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Erschienen in: Supportive Care in Cancer 2/2019

27.07.2018 | Original Article

Perpetuating the cycle of silence: the intersection of uncertainty and sexual health communication among couples after breast cancer treatment

verfasst von: Mollie Rose Canzona, Carla L. Fisher, Christy J. W. Ledford

Erschienen in: Supportive Care in Cancer | Ausgabe 2/2019

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Abstract

Purpose

The aims of this study are (1) to identify sources of uncertainty breast cancer survivors and partners of breast cancer survivors (BCS) report as a result of sexual health changes after primary treatment and (2) to investigate the challenges they experience when attempting to communicate about sexual health-related uncertainty.

Methods

Forty BCS and 13 partners completed written reflections and participated in semi-structured interviews.

Results

Analyses revealed five predominant sources of uncertainty for BCS and partners: perceptions of post-treatment body, worry about effects on relational partners, ethical concerns about dissatisfaction with sexual relationship (partners only), fears about future of the relationship, and apprehension about SH treatment futility. These concerns are linked to communication challenges for couples: supporting survivors’ body esteem, navigating potentially hurtful disclosures, responding to partners’obstructive behavior,” and believing communication is futile.

Conclusions

Findings suggest women and partners find themselves caught in a destructive cycle that reinforces uncertainty and inadvertently perpetuates silence and relational distress. To disrupt the cycle of silence, BCS and partners need to know that their interpretation of the other person’s behaviors/needs is not always accurate. Strategies are required to help women and their partners express uncomfortable thoughts and feelings in safe and supportive environments. Practitioners should be conscious of potential SH issues, be familiar with existing support resources for survivors, and be prepared to disseminate information that will empower women and their partners.
Literatur
1.
Zurück zum Zitat Jolley S (2002) Taking a sexual history: the role of the nurse. Nurs Times 98(18):39–41PubMed Jolley S (2002) Taking a sexual history: the role of the nurse. Nurs Times 98(18):39–41PubMed
2.
Zurück zum Zitat Molassiotis A, Chan CW, Yam BM, Chan SJ (2000) Quality of life in Chinese women with gynaecological cancers. Support Care Cancer 8(5):414–422CrossRef Molassiotis A, Chan CW, Yam BM, Chan SJ (2000) Quality of life in Chinese women with gynaecological cancers. Support Care Cancer 8(5):414–422CrossRef
3.
Zurück zum Zitat Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR (2007) Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol 25(17):2352–2359CrossRef Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR (2007) Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol 25(17):2352–2359CrossRef
5.
Zurück zum Zitat Bakht S, Najafi S (2010) Body image and sexual dysfunctions: comparison between breast cancer patients and healthy women. Procedia Soc Behav Sci 5:1493–1497CrossRef Bakht S, Najafi S (2010) Body image and sexual dysfunctions: comparison between breast cancer patients and healthy women. Procedia Soc Behav Sci 5:1493–1497CrossRef
7.
Zurück zum Zitat Ligibel JA, Denlinger CS (2013) New NCCN guidelines for survivorship care. J Natl Compr Cancer Netw 11(5 Suppl):640–644CrossRef Ligibel JA, Denlinger CS (2013) New NCCN guidelines for survivorship care. J Natl Compr Cancer Netw 11(5 Suppl):640–644CrossRef
8.
Zurück zum Zitat Ganz PA, Coscarelli A, Fred C, Kahn B, Polinsky ML, Petersen L (1996) Breast cancer survivors: psychosocial concerns and quality of life. Breast Cancer Res Treat 38(2):183–199CrossRef Ganz PA, Coscarelli A, Fred C, Kahn B, Polinsky ML, Petersen L (1996) Breast cancer survivors: psychosocial concerns and quality of life. Breast Cancer Res Treat 38(2):183–199CrossRef
9.
Zurück zum Zitat Hodgkinson K, Butow P, Hunt GE, Wyse R, Hobbs KM, Wain G (2007) Life after cancer: couples’ and partners’ psychological adjustment and supportive care needs. Support Care Cancer 15(4):405–415CrossRef Hodgkinson K, Butow P, Hunt GE, Wyse R, Hobbs KM, Wain G (2007) Life after cancer: couples’ and partners’ psychological adjustment and supportive care needs. Support Care Cancer 15(4):405–415CrossRef
10.
Zurück zum Zitat Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P, Supportive Care Review Group (2000) The unmet supportive care needs of patients with cancer. Cancer 88(1):226–237CrossRef Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P, Supportive Care Review Group (2000) The unmet supportive care needs of patients with cancer. Cancer 88(1):226–237CrossRef
11.
Zurück zum Zitat Mishel MH (1981) The measurement of uncertainty in illness. Nurs 30:258–263 Mishel MH (1981) The measurement of uncertainty in illness. Nurs 30:258–263
12.
Zurück zum Zitat Broeckel JA, Thors CL, Jacobsen PB, Small M, Cox CE (2002) Sexual functioning in long-term breast cancer survivors treated with adjuvant chemotherapy. Breast Cancer Res Treat 75(3):241–248CrossRef Broeckel JA, Thors CL, Jacobsen PB, Small M, Cox CE (2002) Sexual functioning in long-term breast cancer survivors treated with adjuvant chemotherapy. Breast Cancer Res Treat 75(3):241–248CrossRef
13.
Zurück zum Zitat Rowland JH, Meyerowitz BE, Crespi CM, Leedham B, Desmond K, Belin TR, Ganz PA (2009) Addressing intimacy and partner communication after breast cancer: a randomized controlled group intervention. Breast Cancer Res Treat 118(1):99–111CrossRef Rowland JH, Meyerowitz BE, Crespi CM, Leedham B, Desmond K, Belin TR, Ganz PA (2009) Addressing intimacy and partner communication after breast cancer: a randomized controlled group intervention. Breast Cancer Res Treat 118(1):99–111CrossRef
14.
Zurück zum Zitat Cuzick J, Sestak I, Cawthorn S, Hamed H, Holli K, Howell A, Forbes JF (2015) Tamoxifen for prevention of breast cancer: extended long-term follow-up of the IBIS-I breast cancer prevention trial. Lancet Oncol 16(1):67–75CrossRef Cuzick J, Sestak I, Cawthorn S, Hamed H, Holli K, Howell A, Forbes JF (2015) Tamoxifen for prevention of breast cancer: extended long-term follow-up of the IBIS-I breast cancer prevention trial. Lancet Oncol 16(1):67–75CrossRef
16.
Zurück zum Zitat Fobair P, Spiegel D (2009) Concerns about sexuality after breast Cancer (Vol. 15, pp. 19–26). Lippincott Williams & Wilkins, New York Fobair P, Spiegel D (2009) Concerns about sexuality after breast Cancer (Vol. 15, pp. 19–26). Lippincott Williams & Wilkins, New York
17.
Zurück zum Zitat Meyerowitz BE, Desmond KA, Rowland JH, Wyatt GE, Ganz PA (1999) Sexuality following breast cancer. J Sex Marital Ther 25(3):237–250CrossRef Meyerowitz BE, Desmond KA, Rowland JH, Wyatt GE, Ganz PA (1999) Sexuality following breast cancer. J Sex Marital Ther 25(3):237–250CrossRef
19.
Zurück zum Zitat Hughes MK (2000) Sexuality and the cancer survivor: a silent coexistence. Cancer Nurs 23(6):477–482CrossRef Hughes MK (2000) Sexuality and the cancer survivor: a silent coexistence. Cancer Nurs 23(6):477–482CrossRef
20.
Zurück zum Zitat Lambert SD, Jones BL, Girgis A, Lecathelinais C (2012) Distressed partners and caregivers do not recover easily: adjustment trajectories among partners and caregivers of cancer survivors. Ann Behav Med 44(2):225–235CrossRef Lambert SD, Jones BL, Girgis A, Lecathelinais C (2012) Distressed partners and caregivers do not recover easily: adjustment trajectories among partners and caregivers of cancer survivors. Ann Behav Med 44(2):225–235CrossRef
21.
Zurück zum Zitat Butler L, Banfield V, Sveinson T, Allen K (1998) Conceptualizing sexual health in cancer care. West J Nurs Res 20(6):683–699CrossRef Butler L, Banfield V, Sveinson T, Allen K (1998) Conceptualizing sexual health in cancer care. West J Nurs Res 20(6):683–699CrossRef
22.
Zurück zum Zitat Stilos K, Doyle C, Daines P (2008) Addressing the sexual health needs of patients with gynecologic cancers. Clin J Oncol Nurs 12(3):457–463CrossRef Stilos K, Doyle C, Daines P (2008) Addressing the sexual health needs of patients with gynecologic cancers. Clin J Oncol Nurs 12(3):457–463CrossRef
23.
Zurück zum Zitat Goldsmith DJ, Miller LE, Caughlin JP (2008) Openness and avoid- ance in couples communicating about cancer. Comm Yearbook 31:59–113 Goldsmith DJ, Miller LE, Caughlin JP (2008) Openness and avoid- ance in couples communicating about cancer. Comm Yearbook 31:59–113
24.
Zurück zum Zitat Crooks DL (2001) Older women with breast cancer: new understandings through grounded theory research. Health Care Women Int 22:99–114CrossRef Crooks DL (2001) Older women with breast cancer: new understandings through grounded theory research. Health Care Women Int 22:99–114CrossRef
26.
Zurück zum Zitat Theiss JA (2011) Modeling dyadic effects in the associations between relational uncertainty, sexual communication, and sexual satisfaction for husbands and wives. Commun Res 38:565–584CrossRef Theiss JA (2011) Modeling dyadic effects in the associations between relational uncertainty, sexual communication, and sexual satisfaction for husbands and wives. Commun Res 38:565–584CrossRef
27.
Zurück zum Zitat Gilbert E, Ussher JM, Perz J (2010) Sexuality after breast cancer: a review. Maturitas 66(4):397–407CrossRef Gilbert E, Ussher JM, Perz J (2010) Sexuality after breast cancer: a review. Maturitas 66(4):397–407CrossRef
29.
Zurück zum Zitat Keatinge D (2002) Versatility and flexibility: attributes of the critical incident technique in nursing research. Nurs Health Sci 4(1–2):33–39CrossRef Keatinge D (2002) Versatility and flexibility: attributes of the critical incident technique in nursing research. Nurs Health Sci 4(1–2):33–39CrossRef
30.
Zurück zum Zitat Glaser B, Strauss A (1967) The discovery of grounded theory. Weidenfield & Nicolson, London Glaser B, Strauss A (1967) The discovery of grounded theory. Weidenfield & Nicolson, London
31.
Zurück zum Zitat Boyatzis RE (1998) Transforming qualitative information: thematic analysis and code development. Sage, Thousand Oaks Boyatzis RE (1998) Transforming qualitative information: thematic analysis and code development. Sage, Thousand Oaks
32.
Zurück zum Zitat Pennebaker JW, Seagal JD (1999) Forming a story: the health benefits of narrative. J Clin Psychol 55(10):1243–1254CrossRef Pennebaker JW, Seagal JD (1999) Forming a story: the health benefits of narrative. J Clin Psychol 55(10):1243–1254CrossRef
33.
Zurück zum Zitat Bodenmann G (2005) Dyadic coping and its significance for marital function- ing. In: Revenson TA, Kayser K, Bodenmann G (eds) Couples coping with stress: emerging perspectives on dyadic coping. American Psychological Association, Washington DC, pp 33–49CrossRef Bodenmann G (2005) Dyadic coping and its significance for marital function- ing. In: Revenson TA, Kayser K, Bodenmann G (eds) Couples coping with stress: emerging perspectives on dyadic coping. American Psychological Association, Washington DC, pp 33–49CrossRef
34.
Zurück zum Zitat Danhauer SC, Russell GB, Tedeschi RG, Jesse MT, Vishnevsky T, Daley K, Carroll S, Triplett KN, Calhoun LG, Cann A, Powell BL (2013) A longitudinal investigation of posttraumatic growth in adult patients undergoing treatment for acute leukemia. J Clin Psychol Med Settings 20(1):13–24CrossRef Danhauer SC, Russell GB, Tedeschi RG, Jesse MT, Vishnevsky T, Daley K, Carroll S, Triplett KN, Calhoun LG, Cann A, Powell BL (2013) A longitudinal investigation of posttraumatic growth in adult patients undergoing treatment for acute leukemia. J Clin Psychol Med Settings 20(1):13–24CrossRef
36.
Zurück zum Zitat Brashers DE (2001) Communication and uncertainty management. J Commun 51:477–497CrossRef Brashers DE (2001) Communication and uncertainty management. J Commun 51:477–497CrossRef
Metadaten
Titel
Perpetuating the cycle of silence: the intersection of uncertainty and sexual health communication among couples after breast cancer treatment
verfasst von
Mollie Rose Canzona
Carla L. Fisher
Christy J. W. Ledford
Publikationsdatum
27.07.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 2/2019
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4369-9

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