Abstract

Abstract Introduction Recent evidence supports bio-psycho-social and non-linear models of sexual functioning. These models expand current understanding of cancer-related sexual health problems to include interpersonal factors such as relationship discord, fear of intimacy, and lack of communication (Bober & Varela, 2012). Sexual satisfaction, defined as “an affective response arising from one’s subjective evaluation of the positive and negative dimensions associated with one’s sexual relationship” (Lawrence & Byers, 1995; p. 268), is regarded as an important metric of sexual health and wellbeing. However, most studies have included only one member of the couple, and little is known about how each partner’s coping may mutually contribute to sexual satisfaction. We examined the reciprocal influence of couples’ coping behaviors on the individual’s and the partner’s sexual satisfaction. Objective The present work describes the relationship between couples’ coping behaviors and satisfaction with sexual relationship among young adult breast cancer patients and partners. Methods A sample of 40 romantic couples receiving care at an NCI-designated comprehensive cancer center completed cross-sectional online surveys. Validated questionnaires of satisfaction with sexual relationship (GMSEX), sexual function (IIEF, FSFI), and couple coping [Dyadic Coping Inventory, (DCI)] were administered. Couple coping includes both partners’ strategies implemented to manage their own and their partners’ distress, as well as shared coping behaviors. Items are organized in multiple subscales: stress communication, supportive, delegate, negative, and common dyadic coping. Stress communication refers to the strategies implemented by the partners to communicate to each other that they are stressed. Supportive dyadic coping occurs when one partner implements problem- and/or emotion-focused coping strategies to support the other person. Delegated dyadic coping occurs when one partner takes over responsibilities to reduce their partner’s stress. Negative dyadic coping includes behaviors that are hostile, ambivalent, and superficial. Common dyadic coping indicates coordinated responses between partners. Descriptive statistics and paired sample t-tests were used to assess differences between partners’ measures. In addition, confirmatory factor analysis (CFA) was used to estimate measurement models using Mplus8, while the pooled regression approach was utilized to estimate the Actor-Partner Interdependence Model (APIM). Results In the present sample, supportive and delegated dyadic coping behaviors contributed to greater sexual satisfaction for both partners, whereas only an actor effect was detected for stress communication, negative, and common dyadic coping. Significant differences were identified between partners, with breast cancer patients reporting higher stress communication (p<.05), partner-reported supportive (p<.05) and delegated coping behaviors (p<.05). Male partners rated higher patients’ engagement in stress communication behaviors (p<.05). In addition, more than one-half of patients screened positive for clinically significant sexual dysfunction (60.6%), compared to 20% of their partners. Conclusions These results provide evidence about the importance of dyadic approaches to investigating sexual satisfaction and functioning post-cancer treatment. Stress communication exerted an individual, rather than mutual, influence on sexual satisfaction of patients and partners. Delegated and supportive dyadic coping styles resulted in reciprocal influence and were associated with the higher sexual satisfaction among dyad members. Additional research is needed to confirm these findings in larger samples of cancer patients and develop effective interventions. Disclosure No

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