Male Caregivers of Patients With Breast and Gynecologic Cancer

Experiences From Caring for Their Spouses and Partners

Violeta Lopez, PhD, RN, FRCNA; Gina Copp, PhD, RN; Alexander Molassiotis, PhD, RN

Disclosures

Cancer Nurs. 2012;35(6):402-410. 

In This Article

Discussion

Given the trend toward shorter hospital stays and moving care to the community, the burden of responsibility for caregivers of cancer patients has increased.[34] In our study, the main experiences of male caregivers appeared to support this trend. Caring for their wives/partners impacted on several aspects of the male caregivers' daily life. Interestingly, our findings showed that these were time related and are no different from previous studies.[1,3] The physical impact of caring for someone with a disease such as cancer has been well documented in the general literature.[5,6] The findings in our study were solely from male caregivers and were relevant in understanding the specific needs and support they require. Like other groups of caregivers, caring for a spouse with cancer appeared not to be any different particularly when it relates to the impact of caregiving on the psychosocial aspects of life.[35] The majority of the male caregivers in our study reported difficulties in finding support for themselves compounded further by limiting social contacts following their wives/partners' diagnoses. This finding is significant in terms of using limited resources more effectively by directly targeting the provision of care and support in a more specific way.

Most of the caregivers went to the extent of changing their lifestyle in order to support their wives/partners through the journey, but at the same time the male caregivers also expressed their own need for support in times of difficulty. In particular, most of the male caregivers found it difficult to express their concerns to other people especially to another male friend. This is something that has not been extensively addressed in the current literature. Although studies have shown that male caregivers have lower distress levels from caregiving than female caregivers,[11,16,17] this was through questionnaires that do not consider the difficulties that men may have in fully expressing their emotions. Also, as shown in our data, it is not clear if this is really the case or whether male caregivers, in general, tend not to express distress openly,[36] as our study did not compare male caregivers with female caregivers. In our study, male caregivers assumed traditionally female roles for which they may not have previous experience of performing. Our results concurred with Calasanti and King's study,[37] where they found that men dealt with problems that arose in their care work in congruent with their masculinity as being the stronger person in the relationship, minimizing disruptions, focusing on tasks, and keeping their own stress to themselves. However, our study population was only small, and the limited literature on male experiences of caregiving makes this area an urgent focus of future research.

Marital intimacy is seen as important in a crisis situation such as when one partner is diagnosed with cancer. Caregivers took it upon themselves to care and protect their partners throughout this illness. This finding appeared to come naturally because of an implied obligation as male caregivers provided both instrumental and emotional support to their loved ones. In the study of Sherman et al[35] of breast cancer patient-partner dyads, it was found that partners had lower psychological well-being and had more problems with social and domestic adjustment. In the construction and management of caregiving, our study showed that although caregivers experience physical and psychological problems, they tend to focus more on caring and protecting the wife/partner by instilling positive thoughts, working together, and putting them first before themselves. The caring and protecting roles concur with Morgan's[38] dyadic strategies of coping by active engagement and protective buffering in a partner-patient relationship in cancer care.

Implications for Practice

Where there are difficulties with caregiving or where the caregiver finds the caregiving experience distressing, it is recommended that appropriate strategies be implemented to help alleviate this burden. Psychological interventions such as couple-based training used by Scott et al[39] and Baucom et al[40] in women with early-stage breast and gynecologic cancer and their partners should be implemented to enhance couples' supportive relationship, reduce psychological distress and coping effort, and improve sexual adjustment. Our study showed that without adequate provision of information, caregivers and their partners attempted to seek information elsewhere and tried alternative treatments to control symptoms and adverse effects of the treatment. Therefore, clear, understandable, and timely information about the disease, care, and caring tasks should be provided to the patients and their caregivers.

Limitations of the Study

This study has limitations, and results should be interpreted with caution. First, the sample size is small, and experiences of caregivers did not focus on 1 specific gynecologic cancer. Second, the experiences of wives/partners of the male caregivers were not explored in this study; therefore, further research is necessary to compare their experiences as well as to explore the effects of intimate partner relationship on each other and coping with cancer. Also, this study was part of a larger program of research; the interview guide was not focused exclusively to male caregivers and was not gender-specific, and hence, these results should be seen as hypothesis generating, needing further clarification. The stage of the disease in the patients may play a significant role in the experience of caregiving over time, but in this study, staging information was not obtained, which should be a consideration in future studies.

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