Partners of breast cancer survivors: Research participation and understanding of survivors' concerns

2011-10-18The majority of studies about adjustment to cancer focus only on the perspectives of the individual with cancer, and overlook the contributions made by those in the survivor’s social network. This dissertation examines post-treatment adjustment of breast cancer survivors and contributions to adjustment from survivors’ male partners. It is presented as two manuscripts. Both studies derive from the Moving Beyond Cancer (MBC) intervention study and a second study of the male partners of the MBC participants. ❧ The first study (Chapter 1) addresses methodological limitations common in research on couples, namely, low rates of participation, and a lack of understanding about how representative couples are of the larger population. This study examined demographic, treatment, relationship and quality of life characteristics associated with recruitment and retention of partners of breast cancer survivors from the MBC intervention study. Of 384 partnered survivors who participated in the MBC intervention study, 280 provided consent for their partners to be contacted, 193 partners completed the initial study questionnaire, and 164 partners completed both study questionnaires. Backward stepwise logistic regression indicated that greater family income, and support from a partner or helpful other increased the likelihood that the survivor would consent to have her partner contacted (χ2 = 56.93, p<.001). Greater family income, better survivor physical and emotional quality of life, and non-Hispanic White ethnicity increased the likelihood of partner participation (χ2 = 30.30, p<.001). The model predicting partner retention from the first to second questionnaire was non-significant (χ2 = 30.30, p<.001). The results indicate that ethnic minorities and individuals with lower SES and poorer physical and mental quality of life are less likely to be included in psycho-oncology couple’s research. ❧ The second study (Chapter 2) examines emotional adjustment following breast cancer treatment from a couples’ perspective. In this longitudinal study of 153 couples, I examined partner understanding of fatigue and fear of recurrence among breast cancer survivors during the post-treatment period, and if partner understanding contributed to survivor emotional adjustment. Partner’s perception of survivor’s fatigue and fear of recurrence did not significantly differ from the survivor’s own rating four months post-treatment (T1), but by eight months post-treatment (T2), partners perceived survivors to have significantly greater fatigue and fear of recurrence than the survivors reported. An interaction effect was found at T1 such that among survivors with low levels of fatigue, partner perception of fatigue was not associated with survivor emotional adjustment. However, for survivors with high levels of fatigue, survivors whose partners perceived them to have high fatigue had worse emotional adjustment than survivors whose partners rated them low on fatigue. Partner under- and overestimation of survivor fear and fatigue were associated with survivor positive affect. Finally, the study also examined partner’s own fear of recurrence. Average partner fear of recurrence remained constant over time, and was associated with less positive affect in the survivor within T1 and T2. Results suggest that while the partner’s perspective of the survivor’s symptoms makes a limited contribution to survivor adjustment, his own fear is detrimental to her positive mood