Marital quality among women with breast cancer: the role of marital intimacy and quality of life

• Autores: Helena Rita Moreira, Carla Crespo, Marco Pereira, Maria Cristina Canavarro
• Localización: Psicooncología: investigación y clínica biopsicosocial en oncología, ISSN 1696-7240, Vol. 7, Nº. 1, 2010, págs. 61-80
• Idioma: inglés
• Enlaces
  • Texto completo
• Resumen
  • español

    Objetivo: este estudio buscó analizar los cambios en la calidad e intimidad conyugal percibida (comunicación y compromiso) de la mujer, a lo largo de su trayectoria de cáncer de mama. Buscamos también explorar las diferencias entre pacientes y controles en estas variables, e investigar el papel predictivo de la intimidad y calidad de vida (CdV) iniciales en la calidad conyugal seis meses después de finalizado el tratamiento.

    Métodos: la muestra está formada por 47 pacientes con cáncer de mama 90 mujeres de la comunidad. Los datos del grupo de pacientes se recogieron en dos momentos:

    post-cirugía de mama (T1) y 6 meses tras la finalización del tratamiento (T2). La calidad conyugal percibida antes de la enfermedad fue también evaluada retrospectivamente. Fueron utilizados los instrumentos: WHOQOL-BREF (CdV psicológica y social); PAIR (comunicación y compromiso) y en un solo ítem para evaluar la calidad conyugal percibida.

    Resultados: se observó un aumento de la calidad conyugal percibida en la evaluación retrospectiva respecto a T1, no habiendo sido encontradas diferencias a lo largo de la enfermedad. Respecto a la intimidad, tan solo la comunicación disminuyó a lo largo del tiempo.

    Al comparar con el grupo control, las pacientes presentaron puntuaciones superiores en las dimensiones de comunicación y compromiso (T1). Una superior calidad conyugal en T2 fue predicha por una mejor CdV psicológica inicial y por niveles iniciales más elevados de comunicación.

    Conclusiones: el diagnóstico de cáncer de mama parece no estar asociado a una disminución de la calidad conyugal. Además, nuestros resultados destacaran la importancia de compartir con la pareja la información relacionada con el cáncer, así como la importancia de mantener una buena CdV psicológica en el inicio de la enfermedad.

  • English

    Objective: this study aimed to analyze changes in woman�s perceived marital quality and intimacy (communication and engagement dimensions) throughout the breast cancer trajectory. We also sought to explore differences between patients and controls on these variables, as well as to investigate the predictive role of initial intimacy and quality of life (QoL) on marital quality 6 months after the treatment�s ending.

    Methods: the sample comprises of 47 breast cancer patients and 90 community controls.

    Data from the patients� group were collected at two time points: following breast surgery (T1) and 6 months after treatments had ended (T2). The perceived marital quality before the disease was also retrospectively assessed. The following measures were used: WHOQOLBREF (psychological and social QoL); PAIR (communication and engagement) and a singleitem to assess perceived marital quality.

    Results: There was an increase in perceived marital quality from the retrospective assessment to T1, and no differences were found throughout the disease. With respect to intimacy, only communication decreased over time. When compared with controls, patients presented higher scores on communication and engagement dimensions (T1). A higher marital quality at T2 was predicted by a higher initial psychological QoL and higher initial levels of communication.

    Conclusions: the diagnosis of breast cancer does not appear to be associated with a decline in marital quality. Moreover, our findings highlighted the importance of sharing with a partner the cancer-related information, as well as the importance of maintaining a good psychological QoL at the beginning of the disease.

• Referencias bibliográficas
  • 1. Rolland J. Families, illness, and disability: An integrative treatment model. New York: Basic, 1994.
  • 2. Broderick C. Understanding family processes: Basics of family systems therapy. Newbury Park, CA: Sage, 1993.
  • 3. Burman B, Margolin G. Analysis of the association between marital relationships and health problems: An interactional perspective. Psychol...
  • 4. Manne S, Badr H. Intimacy and relationship processes in couples’ psychosocial adaptation to cancer. Cancer 2008; 112(11 suppl): 2541-55.
  • 5. Manne S. Cancer in the marital context: A review of the literature. Cancer Invest 1998; 16(3): 188-202.
  • 6. Dorval M, Guay S, Mondor M, Mâsse B, Falardeau M, Robidoux A, et al. Couples who get closer after breast cancer: Frequency and predictors...
  • 7. O’Mahoney J, Carroll R. The impact of breast cancer and its treatment on marital functioning. J Clin Psychol Med S 1997; 4(4): 397-414.
  • 8. Hagedoorn M, Sanderman R, Coyne J, Bolks H, Tuinstra J. Distress in couples coping with cancer: A meta-analysis and critical review of...
  • 9. Carter R, Carter C. Individual and marital adjustment in spouse pairs subsequent to mastectomy. Am J Fam Ther 1993; 21: 291-300.
  • 10. Dorros S, Card N, Segrin C, Badger T. Interdependence in women with breast cancer and their partners: An interindividual model of distress....
  • 11. Northouse L, Dorris G, Charron-Moore C. Factors affecting couples’ adjustment to recurrent breast cancer. Soc Sci Med 1995; 41(1): 69-76.
  • 12. Kayser K, Scott J. Helping couples cope with women’s cancers: An evidence-based approach for practitioners. New York: Springer; 2008.
  • 13. Kayser K, Watson L, Andrade J. Cancer as a “We-Disease”: Examining the process of coping from a relational perspective. Fam Syst Health...
  • 14. Taylor-Brown J, Kilpatrick M, Maunsell E, Dorval M. Partner abandonment of women with breast cancer: Myth or reality? Cancer Pract 2000;...
  • 15. Thornton AA. Perceiving benefits in the cancer experience. J Clin Psychol Med S 2002; 9(2): 153-65.
  • 16. Dorval M, Maunsell E, Taylor-Brown J, Kilpatrick M. Marital stability after breast cancer. J Natl Cancer I 1999; 91: 54-9.
  • 17. Hinnen C, Hagedoorn M, Ranchor A, Sanderman R. Relationship satisfaction in women: A longitudinal case-control study about the role of...
  • 18. Litchtman R, Taylor S, Wood J. Social support and marital adjustment after breast cancer. J Psychosoc Oncol 1987; 5(3): 47-74.
  • 19. Walsh S, Manuel J, Avis N. The impact of breast cancer on younger women’s relationships with their partner and children. Fam Syst Health...
  • 20. Cordova M, Cunningham L, Carlson C, Andrykowski M. Posttraumatic growth following breast cancer: A controlled comparison study. Health...
  • 21. Manne S, Ostroff J, Winkel G, Goldstein L, Fox K, Grana G. Posttraumatic growth after breast cancer: Patient, partner, and couple perspectives....
  • 22. Fuller S, Swensen C. Marital quality and quality of life among cancer patients and their spouses. J Psychosoc Oncol 1992; 10: 41-56.
  • 23. Hannum J, Giese-Davis J, Harding J, Hatfield E. Effects of individual and marital variables on coping with cancer. J Psychosoc Oncol 1991;...
  • 24. Giese-Davis J, Hermanson K, Koopman C, Weibel D, Spiegel, D. Quality of couples’ relationship and adjustment to metastatic breast cancer....
  • 25. Weighs K, Enright T, Howe G, Siemens S. Marital satisfaction and emotional adjustment after breast cancer. J Psychosoc Oncol 1999; 17(1):...
  • 26. Greeff A, Malherbe H. Intimacy and marital satisfaction in spouses. J Sex Marital Ther 2001; 27: 247-57.
  • 27. Dandeneau M, Johnson, S. Facilitating intimacy: Interventions and effects. J Marital Fam Ther 1994; 20(1): 17-33.
  • 28. Schaefer M, Olson L. Assessing Intimacy: The PAIR Inventory. J Marital Fam Ther 1981; 7(1): 47-60.
  • 29. Manne S, Ostroff J, Rini C, Fox K, Goldstein L, Grana G. The interpersonal process model of intimacy: The role of selfdisclosure, partner...
  • 30. Van den Broucke S, Vandereycken W, Vertommen H. Marital intimacy: Conceptualization and assessment. Clin Psychol Rev 1995; 15(3): 217-33.
  • 31. Argyle M, Dean J. Eye-contact, distance and affiliation. Sociometry 1965; 28: 289-304.
  • 32. Chelune GJ, Rosenfeld LB, Waring EM. Spouse disclosure patterns in distressed and nondistressed couples. Am J Fam Ther 1985; 13: 24-32.
  • 33. Fisher M, Stricker G. Intimacy. New York: Plenum; 1982.
  • 34. Laurenceau J-P, Barrett L, Rovine M. The interpersonal process model of intimacy in marriage: A daily-diary and multilevel modeling approach....
  • 35. Prager KJ, The Psychology of Intimacy. New York: The Guilford Press; 1995.
  • 36. Reis HT, Shaver P. Intimacy as an interpersonal process. In: Duck S, editor. Handbook of personal relationships. Wiley: Chichester; 1988....
  • 37. Waring EM. Facilitating marital intimacy through self-disclosure. The Am J Fam Ther 1981; 9: 33-42.
  • 38. Laurenceau J-P, Barrett L, Pietromonaco P. Intimacy as an interpersonal process: The importance of self-disclosure, partner disclosure,...
  • 39. Hook M, Gerstein L, Detterich L, Gridley B. How close are we? Measuring intimacy and examining gender differences. J Couns Dev 2003; 81(4):...
  • 40. Reis HT, Patrick B. Attachment and intimacy: Component processes. In: Higgins T, Kruglanski A, editors. Social Psychology: Handbook of...
  • 41. Manne S, Badr H, Zaider T, Nelson C, Kissane D. Cancer-related communication, relationship intimacy, and psychological distress among...
  • 42. Manne S, Badr H. Intimacy processes and psychological distress among couples coping with head and neck or lung cancers. Psychoncology,...
  • 43. Moreira H, Silva S, Canavarro MC. O papel da intimidade conjugal na qualidade de vida da mulher com cancro da mama. (The role of marital...
  • 44. Porter L, Keefe F, Hurwitz H, Faber M. Disclosure between patients with gastrointestinal cancer and their spouses. Psychooncology 2005;...
  • 45. Figueiredo M, Fries E, Ingram K. The role of disclosure patterns and unsupportive social interactions in the well-being of breast cancer...
  • 46. Pistrang N, Barker C. Disclosure of concerns in breast cancer. Psychooncology 1992; 1: 183-92.
  • 47. Harrison J, Maguire G, Pitceathly C. Confiding in crisis: Gender differences in pattern of confiding among cancer patients. Soc Sci Med...
  • 48. Pistrang N, Barker C. The partner relationship in psychological response to breast cancer. Soc Sci Med 1995; 40(6): 789-97.
  • 49. Cordova M, Cunningham L, Carlson C, Andrykowski M. Social constrains, cognitive processing, and adjustment to breast cancer. J Consult...
  • 50. Manne S, Ostroff J, Norton T, Fox K, Goldstein L, Grana G. Cancer-related relationship communication in couples coping with early stage...
  • 51. Stanton A, Ganz P, Rowland J, Meyerowitz B, Krupnick J, Sears A. Promoting adjustment after treatment for cancer. Cancer 2005; 104(11...
  • 52. Veach T, Nicholas D, Barton M. Cancer and the family life cycle: A practitioner’s guide. New York: Brunner-Routledge, 2002.
  • 53. Deshields T, Tibbs T, Fan MY, Bayer L, Taylor M, Fisher E. Ending treatment: The course of emotional adjustment and quality of life among...
  • 54. Moyer A, Salovey S. Psychosocial sequelae of breast cancer and its treatment. Ann Behav Med 1996; 18(2): 110-25.
  • 55. Johnson S, Jacobs T. Marital interactions of depressed men and women. J Consult Clin Psych 1997; 65(1): 15-23.
  • 56. Coyne J, Thompson R, Palmer S. Marital quality, coping with conflict, marital complaints, and affection in couples with a depressed wife....
  • 57. Levkovitz Y, Lamy D, Ternochiano P, Treves I, Fennig, S. Perception of dyadic relationship and emotional states in patients with affective...
  • 58. Brady S, Helgeson V. Social support and adjustment to recurrence of breast cancer. J Psychosoc Oncol 1991; 17(2): 37-55.
  • 59. Bolger N, Foster M, Vinokur A, Ng R. Close relationships and adjustment to a life crisis: The case of breast cancer. J Pers Soc Psychol...
  • 60. Fang C, Manne S, Pape S. Functional impairment, marital quality, and patient psychological distress as predictors of psychological distress...
  • 61. Moreira H, Amaral A, Canavarro MC. Adaptação do Personal Assessment of Intimacy in Relationships Scale (PAIR) para a população Portuguesa:...
  • 62. Whoqol-Group. The World Health Organization Quality of Life Assessment (WHOQOL): Development and general psychometric properties. Soc...
  • 63. Vaz Serra A, Canavarro MC, Simões M, Pereira M, Gameiro S, Quartilho M, et al. Estudos psicométricos do instrumento de Avaliação da Qualidade...
  • 64. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical...
  • 65. Tabachnick B, Fidell L. Using multivariate statistics. Boston: Allyn and Bacon; 2007.
  • 66. Tedeschi R, Calhoun L. Trauma and transformation: Growing in the aftermath of suffering. Thousand Oaks, CA.: Sage Publications; 1995.
  • 67. Calhoun L, Cann A, Tedeschi R, McMillan J. A correlational test of the relationship between posttraumatic growth, religion, and cognitive...
  • 68. Ford J, Tennen H, Albert D. A contrarian view of growth following adversity In: Joseph S, Linley P, Editors. Trauma, recovery and growth:...
  • 69. Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A. Depression and anxiety in women with early breast cancer: Five year observational...
  • 70. Moreira H, Canavarro MC. Um estudo longitudinal sobre a qualidade de vida e perturbação emocional durante o percurso do cancro da mama....
  • 71. Schou I, Ekeberg O, Sandvik L, Hjermstad M, Ruland C. Multiple predictors of healthrelated quality of life in early stage breast cancer....
  • 72. Schwarz R, Krauss O, Hockel M, Meyer A, Zenger M. The course of anxiety and depression in patients with breast cancer and gynecological...
  • 73. Manne S, Norton T, Ostroff J, Winkel G, Fox K, Grana G. Protective buffering and psychological distress among couples coping with breast...
  • 74. Lepore SJ, Silver, RC, Wortmen, CB, Wayment, HA. Social constrains, intrusive thoughts, and depressive symptoms among bereaved mothers....
  • 75. Janoff-Bulman R. Shattered assumptions: Towards a new psychology of trauma. New York: Free Press; 1992.
  • 76. Ganz P, Kwan L, Stanton A, Krupnick J, Rowland J, Meyerowitz B, et al. Quality of life at the end of primary treatment of breast cancer:...
  • 77. Constanzo ES, Lutgendorf SK, Mattes ML, Trehan S, Robinson CB, Tewfik F, et al. Adjusting to life after treatment: Distress and quality...
  • 78. Coyne J, Smith D. Couples coping with a myocardial infarction. J Pers Soc Psychol 1991; 61: 404-12.