Sexual dysfunction and spousal communication in couples coping with prostate cancer. Psycho-Oncology, 18(7), 735-746

Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77230-1439, USA.
Psycho-Oncology (Impact Factor: 2.44). 07/2009; 18(7):735-46. DOI: 10.1002/pon.1449
Source: PubMed


To characterize the sexual function of both prostate cancer patients and their partners, and to examine whether associations between sexual dysfunction and psychosocial adjustment vary depending on spousal communication patterns.
In this cross-sectional study, 116 prostate cancer patients and their partners completed psychosocial questionnaires.
Patients and partners reported high rates of sexual dysfunction. Within couples, patients' and their partners' sexual function was moderately to highly correlated (r=0.30-0.74). When patients had poor erectile function, their partners were more likely to report that the couple avoided open spousal discussions; this in turn was associated with partners' marital distress (Sobel's Z=12.47, p=0.001). Patients and partners who reported high levels (+1SD) of mutual constructive communication also reported greater marital adjustment, regardless of their own sexual satisfaction. In contrast, greater sexual dissatisfaction was associated with poorer marital adjustment in patients and partners who reported low levels (-1SD) of mutual constructive communication (p<0.05).
Our findings underscore the need for psychosocial interventions that facilitate healthy spousal communication and address the sexual rehabilitation needs of patients and their partners after prostate cancer treatment. Although some couples may be reluctant to engage in constructive cancer-related discussions about sexual problems, such discussions may help alleviate the negative impact that sexual problems have on prostate cancer patients' and their partners' marital adjustment.

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    • "However, it is well documented that intimate partners desire communication and information about post-cancer sexual changes to their own sexual selves and their relationship (Gilbert et al. 2009), with some evidence that partners have a greater need for information than people with cancer (Lavery & Clarke 1999; Rees & Bath 2000). In addition, people with cancer have reported that it is important for their intimate partner to be included in discussions about sexuality with health professionals (Ellingson & Buzzanell 1999; Flynn et al. 2012), with open communication between people with cancer and their partner key to managing changes to sexuality (Lavery & Clarke 1999; Badr & Carmack Taylor 2009). This open communication has been found to be easier if health professionals include both the person with cancer and the partner in discussions about sexuality (Rasmusson & Thome 2008). "
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    ABSTRACT: Changes to sexuality can be one of the most difficult aspects of life following cancer. This study examines the experience of discussing sexuality post cancer with health care professionals (HCPs), from the perspective of women and men with cancer (PWC), and their partners (PPWC), across a range of cancer types. A total of 657 PWC (535 women, 122 men) and 148 PPWC (87 women, 61 men) completed a survey containing closed and open-ended items, analysed by analysis of variance and thematic analysis. Discussions about sexuality with a HCP were more likely to be reported by men (68%) compared to women PWC (43%), and by women (47%) compared to men PPWC (28%), as well as by those with a sexual or reproductive cancer. Men PWC and women PPWC were most likely to want to discuss sexuality with a HCP, with men PWC and PPWC reporting highest levels of satisfaction with such discussions. Open-ended responses revealed dissatisfaction with the unwillingness of HCPs to discuss sexuality, unhappiness with the nature of such discussion, and positive accounts of discussions about sexuality with HCPs. These findings lend support to the notion that people with cancer and their partners may have unmet sexual information and support needs.
    European Journal of Cancer Care 08/2014; 2. DOI:10.1111/ecc.12216 · 1.56 Impact Factor
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    • "While patients express unease with the sexual side-effects of their cancer treatment and this is a significant area of concern, their female partners recognize decreased sexual desire in their partners post-treatment, but this is not considered a primary concern [30]. As greater sexual dissatisfaction has been found to be associated with poorer marital adjustment in couples who reported low levels of communication, psychosocial interventions that facilitate healthy spousal communication and address sexual rehabilitation needs of both the patients and their partners after PC treatment seem essential [31]. Hence, the partners’ involvement in sexual rehabilitation is warranted. "
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    ABSTRACT: Background Despite the growing body of literature which highlights the potential for significant and enduring side-effects of prostate cancer treatment, there is limited research exploring the experience of living with the treatment-induced side-effects such as sexual dysfunction, and their repercussions for men and their partners. The aim of this qualitative study was to explore factors influencing psychosexual adjustment, self-perception, and unmet information and support needs of prostate cancer patients and their partners. Methods Twenty-one men, recruited via a prostate cancer support group newsletter, participated in face-to-face semi-structured interviews, which were subjected to thematic analysis. Results The qualitative analysis revealed three inter-connected main themes which contributed to men’s psychosexual adjustment: i) Psychosexual impact, ii) Communication and support, and iii) Integration process. Men reported distressing sexual and urinary difficulties, tainted self-perception and altered intimate relationships. Receiving adequate information and support, and having good communication with their doctors and partners facilitated better adjustment to prostate cancer treatment. Coming to terms with the significant impact of treatment had involved making lifestyle changes, coping with emotional struggles and striving to accept and integrate their post-treatment “new normal” self and sexual life. Conclusions The importance of adequate communication with health professionals and partners, especially regarding treatment effects on sexual function and rehabilitation options, was highlighted as a key factor facilitating the adjustment process. Prostate cancer patients would benefit from improved access to timely and tailored information and decision-making resources, ongoing multidisciplinary care, and support groups, as well as appropriate referrals for sexual and psychological counselling.
    BMC Urology 07/2014; 14(1):56. DOI:10.1186/1471-2490-14-56 · 1.41 Impact Factor
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    • "Despite increasing interest in dyadic coping among couples facing prostate cancer [21] [22] [23] [24] [25], no study has applied the STM of dyadic coping to this population. Previous studies of couples coping with prostate cancer have focused on the congruence between patients' and spouses' coping responses [22] [24], the importance of open communication to relationship intimacy [21] [25], and the role of collaborative problem solving [23]. Thus, the reciprocal influence of positive and negative dyadic coping behaviors among patients with prostate cancer and their spouses is unclear. "
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    ABSTRACT: Objective Dyadic coping has an impact on couples’ adjustment to breast cancer; however, there is limited evidence regarding whether dyadic coping influences couples’ adjustment to other types of cancer. The objective of this analysis was to further our knowledge of the relationships between dyadic coping, anxiety, depression, and relationship satisfaction among couples facing prostate cancer. Methods Forty-two men recently diagnosed with prostate cancer recruited from urology clinics and their spouses completed measures of dyadic coping, anxiety, depression, and relationship satisfaction. The Actor-Partner Interdependence Model was used to examine the relationships among these concepts. Results Relationship satisfaction was significantly associated with patients’ and wives’ use of positive and negative dyadic coping, and their partners’ use of these strategies. Although patients’ and wives’ use of supportive dyadic coping was not associated with their anxiety and depression, their partner's use of this strategy was associated with anxiety and depression. Only husbands’ and wives’ perceptions of their partner's negative dyadic coping was associated with anxiety and depression. Conclusions/Practice Implications Couples respond to a prostate cancer diagnosis as an interactional system. Future research should focus on tailoring couple-based interventions such that patients and spouses are equipped to provide the specific support their partners need.
    Patient Education and Counseling 07/2014; 96(1). DOI:10.1016/j.pec.2014.04.010 · 2.20 Impact Factor
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