A cohort study of quality of life in partners of young breast cancer survivors compared to partners of healthy controls

Optimizing sexuality of young women with breast cancer: how can the breast clinic help?

BACKGROUND

Breast cancer treatment can lead to sexual dysfunction which, in general, impacts younger women more. Being well informed and having good social support are important elements in dealing with this dysfunction.

AIMS

This study aims to explore how specialized breast clinics can help young women with questions or problems regarding their sexual health by fulfilling their information and social support needs.

METHOD

A thematic analysis was used for 16 interviews with young women (18-45 years) diagnosed with breast cancer, in Belgium.

RESULTS

Participants report a lack of information on sexual issues and find the information insufficiently tailored to young women. The empathy of healthcare providers and their communication skills play an important role in whether sexual issues can be discussed. Finally, they indicate that more attention should be paid to their partner (relationship).

CONCLUSION

The breast clinic might help young women by giving more specific advice on what is sexually allowed (or not) during treatment, by informing them about lubricants and sex toys, by adapting brochures and information sessions to young women, by investing in the partner's well-being and their relationship, and by training healthcare providers better.

Psychosocial Experiences, Challenges, and Recommendations for Care Delivery among Partners of Breast Cancer Survivors: A Qualitative Study

For women diagnosed with breast cancer, partners are consistently identified as the primary support person. Despite growing consensus about the psychosocial experience and unmet needs of cancer caregivers, limited evidence exists about strategies to offer partner-centered care across the cancer continuum. This study describes challenges endured by partners of breast cancer survivors (BCS), strategies implemented to manage these experiences, and recommendations for healthcare providers to inform targeted psychosocial care. Using convenience sampling, 22 partners of female BCS were recruited and completed semi-structured interviews. Conventional content analysis was used to code and synthesize findings. Participants described undergoing five experiences in their role as romantic partners: (a) assuming the role of caregiver, (b) becoming healthcare advocates for BCS, (c) connecting emotionally with the partner, (d) managing their own painful emotions, and (e) connecting with others for support. Experience-specific coping strategies and recommendations were identified. Romantic partners face multiple transitions across the cancer care continuum, which warrant investigation to sustain their well-being and active participation in illness management. Psychosocial interventions for this group will benefit from flexible implementation and attention to care delivery, mental health, and supportive/social needs.

Changes and challenges in sexual life experienced by the husbands of women with breast cancer: a qualitative study

Background

Breast cancer (BC) in women can bring various problems to their marital and family life. Sexual life based on the experiences of the husbands of women diagnosed with BC has not been fully understood. Therefore, this research aimed to explore changes and challenges in sexual life experienced by the husbands of women diagnosed with BC.

Methods

A qualitative research was carried out on 18 men whose wives had been diagnosed with BC at reproductive age. They were selected using purposeful sampling and were interviewed using in-depth semi-structured interviews. Collected data were analyzed using the conventional content analysis method.

Results

‘Sexual life suspension’ was the main theme of this research. Also, ‘unfulfilled sexual expectations’, ‘perceived barriers to satisfy sexual expectations’, and ‘efforts to adapt to sexual problems’ were subthemes.

Conclusions

The husbands of women with BC need support to improve their sexual and marital relationships. Education and counseling about sexual life during the treatment of BC should be incorporated into the healthcare program.

ESO-ESMO fifth international consensus guidelines for breast cancer in young women (BCY5)

We dedicate this manuscript in memory of a dear friend and colleague Bella Kaufman. The fifth International Consensus Symposium for Breast Cancer in Young Women (BCY5) took place virtually in October 2020, organized by the European School of Oncology (ESO) and the European Society of Medical Oncology (ESMO). Consensus recommendations for the management of breast cancer in young women were updated from BCY4 with incorporation of new evidence to inform the guidelines. Areas of research priorities as well as specificities in different geographic and minority populations were identified. This manuscript summarizes the ESO-ESMO international consensus recommendations, which are also endorsed by the European Society of Breast Specialists (EUSOMA).

'Nobody can take the stress away from me': a qualitative study on experiences of partners of patients with cancer regarding their work and health

PURPOSE

To explore experienced health- and work-related problems of partners of patients with cancer, and their needs for support.

MATERIALS AND METHODS

Semi-structured interviews were conducted with Dutch partners of patients with cancer. Interviews were transcribed verbatim. Data were analysed thematically, following the six steps of Braun & Clarke.

RESULTS

Of 20 included partners (mean age: 50 years [31-63]), 60% was female. Five themes consistently emerged from the data: 1) overwhelming chaos calls for taking control; 2) impact of prolonged stress; 3) flexibility and support of the employer are crucial; 4) coping with family and friends is a delicate matter; and 5) support from healthcare professionals is needed, but not a given.

CONCLUSIONS

Findings from this study show that the burden on partners of patients with cancer is substantial and cannot be overlooked. The state of survival mode that partners get into during the diagnosis, treatment and follow-up of their loved ones can have various implications on their physical and mental health, and work situation. Given this high burden and as legislation for care leave from work and (health care) support for partners appear to be insufficiently in place in the Dutch context, there is a need for better-targeted support for partners of patients with cancer. Implications for RehabilitationThe survival mode that partners of patients with cancer get into during the diagnosis, treatment and follow-up of their loved ones can have various implications on their physical and mental health, and work situation.This study showed that the burden on partners of patients with cancer is substantial and cannot be overlooked.Given this high burden and because legislation for care leave from work and (health care) support for partners appears to be insufficiently in place in the Dutch context, there is a need for better-targeted support for partners of patients with cancer.

Reducing research wastage by starting off on the right foot: optimally framing the research question

PURPOSE

Strongly framed research questions are clear as to the population (P), the exposures or interventions (E/I), comparison groups (C), outcomes (O), time when relevant (T), and what the investigator wants to know. A solid framework sets up the measurement model, analysis, and anticipated results. The purpose of this study was to estimate the extent to which research questions in journals that focused on patient-reported outcome measures (PROM) and quality of life (QOL) are clear.

METHODS

All 440 research articles published in four PROM journals in 2020. excluding reviews, psychometric, and qualitative papers, were reviewed. Research questions were classified as: (i) adequately framed (ii) poorly framed; or (iii) unframed based on clarity criteria. Examples from each journal were presented and reframed to match results in the article.

RESULTS

Of 440 articles, 195 (44.3%) were classified as adequately framed; 230 (52.2%) as poorly framed; and 15 (3.4%) as unframed. There was heterogeneity across journals (Chi-square: 20.8; 6 df; p = 0.002). Only 29% were framed according to what the investigators wanted to know; 72% were framed like a "to do" list; and 6% were framed as a research agenda.

CONCLUSION

Almost half of the questions were poorly framed or unframed a practice that could contribute to research wastage. Even "adequately framed" questions rarely stated what they wanted to know a priori, increasing the risk of biased reporting. Researchers, reviewers, and editors should encourage the use established frameworks for research questions.

Anxiety and related factors among parents of patients with breast cancer after surgery in Japan: A multi-informant and multilevel study

AIM

Anxiety and its correlates in parents of patients with breast cancer have rarely been studied. We explored anxiety among parents of postoperative patients with breast cancer and its relationship with parents' social support and care needs and patients' anxiety.

METHODS

A cross-sectional survey using self-report questionnaires and medical records was conducted among patients with breast cancer after surgery and their parents at four designated cancer care hospitals between September 2015 and June 2016. Anxiety was measured using the Hospital Anxiety and Depression Scale (HADS). Parents provided information about social support and care needs. Multilevel analysis was performed on patient-parent paired data controlling for patient-level variation.

RESULTS

Participants included 107 patients, 83 mothers, and 51 fathers. The mean HADS anxiety scores reported by mothers and fathers were 7.2 and 6.5, respectively, which were higher than patients' HADS anxiety scores. Fulfillment of important care needs was related to lower anxiety among mothers and fathers (estimate = -1.38, p = .01). Lower family support and higher patient anxiety were associated with higher anxiety in mothers, but not fathers.

CONCLUSIONS

Parents of patients with breast cancer had high anxiety. Communication, providing cancer-related information, and fulfilling care needs can alleviate anxiety in parents of patients with breast cancer after surgery. Furthermore, increasing family support and decreasing patients' anxiety are essential to alleviating mothers' anxiety.

Fear, worry and sadness: an exploratory study of psychological wellbeing in men caring for their partner with ovarian cancer

PURPOSE

Ovarian cancer is the leading cause of death from female cancers in Australia with the majority of women presenting with advanced disease. The burden of caregiving is largely borne by male carers; however, little research has examined the challenges male ovarian cancer caregivers (MOCC) experience. This study aimed to explore the psychosocial wellbeing and cancer-related challenges experienced by MOCC.

METHODS

A cross-sectional small-scale exploratory online survey study recruited 36 MOCC. The study questionnaire was comprised of the Generalised Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire Depression Module (PHQ-9), Functional Assessment of Cancer Therapy Scale (FACT-G) Family Member, Fear of Cancer Recurrence Scale, Insomnia Severity Index (ISI), Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACTIT-F) and Cancer-Related Challenges Scale (CRCS).

RESULTS

The most common challenges ever experienced were worry about the future (91%), fear of metastasis (90%) and feeling worried or uncertain (88%). The most common current challenges were fear of cancer recurrence (75%), fear of metastasis (68%) and changes in sexual relationships (64%). Depression and anxiety were significantly correlated with all psychosocial variables highlighting the relationships between elements of wellbeing for MOCC. Clinical levels of fear of cancer recurrence were reported by 89% of MOCC.

CONCLUSIONS

The challenges faced by MOCC are psychosocial in nature. There is a high correlation between anxiety and depression, and this coupled with the fear of disease recurrence indicates a greater need for screening of these issues, appropriate referral and development of support resources for this high-risk group of cancer carers.

The correlation between intimate relationship, self-disclosure, and adaptability among colorectal cancer enterostomy patients

The postoperative physiological changes and psychological pressure of cancer patients affect the patient's adaptability to the disease, and thus affect the spousal intimate relationship. This study aimed to evaluate the correlation between spousal intimate relationship, self-disclosure, and adaptability among colorectal cancer (CCI) patients with enteric stoma.This cross-sectional study selected patients with CCI in Henan Province from February 2018 to October 2020. The Marital Adjustment Test (MAT), the Distress Disclosure Index scale, and the Ostomy adjustment inventory-20 scale were used to collect relevant data of the participants. A Pearson correlation analysis was used to test the correlation between variables, and multiple stepwise regression analysis was used to test the influence of general information on the intimate relationship, self-disclosure, and adaptability.Among the respondents, 42.6% had a spousal intimate relationship problem, 58.4% had a low or moderate level of self-disclosure, and 90.8% were at a low or moderate level of adaptation. Education background, self-care ability, and postoperative time were associated with a couple's intimate relationship. Average monthly household income, gender, and place of residence were associated with self-disclosure. Self-care ability, average monthly household income, postoperative time, and educational background were associated with adaptation.Healthcare workers should provide more health education training to guide CCI enterostomy patients to express their thoughts and feelings with each other increase self-disclosure, so as to enhance their intimate relationship then improve their adoption to ostomy, finally elevate their quality of life.