Canzona Mollie Rose, Fisher Carla L, Garcia David S, Dong Thrandia, Ledford Christy J W
Department of Communication, Wake Forest University, Department Social Sciences & Health Policy, Wake Forest School of Medicine, Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC, USA.
College of Journalism and Communications, University of Florida, UF Health Cancer Center, Gainesville, Florida, USA.
J Psychosoc Oncol. 2023;41(2):166-181. doi: 10.1080/07347332.2022.2068397. Epub 2022 May 19.
Breast cancer survivors' (BCSs') sexual health (SH) clinical conversations are rarely studied from a dyadic perspective let alone from a triadic perspective. Using a triadic approach, we evaluated BCSs' comfort discussing SH with partners present and identified factors that can contribute to their comfort level.
Qualitative approach using in-depth interviews.
93 BCSs, partners, and providers involved in BCS care.
In-depth interviews with BCSs, partners, and providers explored triadic perspectives to understand factors informing BCSs' comfort level. Thematic analysis was used to analyze data.
Four themes characterize potential benefits of partner presence: 1) partner facilitates information exchange, 2) partner realizes BCS's SH concerns are "a real thing," 3) partner better understands SH challenges, and 4) partner presence encourages relational communication about SH. Five themes illustrate potential complications of partner presence: 1) partner feels/becomes embarrassed, 2) partner is/becomes defensive, 3) partner presence constrains BCS's agency in clinical conversations, 4) partner presence threatens partner's view of BCS as a sexual being, and 5) partner presence increases partner burden.
Providers should (1) initiate conversations about BCS comfort with partner presence, (2) be aware of the interaction between BCS primary and secondary goals, (3) consider how BCS/partner goal conflicts obstruct BCS agency and sexual/relational health, and (4) offer opportunities to clarify goals and expectations, and coordinate therapeutic options.
乳腺癌幸存者（BCS）的性健康（SH）临床对话很少从二元视角进行研究，更不用说从三元视角了。我们采用三元方法，评估了BCS在伴侣在场时讨论SH的舒适度，并确定了可能影响其舒适度的因素。
采用深入访谈的定性方法。
93名参与BCS护理的BCS、伴侣和提供者。
对BCS、伴侣和提供者进行深入访谈，探讨三元视角，以了解影响BCS舒适度的因素。采用主题分析法对数据进行分析。
伴侣在场的潜在益处有四个主题：1）伴侣促进信息交流；2）伴侣认识到BCS的性健康问题是“真实存在的”；3）伴侣更好地理解性健康挑战；4）伴侣在场鼓励关于性健康的关系沟通。伴侣在场的潜在并发症有五个主题：1）伴侣感到/变得尴尬；2）伴侣变得/具有防御性；3）伴侣在场限制了BCS在临床对话中的自主性；4）伴侣在场威胁到伴侣将BCS视为有性需求者的看法；5）伴侣在场增加了伴侣的负担。
提供者应（1）开启关于BCS在伴侣在场时舒适度的对话；（2）意识到BCS主要和次要目标之间的相互作用；（3）考虑BCS/伴侣目标冲突如何阻碍BCS的自主性以及性/关系健康；（4）提供机会澄清目标和期望，并协调治疗方案。
