Kelly M Shaffer1,2, Erin Kennedy3,4, Jillian V Glazer5, Anita H Clayton6, Wendy Cohn3,4, Jennifer Barsky Reese7, Trish A Millard3,8, Karen S Ingersoll3,6, Lee M Ritterband3,6, Shayna Showalter3,9. 1. Comprehensive Cancer Center, University of Virginia Health System, Charlottesville, VA, USA. kshaffer@virginia.edu. 2. Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA. kshaffer@virginia.edu. 3. Comprehensive Cancer Center, University of Virginia Health System, Charlottesville, VA, USA. 4. Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA. 5. Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, USA. 6. Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA. 7. Fox Chase Cancer Center, Cancer Prevention and Control Program, Philadelphia, PA, USA. 8. Medicine - Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, VA, USA. 9. Surgery - Surgical Oncology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Abstract
PURPOSE: Ensuring there are clear standards for addressing cancer-related sexual side effects is important. Currently, there are differences in two leading sets of clinical guidelines regarding the inclusion of survivors' romantic partners into clinical discussions between survivors and their providers about this issue. To help refine guidelines, we examine breast cancer survivor, partner, and oncology provider perspectives about including partners in discussions about cancer-related sexual side effects in a secondary analysis of a broader qualitative study. METHODS: Partnered female breast cancer survivors (N = 29) completed online surveys, and intimate partners of breast cancer survivors (N = 12) and breast oncology providers (N = 8) completed semi-structured interviews. Themes were derived from thematic content analysis. RESULTS: Among survivors who reported a discussion with their provider, fewer than half indicated their partner had been present, despite most survivors expressing it was - or would have been - helpful to include their partner. Partners also largely indicated being included was or would have been helpful, when welcomed by the survivor. Providers similarly emphasized the importance of survivors' autonomy in deciding whether to discuss sexual concerns in the presence of a partner. CONCLUSIONS: Partners were infrequently included in conversations about cancer-related sexual side effects, even though survivors, partners, and providers alike expressed value in these discussions occurring with the couple together - when that is the survivor's preference. Findings suggest future clinical guidelines should emphasize that incorporating partners into clinical discussions about sexual concerns is important for many breast cancer patients. Soliciting and enacting patients' preferences is essential for truly patient-centered care.
PURPOSE: Ensuring there are clear standards for addressing cancer-related sexual side effects is important. Currently, there are differences in two leading sets of clinical guidelines regarding the inclusion of survivors' romantic partners into clinical discussions between survivors and their providers about this issue. To help refine guidelines, we examine breast cancer survivor, partner, and oncology provider perspectives about including partners in discussions about cancer-related sexual side effects in a secondary analysis of a broader qualitative study. METHODS: Partnered female breast cancer survivors (N = 29) completed online surveys, and intimate partners of breast cancer survivors (N = 12) and breast oncology providers (N = 8) completed semi-structured interviews. Themes were derived from thematic content analysis. RESULTS: Among survivors who reported a discussion with their provider, fewer than half indicated their partner had been present, despite most survivors expressing it was - or would have been - helpful to include their partner. Partners also largely indicated being included was or would have been helpful, when welcomed by the survivor. Providers similarly emphasized the importance of survivors' autonomy in deciding whether to discuss sexual concerns in the presence of a partner. CONCLUSIONS: Partners were infrequently included in conversations about cancer-related sexual side effects, even though survivors, partners, and providers alike expressed value in these discussions occurring with the couple together - when that is the survivor's preference. Findings suggest future clinical guidelines should emphasize that incorporating partners into clinical discussions about sexual concerns is important for many breast cancer patients. Soliciting and enacting patients' preferences is essential for truly patient-centered care.
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