Department of Psychology, Macquarie University, Sydney, NSW, Australia.
Psychooncology. 2010 Jan;19(1):1-11. doi: 10.1002/pon.1582.
For women at high risk of developing hereditary breast and/or ovarian cancer the process of undergoing genetic testing is anxiety provoking and stressful, entailing difficult and complex decisions. Partners of high-risk women are frequently perceived by the women as a source of support during this challenging time. Utilising Self Regulatory Theory, this paper provides a theoretically guided overview of existing data to delineate how partners respond emotionally and behaviourally to the woman's high-risk status.
An extensive literature search was undertaken. Online searches of MEDLINE, CINAHL and PsycINFO databases were conducted, reference lists of all publications identified were examined; and the databases were searched for authors identified in these publications.
The systematic search yielded 10 published studies on at-risk women and their male partners; one study did not investigate male partner distress as an outcome variable. Heterogeneity of methodology in this literature precluded quantitative meta-analyses of study outcomes. Review of the evidence suggests that the genetic testing process may be distressing for some partners, particularly for partners of women identified as mutation carriers. Associations were identified between partner distress and partner beliefs about the woman's perceived breast cancer risk; partner feelings of social separation and lack of couple communication; and partner perceptions of being alienated from the testing process. Lack of partner support was found to be associated with increased distress of the tested woman at the time of testing and following results disclosure. Data are lacking on the role of partner beliefs about breast cancer, partner perceived consequences of genetic testing, and personality factors such as information processing style, on partner distress.
The high level of behavioural and psychological interdependence that exists between a tested woman and her partner means that future research seeking to understand the coping and adjustment processes of partners needs to adopt a dyadic, transactional approach that is grounded in psychological theory. Specific suggestions for future research in this context are delineated.
对于罹患遗传性乳腺癌和/或卵巢癌风险较高的女性，接受基因检测的过程会引发焦虑和压力，需要做出艰难且复杂的决策。高危女性的伴侣通常被女性视为这个充满挑战的时期的支持来源。本文利用自我调节理论，从理论上综述了现有数据，以阐明伴侣如何对女性的高风险状况做出情绪和行为反应。
进行了广泛的文献检索。在线检索了 MEDLINE、CINAHL 和 PsycINFO 数据库，查阅了所有已确定出版物的参考文献，并在这些出版物中检索了作者的数据库。
系统搜索产生了 10 项关于高危女性及其男性伴侣的研究；一项研究并未将男性伴侣的痛苦作为研究结果的一个因变量进行调查。该文献方法的异质性使得无法对研究结果进行定量荟萃分析。对证据的审查表明，基因检测过程对一些伴侣来说可能是痛苦的，特别是对被认定为基因突变携带者的女性的伴侣。伴侣的痛苦与伴侣对女性感知乳腺癌风险的信念、伴侣感到社会隔离和缺乏夫妻沟通、以及伴侣感到被排除在检测过程之外有关。研究发现，伴侣支持不足与被检测女性在检测时和结果披露后的痛苦增加有关。关于伴侣对乳腺癌的信念、伴侣对基因检测后果的感知以及信息处理风格等人格因素对伴侣痛苦的影响，数据尚不足。
接受检测的女性和其伴侣之间存在着高度的行为和心理相互依存，这意味着未来寻求理解伴侣应对和调整过程的研究需要采用基于心理理论的对偶、交互方法。本文阐述了这方面未来研究的具体建议。
