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

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.