| Objective:The status quo of disease communication among young and middle-aged women with breast cancer and their spouses in the breast surgery department of a third grade A hospital in Shanxi Province was investigated and its influencing factors were analyzed.Through qualitative research,we further explored the experience of spouses of breast cancer patients on cancer-related communication,and deeply analyzed the influencing factors of cancer-related communication from the perspective of spouses,so as to provide a new reference for spouses or families of clinical female breast cancer patients to develop marital intervention programs and improve spouse cancer care.Methods:The first part is the quantitative study: 278 patients with breast cancer from June2021 to October 2022 in a grade-A hospital in Shanxi Province were investigated using the patient general information questionnaire,the patient part of the Cancer-Related Communication Problem Scale and M.D.Anderson Symptom Inventory.278 male spouses of female breast cancer patients were investigated by means of spouse general information questionnaire,spouse component of Cancer-Related Communication Problem Scale,Dyadic Coping Inventory,Locke-Wallace Short Marital Adjustment and Prediction Test and Cancer Self-Efficacy Scale-Spouse Cancer.SPSS26.0 software was used for statistical analysis of the data,and one-way analysis of variance,Pearson correlation analysis and stepwise linear regression analysis were used for statistical description.The second part is qualitative research: On the basis of quantitative research,the spouses of 15 breast cancer patients with good communication(CRCP≤15)and poor communication(CRCP≥23)were selected by objective sampling to conduct semi-structured interviews about their disease communication experience.Results:Part I Quantitative research: From the perspective of young and middle-aged breast cancer patients,the score of cancer-related communication was(14.37±2.19),and the entries were all(0.96±0.15).The total score of symptom group was(52.47±5.98),and the total score of item was(4.04±0.46).The communication score of the spouse’s disease was(15.66±2.27),both items were(1.04±0.15),and the total score of binary coping was(87.23±12.03),both items were(2.36±0.33).The total score of marital satisfaction was(91.97±7.90),and the entries were(6.13±0.53).The total score of self-efficacy was(119.36±10.33),and the entries were all(6.28±0.54).The results of univariate analysis showed that there were statistically significant differences in the scores of disease communication between husband and wife in three variables of cancer stage,treatment plan and disease duration of breast cancer patients(all P<0.05).There were statistically significant differences in the scores of disease communication level between husband and wife in six variables including spouse’s age,caregiving type,marriage age,health status,cumulative caregiving duration and per capita monthly family income(all P<0.05).Pearson correlation analysis showed that spouses’ disease communication was negatively correlated with duality coping,marital satisfaction and self-efficacy(all P<0.05),and positively correlated with patients’ disease symptom groups(P<0.01).Stepple-multiple linear regression analysis showed that marital age,self-efficacy,duality coping,per capita monthly family income and patient symptom group were the factors affecting disease communication among spouses of young and middle-aged breast cancer patients,accounting for 48.2% of the total variation.Part II Qualitative research: Through the interview of the influencing factors of disease communication among the spouses of young and middle-aged breast cancer patients,a total of 3 themes and 11 subthemes were obtained.They were the attitude towards disease communication(lack of communication initiative,avoidance of sensitive topics,lack of emotional communication),the factors that promote disease communication(optimistic attitude,social support,cumulative care time,extroversion)and the factors that hinder disease communication(patient symptom burden,patient psychological burden,care ability limitation,economic burden).Conclusion:The cancer-related communication of young and middle-aged breast cancer patients is at a mild level,and the cancer-related communication of spouses is at a medium high level,indicating that there is a greater degree of communication problems between the spouses of breast cancer patients,and the cancer-related communication from the perspective of spouses needs to attract more attention.Clinical attention should be paid to couples with short marriage age,low self-efficacy,low dual coping level,low per capita monthly income in the family and serious symptoms.Spouses and couples can be developed as a starting point for self-efficacy and dual coping to improve the communication between couples. |
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