Partner Perspectives Research Articles

The Partner Perspective on Autologous and Implant-Based Breast Reconstruction.

Partner involvement in the decision-making process concerning breast reconstruction (BR) after a breast cancer diagnosis may be very supportive for the patient. So far, no study evaluates partner satisfaction with the outcome after BR and the relationship to patient satisfaction. The aim of this study was to assess and compare partner satisfaction of BR with autologous tissue (ABR) and prosthetic implants (IBR), respectively, and compare it to patient-reported outcomes. All patients undergoing ABR and IBR between January 2014 and December 2020 were asked to participate with their partners. Patient and partner satisfaction with breast reconstruction, overall outcome as well as patient's perceived and self-reported psychosocial well-being were evaluated using the Breast-Q and a modified partner questionnaire, respectively. Fifty-three couples participated (IBR: n=30, ABR: n = 23). Patient and partner satisfaction with breast (r = 0.552), outcome (r = 0.465) as well as patient's perceived and self-report psychosocial well-being (r = 0.495) were highly correlated with partners scoring significantly higher (p<0.001). In terms of partner satisfaction, both reconstructive procedures achieved satisfactory results. ABR scored higher in terms of softness of breast and how natural the breast feels to touch whereas IBR was rated superior evaluating the breast size. Both reconstructive procedures achieve satisfactory results in terms partner satisfaction whereas patient's psychosocial well-being was highly overestimated by their partners. Hence, partner inclusion in the regular psycho-oncological support might further sensitize them of the high psychological burden of a breast cancer diagnosis and therefore stabilize patients private support system. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Pregnant women and male partner perspectives of secondary distribution of HIV self-testing kits in Uganda: A qualitative study.

HIV self-testing (HIVST) is a promising strategy to increase awareness of HIV status among sub-Saharan African (SSA) men. Understanding user perspectives on HIVST secondary distribution from pregnant women attending antenatal care (ANC) to their male partners is crucial to optimizing delivery strategies. We sampled pregnant women attending ANC without their partners and purposively oversampled pregnant women living with HIV (PWHIV) to understand their unique views. We recruited male partners after obtaining contact information from women. We conducted 14 focus group discussions and 10 in-depth interviews with men and pregnant women. We assessed acceptability of HIVST secondary distribution, barriers, facilitators, and interventions to increase HIVST uptake. Participants felt that HIVST secondary distribution was acceptable, particularly for women in stable relationships. However, many expressed concerns about accusations of mistrust, relationship dissolution, fear of discovering serodifference, and lack of counseling associated with HIVST. PWHIV reported hesitation about secondary distribution, citing fears of unintended HIV status disclosure and abandonment resulting in financial hardship for themselves and their infant. Some participants preferred that providers contact men directly to offer HIVST kits instead of distribution via women. Participants reported that community sensitization, availability of phone-based counseling, male clinic staff, extended clinic hours, and financial incentives could increase men's HIVST use and linkage to care. Participants expressed high interest in using HIVST, but secondary distribution was not universally preferred. We identified potential strategies to increase HIVST acceptability, particularly among PWHIV and those in unstable partnerships which can inform strategies to optimize HIVST distribution.

Under “my way or the highway”! The weaker partner's synergy on collaborative performance in humanitarian relief when experiencing power tactics

PurposeMy way or the highway: A stronger partner in humanitarian relief collaboration often seeks control over its weaker partners by leveraging diverse power tactics that may be non-coercive or coercive in nature. In this backdrop, this research accentuates the perspective of weaker partners to understand how a weaker partner drives collaborative synergy under power tactics. Weaker partner in the collaborative dyad resembles the humanitarian organization (HO) who is less capable in terms of access to resources. This partner is further dependent on the stronger HO's directives to participate in the relief work.Design/methodology/approachBased on social exchange theory (SET), a collaborative dyad in humanitarian relief work is visualized from the perspectives of power and power disparity. In terms of power, mediated power tactics such as legal, coercive and reward powers are considered. Disparity recognizes the presence of a stronger and a weaker partner. Set also magnifies the insight on conflict and trust that can respectively hamper and improve the synergy between partners. In total, 295 executives representing self-reported weaker HOs are surveyed.FindingsLegal power, as experienced by the weaker partner, bears a positive impact over collaborative performance to improve collaborative synergy. Coercive power shows a negative impact. Reward power again bears a positive impact. Coercion can complicate collaborative synergy by establishing conflicts. Yet, the trust of weaker partner on stronger HO positively moderates the negative impact of conflict over collaborative performance.Originality/valueThis research invokes the view of power disparity to explain synergy in inter-organizational collaboration from the perspective of weaker partners.

Do service-users find the outcome of Mild Cognitive Impairment useful? A summary of Blatchford &amp; Cook’s (2020) systematic review

Mild Cognitive Impairment (MCI) is a common outcome following assessment of suspected dementia. However, it is unclear whether service-users perceive that being made aware is beneficial. The term itself is nebulous in terms of prognostic certainty and its utility for guiding interventions. This article summarises the systematic review conducted by Blatchford and Cook (2020) exploring research focused on service-users experiences of receiving the outcome of MCI and the impact of this upon them and their care partners. Service-user and care partner perspectives were shaped by the quality of information and support provided, and several factors shaped their experiences of being informed, including: personal perceptions and experiences, coping styles and living circumstance. The results suggested that clear information and quality support, tailored to service-user needs may improve the utility of the MCI outcome for service-users. The summary concludes by providing suggestions for enhancing service provision.

Beyond the ‘usual suspects’? Engaging children in diverse communities in co-producing an arboretum-meadow: Professional partner perspectives

Nature-based solutions (NBS) can mitigate the challenges of climate change, biodiversity loss and mental wellbeing prioritised by the global Sustainable Development Goals (SDGs). The advantages of co-producing NBS with local communities have been explored, yet there is a lack of understanding of professional partners’ priorities in relation to specific projects, and their perceptions of the opportunities and challenges encountered during the co-productive process. The benefits of co-producing NBS with children are not understood, particularly in deprived, diverse communities. We addressed these gaps by conducting in-depth, semi-structured interviews with eight professional partners in contrasting roles involved in the co-production of an educational arboretum-meadow on a redundant mini-golf site in Wardown Park, within the High Town ward of Luton, Bedfordshire, UK. Here there is considerable ethnic diversity with 41% residents White British, and 59% other ethnicities. There are significant Black and Minority Ethnic communities (38%). A high percentage of households live with overcrowding (24%) and 31% year six children are obese. All partners prioritised connecting children to nature. The social benefits of the project were prioritised over ecological and climate-related ones. Most participants perceived diverse partner expertise and priorities as an opportunity of co-production. Covid-19 was considered a significant challenge and an opportunity. Our research provides insight into the potential for co-production of NBS in a relatively deprived, ethnically diverse context to contribute to “futureproofing” towns and cities by fostering nature connection amongst children, whilst providing a novel, creative approach to managing and maintaining GI under austerity. Learning from this project has international transferability as a ‘flagship project’ illustrating how the global Sustainable Development Goals (SDGs) can be addressed at the local level.

Advancing rapid cycle research in cancer care delivery: a National Cancer Institute workshop report.

Generating actionable research findings quickly and efficiently is critical for improving the delivery of cancer-related care and outcomes. To address this issue, the National Cancer Institute convened subject matter experts, researchers, clinicians, and patients for a 2-day virtual meeting in February 2022. The purpose of this meeting was to identify how rapid cycle interventional research methods can be used to generate findings useful in improving routine clinical practice. The meeting yielded an initial conceptualization of rapid cycle interventional research as being comprised of 6 key elements: use of iterative study designs; reliance on proximal primary outcomes; early and continued engagement with community and clinical partners; use of existing data sources to measure primary outcomes; facilitative features of the study setting and context; and consideration of appropriate rigor relative to intended use of findings. The meeting also identified the types of study designs that can be leveraged to conduct rapid cycle interventional research and provided examples of these; considered this approach from the perspective of key partners; described the clinical and data infrastructure, research resources, and key collaborations needed to support this work; identified research topics best addressed using this approach; and considered needed methodological advances. The National Cancer Institute is committed to exploring opportunities to encourage further development and application of this research approach as a means for better promoting improvements in the delivery of cancer-related care.

Musical coordination affects children's perspective-taking, but musical synchrony does not.

Perspective-taking, which is important for communication and social activities, can be cultivated through joint actions, including musical activities in children. We examined how rhythmic activities requiring coordination affect perspective-taking in a referential communication task with 100 Chinese 4- to 6-year-old children. In Study 1, 5- to 6-year-old children played an instrument with a virtual partner in one of three coordination conditions: synchrony, asynchrony, and antiphase synchrony. Eye movements were then monitored with the partner giving instructions to identify a shape referent which included a pre-nominal scalar adjective (e.g., big cubic block). When the target contrast (a small cubic block) was in the shared ground and a competitor contrast was occluded for the partner, participants who used perspective differences could, in principle, identify the intended referent before the shape was named. We hypothesized that asynchronous and antiphase synchronous musical activities, which require self-other distinction, might have stronger effects on perspective-taking than synchronous activity. Children in the asynchrony and antiphase synchrony conditions, but not the synchrony condition, showed anticipatory looks at the target, demonstrating real-time use of the partner's perspective. Study 2 was conducted to determine if asynchrony and antiphase asynchrony resulted in perspective-taking that otherwise would not have been observed, or if synchronous coordination inhibited perspective-taking that would otherwise have occurred. We found no evidence for online perspective-taking in 4- to 6-year-old children without music manipulation. Therefore, playing instruments asynchronously or in alternation, but not synchronously, increases perspective-taking in children of this age, likely by training self-other distinction and control. A video abstract of this article can be viewed at https://youtu.be/TM9h_GpFlsA. RESEARCH HIGHLIGHTS: This study is the first to show that rhythmic coordination, a form of non-linguistic interaction, can affect children's performance in a subsequent linguistic task. Eye-movement data revealed that children's perspective-taking in language processing was facilitated by prior asynchronous and antiphase synchronous musical interactions, but not by synchronous coordination. The results challenge the common "similar is better" view, suggesting that maintaining self-other distinction may benefit social interactions that involve representing individual differences.

Nasilje nad muškarcima u partnerskom odnosu - pilot studija

Violence in the family has been a frequently discussed topic in the scientific discourse in the last two decades. Thanks to this, today, we have at our disposal a significant body of scientific knowledge, legislative solutions, and practical policies that focus on preventing and protecting victims of violence. However, we do not notice some among the victims of domestic violence. Hereof, our knowledge about the etiology and phenomenology of violence against men is insufficient. Our study represents a small step forward in researching the phenomenology of this phenomenon. We aimed to describe characteristics of violence against men through personal stories and from the perspective of both partners. We used documentary material in the analysis - official records of centers for social work in the territory of the city of Belgrade. Analysis showed that violence against men in a partner relationship is most often recognized by the center's professional workers as mutual. The prosecution of the abuser, except in the case of her partner's life being threatened, is rarely the outcome of the assessment process. The impression is that partner violence against men is seen as an exception rather than the rule. However, the victimization of men in a partner relationship is not such a rare phenomenon, so it is necessary to undertake a research effort to shed light on this dark field and to design prevention strategies and practices aimed at protecting men - victims and helping women - bullies.

Caregiving and Friendship

Friendship is an essential component of quality of life. The ongoing lifestyle changes and strain typically experienced by care partners of people with aphasia (PWA) can impact their social network, with friendships being particularly vulnerable to change. This study aimed to understand the impact of caregiving on care partners' friendships over time from the perspective of care partners of PWA. An online survey addressing care partners' demographics, care recipients' demographics, and care partners' perceptions of their friendships over time (before caregiving and during the acute and chronic stages of caregiving) was codesigned with three care partner stakeholders and then distributed to other individuals who care for a person with aphasia. Survey responses from 35 care partners of PWA who completed the survey were analyzed using quantitative and qualitative methods. Most participants reported their friendships were different in both the acute and chronic stages of caregiving compared with before caregiving. Overall, perceived friendship satisfaction and support decreased over time. Qualitative analysis revealed five main factors that could either facilitate or hinder care partner friendships, including role changes, personal characteristics, friendship initiation, friendship interactions, and outside influences. This work highlights that caring for a loved one with aphasia negatively impacts friendships for many care partners, and these friendship changes are often long-lasting. More resources for managing the impact of aphasia on care partners' social lives are needed, which, in turn, might improve the friendships and well-being of both the care partner and their loved one with aphasia.

Medical Journey of Patients with Mild Cognitive Impairment and Mild Alzheimer's Disease Dementia: A Cross-sectional Survey of Patients, Care Partners, and Neurologists.

Alzheimer's disease (AD) is a progressive, neurodegenerative disease presenting along a continuum ranging from asymptomatic disease to mild cognitive impairment (MCI), followed by dementia characterized as mild, moderate, or severe. To better understand the medical journey of patients with all-cause MCI or mild AD dementia from the perspective of patients, care partners, and physicians. Cross-sectional study. Online surveys in the United States between February 4, 2021, and March 1, 2021. 103 patients with all-cause MCI or mild AD dementia and 150 care partners participated in this survey. 301 physicians (75 of whom were neurologists) completed a survey. The surveys included questions regarding attitudes, experiences, and behaviors related to diagnosis and management of MCI and mild AD dementia. For the patient and care partner surveys, questions regarding healthcare received for MCI and mild AD dementia were only asked of care partners. Most patients (73%) had a similar medical journey. The majority (64%) initially consulted a primary care physician on average 15 months after symptom onset, with symptoms primarily consisting of forgetfulness and short-term memory loss. About half (51%) of patients in the typical medical journey were diagnosed by a neurologist. Upon diagnosis, most neurologists reported having discussions with patients and care partners about the potential causes of MCI or mild AD dementia (83%); of these physicians, 83% explained the effect other conditions have on the risk of the diagnoses and symptom progression. Neurologists (52%) consider themselves the coordinator of care for patients with MCI or mild AD dementia. Amongst patients and care partners, about one-third (35%) perceive the neurologists to be the coordinating physician. Neurologists commonly diagnose MCI and mild AD dementia but are typically not the first point of contact in the medical journey, and patients do not consult with a physician for over a year after symptom onset. Neurologists play a key role in the medical journey for patients and care partners, and could help ensure earlier diagnosis and treatment, and improve clinical outcomes by coordinating MCI and mild AD dementia care and collaborating with primary care physicians.

"I know my body better than anyone else": a qualitative study of perspectives of people with lived experience on antimicrobial treatment decisions for injection drug use-associated infections.

People who inject drugs (PWID) are at risk for severe bacterial and fungal infections including skin and soft tissue infections, endocarditis, and osteomyelitis. PWID have high rates of self-directed discharge and are often not offered outpatient antimicrobial therapies, despite studies showing their efficacy and safety in PWID. This study fills a gap in knowledge of patient and community partner perspectives on treatment and discharge decision making for injection drug use (IDU)-associated infections. We conducted semi-structured interviews with patients (n = 10) hospitalized with IDU-associated infections and community partners (n = 6) in the Portland, Maine region. Community partners include peer support workers at syringe services programs (SSPs) and outreach specialists working with PWID. We transcribed and thematically analyzed interviews to explore perspectives on three domains: perspectives on long-term hospitalization, outpatient treatment options, and patient involvement in decision making. Participants noted that stigma and inadequate pain management created poor hospitalization experiences that contributed to self-directed discharge. On the other hand, patients reported hospitalization provided opportunities to connect to substance use disorder (SUD) treatment and protect them from outside substance use triggers. Many patients expressed interest in outpatient antimicrobial treatment options conditional upon perceived efficacy of the treatment, perceived ability to complete treatment, and available resources and social support. Finally, both patients and community partners emphasized the importance of autonomy and inclusion in medical decision making. Although some participants acknowledged their SUD, withdrawal symptoms, or undertreated pain might interfere with decision making, they felt these medical conditions were not justification for health care professionals withholding treatment options. They recommended open communication to build trust and reduce harms. Patients with IDU-associated infections desire autonomy, respect, and patient-centered care from healthcare workers, and may self-discharge when needs or preferences are not met. Involving patients in treatment decisions and offering outpatient antimicrobial options may result in better outcomes. However, patient involvement in decision making may be complicated by many contextual factors unique to each patient, suggesting a need for shared decision making to meet the needs of hospitalized patients with IDU-associated infections.

Инструменты разработки стратегии организации

The article discusses the tools that are used to develop and implement strategies of organizations operating in various sectors of the economy. A balanced scorecard, which includes a strategic map and a table of activities, acts as a key tool for developing an organization's strategy. The strategic map defines the required number of prospects, goals and indicators to measure the level of achievement of goals, and the table already describes the current and target values, activities and results. Together with a balanced scorecard, it is advisable to use the methodology «goals and key results» in order to describe the intermediate results that will allow achieving the goals.&#x0D; The authors show that when developing strategic maps, it is possible to take into account ESG transformation or the specifics of work in ecosystems. To the four basic perspectives (finance, customers, business processes, training and development), an environmental perspective can be added, taking into account environmental factors in the ESG transformation concept. You can also use the perspective of partners, in the case of considering a business in the ecosystem format.&#x0D; As alternatives to a balanced scorecard, the article considers: the efficiency pyramid of K. McNair, R. Lynch and K. Cross, with which you can describe the strategy of the organization, defining financial indicators, non–financial indicators, as well as actions that take into account the external and internal environment of the organization; the EP2M model, L. Meisel's strategic maps, the prism of efficiency, taking into account 5 perspectives of the organization – satisfaction of stakeholders, strategy, processes, opportunities, as well as contribution interested parties.&#x0D; The article concludes that in order to develop a strategy, it is advisable to use the integration of the analyzed tools, depending on the scope of activity, the type of strategy, and the principles of development.

The impact of venture capital funds with foreign limited partners investment on enterprise internationalization: evidence from China

This paper examines the relationship between local venture capital (VC) funds and portfolio enterprise internationalization from the perspective of limited partners (LPs). Based on a sample consist of 581 listed enterprises invested by local VC funds in China during 2009–2021, it’s found that, compared to the VC funds invested by local LPs completely (LLP_VC), the VC funds with foreign LP investment (FLP_VC) are more likely to help portfolio enterprises list overseas. If FLP_VC syndicates or act as a major investor, it will have a greater role in promoting the internationalization of enterprises.

Toward Optimal Emotional Care During the Experience of Miscarriage: An Integrative Review of the Perspectives of Women, Partners, and Health Care Providers.

Miscarriage is frequently associated with significant emotional impact, causing psychological distress, trauma, and grief. Unfortunately, women and partners frequently report dissatisfaction with care around miscarriage, and health care providers report feeling ill-prepared and underequipped to provide emotional support. This integrative review synthesizes the individual perspectives of the woman experiencing the miscarriage, the partner, and the different health care provider roles involved in the care to better understand what future research is necessary to improve the experiences of bereaved parents and their health care providers. Electronic databases were searched for studies that covered emotional care around miscarriage from the perspective of women, partners, or health care providers. The review included studies published in English between 2015 and 2022, using either quantitative or qualitative methods. Thematic analysis was carried out, and conclusions from these articles were integrated into themes and subthemes. A total of 60 studies met the inclusion criteria. Two main themes were identified for women: (1) a need for more information and (2) a need for acknowledgment of their loss. Two main themes were likewise identified for partners: (1) a need for more information and (2) a need for recognition. Three main themes were identified for health care providers: (1) a need for additional training, (2) components of quality care, and (3) perceived barriers to providing care. There is broad overlap in the needs identified by bereaved parents and their health care providers, as well as general agreement regarding the barriers to providing effective care. Five areas of future research priority were identified to understand how best to meet these needs: empirical evaluation of strategies to meet identified needs, investigation of setting-specific needs, integrated consideration of all relevant roles, investigation of the care needs of diverse groups, and an investigation of the predictors of emotional impact.

Perceived listening ability and hearing loss: Systematic review and qualitative meta-synthesis

Hearing loss (HL) can affect communication in complex ways. Understanding how adults with HL reflect on and conceptualise the way they listen (metacognition) is required if interventions, and the outcome measures used to evaluate them, are to address barriers to functional communication arising from HL. This study describes how adults with HL experience and report the processes, behaviours, and components of listening, as presented in published studies. Systematic review and meta-synthesis of qualitative studies. Systematic searches identified English-language, peer-reviewed journal articles reporting the results of qualitative or mixed-methods studies of adults' with HL perceived listening abilities. Medline, PsychInfo, Web of Science, Embase, and Google Scholar were searched from inception to November 2021. Handsearching reference lists of included studies identified additional studies for inclusion. The Critical Appraisal Skills Programme (CASP) qualitative checklist was used to appraise studies' methodological quality. Data from included studies were analysed using thematic meta-synthesis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Confidence in the Evidence from Reviews of QUALitative (CERQual) approach assessed confidence in the review findings. Two reviewers independently completed all screening and quality appraisal. Thematic meta-synthesis and GRADE CERQual assessment was completed by one reviewer and confirmed by a second reviewer. Discrepancies were resolved through discussion. Data from 46 studies were included in the review. Thematic meta-synthesis identified six descriptive themes: 1) perceived listening ability; 2) external modifiers; 3) psychosocial impacts of hearing loss; 4) communication partner perspectives; 5) self-efficacy for listening; and 6) cognitive load. GRADE CERQual ratings for descriptive themes ranged from low to moderate confidence. Descriptive themes were related by analytic themes of liminality and reciprocity. Adults with HL provide in-depth accounts of components and processes of listening, with studies reporting both cognitive and affective experiences consistent with theoretical models of metacognition. The findings will inform content generation for a hearing-specific patient-reported outcome measure of perceived listening ability in everyday communication.

Development and Validation of the Flexibility in Partner Perspectives Scale

Development and Validation of the Flexibility in Partner Perspectives Scale

Unmet Sexual Health Needs of Patients and Female Partners Following Diagnosis and Treatment for Prostate Cancer

BackgroundProstate cancer (PCa) and its treatment can have significant and pervasive sexual side effects for patients and their partners; however, partner needs are not well understood, and most resources do not incorporate partner priorities. AimOur objective was to perform a qualitative study to identify unmet sexual needs of patients and female partners after PCa diagnosis. MethodsWe conducted a qualitative study of posts to the Inspire Us TOO Prostate Cancer Online Support and Discussion Community. Overall, 6,193 posts were identified in the Sexual Health & Intimacy forum of the community, of which 661 posts were from female authors. A random sample of 10% (n = 66) of posts from female partners and an equal number of randomly selected posts from male patients were analyzed. OutcomesWe assessed sexual health themes among patients and female partners. ResultsMultiple themes emerged that were unique to female partners of PCa survivors. These included expanding the sexual repertoire, feeling invisible, contextualizing sexual intimacy within the broader picture of survival, and addressing relationship concerns. Patients and their partners also shared common sexual health themes, including coming to terms with changes in sexual function and frustration with clinicians. Both patients and their partners use online health communities to get support and share their experiences with sexual recovery and use of sexual aids. Psychosocial treatments were infrequently mentioned, and may be particularly helpful to address partner concerns. Clinical ImplicationsA common concern for couples was not receiving sufficient information from healthcare providers regarding sexual side effects from PCa and its treatment. Strengths and LimitationsStrengths of the study include leveraging a unique data source to address an understudied topic of sexual health concerns among partners after PCa diagnosis. However, members of an online community may not be representative of all couples facing PCa. Also, this analysis is limited to female partners of patients with PCa, and further study is underway to examine the sexual health needs among gay and bisexual couples. ConclusionBoth patients and female partners have many unmet sexual health needs during PCa survivorship, and designing interventions to incorporate partner perspectives may improve the management of sexual side effects of PCa for couples.Li R, Wittmann D, Nelson CJ, et al. Unmet Sexual Health Needs of Patients and Female Partners Following Diagnosis and Treatment for Prostate Cancer. J Sex Med 2022;19:1797–1803.

More than one way to say I love you: An Internet-based intervention for training flexible thinking in romantic relationships.

This study developed and pilot-tested an adaptation of Cognitive Bias Modification (CBM) to target two aspects of relational flexibility in couples: the ability to generate alternative perspectives, and the ability to respond nondefensively when alternative partner perspectives are raised within challenging relationship situations (referred to as flexibility in partner perspectives). CBM-FlexC training materials were developed in Phase 1, and expert users (N = 4) and end-point users (N = 7) provided qualitative feedback. Feasibility and preliminary efficacy of CBM-FlexC were evaluated in Phase 2, using an online sample of distressed couples (N = 18). Using a multiple baseline design, participants completed three baseline assessments, six CBM-FlexC sessions over 2 weeks, and a 1-month follow-up. CBM-FlexC training resulted in greater flexibility in partner perspectives, relationship satisfaction, and general psychological flexibility compared to baseline, and improvements were maintained 1-month after training when using mixed-effects models. However, analyses of reliable change (based on graphical inspection and the Reliable Change Index) indicated that most participants did not experience reliable improvement in flexibility in partner perspectives, or relationship satisfaction. This pilot study provides some positive signals regarding the potential efficacy of CBM-FlexC, while pointing to the need for further development to strengthen its effects.

Social ecological influences on treatment decision-making in men diagnosed with low risk, localised prostate cancer.

Individuals diagnosed with low risk, localised prostate cancer (PCa) face a difficult decision between active surveillance (AS) and definitive treatment. We aimed to explore perceived influences on treatment decision-making from the patient and partner's perspectives. Patients (and partners) who met AS criteria and had chosen their treatment were recruited. Semi-structured individual interviews were conducted via telephone to explore experiences of diagnosis, impact on patient lifestyle, experiences with physicians, treatment preferences/choice, treatment information understanding and needs, and overall decision-making process. Interviews were audio recorded, transcribed verbatim, and analysed using Reflexive Thematic Analysis. Twenty-four male patients (18 chose AS) and 12 female partners participated. Five themes relating to social-ecological influences on treatment choice were identified: (1) partner support and direct influence on patient treatment choice, (2) patient and partner vicarious experiences may influence treatment decisions, (3) the influence of the patient's life circumstances, (4) disclosing to wider social networks: friends, family, and co-workers, and (5) the importance of a good relationship and experience with physicians. Additionally, two themes were identified relating to information patients and partners received about the treatment options during their decision-making process. A range of individual and social influences on treatment decision-making were reported. Physicians providing treatment recommendations should consider and discuss the patient and partner's existing beliefs and treatment preferences and encourage shared decision-making. Further research on treatment decision-making of partnered and non-partnered PCa patients is required. We recommend research considers social ecological factors across the personal, interpersonal, community, and policy levels.

The neurosurgical marriage: evaluating the interplay of work life and home life from the perspective of partners of neurosurgical residents.

Burnout and work-life balance have been noted to be problems for residents across all fields of medicine, including neurosurgery. No studies to date have evaluated how these factors may contribute to issues outside of the hospital, specifically residents' home lives. This study aimed to evaluate the interplay between home life and work life of neurosurgical residents, specifically from the point of view of residents' significant others. Online surveys were distributed to the significant others of neurosurgical residents at 12 US neurosurgery residencies. Residents' partners were asked about relationship dynamics, their views on neurosurgery residency (work-life balance and burnout), and their views of neurosurgery as a career. The majority of residents' significant others (84%) reported being satisfied with their relationship. Significant others who reported dissatisfaction with their relationship were more likely to report frustration with work-life balance and more likely to report their resident partner as having higher levels of burnout. From the perspective of neurosurgery residents' significant others, higher perceived levels of burnout and lower satisfaction with work-life balance are correlated with lower levels of relationship satisfaction. These findings speak to the complex interplay of work life and home life and can be used to inform future interventions into improving the quality of life for both the resident and the significant other.