Lack of Communication
The data give no indication that men deal with cancer by discussing fears of death and dependency with their wives. Instead they express a desire to put the cancer behind them, “to be done with the disease.” The men presented themselves as having adjusted to the disease with a self-identity that is unchanged by prostate cancer. Their lack of communication about emotions received little challenge from their wives. Moreover, the wives collaborated in that they hid their own fears and despair instead of pursuing spousal communication about emotions. Thus, protective buffering is the prevalent coping style by both spouses, confirming the findings of earlier research that spouses’ coping styles and emotions are interrelated.7,19,20
This is problematic for 2 reasons. Earlier research indicates that there is an inverse relationship between protective buffering and marital satisfaction, as well as a strong positive association between protective buffering and patient and spouse distress.7 The couples with metastatic prostate cancer claim that there is little change in their mates. They overwhelmingly portray themselves as happy and content with their marital relationship. Contrary to this depiction, references to moodiness and the emergence of jealousy point to strains on the marital relationship. Also, lack of communication leads to uncertainty about their spouse’s feelings and thoughts, another potential strain on the marital relationship. Although our study does not entail an assessment of men’s and wives individual or joint adjustment to prostate cancer, we certainly find evidence of the risk factors for poor adjustment which previous studies indicate: lack of communicating and protective buffering. Also, losing or abandoning one’s sex life, as in our sample, is a significant change that most likely has a strong association with psychological well-being, as found in earlier studies.21 This appears to suggest that the couples with metastatic prostate cancer may be at risk for distress and poor adjustment.
Conclusions
These insights into couples’ coping styles are of special relevance to physicians who care for men with prostate cancer. Generally, physicians are open to married men involving their wives in the management of prostate cancer. However, our findings raise questions about how involved wives really are. Although women are interested in their husbands’ prostate cancer, the lack of communication within the couple suggests that their active involvement may be less than is commonly assumed. Care providers may positively influence patients’ adaptation and quality of life by facilitating involvement by the patient’s wife, rather than assume that her presence alone signals active involvement. Also, physicians can suspect that patients who choose to go through treatment by themselves may be at risk for poor adjustment to their diagnosis.
Related Resources
- National Prostate Cancer Coalition http://www.4npcc.org/Advocates.htm/
- US TOO, International http://www.ustoo.com/
- Online Decision Support for Prostate Cancer http://www.cancerfacts.com/
· Acknowledgments ·
Support for our research was provided by US Army Medical Research and Materiel Command, Fort Detrick, Maryland, grant number DAMD17-99-1-9052, Principle Investigator, Dr Boehmer. The data collection was supported by the Department of Veterans Affairs Health Services Research and Development Service grant SDR-93-007.