Skip to main content

Advertisement

SpringerLink
Log in

Anxiety in caregiving partners of breast cancer patients

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The aim of the present study was to determine the levels of anxiety of partners of breast cancer patients and to evaluate the differences of anxiety levels between patients and partners according to the stage of treatment, age and education level.

Methods

57 spouses or domestic partners of breast cancer patients and 148 breast cancer patients participated in this prospective cohort study and filled out the questionnaires including the Spielberger state-trait-anxiety-inventory, as well as questions based on stress-triggering procedures during breast cancer diagnosis and therapy.

Results

State anxiety levels of partners were highest in partners who accompanied their patients when presenting for examinations and operations and tumorboard decisions (Mean State-Scores 52, 45 and 46.5). Anxiety scores were lowest at the stage of ongoing chemotherapy or follow-up. The 25% quartile of partners with the highest state anxiety levels had a significantly higher educational level (p = 0.023). Young men aged 18–35 years showed the highest levels of both trait and state anxiety. Partners showed significantly higher levels of anxiety than the patients for anesthetic complications (p < 0.001), e.g., fear of not waking up from general anesthetic and postoperative pain (p < 0.001). Patients showed significantly higher levels of anxiety for hairloss (p < 0.001), weight gain during chemotherapy (p < 0.001) and postoperative scars (p = 0.027).

Conclusion

Breast cancer patients are much more concerned about body image issues than their male partners. As these body image-associated concerns often arise from the fear of loosing attraction to their partner, these fears might be reduced by speaking about them openly. Partners are mostly concerned about surgery and anesthetic-related complications. Therefore, preoperative medical information to the partner is mandatory. Partners of breast cancer patients should be included in psycho-oncological support and medical briefings. Probably high anxiety levels of both partners and patients should be taken into account (due to younger age, lower educational level and procedures causing distress). These partners and patients should receive extra careful (clarification) counselling and (treatment support such as a psycho-oncologist) involvement of a psyco-oncologist.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. RKI (2015) Krebs in Deutschland 2011–2012. Robert Koch Institute 10

  2. Segrin C et al (2007) Interdependent anxiety and psychological distress in women with breast cancer and their partners. Psychooncology 16(7):634–643

    Article  PubMed  Google Scholar 

  3. Wagner JF, Lüdders D, Hoellen F, Rody A, Banz-Jansen C (2019) Treatment anxiety in breast cancer patients. Arch Gynecol Obstet 299(5):1365–1371

    Article  PubMed  Google Scholar 

  4. Borstelmann NA et al (2015) Partner support and anxiety in young women with breast cancer. Psychooncology 24(12):1679–1685

    Article  PubMed  Google Scholar 

  5. Northouse LL (1995) The impact of cancer in women on the family. Cancer Pract 3(3):134–142

    CAS  PubMed  Google Scholar 

  6. Northouse LL, Dorris G, Charron-Moore C (1995) Factors affecting couples' adjustment to recurrent breast cancer. Soc Sci Med 41(1):69–76

    Article  CAS  PubMed  Google Scholar 

  7. Moreira H, Canavarro MC (2013) Psychosocial adjustment and marital intimacy among partners of patients with breast cancer: a comparison study with partners of healthy women. J Psychosoc Oncol 31(3):282–304

    Article  PubMed  Google Scholar 

  8. Jaafar NRN, Dim SHS, Saini S, Ahmad SN, Midin M, Sidi H, Silim UA, Baharudin A (2014) Clinical depression while caring for loved ones with breast cancer. Compr Psychiatry 55(Suppl 1):52–59

    Article  Google Scholar 

  9. Arora NK et al (2001) Impact of surgery and chemotherapy on the quality of life of younger women with breast carcinoma: a prospective study. Cancer 92(5):1288–1298

    Article  CAS  PubMed  Google Scholar 

  10. Baucom DH et al (2005) Psychosocial issues confronting young women with breast cancer. Breast Dis 23:103–113

    Article  PubMed  Google Scholar 

  11. Spielberger CD, Gorsuch RL, Lushene RE (1970) STAI manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo Alto

    Google Scholar 

  12. Laux L, Schaffner GP, Spielberger CD (1981) Das State-Trait-Angstinventar Theoretische Grundlagen und Handanweisung. Beltz Test GmbH, Weinheim

    Google Scholar 

  13. Julian LJ (2011) Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res Hoboken 63(Suppl 11):S467–S472

    Article  PubMed  Google Scholar 

  14. Cd S (1983) Manual for the State-Trait Anxiety Scale. Consulting Psychologists, Palo Alto

    Google Scholar 

  15. Campbell-Enns H, Woodgate R (2015) The psychosocial experiences of women with breast cancer across the lifespan: a systematic review protocol. JBI Database System Rev Implement Rep 13(1):112–121

    Article  PubMed  Google Scholar 

  16. Maunder RG et al (2006) The relationship of attachment insecurity to subjective stress and autonomic function during standardized acute stress in healthy adults. J Psychosom Res 60(3):283–290

    Article  PubMed  Google Scholar 

  17. Mikulincer M, Shaver PR (2007) Attachment, group-related processes, and psychotherapy. Int J Group Psychother 57(2):233–245

    Article  PubMed  Google Scholar 

  18. Favez N et al (2017) Attachment and couple satisfaction as predictors of expressed emotion in women facing breast cancer and their partners in the immediate post-surgery period. Br J Health Psychol 22(1):169–185

    Article  PubMed  Google Scholar 

  19. Tacon AM (2003) Attachment experiences in women with breast cancer. Fam Community Health 26(2):147–156

    Article  PubMed  Google Scholar 

  20. Neel C et al (2015) Determinants of death anxiety in patients with advanced cancer. BMJ Support Palliat Care 5(4):373–380

    Article  PubMed  Google Scholar 

  21. Hüppe M, Uhlig T, Heinze J, Vogelsang H, Schmucker P (2000) Management and methodological approaches for the assessment of emotional states in anesthesiology. Anasthesiol Intensivmed Notfallmed Schmerzther 35(1):3–11

    Article  PubMed  Google Scholar 

  22. Osborne RH, Elsworth GR, Hopper JL (2003) Age-specific norms and determinants of anxiety and depression in 731 women with breast cancer recruited through a population-based cancer registry. Eur J Cancer 39(6):755–762

    Article  CAS  PubMed  Google Scholar 

  23. Van Esch L et al (2011) Trait anxiety predicts disease-specific health status in early-stage breast cancer patients. Qual Life Res 20(6):865–873

    Article  PubMed  PubMed Central  Google Scholar 

  24. Galloway SK et al (2012) Depression and anxiety symptoms relate to distinct components of pain experience among patients with breast cancer. Pain Res Treat 2012:851276

    PubMed  PubMed Central  Google Scholar 

  25. Zimmermann T et al (2011) Fear of progression in partners of chronically ill patients. Behav Med 37(3):95–104

    Article  PubMed  Google Scholar 

  26. Janz NK et al (2016) Worry about recurrence in a multi-ethnic population of breast cancer survivors and their partners. Support Care Cancer 24(11):4669–4678

    Article  PubMed  Google Scholar 

  27. Fiorentino L et al (2011) The symptom cluster of sleep, fatigue and depressive symptoms in breast cancer patients: severity of the problem and treatment options. Drug Discov Today Dis Models 8(4):167–173

    Article  PubMed  PubMed Central  Google Scholar 

  28. Shelke AR et al (2008) Effect of a nausea expectancy manipulation on chemotherapy-induced nausea: a university of Rochester cancer center community clinical oncology program study. J Pain Symptom Manage 35(4):381–387

    Article  PubMed  PubMed Central  Google Scholar 

  29. Pierrisnard C et al (2018) Body image and psychological distress in women with breast cancer: a French online survey on patients' perceptions and expectations. Breast Cancer 25(3):303–308

    Article  PubMed  Google Scholar 

  30. Gilbert E, Ussher JM, Hawkins Y (2009) Accounts of disruptions to sexuality following cancer: the perspective of informal carers who are partners of a person with cancer. Health Lond 13(5):523–541

    Article  Google Scholar 

  31. Vitale SG et al (2016) Comment on: "The consequences of gynaecological cancer in patients and their partners from the sexual and psychological perspective". Prz Menopauzalny 15(3):186–187

    PubMed  PubMed Central  Google Scholar 

  32. Carneiro MM et al (2018) Motherhood after breast cancer: can we balance fertility preservation and cancer treatment? A narrative review of the literature. JBRA Assist Reprod 22(3):244–252

    PubMed  PubMed Central  Google Scholar 

  33. Klafta JM, Roizen MF (1996) Current understanding of patients' attitudes toward and preparation for anesthesia: a review. Anesth Analg 83(6):1314–1321

    CAS  PubMed  Google Scholar 

  34. Belleau FP, Hagan L, Masse B (2001) Effects of an educational intervention on the anxiety of women awaiting mastectomies. Can Oncol Nurs J 11(4):172–180

    Article  CAS  PubMed  Google Scholar 

  35. Goldzweig G et al (2009) Gender and psychological distress among middle- and older-aged colorectal cancer patients and their spouses: an unexpected outcome. Crit Rev Oncol Hematol 70(1):71–82

    Article  PubMed  Google Scholar 

  36. Grunfeld E et al (2004) Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ 170(12):1795–1801

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Author notes

  1. Friederike Hoellen and Julian Frederik Wagner contributed equally.

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Luebeck, 23538, Lübeck, Germany

    Friederike Hoellen & Achim Rody

  2. Department of Cardiac Surgery, University Innsbruck, 6020, Innsbruck, Austria

    Julian Frederik Wagner

  3. Department of Gynecology and Obstetrics, Medical Campus Carl Von Ossietzky University Oldenburg, 26133, Oldenburg, Germany

    Dörte W. Lüdders

  4. Department of Gynecology and Obstetrics, Evangelisches Klinikum Bethel, 33617, Bielefeld, Germany

    Constanze Banz-Jansen

Authors
  1. Friederike Hoellen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julian Frederik Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dörte W. Lüdders
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Achim Rody
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Constanze Banz-Jansen
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Constanze Banz-Jansen: Protocol/project development, Data collection or management, Data analysis. Julian Frederik Wagner: Protocol/project development, Data collection or management, Data analysis, Manuscript writing/editing. Friederike Hoellen: Manuscript writing/editing, Data analysis. Achim Rody: Protocol/project development, Manuscript writing/editing. Dörte Lüdders: Protocol/project development, Manuscript writing/editing.

Corresponding author

Correspondence to Friederike Hoellen.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hoellen, F., Wagner, J.F., Lüdders, D.W. et al. Anxiety in caregiving partners of breast cancer patients. Arch Gynecol Obstet 300, 993–1005 (2019). https://doi.org/10.1007/s00404-019-05253-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-019-05253-2

Keywords

Search

Navigation