Objectives Breast cancer (BC) can be understood as a we‐disease, which affects a couple as a unit and requires coping as a unit (eg, common dyadic coping, CDC). However, partners can be incongruent in their perceptions of CDC, for example, because of misunderstandings and lack of mutuality or conflict, which may likely be associated with greater distress. Thus, this paper examines the effect of CDC congruence on individual psychological distress in cancer patients and their partners. Methods Seventy mixed‐sex couples in which the woman had nonmetastatic BC completed self‐report questionnaires at 2 weeks, 3 months, and 1 year after cancer surgery. CDC congruence measured the difference between patients' and partners' CDC perceptions while controlling for CDC itself. Results Multilevel modeling showed negative associations between couples' CDC and psychological distress. Beyond this effect, female patients' psychological distress was associated with CDC congruence with an interaction showing that psychological distress was greater when couples were congruent with low rather than a high CDC. Conclusion Less congruence was associated with greater psychological distress in BC patients but not their male partners — especially if the couple reported low CDC. Health professionals should identify and address diverging perceptions, so that additional distress can be minimized for BC patients.

The aim of this study was to assess, in the immediate postsurgical period, the influence of attachment avoidance and anxiety on distress and body image disturbances in women facing breast cancer. Seventy-five women participated in the study 3 weeks after surgery. Questionnaires were used to assess study variables. To predict distress and body image disturbances, we controlled for several variables known to influence adjustment to the stress of breast cancer. The results of hierarchical regression analyses show that attachment explains the outcomes above and beyond other influential variables. Insecurely attached women are especially vulnerable to the stress of the disease.

Practitioners should pay attention to the couple relationship in breast cancer. EE is most likely to appear when the cancer stage is low, showing that even when the medical prognosis is optimal, relational and emotional disturbances may occur. Statement of contribution What is already known on this subject? The couple relationship is of paramount importance in breast cancer. Expressed emotion (EE) is related to negative individual and relational psychological outcomes in psychiatric and somatic diseases. Expressed emotion has not yet been studied in the context of breast cancer. What does this study add? Expressed emotion is present in breast cancer situations, especially when the cancer stage is low. There was more EE in women than in their partners. Cancer stage, attachment tendencies, and couple satisfaction are predictors of EE.

How women perceive the impact of breast cancer treatment on their body may be partly determined by the quality of the relational context in which they live.

Multimorbidity, defined as 2 or more chronic diseases, is of increasing importance for health professionals. Many factors are at play when it comes to multimorbidity, but we still know very little about how clinicians actually weigh up the different factors-medical, social, and psychological-to reach a particular course of action. Further research is therefore required to explore the ways in which clinical reasoning processes are involved in the follow up of patients suffering from multimorbidities, to highlight their potential risks of errors. A better understanding of these clinical processes will also enrich supervision of trainees and collaboration between healthcare professionals involved in primary care.

Abstract. This study aimed to validate the French version of the Experiences in Close Relationships–Revised (ECR-R) adult attachment questionnaire by investigating its internal structure and construct validity. The sample (N = 600) consisted of an equal number of male and female participants aged 25–45 years. Variables linked to adult romantic attachment (marital satisfaction, sexual satisfaction and fears associated with sexual activities, and self-esteem) were assessed using a set of questionnaires. The reliability of the two attachment dimensions (viz., avoidance and anxiety) was satisfactory. Confirmatory factor analyses revealed that the original two-factor model explained the data collected with the French ECR-R most satisfactorily. The assessment of measurement invariance showed that the structure is the same across the original U. S. sample and our sample, across men and women, and across single individuals and those in a couple relationship. Our evaluation of construct validity showed that the higher avoidance and anxiety, the lower self-esteem and sexual satisfaction and the higher the fears associated with sexuality. These results are theoretically coherent and consistent with those of previous studies of the English version of the scale. We conclude that the French version is valid.

We examined the evolution of the subjective burden of romantic partners caring for women with non-metastatic breast cancer and investigated the moderating role of couple satisfaction on caring stress. Forty-seven partners filled out questionnaires 3 and 12 months after surgery. Using a stress process model, we examined caring stressors and moderating factors (couple satisfaction, coping and social support) as predictors of subjective burden. Results showed that subjective burden decreases over time and that the couple satisfaction largely explains it above and beyond other influential variables. Partners dissatisfied with their couple relationship are especially vulnerable to the stress of caregiving.

This study describes women's sexual functioning in the early weeks of breast cancer treatment and the possible sexual changes that women may experience compared with pre-treatment functioning. Seventy-five patients filled out a questionnaire on sexual functioning and participated in a semi-structured interview on changes in sexual life and intimacy after treatment. Sixty-two women were sexually active before treatment; three post-treatment patterns of sexual behaviour were identified: 22.6% of these women were as active as before treatment, 35.5% stopped any sexual activity and 41.9% experienced quantitative and qualitative changes. Analyses showed that each pattern had specific characteristics regarding current sexual functioning, the kinds of changes reported (e.g. decreased frequency and increased tenderness) and the reasons for these changes (e.g. tiredness and sex not a priority). Even in the immediate post-surgical period, women may react in very different ways to treatment in terms of sexual functioning. Most women experience changes, but cessation of sexual activity is not inevitable. Positive changes (growing tenderness and affection) also exist. These important interindividual differences require a person-centred approach when the topic of sexuality is being addressed, and practitioners need to be sensitive to individual perceptions of change. Early detection of sexual changes may prevent the crystallisation of difficulties over time. K E Y W O R D Sbreast cancer, early detection, mixed methods, quantitative and qualitative change, sexual functioning