de la Santé, 27 Bd Jean Moulin, 13005 Marseille, Provence-Alpes-Côte d'Azur, France
| | - Julien Mancini
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
- Public Health Department, Service Biostatistique et Technologies de l'Information et de la Communication (BIOSTIC), hôpital Timone, APHM, 13005 Marseille, France
| | - Éric Huyghe
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
- Urology Department, Centre Hospitalier Universitaire de Toulouse, 1, avenue du Professeur Jean Poulhès - TSA 50032 - 31059 Toulouse, France
- Francophone Association for Supportive Care in Cancer (AFSOS), 33130 Bègles, France
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Pawłowska A, Loeys T, Janssen E, Dewitte M. The Role of Dyadic Sexual Desire Similarity in Predicting Sexual Behaviors in Cohabitating Couples: An Ecological Momentary Assessment Study. JOURNAL OF SEX RESEARCH 2024; 61:261-273. [PMID: 36730837 DOI: 10.1080/00224499.2023.2170965] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Although researchers are increasingly paying attention to the dyadic nature of sexual desire and its relevance to sexual and relational outcomes, our understanding of how sexual desire operates on a couple level and how it may influence the occurrence of sexual activity in relationships remains limited. This study used ecological momentary assessments to explore to what extent similarity in levels of desire for sex with one's sexual partner, or dyadic sexual desire, was associated with sexual initiations, receptivity to one's partner's initiations, and partnered sexual activity, and how these associations were moderated by perceived partner support. Ninety-four cohabitating couples (M age = 26.30, SD = 7.60) provided six reports a day for 10 consecutive days. We used response surface analysis to examine the associations among both the degree and direction of (dis)similarity in partners' dyadic desire and each of the three outcome variables. Our results revealed that although partners tended to experience similar levels of desire on a moment-to-moment basis, similarity in desire levels was not associated with the three outcome variables. Rather, higher desire within couples predicted each partner's behavioral outcomes. At lower levels of perceived partner support, dyadic sexual desire was negatively associated with women's receptivity to sexual initiations by their partners, indicating high context-sensitivity of women's sexual responding. These findings offer new insights into the links between the similarity in partners' levels of dyadic desire and sexual behaviors in couples, suggesting the need for increased focus on maintaining desire and promoting perceived partner support in clinical practice.
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Affiliation(s)
- Aleksandra Pawłowska
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurosciences, Institute for Family and Sexuality Studies, KU Leuven, Leuven, Belgium
| | - Tom Loeys
- Department of Data Analysis, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Erick Janssen
- Department of Neurosciences, Institute for Family and Sexuality Studies, KU Leuven, Leuven, Belgium
| | - Marieke Dewitte
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Cimaroli S, Bichanich M, Adamson K, LoGiudice J, Doren E. Evaluating Both Partner and Patient Satisfaction With Postmastectomy Breast Reconstruction. Ann Plast Surg 2023; 91:698-701. [PMID: 38079316 DOI: 10.1097/sap.0000000000003657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
PURPOSE Few studies have looked in-depth at the relationship between patient and partner satisfaction with postmastectomy breast reconstruction. The studies that do exist suggest that perceived partner satisfaction is an important predictor of patient satisfaction in postmastectomy breast reconstruction. METHODS We created a novel survey designed to look at reconstruction outcomes from a partner's perspective. Patients with a history of mastectomy-alone or mastectomy with reconstruction at our institution from January 2011 through December 2020 were contacted electronically to complete a demographic form and the BREAST-Q, while partners completed our novel partner survey. Sixteen mastectomy-only and 76 mastectomy with reconstruction couples completed surveys. RESULTS The mean Breast-Q and partner survey scores were 87 and 87 (maximum possible = 100), respectively, for mastectomy with reconstruction. There was a correlation of 0.57 between patient and partner overall satisfaction. There was no difference in overall satisfaction between patients who underwent reconstruction and those who did not (P = 0.19). There was a relationship between satisfaction with preoperative counseling and overall satisfaction in both patients and partners. The partner survey was found to have high internal consistency for measuring various areas of partner satisfaction. CONCLUSIONS There is a relationship between patient and partner satisfaction with postmastectomy breast reconstruction. Our data may support the positive impact of social support on recovery after breast cancer treatment, as satisfaction was high in both groups. We therefore encourage partners to attend and participate in preoperative consultations. Finally, our novel partner survey is a reliable tool to assess partner satisfaction with postmastectomy breast reconstruction.
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Affiliation(s)
- Sawyer Cimaroli
- From the Medical College of Wisconsin Department of Plastic Surgery, Milwaukee, WI
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Afifi AM, Smith RM. Invited Discussion on: "The Partner Perspective on Autologous and Implant-Based Breast Reconstruction". Aesthetic Plast Surg 2023:10.1007/s00266-023-03357-4. [PMID: 37097453 DOI: 10.1007/s00266-023-03357-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/26/2023]
Affiliation(s)
- Ahmed M Afifi
- Division of Plastic and Reconstructive Surgery, School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792, USA.
| | - Rachel M Smith
- Division of Plastic and Reconstructive Surgery, School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792, USA
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The Partner Perspective on Autologous and Implant-Based Breast Reconstruction. Aesthetic Plast Surg 2023:10.1007/s00266-023-03286-2. [PMID: 36820865 PMCID: PMC10390354 DOI: 10.1007/s00266-023-03286-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/29/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Partner involvement in the decision-making process concerning breast reconstruction (BR) after a breast cancer diagnosis may be very supportive for the patient. So far, no study evaluates partner satisfaction with the outcome after BR and the relationship to patient satisfaction. The aim of this study was to assess and compare partner satisfaction of BR with autologous tissue (ABR) and prosthetic implants (IBR), respectively, and compare it to patient-reported outcomes. PATIENTS AND METHODS All patients undergoing ABR and IBR between January 2014 and December 2020 were asked to participate with their partners. Patient and partner satisfaction with breast reconstruction, overall outcome as well as patient's perceived and self-reported psychosocial well-being were evaluated using the Breast-Q and a modified partner questionnaire, respectively. RESULTS Fifty-three couples participated (IBR: n=30, ABR: n = 23). Patient and partner satisfaction with breast (r = 0.552), outcome (r = 0.465) as well as patient's perceived and self-report psychosocial well-being (r = 0.495) were highly correlated with partners scoring significantly higher (p<0.001). In terms of partner satisfaction, both reconstructive procedures achieved satisfactory results. ABR scored higher in terms of softness of breast and how natural the breast feels to touch whereas IBR was rated superior evaluating the breast size. CONCLUSION Both reconstructive procedures achieve satisfactory results in terms partner satisfaction whereas patient's psychosocial well-being was highly overestimated by their partners. Hence, partner inclusion in the regular psycho-oncological support might further sensitize them of the high psychological burden of a breast cancer diagnosis and therefore stabilize patients private support system. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Zhou X, Wang DY, Ding CY, Liu H, Sun ZQ. Psychosocial adaptation and influencing factors among patients with chemotherapy-induced peripheral neuropathy. World J Clin Cases 2022; 10:4843-4855. [PMID: 35801039 PMCID: PMC9198882 DOI: 10.12998/wjcc.v10.i15.4843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/03/2022] [Accepted: 03/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a severe and long-lasting side effect caused by various anticancer agents that damage sensory, motor and autonomic nerves. It can cause maladaptive behaviors, including disease severity, anxiety, depression, sleep disorders, falls, and social impairment. These disorders have physical, psychological and social effects on patients and can seriously influence their quality of life.
AIM To investigate the current situation of psychosocial adaptation to the disease and its influencing factor in patients with CIPN.
METHODS A convenience sampling method was used to select 233 patients with CIPN in our hospital from February to August 2021. In addition, a cross-sectional survey was conducted using a sociodemographic questionnaire, the Self-Report Psychosocial Adjustment to Illness Scale, and the European Organisation for the Research and Treatment of Cancer Quality of Life CIPN20 (QLQ-CIPN20). Factors influencing psychosocial adaptation in patients with CIPN were analyzed by t-test or one-way analysis of variance, correlation analysis, multiple stepwise regression analysis, and structural equation models.
RESULTS The psychosocial adaptation score of patients with CIPN was 52.51 ± 13.18. Multivariate analysis showed that autonomic nerves, tumor stage, motor nerves, education level, availability of caregivers, semi-retirement status, CIPN grade were independent risk factors for patients with CIPN (P < 0.05). Structural equation models showed that QLQ-CIPN20 mediated the relationship between CIPN grade, tumor stage, and psychosocial adaptation.
CONCLUSION Patients with CIPN have poor psychosocial adaptation and are affected by a variety of physiological, psychological, and social factors. Patients’ adaptive responses should be assessed, and targeted interventions implemented.
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Affiliation(s)
- Xiao Zhou
- Changzhou School of Clinical Medicine, Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Dong-Yang Wang
- Department of Nursing, School of Pharmacy, Changzhou University, Changzhou 213000, Jiangsu Province, China
- Faculty of Nursing, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Cai-Yan Ding
- Department of Nursing, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Hui Liu
- School of Nursing, Bengbu Medical College, Bengbu 233000, Jiangsu Province, China
| | - Zhi-Qin Sun
- Department of Nursing, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
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Borstelmann NA, Gray TF, Gelber S, Rosenberg S, Zheng Y, Meyer M, Ruddy KJ, Schapira L, Come S, Borges V, Cadet T, Maramaldi P, Partridge AH. Psychosocial issues and quality of life of parenting partners of young women with breast cancer. Support Care Cancer 2022; 30:4265-4274. [PMID: 35091846 PMCID: PMC9701537 DOI: 10.1007/s00520-022-06852-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE Data are lacking about the association between quality of life (QOL) and psychosocial issues of partners of young women with breast cancer who co-parent dependent children. METHODS We conducted a cross-sectional analysis of partners of women with breast cancer diagnosed at age ≤ 40. Among those partners reporting at least one dependent child under 18 years old at the time of diagnosis, we used multiple linear regression to examine associations between partner QOL and sociodemographic and psychosocial factors, and the patient's cancer stage and time since diagnosis. RESULTS Of the 219 parenting partners, all identified as male with a median age of 44 years; 96% (204/213) reported working full-time at the time of the survey. Fifty-four percent endorsed behaviors indicating maladaptive coping. In adjusted analyses, less than full-time employment (β = - 8.76; 95% CI = - 17.37, - 0.14), younger age (β = - 0.35; 95% CI = - 0.069, - 0.02), greater parenting concerns (β = 0.56; 95% CI = 0.36, 0.75), clinically relevant anxiety symptoms (β = 13.79; 95% CI = 10.24, 17.35), lower post-traumatic growth score (β = - 0.33; 95% CI = - 0.51, - 0.16), lower social support (β = - 0.21; 95% CI = - 0.29, - 0.12), lower sexual satisfaction (β = - 0.40; 95% CI = - 0.62, - 0.19), and breast cancer stages 3 (β = 7.61; 95% CI = 0.19, 15.02) and 4 (β = 12.63; 95% CI = 1.91, 23.34), when compared to stage 0, were associated with lower partner QOL. CONCLUSION Parenting partners of young women with breast cancer have substantial unmet psychosocial needs. Interventions are needed to enhance QOL and promote adaptive coping for this population.
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Affiliation(s)
| | - Tamryn F Gray
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, USA
| | - Shari Gelber
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Shoshana Rosenberg
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, USA
| | - Yue Zheng
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Meghan Meyer
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | | | | | - Steven Come
- Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Tamara Cadet
- Simmons College School of Social Work, Boston, MA, USA
| | - Peter Maramaldi
- Simmons College School of Social Work, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ann H Partridge
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, USA
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Stulz A, Favez N, Flahault C. Influence des facteurs individuels et dyadiques sur l’ajustement sexuel des couples lors d’un cancer du côlon. PSYCHO-ONCOLOGIE 2022. [DOI: 10.3166/pson-2022-0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Contexte : Le cancer du côlon est le troisième cancer le plus diagnostiqué au monde et a un impact sur tous les aspects de la vie des patients et de leur partenaire. Jusqu’à présent, peu d’études ont étudié l’ajustement sexuel des patients et aucune n’a analysé les interactions entre les partenaires.
Objectif : Décrire les facteurs individuels et dyadiques liés à l’ajustement sexuel des couples.
Méthode : Treize couples ont répondu à un ensemble de questionnaires portant sur le soutien social, la communication et les stratégies de coping dyadique et la satisfaction sexuelle. Des analyses non paramétriques ont été réalisées sur les données quantitatives.
Résultats : Le soutien social, la communication et les stratégies d’adaptation dyadique jouent un rôle dans l’ajustement sexuel des couples. La satisfaction ressentie par les patients et leurs partenaires quant au soutien conjugal est corrélée positivement à l’ajustement sexuel du patient. La qualité de la communication des patients quant au stress engendré par la maladie est liée à la satisfaction sexuelle des partenaires. Le coping dyadique de soutien comme la gestion commune du stress favorisent l’ajustement sexuel des patients et des partenaires. Ces stratégies démontrent l’importance de l’unité au sein du couple, le cancer étant abordé comme une « maladie du couple ». Cet engagement mutuel semble favoriser la satisfaction sexuelle des couples.
Conclusion : Gérer la maladie et le stress lié aux traitements en tant que couple et percevoir son partenaire comme une source de soutien satisfaisante est particulièrement bénéfique pour la satisfaction sexuelle des couples dont un membre est atteint d’un cancer du côlon.
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Helping Us Heal: telephone versus in-person marital communication and support counseling for spouse caregivers of wives with breast cancer. Support Care Cancer 2021; 30:793-803. [PMID: 34386885 PMCID: PMC8363089 DOI: 10.1007/s00520-021-06439-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/13/2021] [Indexed: 11/23/2022]
Abstract
Purpose (1) To test the short-term impact of Helping Us Heal (HUSH), a telephone-delivered counseling program for spouse caregivers of women with breast cancer. (2) To compare outcomes from HUSH with outcomes from a historical control group which received the same program in-person. Methods Two-group quasi-experimental design using both within- and between-group analyses with 78 study participants, 26 in the within-group and 52 in the between-group analyses. Spouse caregivers were eligible if the wife was diagnosed within 8 months with stage 0–III breast cancer and were English-speaking. After obtaining signed informed consent and baseline data, 5 fully scripted telephone intervention sessions were delivered at 2-week intervals by patient educators. Spouses and diagnosed wives were assessed on standardized measures of adjustment at baseline and immediately after the final intervention session. Results Within-group analyses revealed that spouses and wives in HUSH significantly improved on depressed mood and anxiety; spouses improved on self-efficacy and their skills in supporting their wife. Additionally, wives’ appraisal of spousal support significantly improved. Between-group analyses revealed that outcomes from HUSH were comparable or larger in magnitude to outcomes achieved by the in-person delivered program. Conclusions A manualized telephone-delivered intervention given directly to spouse caregivers can potentially improve adjustment in both spouses and diagnosed wives but study outcomes must be interpreted with caution. Given the small samples in the pilot studies and the absence of randomization, further testing is needed with a more rigorous experimental design with a larger study sample.
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Niu Z, Bhurosy T, Heckman C. Cancer Survivors' Emotional Well-being: Roles of Internet Information Seeking, Patient-centered Communication, and Social Support. JOURNAL OF HEALTH COMMUNICATION 2021; 26:514-522. [PMID: 34435927 DOI: 10.1080/10810730.2021.1966685] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cancer survivors' emotional well-being is an integral part of their overall health and may influence their recovery and survival. The current study used the 2018 Health Information National Trends Survey (HINTS) 5 Cycle 2 (N = 593) to evaluate the determinants of cancer survivors' emotional well-being. Internet cancer information seeking, social support, patient-centered communication, cancer beliefs, and self-efficacy to take care of one's health were examined as factors to be associated with cancer survivors' emotional well-being using structural equation modeling. Social support, cancer beliefs, and self-efficacy to take care of one's health were found to be significantly associated with emotional well-being among cancer survivors. Cancer beliefs mediated the associations of cancer information seeking using the Internet, social support, and patient-centered communication with cancer survivors' emotional well-being while health self-efficacy mediated the associations of social support and patient-centered communication with cancer survivors' emotional well-being. It is important for health practitioners to focus on improving social support, self-efficacy for managing health, and cancer-related beliefs in order to enhance the emotional well-being of cancer survivors.
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Affiliation(s)
- Zhaomeng Niu
- Population Science, Rutgers Cancer Institute Of New Jersey, New Brunswick, New Jersey, USA
| | - Trishnee Bhurosy
- Population Science, Rutgers Cancer Institute Of New Jersey, New Brunswick, New Jersey, USA
| | - Carolyn Heckman
- Population Science, Rutgers Cancer Institute Of New Jersey, New Brunswick, New Jersey, USA
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Prevalence of erectile dysfunction in male survivors of cancer: a systematic review and meta-analysis of cross-sectional studies. Br J Gen Pract 2021; 71:e372-e380. [PMID: 33926885 PMCID: PMC8087306 DOI: 10.3399/bjgp20x714197] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/17/2020] [Indexed: 01/26/2023] Open
Abstract
Background Prevalence of erectile dysfunction (ED) in male survivors of cancer across cancer types has not been systematically analysed. Aim To estimate the prevalence of ED in all types of cancer and identify characteristics associated with ED in survivors of cancer. Design and setting Systematic review and meta-analysis (MA) of cross-sectional studies. Method MEDLINE, CINAHL, PsycINFO, and EMBASE were searched, targeting reports published from inception to 1 February 2020. All retrospective or prospective studies reporting prevalence of ED in male patients with cancer and using a validated tool for detection of ED were included. A random-effects MA model was used to pool prevalence of ED as absolute estimates at three different stages, that is, ‘healthy’, ‘at diagnosis’, and ‘after treatment’. A univariate MA regression including the three-level group variable as the only independent variable was used to assess the difference in ED prevalence across the three groups. Further MAs were conducted for studies involving patients at diagnosis and after treatment, and statistical inferences were made with setting for multiple testing controlling for a false discovery rate (FDR) <0.05. Results In total, 1301 studies were assessed for inclusion. Of these, 141 were potentially eligible and subsequently scrutinised in full text. Finally, 43 studies were included with a total of 13 148 participants. Overall, pooled data of the included studies showed an ED prevalence of 40.72% (95% confidence interval [CI] = 31.80 to 50.29) in patients with cancer, with prevalences of 28.60% (95% CI = 12.10 to 53.83) at time of diagnosis and 42.70% (95% CI = 32.97 to 53.03) after treatment, with significant difference between these two stages and across cancer locations, controlling for an FDR <0.05. Conclusion Erectile dysfunction was particularly high in male survivors of cancer and was associated with cancer treatment, cancer site, and age.
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The impact of mastectomy on Iranian women sexuality and body image: a systematic review of qualitative studies. Support Care Cancer 2021; 29:5571-5580. [PMID: 33754199 DOI: 10.1007/s00520-021-06153-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/16/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE Mastectomy in women is perceived as losing feminine identity and reducing sexual attraction. The aim of this review is to explore the perception and impacts of mastectomy on Iranian women with breast cancer on their sexuality and body image. METHODS The review used a systematic literature search that followed the guidelines of the Joanna Briggs Institute (JBI). The data sources PubMed, Scopus, Web of Science, Google Scholar, SID, ProQuest, MEDLINE, and CINAHL (via the EBSCOhost) were systematically searched. Quality appraisal, data extraction, and findings from the included studies were pooled using meta-aggregation with the Qualitative Assessment and Review Instrument (JBI-QARI). RESULTS Eight studies involving 163 women aged from 31 to 65 years, who had mastectomy, were included. A total of 31 findings were extracted and were aggregated into 4 categories and then further grouped into two synthesized findings: (1) fear of losing spouse's sexual monopoly and (2) overcoming the challenges of losing femininity. CONCLUSIONS This review found even in Muslim countries such as Iran women's breasts are perceived as sexually attractive, and changes in body shape can lead to subsequent challenges in marital relationships.
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13
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Lewis-Smith H, Diedrichs PC, Bond R, Harcourt D. Psychological and sociocultural influences on body image among midlife women with and without a history of breast cancer: Testing the Tripartite Influence Model of Body Image. Body Image 2020; 35:114-125. [PMID: 33010788 DOI: 10.1016/j.bodyim.2020.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/24/2020] [Accepted: 08/24/2020] [Indexed: 12/25/2022]
Abstract
Body image concerns are common among breast cancer survivors and women in midlife. However, effective interventions are lacking for breast cancer survivors. This may be related to prior research having examined non-modifiable and medicalised influences on body image, instead of modifiable sociocultural and psychological influences. An adaptation of the 'Tripartite Influence Model of Body Image' was tested among women with (n = 169; mean age = 49.9) and without (n = 323; mean age = 47.6) a history of breast cancer, to investigate whether psychological and sociocultural influences on body image were similar between groups. Structural equation modelling revealed the model fit was satisfactory. Media pressure had an indirect effect on body image among both groups, and a direct effect among women treated for breast cancer. An additional influence of relevance only to women without breast cancer was pressure from friends. Overall, findings indicate common influences of media pressure and appearance comparisons on body image among both groups of women. This suggests that with some tailoring, existing evidence-based body image interventions designed for midlife women targeting these factors may also be relevant and beneficial for breast cancer survivors.
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Affiliation(s)
- Helena Lewis-Smith
- Centre for Appearance Research, University of the West of England, United Kingdom.
| | | | - Rod Bond
- University of Sussex, United Kingdom
| | - Diana Harcourt
- Centre for Appearance Research, University of the West of England, United Kingdom
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14
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Brederecke J, Zimmermann T. Psychometric properties of the German version of the Self Image Scale (SIS-D) in a sample of cancer patients. PLoS One 2020; 15:e0240619. [PMID: 33052971 PMCID: PMC7556474 DOI: 10.1371/journal.pone.0240619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/30/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A cancer disease can affect the satisfaction with the physical appearance, so that the standardized assessment of the body image is important in cancer patients. The German version of the Self-Image Scale is a self-report measure that uses two subscales to assess appearance satisfaction (self-acceptance) and perceptions of partners' acceptance of their appearance (partner-acceptance). The present study aimed to validate the Self-Image Scale's two-factor structure in a sample of cancer patients with a variety of different diagnoses to further increase its utility. METHODS Confirmatory factor analysis methods were used to examine the two-factor model in a sample of cancer patients (N = 278). Scale reliability and validity were then assessed through internal consistency measures and correlations with external criteria such as depressiveness, anxiety, distress, and relationship satisfaction. RESULTS The proposed factor structure was supported by the results and the internal consistencies were good with α = .83 for the self-acceptance scale and α = .88 for the partner-acceptance scale while additional correlations with external criteria were observed as expected. CONCLUSIONS The results support the use of the German version of the Self-Image Scale in cancer patients in general. Future research directions include validation across further entities of cancer, the in-depth investigation of sex differences, and research in other diseases that might impact body image.
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Affiliation(s)
- Jan Brederecke
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
- * E-mail:
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
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15
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Borstelmann NA, Rosenberg S, Gelber S, Zheng Y, Meyer M, Ruddy KJ, Schapira L, Come S, Borges V, Cadet T, Maramaldi P, Partridge AH. Partners of young breast cancer survivors: a cross-sectional evaluation of psychosocial concerns, coping, and mental health. J Psychosoc Oncol 2020; 38:670-686. [PMID: 33000705 DOI: 10.1080/07347332.2020.1823546] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Evaluation of psychosocial concerns, coping style, and mental health in partners of young (diagnosed at ≤40 years) survivors of early-stage breast cancer (BC). DESIGN Cross-sectional; partners participated in a one-time survey. SAMPLE 289 participants; most were male, white, working full-time, college educated, with median age of 43 years, parenting children <18 years old. METHODS Logistic regression was used to explore associations with anxiety and depression (≥8 on Hospital Anxiety and Depression sub-scales). FINDINGS Overall, 41% reported symptoms of anxiety, 18% reported symptoms of depression, and 44% identified maladaptive coping. Multivariable regression analyses revealed: lower social support and poorer quality of life significantly associated with depression (p < .05); maladaptive coping, fulltime employment, poorer caregiver QOL, and less education significantly associated with anxiety. CONCLUSIONS Partners of young BC survivors who use more maladaptive coping strategies, report less social support, work fulltime, and/or who have lower education levels experience negative mental health outcomes. IMPLICATIONS FOR PSYCHOSOCIAL ONCOLOGY Enhancing constructive coping and ensuring all partners have access to supportive resources may improve partners' emotional adjustment.
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Affiliation(s)
| | - Shoshana Rosenberg
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Shari Gelber
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Yue Zheng
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Meghan Meyer
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Lidia Schapira
- Stanford University Medical Center, Stanford, California, USA
| | - Steven Come
- Harvard Medical School, Boston, Massachusetts, USA.,Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | | | - Tamara Cadet
- Simmons College School of Social Work, Boston, Massachusetts, USA
| | - Peter Maramaldi
- Simmons College School of Social Work, Boston, Massachusetts, USA.,Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ann H Partridge
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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16
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Exploring the Role of Partner Satisfaction in Predicting Patient Satisfaction Regarding Post-mastectomy Breast Reconstruction. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2943. [PMID: 32802647 PMCID: PMC7413778 DOI: 10.1097/gox.0000000000002943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 04/28/2020] [Indexed: 11/30/2022]
Abstract
Supplemental Digital Content is available in the text. Qualitative studies have suggested that perceived partner satisfaction is an important predictor of patient satisfaction in post-mastectomy breast reconstruction. To better characterize these relationships, a couple-based study employing a quantitative analysis was conducted.
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17
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Yan R, Yu J, Tanimoto T, Ozaki A, Lu X, Che B, Zhang Y, Chen P, Wang J. The relationship between sexual activity and sexual attitudes among breast cancer survivors in China. Cancer Med 2020; 9:3425-3436. [PMID: 32207884 PMCID: PMC7221310 DOI: 10.1002/cam4.2874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/23/2019] [Accepted: 01/11/2020] [Indexed: 12/29/2022] Open
Abstract
Purpose Less is known about sexual attitudes of breast cancer survivors (BCSs) and its association with sexual activity and sexual dissatisfaction. Methods We investigated the proportion of sexual activity and sexual dissatisfaction in a cross‐sectional study among 341 Chinese BCSs aged 30‐75 years old, and we described their association with sexual attitudes, as well as socio‐demographic characteristics, physical health conditions, and mental health problems. Results Only 83 (24.3%) individuals reported sexual activity in the past year. More than 50% of BCSs considered that sexual activity had adverse impact on their disease recovery. The sexual attitudes such as “sexual activity may impede disease recovery” (adjusted odds ratio [AOR] = 0.51; 95% confidence interval, 95% CI: 0.30‐0.88), “sexual activity may cause cancer recurrence or metastasizes” (AOR = 0.51; 95% CI: 0.30‐0.87), and “their partner fear contracting cancer by sexuality” (AOR = 0.47; 95% CI: 0.23‐0.98) were significantly associated with decreased likelihood of reporting sexual activity in the past year. Although 201 (58.9%) BCSs reported that breast cancer decreased the frequency of their sexual activity, only 37 (10.9%) had ever discussed sexuality with a doctor to seek advice. Conclusions Most Chinese BCSs were sexually inactive. The sexual misconceptions about cancer were great barriers of sexual activity. Professional sexual education and consultation may be regarded as easy and effective intervention measures to correct BCSs' misguided sexual attitudes, and finally improving the overall sexual health for BCSs.
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Affiliation(s)
- Rui Yan
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Jinming Yu
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Tokyo, Japan.,Jyoban Hospital of Tokiwa Foundation, Fukuhsima, Japan
| | - Akihhiko Ozaki
- Medical Governance Research Institute, Tokyo, Japan.,Jyoban Hospital of Tokiwa Foundation, Fukuhsima, Japan
| | - Xinyuan Lu
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Beibei Che
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Yaxuan Zhang
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Panzhen Chen
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Jiwei Wang
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
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18
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Psychometric properties of the German version of the Self-Image Scale (SIS-D). PLoS One 2020; 15:e0230331. [PMID: 32176730 PMCID: PMC7075632 DOI: 10.1371/journal.pone.0230331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/27/2020] [Indexed: 12/02/2022] Open
Abstract
Background The Self-Image Scale is a self-report measure originally developed for use in women with cancer. Two subscales assess appearance satisfaction (self-acceptance) and perceptions of partners’ acceptance of their appearance (partner-acceptance). This study aimed to increase the Self-Image Scale’s utility by 1) confirming the two-factor structure of the German version of the Self-Image Scale, 2) testing measurement invariance across sex and age groups and validity, and 3) gathering general population normative data. Methods Confirmatory factor analysis methods were used to examine the proposed two-factor model in a random sample of adults from the general German population (N = 1367). Measurement invariance, scale reliability, and validity were assessed. Results The original factor structure and measurement invariance across sexes and age groups were supported. Women showed significantly lower self-acceptance than men. Adolescent and young adult women showed higher self-acceptance than senior women. For both sexes, partner-acceptance lowered across successive age cohorts. Internal consistencies were good. Conclusions Results support the use of the German version of the Self-Image Scale in research and clinical practice. Research directions include validation in further diseases, collecting normative data across countries, and dyadic research, particularly exploring partner-acceptance across the life span.
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19
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Does Marital Adjustment Mediate Type C Personality-Depressive Symptoms Relation? A Comparison between Breast Cancer Patients and Cancer-Free Women. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-017-9693-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Sanabria Mazo JP, Gers Estrada M. Repercusiones del Dolor Crónico en las Dinámicas de Pareja: Perspectivas de Mujeres con Fibromialgia. REVISTA COLOMBIANA DE PSICOLOGÍA 2019. [DOI: 10.15446/rcp.v28n2.71021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
El objetivo de esta investigación fue comprender las repercusiones del dolor crónico en las dinámicas de pareja, desde la perspectiva de mujeres con fibromialgia. Se realizó un estudio cualitativo de diseño fenomenológico interpretativo en el cual se entrevistó a 15 mujeres. Las participantes reportaron inconformidad con el cambio de su rol en la relación. Además, ocultar el dolor fue una estrategia para evitar la sobreprotección y los conflictos. Las repercusiones en la percepción de la relación, los espacios compartidos, el apoyo de la pareja, la comunicación y la sexualidad se asociaron con la interferencia de los síntomas. Finalmente, la aparición de la enfermedad fue una oportunidad para fortalecer o fragmentar la relación.
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21
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Arthur EK, Wills CE, Menon U. A Systematic Review of Interventions for Sexual Well-Being in Women With Gynecologic, Anal, or Rectal Cancer. Oncol Nurs Forum 2019; 45:469-482. [PMID: 29947348 DOI: 10.1188/18.onf.469-482] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Treatments for cancer in the lower pelvis often cause lasting effects on women's sexual well-being. The purpose of this review is to describe interventions to improve sexual well-being in gynecologic, anal, or rectal cancer survivors. LITERATURE SEARCH This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2009 checklist and guidelines. A literature search was conducted using PubMed, CINAHL®, PsycINFO, and Cochrane Library. DATA EVALUATION Articles were original intervention research studies of women treated for gynecologic, anal, or rectal cancer and included sexual well-being outcomes. Study characteristics were extracted and compared in a table for analysis and synthesis. SYNTHESIS Of the 16 included studies, 1 focused on genitourinary rehabilitation, 12 focused on psychoeducational interventions, and 3 focused on combination interventions. Most interventions reported at least one positive sexual well-being outcome. Intervention format, delivery, dose, and outcome variables varied widely. IMPLICATIONS FOR RESEARCH Preliminary efficacy and feasibility of interventions are promising, but larger studies designed to discern optimal content, delivery format, dose, and timing are needed.
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22
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Schneiderman N, McIntosh RC, Antoni MH. Psychosocial risk and management of physical diseases. J Behav Med 2019; 42:16-33. [PMID: 30632000 PMCID: PMC6941845 DOI: 10.1007/s10865-018-00007-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 12/18/2018] [Indexed: 12/24/2022]
Abstract
During the 40 years since the Yale conference on Behavioral Medicine and the founding of the Journal of Behavioral Medicine considerable progress has been made in understanding the role of psychosocial risk and management of physical diseases. We here describe the development of these fundamental concepts from early research on stress through studies of the Type A behavior pattern to more contemporary approaches to the relationship between psychosocial risks and benefits in relation to disease processes. This includes the relationship of psychosocial risk to cancers, cardiovascular diseases (CVD), cardiometabolic disorders, Human Immunodeficiency Virus (HIV)/Acquired Human Immune Deficiency Syndrome. During the past 40 years the effects of prolonged distress responses in the pathogenesis of some cancers and CVD have been well-established and modifiable behavioral, cognitive and social factors have been shown to produce favorable outcome components in the management of such diseases as breast cancer, coronary heart disease and HIV.
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Affiliation(s)
- Neil Schneiderman
- Health Division, Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Coral Gables, FL, 33124, USA.
| | - Roger C McIntosh
- Health Division, Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Coral Gables, FL, 33124, USA
| | - Michael H Antoni
- Health Division, Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Coral Gables, FL, 33124, USA
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23
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Depression and marital satisfaction: the mediating role of sexual satisfaction and perceived partner acceptance in women after mastectomy. HEALTH PSYCHOLOGY REPORT 2019. [DOI: 10.5114/hpr.2019.84213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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24
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Lewis FM, Griffith KA, Alzawad Z, Dawson PL, Zahlis EH, Shands ME. Helping Her Heal: Randomized clinical trial to enhance dyadic outcomes in couples. Psychooncology 2018; 28:430-438. [PMID: 30549145 DOI: 10.1002/pon.4966] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 10/29/2018] [Accepted: 12/07/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of this study was to test the short-term efficacy of a brief, fully manualized marital communication and interpersonal support intervention for couples facing recently diagnosed breast cancer. METHODS A total of 322 women diagnosed within 6 months with stages 0 to III breast cancer and their 322 spouse caregivers were enrolled. Spouses in the experimental group received five 30- to 60-minute intervention sessions at 2-week intervals by master's-prepared patient educators; controls received the booklet, "What's Happening to the Woman I Love?" Outcomes were assessed at 3, 6, and 9 months using the linear mixed models within an intent-to-treat analysis. RESULTS Compared with controls, at 3 months, spouse caregivers significantly improved on standardized measures of depressed mood, anxiety, cancer-related marital communication, interpersonal support, and self-care. All differences except depressed mood and anxiety were sustained at 9 months. Wives significantly improved at 3 months on marital communication and positive appraisal of spouses' interpersonal support; gains remained significant at 9 months. Compared with controls on chemotherapy, wives in the experimental group additionally improved on depressed mood and tended to improve on anxiety. CONCLUSIONS A brief, fully manualized intervention delivered directly to spouse caregivers early in the course of their wives' medical treatment improves caregivers' self-care and behavioral-emotional adjustment and wives' positive view of their spouses' support and communication. The brevity and manualized structure of the intervention argue strongly for its scalability, use in cost-sensitive settings, and its potential dissemination through e-health channels.
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Affiliation(s)
- Frances Marcus Lewis
- School of Nursing, University of Washington, Seattle, Washington, USA.,Division of Public Health Sciences and Clinical Research Divisions, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Zainab Alzawad
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Patricia L Dawson
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Ellen H Zahlis
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Mary Ellen Shands
- School of Nursing, University of Washington, Seattle, Washington, USA
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25
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Oh YK, Hwang SY. [Impact of Uncertainty on the Quality of Life of Young Breast Cancer Patients: Focusing on Mediating Effect of Marital Intimacy]. J Korean Acad Nurs 2018. [PMID: 29535284 DOI: 10.4040/jkan.2018.48.1.50] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients. METHODS This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis. RESULTS Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (β=-.39, p=.013) and 4 sub-scales of QoL were also affected by uncertainty. Among the 4 sub-scales of QoL, physical well-being (PWB) (β=.17, p=.026), social well-being (SWB) (β=.49, p=.010), and functional well-being (FWB) (β=.38, p=.009) were affected by marital intimacy but emotional well-being (EWB) was not affected by it. The mediating effect of marital intimacy on the impact of uncertainty on QoL was confirmed. Marital intimacy showed a significant indirect effect on PWB (β=-.07, p=.024), SWB (β=-.19, p=.008), and FWB (β=-.15, p=.005), and it means that marital intimacy has a partial mediating effect on the impact of uncertainty on PWB, SWB, and FWB. CONCLUSION Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.
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Affiliation(s)
| | - Seon Young Hwang
- School of Nursing · The Research Institute of Nursing Science, Hanyang University, Seoul, Korea.
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26
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Azlan HA, Overton PG, Simpson J, Powell PA. Effect of Partners' Disgust Responses on Psychological Wellbeing in Cancer Patients. J Clin Psychol Med Settings 2017; 24:355-364. [PMID: 29164511 DOI: 10.1007/s10880-017-9521-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to explore quantitatively the relationship between disgust responses in cancer patients and their partners, and in turn their relationship to patients' psychological well-being. We recruited 50 participants with heterogeneous cancer diagnoses and their partners from cancer-related groups (e.g., charities). Patients completed questionnaires to determine levels of disgust propensity, disgust sensitivity, self-disgust, and symptoms of anxiety and depression. Disgust propensity and sensitivity were also assessed in their partners. Partners' disgust sensitivity was significantly positively correlated with cancer patients' self-disgust, disgust propensity, and depression. Path analyses suggested that patients' self-disgust plays a role in mediating the effect of partners' disgust sensitivity on patients' psychological well-being. This study provides the first quantitative evidence that psychological well-being in cancer patients is contingent on their partners' sensitivity to disgust, and that patients' self-disgust plays a mediating role. Focusing therapeutically on disgust responses could well be beneficial to people with cancer.
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Affiliation(s)
- Haffiezhah A Azlan
- Department of Psychology, University of Sheffield, Western Bank, Sheffield, UK
| | - Paul G Overton
- Department of Psychology, University of Sheffield, Western Bank, Sheffield, UK.
| | - Jane Simpson
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Philip A Powell
- Department of Economics, University of Sheffield, Sheffield, UK
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27
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Fouladi N, Pourfarzi F, Dolattorkpour N, Alimohammadi S, Mehrara E. Sexual life after mastectomy in breast cancer survivors: A qualitative study. Psychooncology 2017; 27:434-441. [PMID: 28618128 DOI: 10.1002/pon.4479] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 05/14/2017] [Accepted: 06/09/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Nasrin Fouladi
- Ardebil University of Medical Sciences Ringgold Standard Institution-Community Medicine, Faculty of Medicine; Ardebil The Islamic Republic of Iran
| | - Farhad Pourfarzi
- Ardebil University of Medical Sciences Ringgold Standard Institution-Community Medicine, Faculty of Medicine; Ardebil The Islamic Republic of Iran
| | - Negin Dolattorkpour
- Ardebil University of Medical Sciences Ringgold Standard Institution-Community Medicine, Faculty of Medicine; Ardebil The Islamic Republic of Iran
| | - Sara Alimohammadi
- Shahid Behesti University of Medical Sciences; Tehran The Islamic Republic of Iran
| | - Elham Mehrara
- University of Tabriz Ringgold standard institution; Tabriz East Azerbaijan The Islamic Republic of Iran
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28
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Soriano EC, Otto AK, Siegel SD, Laurenceau JP. Partner social constraints and early-stage breast cancer: Longitudinal associations with psychosexual adjustment. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2017; 31:574-583. [PMID: 28206777 PMCID: PMC5555802 DOI: 10.1037/fam0000302] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Women with breast cancer (BC) who perceive social constraints on their disclosure of cancer-related concerns are more likely to experience distress and have difficulty adjusting after diagnosis. Much of the existing research on psychosocial adjustment is cross-sectional in nature and an important area of concern that has received little attention is psychosexual adjustment to cancer surgery and treatment. This study examined whether perceived partner social constraints were associated with psychosexual adjustment over time in 108 BC survivors. Early-stage BC patients completed measures of partner social constraints, psychosexual adjustment, and relationship dissatisfaction approximately 1 month, 8 months, and 4 years after initial surgery. Latent growth curve modeling revealed partner social constraints to be a significant time-varying, within-person predictor of psychosexual adjustment at each time point after controlling for relationship dissatisfaction. BC surgery type, reconstructive surgery, cancer stage, chemotherapy, or antihormonal adjuvant treatment did not moderate this effect. Findings point to a long-term link between social constraints and psychosexual outcomes in BC patients and clinical implications for women coping with BC. (PsycINFO Database Record
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Affiliation(s)
- Emily C Soriano
- Department of Psychological and Brain Sciences, University of Delaware
| | - Amy K Otto
- Department of Psychological and Brain Sciences, University of Delaware
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29
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Gürsoy A, Koçan S, Aktuğ C. Nothing is more important than my partner's health: Turkish men's perspectives on partner's appearance after mastectomy and alopecia. Eur J Oncol Nurs 2017; 29:23-30. [PMID: 28720262 DOI: 10.1016/j.ejon.2017.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/17/2017] [Accepted: 04/20/2017] [Indexed: 11/28/2022]
Abstract
PURPOSES The aim of this study was to acquire a deeper understanding of male experiences on the emotional and social impact of their partners' mastectomy and chemotherapy-induced alopecia. METHODS A purposive sample of 16 males whose partners had undergone mastectomy and alopecia due to chemotherapy was chosen. The data were collected through a semi-structured interview method. Interpretative Phenomenological Analysis of tape-recorded interviews was employed. RESULTS Two main themes emerged from the data: facing the changes and my wife and I at present. Male partners were affected differently by the change in the physical appearance of their female partners. Our study participants said it was a difficult experience to see their partners for the first time after the surgery, but they emphasized that it was more important that their partners were healthy than the fact that they did not have a breast and hair. They also said they did not know how to behave towards their partners after surgery and/or chemotherapy. Nevertheless, they felt that the disease process of their partners had strengthened their bond and had not negatively influenced their relationship with others. CONCLUSIONS The changes in the partners' physical appearance after mastectomy and chemotherapy affected males differently in psychological, emotional and social terms. Since nurses working in this field are in contact with patients during all phases of treatment and care, it would be positive and beneficial to plan nursing interventions that give emotional support for male partners of patients with breast cancer.
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Affiliation(s)
- Ayla Gürsoy
- Karadeniz Technical University, Faculty of Health Sciences, Nursing Department, Surgical Nursing, 61040 Trabzon, Turkey.
| | - Sema Koçan
- Recep Tayyip Erdogan University, Vocational School of Health Services, 53100 Rize, Turkey.
| | - Cemile Aktuğ
- Gümüşhane University, Faculty of Health Sciences, Nursing Department, 29100 Gümüşhane, Turkey.
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Brandão T, Pedro J, Nunes N, Martins MV, Costa ME, Matos PM. Marital adjustment in the context of female breast cancer: A systematic review. Psychooncology 2017; 26:2019-2029. [PMID: 28342270 DOI: 10.1002/pon.4432] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/15/2017] [Accepted: 03/22/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Breast cancer (BC) diagnosis and subsequent treatments present significant challenges and distress for both patients and their partners. This can lead to difficulties in marital relationships and, consequently, decreases in marital adjustment and psychosocial adaptation to BC for both partners. Our objective was to systematically review studies assessing marital adjustment in the context of female BC to understand which factors are associated with marital adjustment in both patients and partners and characterize the measures used to assess marital adjustment within these studies. METHODS This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English, peer-reviewed articles exploring factors associated with marital adjustment in the context of female BC were considered for inclusion. RESULTS Fourteen studies were included. Results evidenced that psychosocial variables play an important role on marital adjustment. Specifically, open and constructive communication, more social support, and supportive dyadic coping were found to be associated with higher levels of marital adjustment. Other variables such as self-efficacy, sexual functioning, and psychological adjustment were also positively associated with marital adjustment. CONCLUSIONS Most studies evidenced an association between psychosocial variables and marital adjustment for both women and their partners. Some important dimensions such as communication patterns, coping strategies, and social support dynamics were identified as potential targets for psychological interventions. Some variables, however, were explored only in a few studies, which limit our conclusions. Future studies should explore the role these variables and other relational and emotional variables play in promoting marital adjustment after BC.
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Affiliation(s)
- Tânia Brandão
- Center for Psychology at University of Porto, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Juliana Pedro
- Center for Psychology at University of Porto, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Nuno Nunes
- Center for Psychology at University of Porto, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Mariana V Martins
- Center for Psychology at University of Porto, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Maria Emília Costa
- Center for Psychology at University of Porto, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Paula Mena Matos
- Center for Psychology at University of Porto, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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The Relationship Between Body Image, Gender, Subjective Norms, and the Decision to Undergo Preventive Mastectomy Among Arab and Jewish BRCA Carriers. Cancer Nurs 2017; 41:255-262. [PMID: 28481778 DOI: 10.1097/ncc.0000000000000503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Carriers for a mutation in BRCA1/2 genes have a high, lifelong risk for developing breast cancer. Preventive mastectomy is considered an effective risk reduction surgery. Many factors might affect the decision to undergo preventive mastectomy, including culture, perceived body image after mastectomy and important others opinion. OBJECTIVE The aim of this study is to evaluate BRCA mutation carriers' decision to undergo preventive mastectomy and the relationship between culture, gender, body image, and the decision. METHODS The study was a cross-sectional design where Arab and Jewish men and women were requested to imagine that they were/their spouse was a BRCA mutation carrier. The sample consisted of 200 participants, 101 Arab and 99 Jews, included 101 women and 99 men. RESULTS The results show a high intention to undergo preventive mastectomy. Being Arab and having a more positive perception of body image after the surgery were connected to more intention to undergo the surgery. Also, those who intended to choose the surgery considered more the opinions of important others. CONCLUSIONS The results point to the importance of partners' involvement in the decision to undergo preventive mastectomy. Also, important others (relatives, friends, and health caregivers) have an impact on the decision. IMPLICATIONS FOR PRACTICE Nurses need to consider cultural aspects of patients considering a decision about whether to undergo preventive mastectomy. Understanding the important others who might influence the decision and including them in the decision process are both essential.
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Parton C, Ussher JM, Perz J. Experiencing menopause in the context of cancer: Women’s constructions of gendered subjectivities. Psychol Health 2017; 32:1109-1126. [DOI: 10.1080/08870446.2017.1320799] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Chloe Parton
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Jane M. Ussher
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
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Parton C, Ussher JM, Perz J. Women’s constructions of heterosex and sexual embodiment after cancer. FEMINISM & PSYCHOLOGY 2016. [DOI: 10.1177/0959353516674493] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The significant impact of cancer on women’s sexual well-being has been acknowledged increasingly within research. However, the role of cultural discourse in shaping women’s construction and embodied experience of sexuality has received less attention. In this study, we examined heterosexual women’s constructions of sexual embodiment in the context of cancer. Sixteen women across a range of ages (20–71 years), cancer types and stages took part in in-depth semi-structured interviews. A thematic decomposition analysis was conducted on the interview transcripts, drawing on feminist poststructuralist theory. A main theme was identified in which the women took up subject positions of “Embodying sexuality” and “Embodying the absence of sexuality”. Accounts of “Embodying sexuality” included “Experiencing bodily ease during sex” and “Managing a dysfunctional body during sex”. The women’s positioning of “Embodying the absence of sexuality” included “Asexuality and the absence of desire” and “Unsuccessful attempts to renegotiate sex”. Women’s intrapsychic negotiation of sexual and gendered discourse, the materiality of embodied change and relationship context influenced their constructions of sexual subjectivity. These findings indicate a need for researchers and clinicians to acknowledge cultural discourses of sex and gender that shape the possibilities and constraints for women’s sexual well-being after cancer.
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Vieira EM, Santos DB, Santos MAD, Giami A. Experience of sexuality after breast cancer: a qualitative study with women in rehabilitation. Rev Lat Am Enfermagem 2016; 22:408-14. [PMID: 25029051 PMCID: PMC4292614 DOI: 10.1590/0104-1169.3258.2431] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 02/12/2014] [Indexed: 11/22/2022] Open
Abstract
Objective to comprehend the psychosocial and cultural repercussions of breast cancer
and its treatment on the sexuality of women. Method this is a qualitative study grounded in the Sexual Scripts Theory with the
participation of 23 women who were interviewed and participated in focus
groups discussion. Results each category was related to a level of the sexual scripts. At the cultural
scenario level a discourse on sexuality that includes definitions of sexual
attractiveness and sexuality was highlighted. The interpersonal scripts
level focused on the communication regarding sexuality established with the
partner and with healthcare professionals category; and at the subjectivity
scripts level the reports of improvement, deterioration and no change in the
sexual life after cancer were analyzed. Conclusion the experience of cancer involves cultural, relational, and subjective
aspects that affect the sexual life, therefore, healthcare professionals
should be aware of them to improve integral healthcare.
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Affiliation(s)
- Elisabeth Meloni Vieira
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Daniela Barsotti Santos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Manoel Antônio dos Santos
- Departamento de Psicologia, Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Alain Giami
- Centre de recherche en Epidémiologie e Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Le Kremlin, Bicêtre, France
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Kwait RM, Pesek S, Onstad M, Edmonson D, Clark MA, Raker C, Stuckey A, Gass J. Influential Forces in Breast Cancer Surgical Decision Making and the Impact on Body Image and Sexual Function. Ann Surg Oncol 2016; 23:3403-11. [DOI: 10.1245/s10434-016-5365-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Indexed: 01/12/2023]
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Patients' experience of sexuality 1-year after allogeneic Haematopoietic Stem Cell Transplantation. Eur J Oncol Nurs 2015; 19:419-26. [DOI: 10.1016/j.ejon.2014.12.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/17/2014] [Accepted: 12/22/2014] [Indexed: 12/22/2022]
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Santisteban DA, Mena MP, Muir J, McCabe BE, Abalo C, Cummings AM. The efficacy of two adolescent substance abuse treatments and the impact of comorbid depression: results of a small randomized controlled trial. Psychiatr Rehabil J 2015; 38:55-64. [PMID: 25799306 PMCID: PMC5021542 DOI: 10.1037/prj0000106] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The purpose of this randomized trial was to investigate the efficacy of 2 behavioral treatments focusing on different change mechanisms in ameliorating a borderline personality disorder constellation of behaviors and substance use in adolescents referred by juvenile diversion programs. METHODS Forty adolescents 14-17 years of age and meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for borderline personality disorder and substance use disorders were randomized to integrative borderline personality disorder-oriented adolescent family therapy (I-BAFT) or individual drug counseling. This design allowed a comparison of 2 manualized interventions, 1 family based and 1 individually oriented. Profiles of clinical change were used to detect impact and estimate treatment effect sizes. RESULTS Primary analyses showed that both interventions had a clinically significant impact on borderline personality disorder behaviors 12 months after baseline but with no differential treatment effects. The impact on substance use was more complex. Subgroup analyses revealed that adolescents with depression had significantly more severe profiles of borderline personality disorder and substance use. These youths were the only group to show reductions in substance use, but they only did so if they received the I-BAFT intervention. Study data also documented the high dosage of intensive residential treatment needed by this population. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Results highlight the intensive treatment needs of juvenile justice-involved youths with co-occurring substance use and borderline personality disorder including depression, the hybrid outpatient and residential treatment often required by this population, and the promise of a family-oriented approach, particularly for youths with severe symptoms and co-occurring depression. (PsycINFO Database Record
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Affiliation(s)
- Daniel A Santisteban
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami
| | - Maite P Mena
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami
| | - Joan Muir
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Brian E McCabe
- School of Nursing and Health Studies, University of Miami
| | - Clara Abalo
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami
| | - Amanda M Cummings
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami
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Santos DB, Santos MAD, Vieira EM. Sexualidade e câncer de mama: uma revisão sistemática da literatura. SAUDE E SOCIEDADE 2014. [DOI: 10.1590/s0104-12902014000400018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi compreender como o câncer de mama e seus tratamentos afetam a vivência da sexualidade da mulher acometida. Foi realizada uma revisão sistemática qualitativa de artigos científicos, publicados entre 2000 e 2010, disponíveis nas bases de dados PubMed, Web of Science, LILACS e SciELO. Foram obtidos 50 artigos cujos textos foram categorizados segundo análise de conteúdo temática. Foram identificadas seis categorias temáticas: a cirurgia mamária e os demais tratamentos para o câncer de mama; a experiência da mulher acometida; o relacionamento afetivo-sexual; estudos sobre relação entre sexualidade e características específicas do câncer; os profissionais de saúde e a atenção à sexualidade; e propostas para amenizar as consequências negativas dos tratamentos na sexualidade. Há necessidade de novos estudos a respeito dos aspectos culturais da sexualidade, diversidade sexual, relacionamento com o parceiro, formação do profissional de saúde e intervenções em sexualidade no contexto do câncer de mama.
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Wimberly SR, Carver CS, Antoni MH. Effects of optimism, interpersonal relationships, and distress on psychosexual well-being among women with early stage breast cancer. Psychol Health 2014; 23:57-72. [PMID: 25159907 DOI: 10.1080/14768320701204211] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study examined associations between optimism, social support, and distress as they relate to psychosexual well-being among 136 women with Stage 0, I, and II breast cancer. Women were assessed immediately post-surgery and 3, 6, and 12 months post-surgery. Results support two cross-sectional mediation models. The first model indicates that patients who are more optimistic experience greater psychosexual well-being (i.e., feel more feminine, attractive, and sexually desirable) partly because they perceive themselves as having more social support available. The second model indicates that patients who are more optimistic experience greater psychosexual well-being partly because they experience less emotional distress related to the disease. When the two models were tested simultaneously, distress no longer contributed uniquely to the model at any time point except for 12 months follow-up.
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Affiliation(s)
- Sarah R Wimberly
- a Department of Psychology , University of Miami , 5665 Ponce De Leon Blvd. , Coral Gables , FL , USA
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Rowland E, Metcalfe A. A systematic review of men's experiences of their partner's mastectomy: coping with altered bodies. Psychooncology 2014; 23:963-74. [DOI: 10.1002/pon.3556] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 02/10/2014] [Accepted: 03/20/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Emma Rowland
- Florence Nightingale School of Nursing and Midwifery; King's College London; London UK
| | - Alison Metcalfe
- Florence Nightingale School of Nursing and Midwifery; King's College London; London UK
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Pan XF, Fei MD, Zhang KY, Fan ZL, Fu FH, Fan JH. Psychopathological Profile of Women with Breast Cancer Based on the Symptom Checklist-90-R. Asian Pac J Cancer Prev 2013; 14:6579-84. [DOI: 10.7314/apjcp.2013.14.11.6579] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sexual functioning in young women in the context of breast cancer treatment. Rep Pract Oncol Radiother 2013; 18:193-200. [PMID: 24416553 DOI: 10.1016/j.rpor.2013.04.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 04/09/2013] [Indexed: 11/21/2022] Open
Abstract
Breast cancer is the most common type of cancer among women worldwide. The number of breast cancer survivors has been growing because of earlier detection and improved treatment. Young women under 50 years of age account for relatively small percentage of all newly diagnosed breast cancer patients. However, their medical and psychosocial context of the disease is unique. Breast cancer is diagnosed at the most productive time in life. Concerns about childbearing, partner rejection, sexual function, body image, sexual attractiveness and career are common. For all these reasons experience of breast cancer diagnosis and treatment among young women requires special attention. Researches indicate that oncological treatment may negatively affect female sexual functioning. Chemotherapy is one of the greatest risk factors of sexual dysfunctions, especially when it results in medication-induced menopause. The duration and severity of sexual problems depend on a wide variety of factors: medical, psychological and interpersonal. These side effects may last for many years after the end of treatment. It is known that breast cancer affects both patients and their partners. The first sexual experience after surgery may be a turning point in sexual adaptation in couples. Communication is crucial in this process. More knowledge about sexual difficulties and sexual adaptation process of young breast cancer survivors (YBCSs) and their partners is needed. Knowing protective and risk factors is necessary to identify couples at risk for sexual dysfunctions in order to professionally support them in the best way and at the right time.
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Velikova-Tzonkova B. Perceived Social Support in Cancer Survivors: Some Preliminary Results. PSYCHOLOGICAL THOUGHT 2013. [DOI: 10.5964/psyct.v6i1.64] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Psychosocial intervention effects on adaptation, disease course and biobehavioral processes in cancer. Brain Behav Immun 2013; 30 Suppl:S88-98. [PMID: 22627072 PMCID: PMC3444659 DOI: 10.1016/j.bbi.2012.05.009] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 05/09/2012] [Accepted: 05/11/2012] [Indexed: 02/06/2023] Open
Abstract
A diagnosis of cancer and subsequent treatments place demands on psychological adaptation. Behavioral research suggests the importance of cognitive, behavioral, and social factors in facilitating adaptation during active treatment and throughout cancer survivorship, which forms the rationale for the use of many psychosocial interventions in cancer patients. This cancer experience may also affect physiological adaptation systems (e.g., neuroendocrine) in parallel with psychological adaptation changes (negative affect). Changes in adaptation may alter tumor growth-promoting processes (increased angiogenesis, migration and invasion, and inflammation) and tumor defense processes (decreased cellular immunity) relevant for cancer progression and the quality of life of cancer patients. Some evidence suggests that psychosocial intervention can improve psychological and physiological adaptation indicators in cancer patients. However, less is known about whether these interventions can influence tumor activity and tumor growth-promoting processes and whether changes in these processes could explain the psychosocial intervention effects on recurrence and survival documented to date. Documenting that psychosocial interventions can modulate molecular activities (e.g., transcriptional indicators of cell signaling) that govern tumor promoting and tumor defense processes on the one hand, and clinical disease course on the other is a key challenge for biobehavioral oncology research. This mini-review will summarize current knowledge on psychological and physiological adaptation processes affected throughout the stress of the cancer experience, and the effects of psychosocial interventions on psychological adaptation, cancer disease progression, and changes in stress-related biobehavioral processes that may mediate intervention effects on clinical cancer outcomes. Very recent intervention work in breast cancer will be used to illuminate emerging trends in molecular probes of interest in the hope of highlighting future paths that could move the field of biobehavioral oncology intervention research forward.
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Schmid-Büchi S, Halfens RJ, Müller M, Dassen T, van den Borne B. Factors associated with supportive care needs of patients under treatment for breast cancer. Eur J Oncol Nurs 2013; 17:22-9. [DOI: 10.1016/j.ejon.2012.02.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 02/16/2012] [Accepted: 02/20/2012] [Indexed: 12/24/2022]
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Andrzejczak E, Markocka-Mączka K, Lewandowski A. Partner relationships after mastectomy in women not offered breast reconstruction. Psychooncology 2012; 22:1653-7. [PMID: 23045167 DOI: 10.1002/pon.3197] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 09/05/2012] [Accepted: 09/06/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND The present study assessed the degree to which undergoing a mastectomy without reconstructive surgery negatively impacts the patient's psychological state. We focus on body image and self-esteem as well as the influence of mastectomy on patient sex lives and partnership relations. METHODS The participants were 60 women, either married or in a relationship, who had had a mastectomy because of breast cancer and no subsequent reconstructive surgery. A marital happiness questionnaire was used to evaluate the research problem. RESULTS Surgery negatively impacted partnership relations for 33% of participants. In particular, 31% reported deterioration in attractiveness; 31%, a feeling of malaise; and 30%, that their partners perceived them as less attractive. Moreover, 80% in the youngest group reported that they covered their body during intimate contact, whereas 58% in the oldest age group reported the same behaviour. Deterioration in satisfaction with sex life and in the pleasure of sexual intercourse was indicated by 71% and 77%, respectively. Correspondingly, 71% also noticed a decrease in sexual activity, with 76% of participants aged 50-65 years reporting such a decline. The oldest women were also less satisfied with their sexual intercourse. CONCLUSIONS Breast excision due to cancer negatively impacted the quality of sexual life for 71% of participants. Partnership relations after surgery remained unchanged for 67% of them. There was significant impact of surgery on the perception of one's own body.
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Affiliation(s)
- Ewa Andrzejczak
- Silesian Piasts University of Medicine in Wrocław, Department of Gastrointestinal and General Surgery, Wrocław, Poland
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Mechanisms of psychological resiliency in women after mastectomy. Contemp Oncol (Pozn) 2012; 16:341-4. [PMID: 23788906 PMCID: PMC3687422 DOI: 10.5114/wo.2012.30065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 03/09/2012] [Accepted: 03/19/2012] [Indexed: 11/17/2022] Open
Abstract
AIM OF THE STUDY To investigate into the mechanisms of resiliency in women after mastectomy. We hypothesized that the mechanism of resiliency in women with breast cancer would involve facilitation of adaptive coping strategies and inhibition of maladaptive strategies. We tested a mediational model in which resiliency was related to satisfaction with life through coping strategies. MATERIAL AND METHODS Thirty women after mastectomy aged 28-69 years (M = 53.23, SD = 9.00) completed the Ego Resiliency Scale, Mental Adjustment to Cancer Scale, and Satisfaction with Life Scale. RESULTS The bootstrapping technique revealed that there were significant indirect effects for positive reframing (95% CI: 0.01-0.36), hopelessness/helplessness (95% CI: 0.18-0.83) and anxious preoccupation (95% CI: 0.001-0.55) but not for fighting spirit. The models explained up to 33% of the variance in satisfaction with life. CONCLUSIONS Coping strategies fully explain the effect of resiliency on satisfaction with life in women after mastectomy. This finding provides additional evidence of the fundamental role of coping strategies in the mechanisms of resiliency. We obtained similar results in patients with type II diabetes and rheumatoid arthritis. The lack of significant associations of fighting spirit with resiliency suggests that this coping strategy may be beneficial for somatic health but its contribution to the mechanisms of psychological resiliency is complex.
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Child maltreatment and breast cancer survivors: social support makes a difference for quality of life, fatigue and cancer stress. Eur J Cancer 2012; 48:728-36. [PMID: 21752636 DOI: 10.1016/j.ejca.2011.06.022] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 06/07/2011] [Accepted: 06/07/2011] [Indexed: 01/19/2023]
Abstract
PURPOSE To identify how child maltreatment is associated with quality of life (QOL) among breast cancer survivors. PATIENTS AND METHODS One hundred and thirty two women who had completed treatment for stage 0-IIIA breast cancer within the past 2 years (except for tamoxifen/aromatase inhibitors) and were at least 2 months post surgery, radiation, or chemotherapy completed questionnaires including the Childhood Trauma Questionnaire, the Impact of Events Scale, the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) and the Fact-B breast cancer quality of life questionnaire. RESULTS Women who were abused or neglected as children reported more cancer-related psychological distress, more fatigue and poorer physical, emotional, functional and breast cancer-specific well-being after treatment. These relations were partially explained by the fact that breast cancer survivors reported receiving less support as adults. CONCLUSION The findings suggest that child maltreatment is an important predictor of QOL among breast cancer survivors. One reason why this association exists is because those who are maltreated as children report less support as adults. A better understanding of how child maltreatment contributes to breast cancer survivor QOL will help in tailoring and, therefore, enhancing the efficacy of interventions aimed at improving QOL.
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50
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White JL, Boehmer U. Long-term breast cancer survivors' perceptions of support from female partners: an exploratory study. Oncol Nurs Forum 2012; 39:210-7. [PMID: 22374495 DOI: 10.1188/12.onf.210-217] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe the social support experiences of long-term breast cancer survivors who have female partners, from the perspective of survivors. RESEARCH APPROACH Descriptive study using qualitative methods. SETTING United States. PARTICIPANTS A purposive convenience sample of 15 partnered sexual minority women (SMW) (e.g., women with female partners) diagnosed with nonmetastatic breast cancer from 2000-2005. METHODOLOGIC APPROACH One-on-one interviews were conducted by telephone. Interviews were semistructured through the use of an interview guide. Transcribed data were coded and analyzed to identify emergent themes. MAIN RESEARCH VARIABLES Perceptions of support and broad aspects of the intimate partner relationship that may critically impact the psychological well-being of SMW following breast cancer. FINDINGS Six salient themes describe SMW survivors' perceptions of support: (a) female partners are the singular source of survivors' most valuable support; partners support survivors by (b) discussing survivors' health and distress, which survivors associate with (c) perceived partner distress, and (d) managing the home and caretaking, which survivors associate with (e) perceived partner burden; and partners support survivors by (f) sharing in a life beyond cancer. CONCLUSIONS Female partners play a central and comprehensive support role as well as experience ongoing stress and burden related to survivors' cancer. INTERPRETATION Future research and direct investigation may inform healthcare providers about caring for SMW and their families following breast cancer.
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Affiliation(s)
- J Lee White
- Department of Community Health Sciences in School of Public Health, Boston University in Massachusetts, USA
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