Hasdenteufel Marie, Quintard Bruno
LabPsy - Laboratoire de psychologie de l'université de Bordeaux, Unité de recherche EA 4139, Bordeaux, France.
Front Psychol. 2022 Jun 8;13:827947. doi: 10.3389/fpsyg.2022.827947. eCollection 2022.
Cancer diagnosis and treatment represent a real upheaval both for the patient and for his or her life partner. Adjustment to cancer has been widely studied at the individual level, however, there is little in the literature about the experiences of the couple as an entity. This is especially true with regard to a population facing advanced cancer. This systematic review aimed to make an inventory of 1) the current knowledge relating to the experience of the patient-partner dyad when confronted with advanced cancer, and 2) the psychosocial interventions specifically centered on this dyad.
This review was conducted using the Cochrane methodology. The eligibility criteria for the literature review were: one of the members of the dyad being treated for advanced cancer, dyad composed of the patient and his/her life partner. Databases from PubMed, PsycArticle, PsycInfo, Psychology and Behavioral Sciences Collection and Scopus were investigated. A thematic content analysis on the basis of admitted articles made it possible to respond to each of our research objectives.
Three hundred eighty-nine citations were found. Twenty were admitted to the systematic review of the literature. It highlighted the following experiences of the advanced cancer patient-life partner dyad: uncertainty about the future, disjointed time, intrusion into the couple's intimacy, attachment style and caregiving within the couple, couple's adjustment to cancer symptomatology, the couple's supportive care needs, role changes, nature of communication within the couple, anticipation of the coming death, and the meanings and beliefs around death. This review also describes the range of couple therapies used in the context of advanced cancer: emotionally focused-couple therapy, existential therapy, art therapy, support therapy and couple communication and intimacy promotion. These therapies seem to have individual beneficial effects for both the patient and his or her life partner as well as improving marital functioning.
These results clearly highlight that consideration of the couple and communication within the couple during care are fundamental to dyadic adjustment to advanced cancer. Further studies (qualitative and quantitative) are needed to better understand the couple's experience in order to adapt the management of the couple facing advanced cancer.
癌症的诊断和治疗对患者及其生活伴侣来说都是一场巨大的变故。针对个体层面上对癌症的适应情况已有广泛研究，然而，关于夫妻作为一个整体的经历，文献中却鲜有提及。对于面临晚期癌症的人群而言，情况尤其如此。本系统综述旨在梳理以下两方面内容：1）目前有关晚期癌症患者及其伴侣二元组经历的知识；2）专门针对该二元组的心理社会干预措施。
本综述采用Cochrane方法进行。文献综述的纳入标准为：二元组中的一方正在接受晚期癌症治疗，二元组由患者及其生活伴侣组成。对来自PubMed、PsycArticle、PsycInfo、心理学与行为科学文集以及Scopus的数据库进行了检索。基于纳入文章进行的主题内容分析，使我们能够回答每个研究目标。
共检索到389条引用文献。其中20篇被纳入文献的系统综述。该综述突出了晚期癌症患者及其伴侣二元组的以下经历：对未来的不确定性、时间的脱节、对夫妻亲密关系的侵扰、依恋风格与夫妻间的照料、夫妻对癌症症状的适应、夫妻的支持性护理需求、角色变化、夫妻间沟通的性质、对即将到来的死亡的预期，以及围绕死亡的意义和信念。本综述还描述了在晚期癌症背景下所采用的夫妻治疗方法的范围：情感聚焦夫妻治疗、存在主义治疗、艺术治疗、支持性治疗以及夫妻沟通与亲密关系促进。这些治疗方法似乎对患者及其伴侣都有个体层面的有益效果，同时还能改善婚姻功能。
这些结果清楚地表明，在护理过程中考虑夫妻关系以及夫妻间的沟通，对于二元组适应晚期癌症至关重要。需要进一步开展研究（定性和定量研究），以更好地理解夫妻的经历，从而调整针对面临晚期癌症夫妻的管理方式。
