A dyadic approach to understanding the impact of breast cancer on relationships between partners during early survivorship

Abstract

BackgroundThe shared impact of breast cancer for women and their male partners is emerging as an important consideration during the experience of a breast cancer diagnosis, particularly during survivorship. This study aimed to explore the experiences of women and their partners during early survivorship and contributes a range of insights into the lives of those intimately affected by breast cancer.MethodsIn-depth interviews were completed with Australian women survivors of breast cancer (n = 8) and their partners (n = 8), between six months and five years following cessation of treatment. Questions included a focus on the women and their partners’ daily experiences during early survivorship, including the management of ongoing symptoms, engagement in leisure and social interests, returning to work, communicating with each other, maintenance of the current relationship and other important roles and responsibilities. Thematic analysis was employed to determine key themes arising from the dyadic accounts of women and their partners’ experiences during early breast cancer survivorship.ResultsWomen and their partners experienced many changes to their previous roles, responsibilities and relationships during early breast cancer survivorship. Couples also reported a range of communication, intimacy and sexuality concerns which greatly impacted their interactions with each other, adding further demands on the relationship. Three significant themes were determined: (1) a disconnection within the relationship - this was expressed as the woman survivor of breast cancer needing to prioritise her own needs, sometimes at the expense of her partner and the relationship; (2) reformulating the relationship - this reflects the strategies used by couples to negotiate changes within the relationship; and (3) support is needed to negotiate the future of the relationship - couples emphasised the need for additional support and resources to assist them in maintaining their relationship during early survivorship.ConclusionIt can be concluded that the early survivorship period represents a crucial time for both women and their partners and there are currently limited options available to meet their shared needs and preferences for support. Findings indicate that a suitable model of care underpinned by a biopsychosocial framework, access to comprehensive assessment, timely support and the provision of targeted resources are urgently needed to assist women and their partners during this critical time.

The Lived Experience of Australian Women Living with Breast Cancer: A Meta-Synthesis

“…Fear of recurrence and death were evident in multiple studies (Oxlad et al, 2008;Mackenzie, 2014;Keesing et al, 2016;Connell et al, 2006;Thewes et al, 2016;Elmir et al, 2010;Kwok and White, 2014;Coyne et al, 2012;Coyne and Borbasi, 2014;Connell et al, 2006;Fisher and Connor, 2012;Kwok and White, 2013;Gibson et al, 2015;Ives et al, 2012;Halkett et al, 2006;Beatty et al, 2008;Powers et al, 2014). In particular, mothers expressed their fear and concern over their children's future in the event of their death (excerpts 2.1.1).…”

“…In particular, mothers expressed their fear and concern over their children's future in the event of their death (excerpts 2.1.1). They feared they may not be able fulfil their roles and responsibilities as a mother if they died (Keesing et al, 2016;Connell et al, 2006;Coyne and Borbasi, 2014;Connell et al, 2006;Fisher and 3). Other first-time mothers were so concerned with the effects of treatment on their unborn child, they chose to start on their treatment immediately after childbirth (excerpt 2.2.4).…”

“…The study by Anderson et al, 2011, found women <40 years experienced more body image disturbances when compared to older women because of early onset of menopause (excerpt 3.3.6). This led to greater sexual difficulties (excerpt 3.3.7) (Oxlad et al, 2008, Keesing et al, 2016Perz et al, 2013;Beatty et al, 2008;Anderson et al, 2011). Some women lost their interest in sex as a result of the side effects of their treatments (excerpt 3.3.8) due to lack of libido (Perz et al, 2013;Shaw et al, 2016;Anderson et al, 2011).…”

“…The women did more for children rather than asking more assistance from children. Keesing et al, (2016) To explore the experiences of women and their partners during early survivorship and contributes a range of insights into the lives of those intimately affected by breast cancer. 1. a disconnection within the relationship by women 2. reformulating the relationship 3. support is needed to negotiate the future of the relationship Women felt their physical, psychological and emotional needs were largely undervalued by their usual medical supports Partners of women reported many unmet needs and were unaware of where they could obtain assistance to help them.…”

Marital adjustment in the context of female breast cancer: A systematic review

“…The present systematic review aims to accomplish 2 main objectives: (1) to identify which factors (including demographic, disease‐related, and psychosocial factors) have been associated with marital adjustment in both patients and their partners and (2) to identify and describe which measures have been used to assess marital adjustment in the context of BC. Because BC can impact marital adjustment, and both patients and their partners can experience multiple changes in roles and responsibilities besides difficulties in communication, intimacy, and sexual issues, it is important to understand which dimensions have been used to assess marital adjustment within this specific context. To our knowledge, this is the first systematic review addressing this topic.…”