Skip to main content

Advertisement

Log in

Marital Relationship, Body Image and Psychological Quality of Life among Breast Cancer Patients: The Moderating Role of the Disease’s Phases

  • Original Paper
  • Published:
Contemporary Family Therapy Aims and scope Submit manuscript

Abstract

In this cross-sectional study we analyzed the links between marital quality and intimacy, body image, and psychological quality of life (PQoL) of breast cancer patients, as well as the moderating role of cancer phase (treatment, survivorship) on the aforementioned links. We also evaluated whether body image mediated the associations between marital relationship variables and PQoL. An analysis of the data from 128 patients (66 undergoing treatment, 62 survivors) indicated that the majority of links between variables were significant only during the treatment phase. Mediating effect of body image on the associations between relationship variables and PQoL was found only at the treatment phase.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Aiken, L., & West, S. (1991). Multiple regression: Testing and interpreting interactions. Thousand Oaks: Sage Publications, Inc.

    Google Scholar 

  • Bloom, J., Stewart, S., Chang, S., & Banks, P. (2004). Then and now: Quality of life of young breast cancer survivors. Psycho-Oncology, 13, 147–160.

    Article  PubMed  Google Scholar 

  • Bloom, J., Stewart, S., Johnston, M., Banks, P., & Fobair, P. (2001). Sources of social support and the physical and mental well-being of young women with breast cancer. Social Science and Medicine, 53, 1513–1524.

    Article  PubMed  Google Scholar 

  • Boyes, A., Fletcher, G., & Latner, J. (2007). Male and female body image and dieting in the context of intimate relationships. Journal of Family Psychology, 21(4), 764–768.

    Article  PubMed  Google Scholar 

  • Brennan, J. (2001). Adjustment to cancer—coping or personal transition? Psycho-Oncology, 10, 1–18.

    Article  PubMed  Google Scholar 

  • Broderick, C. (1993). Understanding family process: Basics of family systems theory. Thousand Oaks, CA: Sage Publications, Inc.

    Google Scholar 

  • Browall, M., Ahlberg, K., Karlsson, P., Danielson, E., Persson, L.-O., & Gaston-Johansson, F. (2008). Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women. European Journal of Oncology Nursing, 12, 180–189.

    Article  PubMed  Google Scholar 

  • Burman, B., & Margolin, G. (1992). Analysis of the association between marital relationships and health problems: An interactional perspective. Psychological Bulletin, 112(1), 39–63.

    Article  PubMed  Google Scholar 

  • Carver, C., Pozo-Kaderman, C., Price, A., Noriega, V., Harris, S., Derhagopian, R., et al. (1998). Concern about aspects of body image and adjustment to early stage breast cancer. Psychosomatic Medicine, 60, 168–174.

    PubMed  Google Scholar 

  • Cash, T. (1997). The body image workbook: An 8-step program for learning to like your looks. Oakland, CA: New Harbinger Publications, Inc.

    Google Scholar 

  • Cash, T. (2002). Cognitive-behavioral perspectives on body image. In T. Cash & T. Pruzinsky (Eds.), Body Image: A handbook of theory, research, and clinical practice (pp. 38–46). New York: The Guilford Press.

    Google Scholar 

  • Collins, N. L., & Feeney, B. C. (2004). An attachment theory perspective on closeness and intimacy. In D. J. Mashek & A. Aron (Eds.), Handbook of closeness and intimacy. New Jersey & London: Lawrence Erlbaum.

    Google Scholar 

  • Creamer, M., Burgess, P., & Pattison, P. (1992). Reaction to trauma: A cognitive processing model. Journal of Abnormal Psychology, 101, 452–459.

    Article  PubMed  Google Scholar 

  • Dorval, M., Maunsell, E., Deschênes, L., Brisson, J., & Masse, B. (1998). Long-term quality of life after breast cancer: Comparison of 8-year survivors with population controls. Journal of Clinical Oncology, 16, 487–494.

    PubMed  Google Scholar 

  • Dow, K., Ferrell, B., Leigh, S., Ly, J., & Gulasekaram, P. (1996). An evaluation of the quality of life among long-term survivors of breast cancer. Breast Cancer Research and Treatment, 39, 261–273.

    Article  PubMed  Google Scholar 

  • Ferrell, B. R., Dow, K. H., Leigh, S., Ly, J., & Gulasekaram, P. (1995). Quality of life in long-term cancer survivors. Oncology Nursing Forum, 22(6), 915–922.

    PubMed  Google Scholar 

  • Figueiredo, M., Fries, E., & Ingram, K. (2004). The role of disclosure patterns and unsupportive social interactions in the well-being of breast cancer patients. Psycho-Oncology, 13(2), 96–105.

    Article  PubMed  Google Scholar 

  • Friedman, M., Dixon, A., Brownell, K., Whisman, M., & Wilfle, D. (1999). Marital status, marital satisfaction, and body image dissatisfaction. International Journal of Eating Disorders, 26, 81–85.

    Article  PubMed  Google Scholar 

  • Frost, M., Suman, V., Rummans, T., Dose, A., Taylor, M., Novotny, P., et al. (2000). Physical, psychological and social well-being of women with breast cancer: The influence of disease phase. Psycho-Oncology, 9, 221–231.

    Article  Google Scholar 

  • Giese-Davis, J., Hermanson, K., Koopman, C., Weibel, D., & Spiegel, D. (2000). Quality of couples’ relationship and adjustment to metastatic breast cancer. Journal of Family Psychology, 14, 251–266.

    Article  PubMed  Google Scholar 

  • Greeff, A., & Malherbe, H. (2001). Intimacy and marital satisfaction in spouses. Journal of Sex and Marital Therapy, 27, 247–257.

    Article  PubMed  Google Scholar 

  • Hartl, K., Janni, W., Kastner, R., Sommer, H., Strobl, B., Rack, B., et al. (2003). Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients. Annals of Oncology, 14, 1064–1071.

    Article  PubMed  Google Scholar 

  • Hayes, A. (2009). Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Communication Monographs, 76(4), 408–420.

    Article  Google Scholar 

  • Helgeson, V., & Cohen, S. (1996). Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research. Health Psychology, 15(2), 135–148.

    Article  PubMed  Google Scholar 

  • Hopwood, P., Fletcher, I., Lee, A., & Al Ghazal, S. (2001). A body image scale for use with cancer patients. European Journal of Cancer, 37, 189–197.

    Article  PubMed  Google Scholar 

  • Knobf, M. T. (2007). Psychosocial responses in breast cancer survivors. Seminars in Oncology Nursing, 23(1), 71–83.

    Article  PubMed  Google Scholar 

  • Kornblith, A. (1998). Psychosocial adaptation of cancer survivors. In J. Holland (Ed.), Psycho-oncology (pp. 223–254). New York: Oxford University Press.

    Google Scholar 

  • Lemieux, J., Maunsell, E., & Provencher, L. (2008). Chemotherapy-induced alopecia and effects on quality of life among women with breast cancer: A literature review. Psycho-Oncology, 17(4), 317–328.

    Article  PubMed  Google Scholar 

  • Lepore, S., Ragan, J., & Jones, S. (2000). Talking facilitates cognitive-emotional processes of adaptation to an acute stressor. Journal of Personality and Social Psychology, 78(3), 499–508.

    Article  PubMed  Google Scholar 

  • MacKinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivariate Behavioral Research, 39, 99–128.

    Article  PubMed  Google Scholar 

  • Manne, S. (1994). Couples coping with cancer: Research issues and recent findings. Journal of Clinical Psychology in Medical Settings, 1(4), 317–330.

    Article  Google Scholar 

  • Manne, S., & Badr, H. (2008). Intimacy and relationship processes in couples’ psychosocial adaptation to cancer. Cancer, 112(11 suppl), 2541–2555.

    Article  PubMed  Google Scholar 

  • Manne, S., & Badr, H. (2010). Intimacy processes and psychological distress among couples coping with head and neck or lung cancers. Psycho-Oncology, 19(9), 941–954.

    Article  PubMed  Google Scholar 

  • Manne, S., Badr, H., Zaider, T., Nelson, D., & Kissane, D. (2010). Cancer-related communication, relationship intimacy, and psychological distress among couples coping with localized prostate cancer. Journal of Cancer Survivorship, 4(1), 74–85.

    Article  PubMed  Google Scholar 

  • Manne, S., & Glassman, M. (2000). Perceived control, coping efficacy, and avoidance coping as mediators between spouses’ unsupportive behaviors and cancer patients’ psychological distress. Health Psychology, 19(2), 155–164.

    Article  PubMed  Google Scholar 

  • Manne, S., Ostroff, J., Winkel, G., Fox, K., Grana, G., Miller, E., et al. (2005). Couple-focused group intervention for women with early stage breast cancer. Journal of Consulting and Clinical Psychology, 73(4), 634–645.

    Article  PubMed  Google Scholar 

  • Moreira, H., Amaral, A., & Canavarro, M. C. (2009). Adaptação do personal assessment of intimacy in relationships scale (PAIR) para a população Portuguesa: Estudo das suas características psicométricas. [Adaptation of the personal assessment of intimacy in relationships scale (PAIR) for the Portuguese population: Study of its psychometric properties]. Psychologica, 50, 353–373.

    Google Scholar 

  • Moreira, M., Silva, S., & Canavarro, M. C. (2010a). The role of appearance investment in the adjustment of women with breast cancer. Psycho-Oncology, 19, 959–966.

    Article  PubMed  Google Scholar 

  • Moreira, M., Silva, S., Marques, A., & Canavarro, M. C. (2010b). The Portuguese version of the body image scale (BIS)—psychometric properties in a sample of breast cancer patients. European Journal of Oncology Nursing, 14, 111–118.

    Article  PubMed  Google Scholar 

  • Moyer, A. (1997). Psychosocial outcomes of breast-conserving surgery versus mastectomy: A meta-analytic review. Health Psychology, 16(3), 284–298.

    Article  PubMed  Google Scholar 

  • Moyer, A., & Salovey, P. (1996). Psychosocial sequelae of breast cancer and its treatment. Annals of Behavioral Medicine, 18(2), 110–125.

    Article  Google Scholar 

  • Nosarti, C., Roberts, J., Caryford, T., McKenzie, K., & David, A. (2002). Early psychological adjustment in breast cancer patients: A prospective study. Journal of Psychosomatic Research, 53, 1123–1130.

    Article  PubMed  Google Scholar 

  • O’Mahoney, J., & Carroll, R. (1997). The impact of breast cancer and its treatment on marital functioning. Journal of Clinical Psychology in Medical Settings, 4(4), 397–414.

    Article  Google Scholar 

  • Peuckmann, V., Ekholm, O., Rasmussen, N. K., Moller, S., Groenvold, M., Christiansen, P., et al. (2007). Health-related quality of life in long-term breast cancer survivors: Nationwide survey in Denmark. Breast Cancer Research and Treatment, 104(1), 39–46.

    Article  PubMed  Google Scholar 

  • Pikler, V., & Winterowd, C. (2003). Racial and body image differences in coping for women diagnosed with breast cancer. Health Psychology, 22(6), 632–637.

    Article  PubMed  Google Scholar 

  • Pistrang, N., & Barker, C. (1995). The partner relationship in psychological response to breast cancer. Social Science Medicine, 40(6), 789–797.

    Article  PubMed  Google Scholar 

  • Prager, K. J. (1995). The psychology of intimacy. New York: The Guilford Press.

    Google Scholar 

  • Prager, K. J., & Buhrmester, D. (1998). Intimacy and need fulfillment in couple relationship. Journal of Social and Personal Relationships, 15, 435–469.

    Article  Google Scholar 

  • Preacher, K., & Hayes, A. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36(4), 717–731.

    Article  Google Scholar 

  • Preacher, K., & Hayes, A. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891.

    Article  PubMed  Google Scholar 

  • Reis, H. T., & Patrick, B. (1996). Attachment and intimacy: Component processes. In T. Higgins & A. Kruglanski (Eds.), Social psychology: Handbook of basic principles. New York: The Guilford Press.

    Google Scholar 

  • Reis, H. T., & Shaver, P. (1988). Intimacy as an interpersonal process. In S. Duck (Ed.), Handbook of personal relationships (pp. 367–389). Chichester: Wiley.

    Google Scholar 

  • Rolland, J. (1994). Families, illness, and disability: An integrative treatment model. New York: Basic Books.

    Google Scholar 

  • Schaefer, M., & Olson, D. (1981). Assessing intimacy: The PAIR inventory. Journal of Marital and Family Therapy, 7(1), 47–60.

    Article  Google Scholar 

  • So, W., Marsh, G., Ling, W., Leung, F., Lo, J., Leung, M., et al. (2010). Anxiety, depression and quality of life among Chinese breast cancer patients during adjuvant treatment. European Journal of Oncology Nursing, 14(1), 17–22.

    Article  PubMed  Google Scholar 

  • Tomich, P., & Helgeson, V. (2002). Five years later: A cross-sectional comparison of breast cancer survivors with healthy women. Psycho-Oncology, 11, 154–169.

    Article  PubMed  Google Scholar 

  • Vaz Serra, A., Canavarro, M. C., Simões, M., Pereira, M., Gameiro, S., Quartilho, M., et al. (2006). Estudos psicométricos do instrumento de Avaliação da Qualidade de Vida da Organização Mundial de Saúde (WHOQOL-bref) para Português de Portugal. [Psychometric studies of the World Health Organization Quality of Life Assessment (WHOQOL-Bref) for Portuguese from Portugal]. Psiquiatria Clínica, 27(1), 41–49.

    Google Scholar 

  • Veach, T., Nicholas, D., & Barton, M. (2002). Cancer and the family life cycle: A practitioner’s guide. New York: Brunner-Routledge.

    Google Scholar 

  • White, C. (2000). Body image dimensions and cancer: A heuristic cognitive behavioural model. Psycho-Oncology, 9, 183–192.

    Article  PubMed  Google Scholar 

  • Whoqol-Group. (1998). Development of World Health Organization WHOQOL-bref Quality of Life Assessment. Psychological Medicine, 28, 551–558.

    Article  Google Scholar 

  • Zimmermann, T., Scott, J., & Heinrichs, N. (2010). Individual and dyadic predictors of body image in women with breast cancer. Psycho-Oncology, 19(10), 1061–1068.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Helena Moreira.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Moreira, H., Crespo, C., Paredes, T. et al. Marital Relationship, Body Image and Psychological Quality of Life among Breast Cancer Patients: The Moderating Role of the Disease’s Phases. Contemp Fam Ther 33, 161–178 (2011). https://doi.org/10.1007/s10591-011-9149-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10591-011-9149-3

Keywords

Navigation