Women with Breast Cancer and their Spouses Experiences, from their Partner Unsupportive Behavior: A Mixed Methods Study

Abstract

ABSTRACT: Introduction: Unsupportive responses from relatives, particularly spouses, play a significant role in the psychological adjustment of breast cancer patients and their spouses. Failure to meet the physical and psychological needs of breast cancer patients and their spouses can lead to anxiety, depression, and numerous marital problems. The aim of this study was designed to describe perceived spouse unsupportive behaviors in women with breast cancer and their spouses. Methods: The present study is a combined study with an explanatory approach. The first part was a quantitative study that was conducted in the educational and medical centers of Shahid Ghazi Tabatabai and Shahid Madani in Tabriz. In the first part, a cross-sectional study was conducted to determine the unsupportive behaviors of women with breast cancer and their spouses and related factors. In the second part, a qualitative study was conducted to explain the experiences of women with breast cancer and their spouses from uvsupportive behaviors. In a quantitative section, 220 couples of women with breast cancer and their spouses were included in the study through random sampling. In order to collect quantitative data, a checklist of demographic-social characteristics and a questionnaire of unsupportive behaviors of the spouse were used. The method of data collection was face-to-face interviews. Due to the normality of the data and the median (quarters 25 to 75) in the case of abnormal data were used with minimum and maximum scores. In the inferential section, Pearson correlation test was used to examine the relationship between unsupportive behaviors of spouses and women themselves due to the normality of the data. Due to the normal distribution of unsupportive behaviors (using skewness and elongation indices and Kolmogorov-Smirnov test P> 0.05), men and women, mean index and standard deviation were used for summarization. ANOVA analysis of variance and t-test of two independent samples were used to distribute unsupported behaviors by demographic characteristics. Differences between male and female unsupportive behaviors were used to determine. To control for potentially confounding variables, linear and multiple regression were used to determine the relationship between male and female unsupportive behaviors with demographic information. Data were analyzed in statistical software (IBM SPSS software version 24; SPSS, Chicago, IL). The significance level of the tests will be considered 0.05. In the qualitative phase, the experiences of women with breast cancer from unprotected behaviors of their spouses were explained from the perspective of 9 women with breast cancer and 6 cases of patients' spouses. Data were collected using in-depth individual interviews and note-taking using purposive sampling method and analyzed using Van Mannen phenomenology. Results: The mean and standard deviation of the age of the participants in the present study were 45.65 ± 9.802 in women and 51.21 ± 10.703 in men. The age range was 27 to 83 years for women and 28 to 85 years for men. Also, the highest percentage of participants 113 (51.4) had 1 or 2 children and the highest percentage of participants 211 (95.9) lived with a spouse. The higher income of the participants 135 (61.4) is not enough for the treatments at all. The participation of housewives (92.7) was 204 and in free men (33.6) was 74 and the maximum duration of marriage was between 20 and 30 years (35.5) 78. The most type of surgery performed on mastectomy patients was 119 (54.1) and the highest percentage of chemotherapy patients received 125.8 (56.8). Were located. The mean of perceived unsupportive behaviors in women and spouses is equal to 20.73 (8.44) and 18.80 (5.83) and the confidence interval of unsupported behaviors of women and spouses is 19.61-19.85 and 47.47, respectively. It was 17.79-19. Also, the average perceived unsupported behavior of women was higher than the average perceived unsupported behavior of men, which was statistically significant (P = 0.003). On the other hand, considering the cut-off point of 2.5 (middle) For each item and cut point 32.5 for the total items, the mean (standard error) was (0.03) (0.69), t-test was 2.95 and the degree of freedom was 438 (P = 0.003). It was equal to (10/10) 22 and (3.6) 8, respectively. Also, the results of Chi-square test (after confirming the blind and independent conditions and randomness of the samples) showed that there is a statistically significant difference between the perceived non-supportive behavior of women and spouses (P = 0.008). Predictors of perceived non-supportive behaviors in women include the number of children, living in relatives' homes, male education, male occupation, single referral, type of treatment received, duration of diagnosis, place of residence, and status of laundry. Predictors in perceived unsupportive behaviors of men include male and female education, male occupation, female employment, type of treatment received. Analysis of qualitative data related to the experiences of women with breast cancer and their husbands led to the formation of 5 main themes in women and 2 main themes in their husbands, including: financial exhaustion, emotional poverty and disintegration of cohabitation, loss of existential value as a Wife, partner violence, positive spouse role model of supportive behavior of medical staff; In women and in patients's spouses Was: coldness and freezing of women, laundry, partner violence. Conclusion: Women perceive their spouses behaviors as less supportive than their spouses perceptions of women's behavior, which indicates the need for the spouses to pay more attention to the impact of his behavior on his wife. It can be said that couples who are not willing to talk to each other about the problem also understand less support from each other. Also, men and women do not think alike in understanding the needs of their patient partner. Male caregivers usually understand their spouse less. Therefore, health professionals should pay more attention and help men to cope with this disease and endure the suffering of their wives. Women should also support each other and understand their feelings at all stages of the illness. Based on this information, part of the negative reactions of patients' spouses due to unexpected big problems and lack of necessary support resources is necessary.