Academic journal article Health and Social Work

Men's Adjustment to Their Partners' Breast Cancer: A Dyadic Coping Perspective

Academic journal article Health and Social Work

Men's Adjustment to Their Partners' Breast Cancer: A Dyadic Coping Perspective

Article excerpt

The American Cancer Society (2003) estimated that there would be 212,600 new breast cancer cases in the United States in 2003. In 2000, 182,000 cases were diagnosed, which represents an increase of 30,000 new cases in just three years. With this increase in occurrence, growing numbers of men are likely to experience the impact of breast cancer on their relationships.

The psychosocial impact of breast cancer and its treatment generates a ripple effect from the patient to her partner and ultimately to the entire family system (Lewis, Ellison, & Woods, 1985).This ripple effect affects a family's basic identity by triggering multiple challenges (Sabo, 1990) that alter the routines of daily living as well as exposing the patient, her spouse, and other family members to significant psychological stress (Given & Given, 1992; Lewis et al., 1985; Northouse & Peters-Golden, 1993). In fact, Rolland (1994a) noted that a woman's serious illness can present the greatest overall risk to couples' and family functioning because historically women have served many of the practical and nurturant roles in families.

As the number of women facing breast cancer and national concern over medical costs continue to increase, managed care in health care provision has precipitated changes in patient caregiving. One way managed care companies have lowered their costs is by shifting the burden of patient care from hospitals to patients' partners and families. Consequently, more men have become primary caregivers to their wives and partners on top of coping with the stress and chaotic disturbances that accompany breast cancer. Male partners of breast cancer patients assume fundamental roles in patient and family care, yet their issues and the ripple effect of this disease on the family tend to be neglected or disregarded because health care professionals focus on patient concerns (Northouse & Peters-Golden, 1993).The purpose of this study was to explore the relationship between dyadic coping and men's adjustment to their partners' illness.

BREAST CANCER'S IMPACT ON THE PARTNER

In an early article about the psychosocial aspects of the cancer experience, Dyk and Sutherland (1956) suggested,"The spouse is often the key to the patient's success or failure in adapting ... to the disability" (p. 138). Nevertheless, until the 1970s partners of breast cancer patients were viewed as passive observers rather than active participants in the cancer experience. In the 1970s and 1980s, descriptive studies documented that men often experienced psychosomatic symptoms and sexuality and intimacy distress (Wellisch, Jamison, & Pasnau, 1978), increased anxiety and depression (Maguire, 1981; Oberst & James, 1985), a general sense of helplessness (Vachon et al., 1977), fear of cancer and its treatment (Gotay, 1984), and concern about their own and their partner's ability to cope with the cancer (Grandstaff, 1975). Despite methodological problems, these studies provided important information about the process of adjusting to breast cancer.

For example, Wellisch and colleagues (1978) surveyed 31 men approximately two years after their wife's mastectomy and found that most men reported good overall adjustment but that close to half of them reported problems with their ability to work and sleep and about a quarter reported symptoms consistent with eating disorders. In addition, more than a third stated that the influence of breast cancer on their sexual relationship was "somewhat bad" or "bad." Not surprising, the higher the men's evaluation of their relationships, the less negative influence they attributed to the mastectomy. Overall, most of the men coped well or denied psychosocial stresses. However, a smaller subgroup was distressed, remained distressed, and reported a downward spiraling in their relationship quality.

In 1981 Maguire assessed husbands' adjustment to breast cancer over time. He included a comparison group of husbands of women with nonmalignant breast disease. …

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