Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-24T15:00:28.613Z Has data issue: false hasContentIssue false
  • English
  • Français

When cancer cannot be cured: A qualitative study on relationship changes in couples facing advanced melanoma

Published online by Cambridge University Press:  15 March 2016

Natalie Drabe ,
Josef Jenewein ,
Steffi Weidt ,
Lucia Engeli ,
Caroline Meier ,
Stefan Büchi ,
Karin Schad ,
Verena Schönbucher ,
Claudia Canella  and
David Garcia Nuñez
Natalie Drabe*
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Zürich, University of Zürich, Zürich, Switzerland
Josef Jenewein
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Zürich, University of Zürich, Zürich, Switzerland
Steffi Weidt
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Zürich, University of Zürich, Zürich, Switzerland
Lucia Engeli
Affiliation:
Department of Psychosomatic Medicine, University Hospital of Basel, Basel, Switzerland
Caroline Meier
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Zürich, University of Zürich, Zürich, Switzerland
Stefan Büchi
Affiliation:
Clinic for Psychotherapy and Psychosomatic “Hohenegg,” Meilen, Switzerland
Karin Schad
Affiliation:
Department of Dermatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
Verena Schönbucher
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Zürich, University of Zürich, Zürich, Switzerland
Claudia Canella
Affiliation:
Institute for Complementary and Integrative Medicine, University Hospital Zürich, University of Zürich, Zürich, Switzerland
David Garcia Nuñez
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Zürich, University of Zürich, Zürich, Switzerland
*
Address correspondence and reprint requests to Natalie Drabe, Department of Psychiatry and Psychotherapy, University Hospital Zürich, University of Zürich, Rämistrasse 100, 8091 Zürich, Switzerland. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The aim of this qualitative study was to gain a deeper understanding about couples' relationship changes over time (the first six months) after one partner is diagnosed with an incurable advanced melanoma (stage III or IV).

Method:

In semistructured interviews, eight patients and their partners were asked separately about potential changes in their relationship since diagnosis. The same questions were asked again six months later, but focusing on relationship changes over the preceding six months. Some 32 audiotaped interviews were analyzed applying qualitative content analysis.

Results:

At baseline (t1), relationship changes were mostly reported in terms of caring, closeness/distance regulation, and communication patterns. While changes in caregiving and distance/closeness regulation remained main issues at six months follow-up (t2), greater appreciation of the relationship and limitations in terms of planning spare time also emerged as major issues. Unexpectedly, 50% of patients and partners reported actively hiding their negative emotions and sorrows from their counterparts to spare them worry. Furthermore, qualitative content analysis revealed relationship changes even in those patients and partners who primarily reported no changes over the course of the disease.

Significance of results:

Our findings revealed a differentiated and complex picture about relationship changes over time, which also might aid in the development of support programs for couples dealing with advanced cancer, focusing on the aspects of caring, closeness/distance regulation, and communication patterns.

Keywords

CancerMelanomaPalliative careQualitative studyRelationship changes
Type
Original Articles
Information
Palliative & Supportive Care , Volume 14 , Issue 6 , December 2016 , pp. 652 - 663
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Antoine, P., Vanlemmens, L., Fournier, E., et al. (2013). Young couples' experiences of breast cancer during hormone therapy: An interpretative phenomenological dyadic analysis. Cancer Nursing, 36, 213–220.CrossRefGoogle ScholarPubMed
Badr, H. & Cammack Taylor, C.L. (2006). Social constraints and spousal communication in lung cancer. Psycho-Oncology, 15, 673–683.CrossRefGoogle ScholarPubMed
Baider, L. & Bengel, J. (2001). Cancer and the spouse: Gender-related differences in dealing with health care and illness. Critical Reviews in Oncology/Hematology, 40, 115–123.Google Scholar
Baider, L., Ever-Hadani, P., Goldzweig, G., et al. (2003). Is perceived family support a relevant variable in psychological distress? A sample of prostate and breast cancer couples. Journal of Psychosomatic Research, 55(5), 453–460.CrossRefGoogle ScholarPubMed
Ben-Zur, H., Gilbar, O. & Lev, S. (2001). Coping with breast cancer: Patient, spouse, and dyad models. Psychosomatic Medicine, 63, 32–39.CrossRefGoogle ScholarPubMed
Bultz, B.D. (2014). Integrating psycho-oncology into mainstream cancer care: From research to action. Paper presented at the 16th World Congress of Psycho-Oncology and Psychosocial Academy 2014. Lisbon, Portugal.Google Scholar
Cammack Taylor, C.L., Badr, H., Lee, J.H., et al. (2008). Psychological and relationship functioning of lung cancer patients and their spouses. Annals of Behavioral Medicine, 35, S173–S185.Google Scholar
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–46.CrossRefGoogle Scholar
Compas, B.E., Worsham, N.L., Eppingjordan, J.E., et al. (1994). When mom or dad has cancer: Markers of psychological distress in cancer patients, spouses, and children. Health Psychology, 13, 507–515.Google Scholar
Dorval, M., Guay, S., Mondor, M., et al. (2005). Couples who get closer after breast cancer: Frequency and predictors in a prospective investigation. Journal of Clinical Oncology, 23, 3588–3596.CrossRefGoogle Scholar
Douglass, L.G. (1997). Reciprocal support in the context of cancer: Perspectives of the patient and spouse. Oncology Nursing Forum, 24, 1529–1536.Google Scholar
Drabe, N., Wittmann, L., Zwahlen, D., et al. (2013). Changes in close relationships between cancer patients and their partners. Psycho-Oncology, 22, 1344–1352.Google Scholar
Drabe, N., Klaghofer, R., Weidt, S., et al. (2014). Mutual associations between patients' and partners' depression and quality of life with respect to relationship quality, physical complaints, and sense of coherence in couples coping with cancer. Psycho-Oncology, 24(4), 442–450.CrossRefGoogle ScholarPubMed
Dummer, R., Hauschild, A., Guggenheim, M., et al. (2012). Cutaneous melanoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 23(Suppl. 7), vii86–vii91.Google Scholar
Fergus, K.D. & Gray, R.E. (2009). Relationship vulnerabilities during breast cancer: Patient and partner perspectives. Psycho-Oncology, 18, 1311–1322.Google Scholar
Germino, B.B., Fife, B.L. & Funk, S.G. (1995). Cancer and the partner relationship: What is its meaning? Seminars in Oncology Nursing, 11, 43–50.Google Scholar
Given, B.A., Given, C.W. & Kozachik, S. (2001). Family support in advanced cancer. CA: A Cancer Journal for Clinicians, 51, 213–231.Google ScholarPubMed
Grbich, C., Parker, D. & Maddocks, I. (2001). The emotions and coping strategies of caregivers of family members with a terminal cancer. Journal of Palliative Care, 17, 30–36.CrossRefGoogle ScholarPubMed
Greenhalgh, T. & Taylor, R. (1997). Papers that go beyond numbers (qualitative research). BMJ, 315, 740–743.Google Scholar
Hagedoorn, M., Buunk, B.P., Kuijer, R.G., et al. (2000). Couples dealing with cancer: Role and gender differences regarding psychological distress and quality of life. Psycho-Oncology, 9, 232–242.Google Scholar
Hagedoorn, M., Sanderman, R., Bolks, H.N., et al. (2008). Distress in couples coping with cancer: A meta-analysis and critical review of role and gender effects. Psychological Bulletin, 134, 1–30.Google Scholar
Hamama-Raz, Y. (2012). Does psychological adjustment of melanoma survivors differs between genders? Psycho-Oncology, 21, 255–263.Google Scholar
Hamama-Raz, Y., Solomon, Z., Schachter, J., et al. (2007). Objective and subjective stressors and the psychological adjustment of melanoma survivors. Psycho-Oncology, 16, 287–294.CrossRefGoogle ScholarPubMed
Harden, J.K., Northouse, L.L. & Mood, D.W. (2006). Qualitative analysis of couples' experience with prostate cancer by age cohort. Cancer Nursing, 29, 367–377.Google Scholar
Hodges, L.J., Humphris, G.M. & Macfarlane, G. (2005). A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers. Social Science & Medicine, 60, 1–12.Google Scholar
Holland, J.C. & Alici, Y. (2010). Management of distress in cancer patients. The Journal of Supportive Oncology, 8, 4–12.Google ScholarPubMed
Kim, Y., Schulz, R. & Carver, C.S. (2007). Benefit-finding in the cancer caregiving experience. Psychosomatic Medicine, 69, 283–291.CrossRefGoogle ScholarPubMed
Lim, J.W., Paek, M.S. & Shon, E.J. (2014). Gender and role differences in couples' communication during cancer survivorship. Cancer Nursing, 38(3), E51–E60.CrossRefGoogle Scholar
Maliski, S.L., Heilemann, M.V. & McCorkle, R. (2002). From “death sentence” to “good cancer”: Couples' transformation of a prostate cancer diagnosis. Nursing Research, 51, 391–397.CrossRefGoogle Scholar
Manne, S., Ostroff, J., Rini, C., et al. (2004). The interpersonal process model of intimacy: The role of self-disclosure, partner disclosure, and partner responsiveness in interactions between breast cancer patients and their partners. Journal of Family Psychology, 18, 589–599.Google Scholar
Mayring, P. (2008). Qualitative Inhaltsanalyse. Weinheim und Basel: Beltz Verlag.Google Scholar
Pitceathly, C. & Maguire, P. (2003). The psychological impact of cancer on patients' partners and other key relatives: A review. European Journal of Cancer, 39, 1517–1524.Google Scholar
Segrin, C., Badger, T., Dorros, S.M., et al. (2007). Interdependent anxiety and psychological distress in women with breast cancer and their partners. Psycho-Oncology, 16, 634–643.Google Scholar
Segrin, C., Badger, T.A. & Harrington, J. (2012). Interdependent psychological quality of life in dyads adjusting to prostate cancer. Health Psychology, 31, 70–79.Google Scholar
Sinding, C. (2003). “Because you know there's an end to it”: Caring for a relative or friend with advanced breast cancer. Palliative & Supportive Care, 1, 153–163.CrossRefGoogle ScholarPubMed
Skerett, K. (1998). Couple adjustment to the experience of breast cancer. Families, Systems, & Health, 16, 281–298.CrossRefGoogle Scholar
Strickling, B.L. (ed.) (1988). Self-abnegation. Toronto: University of Toronto Press.Google Scholar
Ussher, J.M. & Sandoval, M. (2008). Gender differences in the construction and experience of cancer care: The consequences of the gendered positioning of carers. Psychology & Health, 23, 945–963.Google Scholar
Ussher, J.M., Tim Wong, W.K. & Perz, J. (2011). A qualitative analysis of changes in relationship dynamics and roles between people with cancer and their primary informal carer. Health (London), 15, 650–667.CrossRefGoogle ScholarPubMed
Zabora, J., BrintzenhofeSzoc, K., Curbow, B., et al. (2001). The prevalence of psychological distress by cancer site. Psycho-Oncology, 10, 19–28.Google Scholar
Zwahlen, D., Hagenbuch, N., Carley, M.I., et al. (2010). Posttraumatic growth in cancer patients and partners: Effects of role, gender and the dyad on couples' posttraumatic growth experience. Psycho-Oncology, 19, 12–20.CrossRefGoogle ScholarPubMed