cancer impact - Journal of Consulting and Clinical...

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Perceived Partner Reactions to Diagnosis and Treatment of Breast Cancer: Impact on Psychosocial and Psychosexual Adjustment Sarah R. Wimberly, Charles S. Carver, Jean-Philippe Laurenceau, Suzanne D. Harris, and Michael H. Antoni University of Miami Two studies examined breast cancer patients’ perceptions of their partners’ reactions to their diagnosis and treatment as influences on 3 aspects of patients’ well-being: psychosexual adjustment, emotional distress, and marital satisfaction. Study 1, cross-sectional, indicated that partner initiation of sex, frequency of sex, a positive 1st sexual experience after treatment, and especially perception of the partner’s emotional involvement in the relationship, were relevant to these outcomes. Study 2, longitu- dinal, confirmed many of these findings in prospective tests across 1 year of recovery after surgery. Partner involvement prospectively predicted all 3 outcomes. Partner initiation of sex predicted greater marital satisfaction; partner adverse reaction to the scar predicted less marital satisfaction. Rated quality of the 1st sexual experience after treatment predicted less distress. The pattern suggests that women’s impressions of their partners’ emotional involvement after surgery for breast cancer forecast their adjustment in sexual, marital, and emotional arenas over the following year. Women who are diagnosed with and treated for breast cancer face challenges on many levels. Most women with early-stage breast cancer (who thus have a good prognosis) do not experience severe long-term psychological problems, but almost all experi- ence some difficulties in adjustment, particularly early in the experience (Bloom et al., 1987; Compas & Luecken, 2002; Hjerl, Andersen, Keiding, Mortensen, & Jørgensen, 2002; Irvine, Brown, Crooks, Roberts, & Browne, 1991; Moyer & Salovey, 1996; Nosarti, Roberts, Crayford, McKenzie, & David, 2002). The psy- chosocial sequelae of this disease include emotional distress, sex- ual and relationship difficulties (Henson, 2002; Tan, Waldman, & Bostick, 2002), and concerns for the future stemming from both the possibility of relapse and the long-term impact of the cancer treatment (Moyer & Salovey, 1996; Spencer et al., 1999). Clearly, however, some women are more resilient than others. The psychosocial and psychosexual adjustment of the patient varies with a number of factors, including aspects of her intimate relationship (Holmberg, Scott, Alexy, & Fife, 2001). Interpersonal relationships play a key role in how people cope with distress and adjust to life crises of all kinds, including breast cancer (Abend & Williamson, 2002; Bloom, Stewart, Johnston, Banks, & Fobair, 2001; Holland & Holahan, 2003; Manne, 1998; Michael, Berk- man, Colditz, Holmes, & Kawachi, 2002). The role of the marital (partner) relationship is particularly important, because research has consistently found that a good marital relationship predicts better emotional adaptation to breast cancer (Coyne & Anderson, 1999; Ghizzani, Pirtoli, Bellezza, & Velicogna, 1995; O’Mahoney & Carroll, 1997; Skerrett, 1998).
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