Couples’ experiences after cancer treatment: a systematic review and qualitative study
Background: The incidence of cancer is increasing alongside a fall in mortality rates. This has resulted in a growing number of cancer survivors overall, including for colorectal (bowel) cancer. For healthcare services to effectively support recovery and adjustment for survivors and their caregivers, there is a need to develop an understanding of couples’ experiences after treatment. Objectives: The systematic review aimed to identify qualitative research on partners' experiences of cancer care-giving after treatment, and to synthesise findings on partners’ psychological adjustment. The primary qualitative study aimed to explore couples' experiences of colorectal cancer services from the perspectives of patients and their partners, focusing on the transition period after treatment. Methods: For the systematic review, 10 qualitative studies were purposefully sampled to focus on partners’ psychological adjustment post-treatment. Findings from these studies were analysed and synthesised using the Framework approach. For the empirical study, semi-structured interviews were conducted separately with a purposeful sample of 10 participants, comprising five patient-partner dyads. Data were analysed using the Framework approach, incorporating dyadic analysis to compare narratives within and between couples. Results: The synthesis highlighted the importance of considering the patient-caregiver relationship across the cancer trajectory and within the wider context. Specific barriers and facilitators of partners’ adjustment related to communication and cohesion, transitions and gradual changes, as well as healthcare and cultural belief systems. The empirical study identified three overarching themes: the process of recovery, the impact of relationship dynamics, and mixed experiences of healthcare services. An additional discussion chapter provided further comparison of the primary research study with the extant literature. Conclusions: Recovery and adjustment after cancer can be facilitated by a proactive and systemic approach to healthcare. The findings illustrate the significant impact that patients and partners can have on each other and underscore the need for consistency in good clinical practice throughout the recovery process.