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应对晚期乳腺癌的夫妻的育儿及家庭问题:探讨围绕育儿挑战及干预目标的讨论

Parenting and Family Concerns of Couples Navigating Advanced Breast Cancer: Exploring Discussions Around Parenting Challenges and Targets for Intervention.

作者信息

Kroll Juliet L, Jones Morgan, Ann-Yi Sujin, Chavez-MacGregor Mariana, Bruera Eduardo, Milbury Kathrin

机构信息

Department of Palliative Care and Rehabilitative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

出版信息

Psychooncology. 2025 Jan;34(1):e70069. doi: 10.1002/pon.70069.

Abstract

BACKGROUND

Parents with advanced cancer and their partners are more likely to experience psychological distress than their counterparts without minor children. Greater relationship functioning may support parents in distress.

AIMS

The current study seeks to explore couples' cancer-related parenting communication behaviors, perception and their associations with psychological and relational wellbeing.

METHODS

Women diagnosed with an advanced breast cancer (Stage III-IV) and their partners (n = 46 dyads) parenting a minor child reported psychological symptoms (CES-D, GAD-7), relational wellbeing (DAS-7) and cancer-related parenting concerns (PCQ, patient only). As part of an observational task, couples completed a Family Concern Inventory (FCI) to identify cancer-related family concerns. Then, each member selected one concern to discuss. Immediately after the discussion, participants rated their perception of the discussion and their state positive and negative affect.

RESULTS

Parents (mean age = 43.4 years, 56% non-Hispanic White, two female couples) endorsed high psychological distress, with patients reporting greater family concerns than partners (t = 3.80, p < 0.001). Both members of the couple indicated high levels of self-disclosure and felt validated and accepted by their partners during the discussion. Yet, patients rated the discussion as more helpful than partners (t = 2.3, p = 0.03). There was a small reduction in positive affect following discussion for partners only. However, the more partners disclosed their emotions, the greater their post-discussion positive affect (r = 0.50, p < 0.001).

CONCLUSIONS

Couples' ability to openly communicate around cancer-related parenting concerns is associated with aspects of psychological adjustment. Findings identify targets and underscore importance of flexibility for future interventions.

摘要

背景

与没有未成年子女的父母相比,患有晚期癌症的父母及其伴侣更有可能经历心理困扰。更好的关系功能可能会支持处于困境中的父母。

目的

本研究旨在探讨夫妻与癌症相关的育儿沟通行为、认知及其与心理和关系幸福感的关联。

方法

被诊断患有晚期乳腺癌(III-IV期)的女性及其伴侣(n = 46对)育有未成年子女,他们报告了心理症状(CES-D、GAD-7)、关系幸福感(DAS-7)以及与癌症相关的育儿担忧(PCQ,仅患者)。作为一项观察任务的一部分,夫妻完成了一份家庭担忧清单(FCI)以识别与癌症相关的家庭担忧。然后,每个成员选择一个担忧进行讨论。讨论结束后,参与者对他们对讨论的认知以及他们的积极和消极情绪状态进行评分。

结果

父母(平均年龄 = 43.4岁,56%为非西班牙裔白人,两对女性夫妻)认可高度的心理困扰,患者报告的家庭担忧比伴侣更多(t = 3.80,p < 0.001)。夫妻双方都表示自我表露程度很高,并且在讨论期间感到被伴侣认可和接受。然而,患者对讨论的评价比伴侣更高(t = 2.3,p = 0.03)。仅伴侣在讨论后积极情绪有小幅下降。然而,伴侣表露的情绪越多,他们讨论后的积极情绪就越高(r = 0.50,p < 0.001)。

结论

夫妻围绕与癌症相关的育儿担忧进行公开沟通的能力与心理调适的各个方面相关。研究结果确定了目标,并强调了未来干预灵活性的重要性。

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