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Acquati C, Cotter-Mena K, Sanchez C, LaMarca-Lyon A, Zhang A, Roth M. Informing Psychosocial Care for Young Couples Coping with Early-Onset Breast Cancer: A Cross-Sectional Examination of Unmet Service Needs and Their Association with Psychological Distress in the First Year Post-Diagnosis. J Adolesc Young Adult Oncol 2024. [PMID: 39452509 DOI: 10.1089/jayao.2024.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2024] Open
Abstract
Objective: Young women diagnosed with breast cancer report greater psychological and physical morbidity than both older women and healthy peers. Similarly, young partners experience elevated cancer-related distress. Psychosocial oncology programs are not frequently attuned to the needs of young adult patients and may exclude their social networks. This marks a critical gap in psychosocial care delivery. The study investigated unmet service needs, psychological distress, and care preferences of young couples managing breast cancer in the first year post-diagnosis. Methods: Forty dyads (n = 80) of women aged 18-45 and their partners completed measures of anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), and a service use questionnaire adapted from previously published Adolescent and Young Adult (AYA) literature. The resulting 25 items assessed perceived care needs and service utilization across three domains: informational, emotional/supportive, and practical issues. Descriptive statistics, cross-tabulations, and bivariate correlations were computed. Actor and partner effects of unmet needs on mental health outcomes were investigated with generalized estimating equations (GEE). Results: Patients and partners were in their late thirties, mostly non-Hispanic White, married, highly educated, and employed. Approximately 60% of patients and 43%-66% of partners presented one or more unmet service needs, which correlated with greater distress. Unmet needs about information related to exercise, recurrence, nutrition, and symptom management were prevalent. Unmet supportive service needs of both patients and partners included age-appropriate programs, sexual health, and family counseling. Women reported practical needs for work/school accommodations, integrative care, financial issues and health coverage; while financial concerns, health insurance, and caregiving demands were priorities for partners. Conclusion: Young couples facing early-onset breast cancer experience large proportions of unmet service needs. These challenges were exacerbated by the lack of developmentally targeted psychosocial programs pertaining to informational, supportive, and practical care needs. Enhancing providers' understanding of the psychosocial issues affecting young couples' well-being, and the implementation of systematic procedures to detect and respond to their distress, is urgently needed.
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Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
- Department of Clinical Sciences, Fertitta Family College of Medicine, University of Houston, Houston, Texas, USA
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kristin Cotter-Mena
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
- Datatude, Inc, Houston, Texas, USA
| | - Chelsea Sanchez
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Amy LaMarca-Lyon
- Department of Social Work, The UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Anao Zhang
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael Roth
- Division of Pediatrics, Department of Pediatrics Patient Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Praça MSL, de Sousa FTR, Cândido EB, Lamaita RM, Wender MCO, Silva AL. Beyond the diagnosis: gender disparities in the social and emotional impact of cancer. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e2024S115. [PMID: 38865535 PMCID: PMC11164259 DOI: 10.1590/1806-9282.2024s115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 06/14/2024]
Affiliation(s)
- Mariana Seabra Leite Praça
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
| | | | - Eduardo Batista Cândido
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
| | - Rívia Mara Lamaita
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
| | - Maria Celeste Osório Wender
- Universidade Federal do Rio Grande do Sul, Department of Gynecology and Obstetrics – Porto Alegre (RS), Brazil
| | - Agnaldo Lopes Silva
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
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Yoshida K, Matsui Y. An Examination of the Association Between Psychosocial Aspects of Fertility Issues and Demographic Characteristics of Unmarried Adolescent and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2024; 13:293-299. [PMID: 37902972 DOI: 10.1089/jayao.2023.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023] Open
Abstract
Purpose: The purpose of this study was to examine the association between fertility issues and demographic characteristics of unmarried adolescent and young adult cancer survivors. Methods: We conducted a survey among cancer survivors who were 15-39 years old and unmarried at the time of cancer diagnosis and 20-45 years old at the time of the survey. Views on fertility issues, originally developed based on the results of a qualitative study conducted with the same inclusion criteria, were used to assess thoughts and feelings regarding fertility issues. Results: Through exploratory factor analysis of the 128 respondents who either had children or desired children, two factors related to fertility issues were identified: "anxiety related to the possibility of not being able to have children" and "pressure from others to have children." Multiple regression analysis was performed to examine the association between these factors and demographic characteristics. The analysis revealed that being male and having a partner were significant predictors for both factors for views on fertility issues. Additionally, younger age at the time of diagnosis was a significant predictor for the first factor. Conclusions: Greater fertility issues among unmarried cancer survivors were associated with younger age at diagnosis, having a partner, and being male. Surprisingly, contrary to previous findings, male cancer survivors experienced more significant fertility problems than women. This result may be attributed to the well-established gender roles in Japan, where men are predominantly considered the heirs and inheritors of the family.
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Affiliation(s)
- Kanako Yoshida
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Yutaka Matsui
- Institute of Human Sciences, University of Tsukuba, Tokyo, Japan
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Reuvers MJP, Gedik A, Way KM, Elbersen-van de Stadt SM, van der Graaf WTA, Husson O. Caring for Adolescents and Young Adults (AYA) with Cancer: A Scoping Review into Caregiver Burdens and Needs. Cancers (Basel) 2023; 15:3263. [PMID: 37370873 DOI: 10.3390/cancers15123263] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
AYAs with cancer (aged 15 to 39 at primary diagnosis) form a specific group within oncology, and there is limited information on the impact on their informal caregivers. This scoping review aimed to gain insight into the burden on caregivers of AYAs with cancer and identify the unmet needs they might have. Eligible articles focused on impacts in one of the domains of caregiver burden (physical, psychological, social, on schedule, financial) or unmet needs. In all domains of caregiver burden, impact was reported by caregivers. Caregiving leads to physical problems (such as sleep problems) and psychological symptoms (e.g., depression, anxiety, and negative emotions). Loneliness is reported, and little peer-support. Many different tasks and roles must be undertaken, which is perceived as challenging. In addition, there is a financial impact and there are unmet needs to be met. Several domains of the lives of caregivers of AYA cancer patients are negatively affected by the disease. Some of these are age-specific, and tailored to a particular group of caregivers (parents, partners, or friends). AYA cancer patients represent a wide age range, resulting in the engagement of many different caregivers. Future research will need to take this into account in order to adequately provide support.
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Affiliation(s)
- Milou J P Reuvers
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1006 BE Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Asiye Gedik
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Kirsty M Way
- School of Heath Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | | | - Winette T A van der Graaf
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1006 BE Amsterdam, The Netherlands
| | - Olga Husson
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
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Gorman JR, Lyons KS, Harvey SM, Acquati C, Salsman JM, Kashy DA, Drizin JH, Smith E, Flexner LM, Hayes-Lattin B, Reese JB. Opening the Conversation: study protocol for a Phase III trial to evaluate a couple-based intervention to reduce reproductive and sexual distress among young adult breast and gynecologic cancer survivor couples. Trials 2022; 23:730. [PMID: 36056413 PMCID: PMC9438271 DOI: 10.1186/s13063-022-06665-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Reproductive and sexual health (RSH) concerns are common and distressing for young adults diagnosed with breast and gynecologic cancer and their partners. This study evaluates the efficacy of a virtual couple-based intervention called Opening the Conversation (OC). The OC intervention is grounded in theory and evidence-based practice and was adapted to improve coping and communication specifically in relation to RSH concerns after cancer. METHODS This Phase III trial is conducted in a fully remote setting and enrolls young adult couples (current age 18-44 years) with a history of breast or gynecologic cancer (stage 1-4, diagnosed under age 40) within the past 6 months to 5 years. Eligible dyads are recruited from across the USA. The target sample size is 100 couples. Dyads are randomly assigned to receive either the 5-session OC intervention or a 4-session active control intervention (Side by Side). The primary outcomes are change in reproductive distress and sexual distress. Secondary outcomes include communication about reproductive concerns, communication about sexual concerns, depressive symptoms, sexual function, relationship quality, relationship intimacy, sexual satisfaction, self-efficacy to communicate about sex and intimacy, and quality of life. An exploratory aim examines whether dyadic coping and communication quality mediate intervention effects on survivors' and partners' reproductive distress or sexual distress. Self-report outcome measures are assessed for both groups at baseline (T1), 2 weeks post-treatment (T2), and 3 months post-treatment (T3). DISCUSSION Despite the importance of RSH for quality of life for young adult cancer survivors and their partners, evidence-based interventions that help couples navigate RSH concerns are lacking. This randomized controlled trial will determine the efficacy of a novel couple-based intervention to reduce distress related to RSH concerns for younger couples after breast or gynecologic cancer, in comparison to an active control intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT04806724. Registered on Mar 19, 2021.
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Affiliation(s)
- Jessica R Gorman
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA.
| | - Karen S Lyons
- Connell School of Nursing, Boston College, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
| | - S Marie Harvey
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, 3511 Cullen Blvd, Houston, TX, 77204-4013, USA
- College of Medicine, Department of Clinical Sciences, University of Houston, 4349 Martin Luther King Blvd, Houston, TX, 77004, USA
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - John M Salsman
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157, USA
- Wake Forest Baptist Comprehensive Cancer Center, Medical Center Blvd, Winston Salem, NC, 27157, USA
| | - Deborah A Kashy
- Department of Psychology, Michigan State University, 316 Physics Road, East Lansing, MI, 48824, USA
| | - Julia H Drizin
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA
| | - Ellie Smith
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA
| | - Lisa M Flexner
- Doctor of Physical Therapy Program, Oregon State University- Cascades, 1500 SW Chandler Ave, OR, 97702, Bend, USA
| | - Brandon Hayes-Lattin
- School of Medicine, Oregon Health & Sciences University, 3266 SW Research Dr, Portland, OR, 97239, USA
- OHSU Knight Cancer Institute, 3485 S Bond Ave, Portland, OR, 97239, USA
| | - Jennifer B Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
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Hamilton AC, Donnelly DW, Fitzpatrick D, Coleman HG. Early-Onset Cancers in Adults: A Review of Epidemiology, Supportive Care Needs and Future Research Priorities. Cancers (Basel) 2022; 14:4021. [PMID: 36011014 PMCID: PMC9406462 DOI: 10.3390/cancers14164021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 12/03/2022] Open
Abstract
Rising incidence of specific types of early-age onset cancers in adults aged 18-49 years has been reported in high-income countries. In this review, we summarise the epidemiology of early-onset cancers using exemplar data from a high-income UK region, discuss supportive care needs for young patients and outline future research directions. The incidence rate of early-onset cancers increased by 20.5% from 1993 to 2019 in Northern Ireland. Differences in types of cancer were observed between sexes and across age groups of 18-29, 30-39 and 40-49 years. One and five-year net survival was mostly better in 18-29-year-olds for all cancers combined compared to older age groups for both sexes, but there were variations in specific cancer types. Poorer survival was observed for patients with brain/central nervous system, connective and soft tissue or lung cancers. Patients with early-onset cancers face unique supportive care needs and require holistic care. The impact of cancer treatment on fertility and fertility preservation treatments is an important consideration. Social media can be used for patient support, information, fundraising, advocacy work and recruitment to research studies. We also outline suggested future research priorities for early-onset cancers, spanning prevention, diagnosis, treatment and supportive care needs.
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Affiliation(s)
| | - David W. Donnelly
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
- Northern Ireland Cancer Registry, Queen’s University Belfast, Belfast BT12 6DP, UK
| | - Deirdre Fitzpatrick
- Northern Ireland Cancer Registry, Queen’s University Belfast, Belfast BT12 6DP, UK
| | - Helen G. Coleman
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
- Northern Ireland Cancer Registry, Queen’s University Belfast, Belfast BT12 6DP, UK
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
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7
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Goria S, Girgis A, Shaw J, Przezdziecki A, Levesque J, Bamgboje‐Ayodele A. A Delphi‐based approach to developing the contents of an online resource, Care Assist, for male caregivers of women with breast cancer. Psychooncology 2022; 31:1474-1482. [PMID: 35575006 PMCID: PMC9543824 DOI: 10.1002/pon.5962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022]
Abstract
Objective Informal male caregivers of women with breast cancer (BC) have significant psychological, emotional, and social burdens that are inadequately addressed by current face‐to‐face interventions. Online interventions overcome barriers that limit engagement with face‐to‐face interventions. This study aimed to develop the contents of Care Assist, an online supportive care resource for male caregivers of BC patients, through expert consensus. Methods A Delphi study comprising two survey rounds and an expert consultation was conducted. In Round 1, experts in BC care rated the importance of 25 content items. In Round 2, they re‐rated content items that failed to reach consensus (i.e. 80% agreement) in Round 1 or were newly developed. Free‐text responses were also collected. During expert consultation, the resource was reviewed and revised for clarity. Iterative refinement followed all rounds. Quantitative data was analysed descriptively, and qualitative data was analysed using content analysis. Results Twenty‐two experts participated and reached consensus on 96% of items, with 217 comments provided on: (a) the perceived benefits of Care Assist to caregivers and care recipients, (b) recommendations of newly suggested content items, wording, and use of external links, and (c) concerns regarding information overload and need for tailoring. The expert consultation comments focused on clarifying scope, wording, and information tailoring. Conclusion The rigorous Delphi process resulted in the content for a comprehensive online supportive care intervention for male caregivers. Information overload can be minimised through self‐identification of needs and utilisation of eHealth to personalise the resource for the heterogeneous male caregiver population.
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Affiliation(s)
- Sandra Goria
- Ingham Institute for Applied Medical Research Sydney Australia
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
| | - Afaf Girgis
- Ingham Institute for Applied Medical Research Sydney Australia
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
| | - Joanne Shaw
- Psycho‐oncology Co‐operative Research Group (PoCoG) University of Sydney Sydney Australia
| | - Astrid Przezdziecki
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
- Liverpool Hospital South Western Sydney Local Health District Liverpool Australia
| | - Janelle Levesque
- School of Psychological Sciences Faculty of Medicine Nursing and Health Sciences Monash University Melbourne Australia
| | - Adeola Bamgboje‐Ayodele
- Ingham Institute for Applied Medical Research Sydney Australia
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
- School of Medical Sciences Biomedical Informatics and Digital Health Faculty of Medicine and Health University of Sydney Sydney Australia
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Ergin B, Uluutku GB, Kale İ, Topal CS, Toğrul C, Muhcu M. Protective effects of sildenafil administration on chemotherapeutic-induced ovarian damage in rats. Can J Physiol Pharmacol 2022; 100:486-491. [PMID: 35226516 DOI: 10.1139/cjpp-2021-0576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Agents to reduce the gonadotoxic effects of chemotherapeutics are still under investigation. In this context, we aimed to investigate the protective effect of sildenafil against chemotherapeutic-induced gonadotoxicity in a rat model. A total of 62 female rats were divided into eight groups as control, sildenafil (1.4 mg/kg, orally), doxorubicin (3 mg/kg, i.p.), cisplatin (5 mg/kg, i.p.), cyclophosphamide (200 mg/kg, i.p.), doxorubicin+sildenafil, cisplatin+sildenafil, and cyclophosphamide+sildenafil (1.4 mg/kg orally sildenafil in addition to the same dose of chemotherapeutics). The groups were compared in terms of follicle count, ovarian size, and anti-müllerian hormone (AMH) levels. Use of sildenafil with cyclophosphamide was effective only in preserving primary follicle count (p = 0.026) and had no significant change in the secondary follicle count, ovarian size, or AMH level. Adding sildenafil to cisplatin had a significant protective effect on primary follicle count (p = 0.011), secondary follicle count (p = 0.009), and ovarian size (p = 0.001), but this effect could not be demonstrated at AMH level. Sildenafil was not effective on any parameter in the doxorubicin group. Sildenafil may be effective in reducing the gonadotoxicity associated with the use of cisplatin and cyclophosphamide.
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Affiliation(s)
- Başak Ergin
- Department of Obstetrics and Gynecology, Reşadiye State Hospital, Tokat, Turkey
| | - Gizem Berfin Uluutku
- Department of Obstetrics and Gynecology, Başakşehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - İbrahim Kale
- Department of Obstetrics and Gynecology, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Cumhur Selçuk Topal
- Department of Pathology, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Cihan Toğrul
- Department of Obstetrics and Gynecology, Hitit University, Çorum, Turkey
| | - Murat Muhcu
- Department of Obstetrics and Gynecology, Umraniye Education and Research Hospital, Istanbul, Turkey
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Gorman JR, Lyons KS, Reese JB, Acquati C, Smith E, Drizin JH, Salsman JM, Flexner LM, Hayes-Lattin B, Harvey SM. Adapting a Theory-Informed Intervention to Help Young Adult Couples Cope With Reproductive and Sexual Concerns After Cancer. Front Psychol 2022; 13:813548. [PMID: 35185733 PMCID: PMC8854289 DOI: 10.3389/fpsyg.2022.813548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveMost young adults diagnosed with breast or gynecologic cancers experience adverse reproductive or sexual health (RSH) outcomes due to cancer and its treatment. However, evidence-based interventions that specifically address the RSH concerns of young adult and/or LGBTQ+ survivor couples are lacking. Our goal is to develop a feasible and acceptable couple-based intervention to reduce reproductive and sexual distress experience by young adult breast and gynecologic cancer survivor couples with diverse backgrounds.MethodsWe systematically adapted an empirically supported, theoretically grounded couple-based intervention to address the RSH concerns of young couples coping with breast or gynecologic cancer through integration of stakeholder perspectives. We interviewed 11 couples (22 individuals) with a history of breast or gynecologic cancer to review and pretest intervention materials. Three of these couples were invited to review and comment on intervention modifications. Content experts in RSH and dyadic coping, clinicians, and community advisors (one heterosexual couple and one LGBTQ+ couple, both with cancer history) participated throughout the adaptation process.ResultsFindings confirmed the need for an online, couple-based intervention to support young couples experiencing RSH concerns after breast or gynecologic cancer. Qualitative themes suggested intervention preferences for: (1) A highly flexible intervention that can be tailored to couples’ specific RSH concerns; (2) Active steps to help members of a dyad “get on the same page” in their relationship and family building plans; (3) A specific focus on raising partners’ awareness about how cancer can affect body image and physical intimacy; and (4) Accessible, evidence-based information about RSH for both partners. These results, along with feedback from stakeholders, informed adaptation and finalization of the intervention content and format. The resulting virtual intervention, Opening the Conversation, includes five weekly sessions offering training to couples in communication and dyadic coping skills for addressing RSH concerns.ConclusionThe systematic adaptation process yielded a theory-informed intervention for young adult couples facing breast and gynecological cancers, which will be evaluated in a randomized controlled trial. The long-term goal is to implement and disseminate Opening the Conversation broadly to reach young adult couples with diverse backgrounds who are experiencing RSH concerns in cancer survivorship.
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Affiliation(s)
- Jessica R. Gorman
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
- *Correspondence: Jessica R. Gorman,
| | - Karen S. Lyons
- Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
| | - Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, United States
- Department of Clinical Sciences, College of Medicine, University of Houston, Houston, TX, United States
- Department of Health Disparities Research, The UT MD Anderson Cancer Center, Houston, TX, United States
| | - Ellie Smith
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Julia H. Drizin
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - John M. Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, United States
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, United States
| | - Lisa M. Flexner
- Doctor of Physical Therapy Program, Oregon State University, Bend, OR, United States
| | - Brandon Hayes-Lattin
- School of Medicine, OHSU Knight Cancer Institute, Oregon Health and Sciences University, Portland, OR, United States
| | - S. Marie Harvey
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
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10
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Hawkey A, Ussher JM, Perz J, Parton C. Talking but not always understanding: couple communication about infertility concerns after cancer. BMC Public Health 2021; 21:161. [PMID: 33468106 PMCID: PMC7816453 DOI: 10.1186/s12889-021-10188-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 01/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer related infertility can have an impact on couple relationships, with evidence that couple communication facilitates coping. However, little is known about the ways in which couples communicate about cancer-related fertility concerns. The aim of this article is to examine couple communication about fertility concerns in the context of cancer, and the perceived quality of such communication from the perspective of cancer survivors and their partners. METHODS Eight-hundred and seventy-eight cancer survivors (693 women, 185 men) and 144 partners (82 women, 62 men), across a range of tumour types and age groups, completed a survey which examined cancer related fertility concerns. Seventy-eight survivors (61 women and 17 men), and 26 partners (13 women and 13 men), participated in semi-structured interviews, in order to examine the subjective experience of fertility concerns in-depth. Thematic analysis was used to analyse the interviews and open ended survey questions. Valid percentages for single items from the relationships subscale of the Fertility Preservation Inventory (FPI) related to qualitative themes, identified frequency of responses. RESULTS The major theme was 'talking but not always understanding". 89.6% of cancer survivors and partners (95.1%) reported working well together handling fertility questions (FPI), but agreed that communication could be improved (65.9% survivors; 65% partners). Open and honest couple communication was associated with feelings of support, understanding and relationship growth, including perception of partner comfort (79.2% survivors, 81.6% partners). However, 32% survivors and 31.1% partners concealed fertility concerns to avoid upsetting their partner, or reported that their partner doesn't understand their fertility concerns (survivors 25.5%, partners 14.6%), with 14.1% of cancer survivors and 19.4% partners reporting fear of relationship breakdown because of fertility issues. Fear of rejection when forming new relationships, and concerns about how to talk to future partners, was reported by non-partnered individuals. CONCLUSION Health-care professionals should include partners of cancer survivors in fertility discussions. Couple interventions developed in general psycho-oncology should be extended to the domain of fertility, in order to facilitate effective couple communication. Communication in future relationships needs to be addressed for single people and adolescents and young adults (AYAs) who have fertility concerns.
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Affiliation(s)
- Alexandra Hawkey
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, Australia
| | - Jane M Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, Australia.
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, Australia
| | - Chloe Parton
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, Australia
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