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Item Breast Cancer Survivors' Perceptions of Partners' Intervention Needs(2018) Cohee, Andrea A.; Johns, Shelley A.Breast cancer survivors and their partners report similar levels of fear of recurrence; however, partners are rarely the subject of intervention. Survivors' perceptions for partners' interests and barriers in a survivorship education intervention are discussed.Item Breast cancer survivors’ perceptions of their partners’ interest in cancer-focused psychosocial interventions(LWW, 2021) Cohee, Andrea A.; Krueger, Ellen F.; Vachon, Eric A.; Cottingham, Ann H.; Stutz, Patrick V.; Alwine, Jennifer S.; Johns, Shelley A.Background: Despite that partners of breast cancer survivors (BCS) often experience long-term consequences from the cancer experience, including fear of recurrence and depression, there are rarely psychosocial interventions aimed at mitigating these consequences. Because partners are usually recruited to research studies through BCS, it is important to understand the views of BCS regarding their partners’ involvement in interventions. The aim of this study was to explore perceptions of BCS regarding the advisability of offering a psychosocial intervention to their partners. Methods: BCS (N = 22) enrolled in 1 of 3 interventions (acceptance and commitment therapy [ACT], survivorship education [SE], or enhanced usual care [EUC]) were queried about whether they believed their partner would be interested in a psychosocial intervention similar to what they had just completed and asked to provide their opinions about how a partner intervention should be structured and what it should address. Twenty-two BCS (ACT group [n = 5], SE [n = 11], and EUC [n = 6]) completed the interviews. Results: The participants identified 3 unmet partner needs that they thought could be addressed by a psychosocial intervention: problems with coping, communication breakdowns, and lack of information. They also provided 3 recommendations regarding the development of a partner intervention: the use of a group format, the provision of separate sessions for partners and BCS, and the inclusion of intervention components that provide practical or factual information related to breast cancer. Conclusions: BCS can provide valuable insights that can inform the development of psychosocial interventions for partners of survivors. The development of such partner interventions is critical to address the negative and often hidden health and social effects experienced by partners of BCS.Item The long-term psychosocial impact of breast cancer on young survivors and their partners(2015-03-20) Cohee, Andrea A.; Champion, Victoria L.; Fife, Betsy L.; Von Ah, Diane Marie; Zoppi, Kathleen A.Long-term psychosocial consequences of breast cancer are increasingly more important to study as survivors are living longer. However, the survivors do not experience cancer alone; their significant others often suffer just as much if not more than the survivors themselves. In this dissertation, we explore some long-term consequences of cancer within the context of the Social Cognitive Processing Theory (SCPT). SCPT proposes that an individual must be able to discuss their feelings in order to cognitively process a traumatic event, such as cancer. If discussions are hindered, in particular by a significant other, then one will be unable to work through his/her concerns, leading to poor psychological outcomes, such as depression and fear of recurrence. The purpose of this dissertation is to use SCPT to identify causal mechanisms of depressive symptoms and fear of recurrence using a large sample of young breast cancer survivors and their partners. For one paper, we also included a large set of older participants for comparison. This dissertation is divided into three distinct articles. Each article tests long-term consequences of breast cancer and its treatment on breast cancer survivors and their partners using SCPT to explain relationships. First we examine the hypothesized predictors of younger breast cancer survivors’ depressive symptoms including the partner variable of depressive symptoms. The second article addresses the partners by predicting their depressive symptoms using SCPT. The third and final article seeks to identify the relationship of predictors and FOR on both survivors and their partners again using SCPT. For survivors, structural equation modeling analyses found significant direct and indirect paths between depressive symptoms and theoretical variables, including social constraints (stb=.266, p<.001) and intrusive thoughts (stb=.453, p<.001). In partners, cognitive processing variables (intrusive thoughts and cognitive avoidance) mediated the relationship between social constraints and depressive symptoms (F(5,498)= 19.385, R2=.163, p<.001). And finally, cognitive processing mediated the relationship between social constraints and fear of recurrence both for survivors [F(3,213)= 47.541, R2=.401, p<.001] and partners [F(3,215)= 27.917, R2=.280, p<.001). The evidence from these studies supports the use of SCPT in predicting depressive symptoms and fear of recurrence in both long-term survivors and partners.Item Psychosocial Experiences, Challenges, and Recommendations for Care Delivery among Partners of Breast Cancer Survivors: A Qualitative Study(MDPI, 2023-02-04) Acquati, Chiara; Head, Katharine J.; Rand, Kevin L.; Alwine, Jennifer S.; Short, Danielle Nicole; Cohee, Andrea A.; Champion, Victoria L.; Burke Draucker, Claire; Communication Studies, School of Liberal ArtsFor women diagnosed with breast cancer, partners are consistently identified as the primary support person. Despite growing consensus about the psychosocial experience and unmet needs of cancer caregivers, limited evidence exists about strategies to offer partner-centered care across the cancer continuum. This study describes challenges endured by partners of breast cancer survivors (BCS), strategies implemented to manage these experiences, and recommendations for healthcare providers to inform targeted psychosocial care. Using convenience sampling, 22 partners of female BCS were recruited and completed semi-structured interviews. Conventional content analysis was used to code and synthesize findings. Participants described undergoing five experiences in their role as romantic partners: (a) assuming the role of caregiver, (b) becoming healthcare advocates for BCS, (c) connecting emotionally with the partner, (d) managing their own painful emotions, and (e) connecting with others for support. Experience-specific coping strategies and recommendations were identified. Romantic partners face multiple transitions across the cancer care continuum, which warrant investigation to sustain their well-being and active participation in illness management. Psychosocial interventions for this group will benefit from flexible implementation and attention to care delivery, mental health, and supportive/social needs.Item Quality of Life in Partners of Young and Old Breast Cancer Survivors(Wolters Kluwer, 2018-11) Cohee, Andrea A.; Bigatti, Silvia M.; Shields, Cleveland G.; Johns, Shelley A.; Stump, Timothy; Monahan, Patrick O.; Champion, Victoria L.; School of NursingBackground: Partners of breast cancer survivors experience the effects of a spouse's cancer years after treatment. Partners of younger survivors (YP) may experience greater problems than partners of older survivors (OP), just as younger survivors experience greater problems than their older counterparts. Objectives: To 1) compare quality of life (QoL) in YP and OP, and 2) determine contributing factors to each group's QoL. Methods: Cross-sectional data were collected from YP (n=227) and OP (n=281) through self-report. MANOVA was used to determine differences between YP and OP on QoL while controlling for covariates. Multiple regression analyses were conducted to determine what contributes to each group's QoL. Results: YP reported better physical function (effect size (ES)= -0.57), lower marital satisfaction (ES=0.39), and lower overall QoL (ES=0.43) than partners of older survivors. Predictors of QoL also differed between partner groups. For YP, overall QoL was predicted by greater physical functioning, fewer depressive symptoms, higher marital satisfaction, higher parenting satisfaction, and more personal resources. R2= .47; F(5, 195)= 35.05; p<.001. For OP, overall QoL was predicted by fewer depressive symptoms, higher parenting satisfaction, higher spirituality, and greater social support from the breast cancer survivor spouse. R2= .33; F(4, 244)= 29.80; p<.001. Conclusions: OP reported greater QoL than YP. Common factors contributing to QoL between YP and OP were fewer depressive symptoms and higher parenting satisfaction. Implications for Practice: Partners of breast cancer survivors may need support coping with their spouse’s/partner’s cancer. Partners of younger survivors may require more support than partners of older survivors.Item The Relationship Between Depressive Symptoms and Social Cognitive Processing in Partners of Long-Term Breast Cancer Survivors(Oncology Nursing Society, 2017-01) Cohee, Andrea A.; Adams, Rebecca N.; Fife, Betsy L.; Von Ah, Diane M.; Monahan, Patrick O.; Zoppi, Kathleen A.; Cella, David; Champion, Victoria L.; IU School of NursingPurpose/Objectives: To determine 1) if depressive symptoms in partners of long-term breast cancer survivors (BCS) could be predicted by social cognitive processing theory, and 2) if partners of younger and older breast cancer survivors were differentially affected by the cancer experience. Design: A cross-sectional, descriptive study utilizing self-report questionnaires. Setting: Indiana University and 97 ECOG-ACRIN sites. Sample: Partners of breast cancer survivors (n=508) diagnosed 3-8 years prior. Methods: Secondary data mediation analyses were conducted to determine if cognitive processing mediated the relationship between social constraints and depressive symptoms. Age-related differences on all scales were tested. Main Research Variables: Depressive symptoms; secondary variables included social constraints, cognitive processing (avoidance and intrusive thoughts), and potentially confounding variables. Findings: Cognitive processing mediated the relationship between social constraints and depressive symptoms for partners (F(5,498)= 19.911, R2=.167, p<.001). Partners of young BCS reported worse outcomes on all measures than partners of older breast cancer survivors Conclusions: As predicted by the social cognitive processing theory, cognitive processing mediated the relationship between social constraints and depressive symptoms. Furthermore, partners of younger BCS fared worse on social constraints, intrusive thoughts and depressive symptoms than partners of older BCS. Implications for Nursing: Results provide support for using the social cognitive processing theory in intervention design with partners of long-term BCS to decrease depressive symptoms. Knowledge Translation: • Partners of long-term BCS report clinically significant depression. • Partners of younger BCS report higher levels of depressive symptoms than the national average and than partners of older survivors. • Addressing social constraints within the dyad may improve depressive symptoms.