The Influence of Husbands' or Male Partners' Support on Women's Psychosocial Adjustment to Having an Ostomy Resulting From Colorectal Cancer

OBJECTIVESome patients with colorectal cancer (CRC) require a permanent ostomy, which changes bodily function and can create psychosocial distress. However, little is known about the influence of men's support on women's psychosocial adjustment to having an ostomy as a result of CRC. METHODSParticipants initially completed the City of Hope-CRC Quality of Life questionnaire. We then conducted in-depth interviews with 30 female participants. Interview questions focused on body image, gender, and sexuality. Interviews were recorded and transcribed. We used qualitative methods to analyze the interview data and compared global health-related quality of life (HRQOL) quartile scores to the overall ways that women discussed husbands' or partners' support regarding psychosocial adjustments to having ostomies. RESULTSOf 30 participants, 22 were married or partnered at the time of surgery and 8 were single. The nonpartnered respondents are not included in this analysis. Of the 22 married/partnered women, 17 described positive support from husbands being central to their psychosocial adjustment, 3 described a lack or withdrawal of support negatively affecting adjustment, and 2 described support as neither positive nor negative. In 17 cases, women's high or low quantitative HRQOL scores matched the positive or negative qualitative findings. There were 3 cases in which there were positive qualitative data and low HRQOL scores, but in each of these cases, women reported serious current comorbidities. CONCLUSIONSThese findings suggest that the provision or withdrawal of husbands' or partners' support can have a considerable impact on the psychosocial adjustment of female CRC patients with ostomies. These findings appear to be both short term and long term. Survivorship assessments should include appraisals of women's relationships to their spouses/partners.

[1]  M. Hornbrook,et al.  The Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors Study: objectives, methods and patient sample , 2008, Current medical research and opinion.

[2]  T. Nichols,et al.  The Impact of Stabilizing Forces on Postsurgical Recovery in Ostomy Patients , 2008, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[3]  M. Hornbrook,et al.  The greatest challenges reported by long-term colorectal cancer survivors with stomas. , 2008, The journal of supportive oncology.

[4]  D. V. Nelson,et al.  Husbands' perceptions of wives' adjustment to breast cancer: the impact on wives' mood , 2008, Psycho-oncology.

[5]  J. Gralow,et al.  Helping Her Heal: a pilot study of an educational counseling intervention for spouses of women with breast cancer , 2008, Psycho-oncology.

[6]  David C. Smith,et al.  Randomized clinical trial of a family intervention for prostate cancer patients and their spouses , 2007, Cancer.

[7]  J. Ostroff,et al.  Social-cognitive processes as moderators of a couple-focused group intervention for women with early stage breast cancer. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[8]  B. Ferrell,et al.  Quality of life outcomes in 599 cancer and non-cancer patients with colostomies. , 2007, The Journal of surgical research.

[9]  L. Manderson Boundary breaches: the body, sex and sexuality after stoma surgery. , 2005, Social science & medicine.

[10]  T. Kershaw,et al.  Effects of a family intervention on the quality of life of women with recurrent breast cancer and their family caregivers , 2005, Psycho-oncology.

[11]  B. Ferrell,et al.  Revision and Psychometric Testing of the City of Hope Quality of Life–Ostomy Questionnaire , 2004, Quality of Life Research.

[12]  N. Aaronson,et al.  Quality of life in colorectal cancer , 1995, Diseases of the colon and rectum.

[13]  U. Ofman,et al.  Sexual dysfunction in cancer patients , 1992, Current opinion in oncology.

[14]  A. Vernava,et al.  Preservation of urine voiding and sexual function after rectal cancer surgery , 1991, Diseases of the colon and rectum.

[15]  K. Grunberg Sexual rehabilitation of the cancer patient undergoing ostomy surgery , 1986, Journal of enterostomal therapy.

[16]  J. Holland,et al.  Psychosocial sequelae of ostomies in cancer patients , 1985, CA: a cancer journal for clinicians.

[17]  R. Schwarzer,et al.  Emotional support for men and women with cancer: Do patients receive what their partners provide? , 2007, International journal of behavioral medicine.

[18]  T. Templin,et al.  Couples' patterns of adjustment to colon cancer. , 2000, Social science & medicine.

[19]  L. Northouse,et al.  The concerns of patients and spouses after the diagnosis of colon cancer: a qualitative analysis. , 1999, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[20]  B. Borwell The psychosexual needs of stoma patients. , 1997, Professional nurse.

[21]  C. Thomas,et al.  Psychological effects of stomas--I. Psychosocial morbidity one year after surgery. , 1987, Journal of psychosomatic research.