ASPO Abstracts
Discussing sexual health concerns after primary cancer treatment: Breast cancer survivor, romantic partner, and health care provider perspectives on the triadic interaction
Category: Behavioral Science & Health Communication, Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2018
Abstract Body:
Purpose: To investigate breast cancer survivor (BCS), romantic partner, and healthcare provider (HP) perceptions of romantic partners’ involvement in patient-provider conversations regarding sexual health (SH) concerns after primary cancer treatment. Methods: Forty female BCSs, 13 partners, and 40 HPs from a range of specialties participated in semi-structured interviews. Transcripts were thematically analyzed. BSC, partner, and HP accounts were compared to identify similarities and discrepancies, which could inform efforts to enhance care. Results: BCSs, partners, and HPs reported that including partners is helpful because their presence serves as a memory aid and helps facilitate partners’ understanding of women’s experiences. BCSs further reported partners’ presence can help the couple discuss delicate matters in a “neutral and safe environment.” BCSs, partners, and HPs reported that including partners is problematic when their presence threatens women’s privacy or when discussing physical aspects of sexual functioning makes women or partners uncomfortable. Women reported additional concerns regarding the presence of partners. They suggested discussing this issue in front of partners changes the way partners view them as women, places unnecessary burden on partners, provokes partner defensiveness, and leads to feelings of exclusion when HPs begin talking only to partners. Partners reported that in many cases they do not wish to be involved in SH discussions. Being compelled to can make them feel reprimanded, resulting in active resistance to communication attempts. HPs report difficulties navigating these conversations either because they sense partners’ discomfort or because partners “hijack” the interaction. Conclusions: Important variations emerged among BCS, partner, and HP themes. Partners can find it difficult to engage in face-to-face SH conversations. Research should explore how to help partners more openly communicate about SH issues. Less threatening means for providing couples with information should be explored. HPs struggle to integrate both perspectives. Resources should be created to help HPs navigate uncertain terrain and to provide alternative strategies when in-person triadic interactions are not feasible.
Keywords: breast cancer, survivorship, sexual health, patient provider communication, partner communication