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Young women with breast cancer (BC) and their partners generally face greater psychosocial difficulties relative to older couples, justifying the need for targeted support for this group. Toward this end, we examined how couples facing BC responded to participating in a self-in-relationship observation exercise intended to improve the relationship. Participants (N = 60) were 30 women and 30 male partners who, over the course of a week, observed and textually described/reported their "turning-towards-and-away-behaviors" deemed to contribute to relationship closeness/distance. Text-based feedback on the exercise was thematically analyzed. Findings suggest an online exercise promoting in vivo awareness of relationship interactions was feasible and acceptable to the majority of couples. Language accounts reflected acting with and through the shared "turning-towards-and-away-framework" with the intention of increasing closeness with one's partner. We discuss differences in exercise engagement and how participants reported changes in their attending, understanding, and acting in relationship, primarily for the better.

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Purpose: Healthy lifestyle interventions after breast cancer treatment have generally been studied in terms of weight-loss outcomes, which leaves a gap in our understanding of the phenomenological experience of such programs. Our knowledge of how or why women recovering from breast cancer engage or do not engage in these programs is limited. Thus, we aimed to share subjective experiences of lifestyle change within a 12-week group intervention entitled "Healthy Lifestyle Modification After Breast Cancer" (HLM-ABC). Methods: The present research entailed a multiple case study of four breast cancer survivors who participated in the HLM-ABC. Participants were interviewed longitudinally at four time-points: (1) pre-intervention; (2) mid-way intervention; (3) post-intervention, and (4) three-months post-intervention. Results: We analysed storytelling of participation in the HLM-ABC program to investigate participants' unique and gradual endeavours towards living a healthier lifestyle. A qualitative, narrative analysis was applied to each participant's set of interviews, which yielded two distinct story-telling patterns while participating in the HLM-ABC program: one "plot-driven" and one "character-driven". Conclusions: These two narrative styles appeared to correspond with differing levels of intervention uptake and perceived success in the program. The implications of these narrative styles and their relationship to healthy lifestyle intervention are discussed.

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PURPOSE OF REVIEW: Cancer diagnosis and treatment can have long-lasting psychological and physical consequences that affect both patients and their intimate partners. Improved understanding of extant dyadic interventions in the context of cancer, and how access to these may be enhanced through web-based technologies, introduce new directions for how cancer-related psychological distress for couples may be ameliorated. RECENT FINDINGS: Couples are negatively impacted by cancer, both individually, and as a dyad. Bolstering techniques to support effective communication about common cancer-related concerns and support for adjusting to new roles and responsibilities may help to strengthen the couple's relationship so partners are better able to cope with cancer. Although there are various intervention options available for couples dealing with cancer, many pose barriers to participation because of constraints on time and/or distance. However, online interventions have been shown to be effective, both in easing psychological distress and reducing participant burden. SUMMARY: Couples dealing with cancer experience psychological distress and must learn to navigate changing roles and responsibilities in the face of the disease. Online interventions offer flexible and innovative platforms and programs that help to address couples' educational needs while strengthening dyadic coping.

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PURPOSE: Healthy lifestyle adoption among breast cancer (BC) survivors remains a poorly understood process. This study aimed to qualitatively examine the unique change trajectories of BC survivors who partook in a pilot version of the Healthy Lifestyle Modification After Breast Cancer (HLM-ABC) intervention. METHODS: A sample of four BC survivors were studied intensively through longitudinal interviews conducted at four time points with each participant: (1) pre-treatment, (2) mid-way treatment, (3) post-treatment, and (4) three-months following their participation in the HLM-ABC. A multiple-case study, narrative analysis was applied to 15 interviews, resulting in individual narratives as well as shared 'thematic intersections' elucidating cross-participant experiences. RESULTS: The findings showed that participants offered unique styles of authorship, characterized by diverse struggles, victories, and motivational insights, organized around the following intersecting themes: (1)Weight management prescription as a motivator or deterrent, (2) 'Time for me' is time away from my family, and (3) Patterns of opposition to lifestyle change. These women's rich, storied accounts suggest experiences of personal growth and imply that existential concerns can be both motivating and deterring in relation to health behavior change. CONCLUSION: This research provides a comprehensive and nuanced grasp of healthy lifestyle modification in the survivorship stage of BC.

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The experience of weight-based bullying in young adult bariatric patients has not yet been examined. Thirteen young adults (age, 18-24) that were seeking or had undergone bariatric surgery participated in semi-structured in-depth interviews. A thematic analysis informed by grounded theory principles was conducted. Analysis revealed the following three major themes: (1) being the biggest kid, (2) coping through avoidance, and (3) compromised peer and intimate relationships. Victims of weight-based bullying often avoid and withdraw socially in response to persistent verbal abuse. The decision to pursue bariatric surgery at a relatively young age adds another dimension of difficulty when navigating peer relationships.

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Synchronous online support groups (OSGs) represent a promising psychosocial resource, as they offer many of the same therapeutic factors as face-to-face groups as well as unique benefits (e.g., anonymity, convenience). Despite their advantages, OSGs also present challenges to participation, including lack of visual cues, disjointed text communication, and rapid pace, which render the presence of a professional facilitator especially important. This study involved an in-depth qualitative analysis of 38 sessions of four time-limited OSGs for informal caregivers (i.e., family) of patients with advanced-stage cancer. Results depict the ways in which four trained facilitators maximized the utility of their respective online groups-namely, by structuring and guiding, actively scanning, and modulating experiencing. These findings expand our limited understanding of the facilitative processes that take place in OSGs and may be clinically informative to professionals with an interest in this relatively novel group modality.

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PURPOSE OF REVIEW: Breast cancer treatment indelibly alters a woman's reproductive and sexual functioning, body integrity, and the ways in which she self-identifies as a sexual being. Improved understanding of how treatment affects these aspects of a woman's health, identity, and relationships is necessary to ameliorate the effectiveness with which these issues are addressed by healthcare providers. RECENT FINDINGS: Women with breast cancer experience significantly greater rates of sexual dysfunction and poorer body image than do healthy women. Despite this reality, most breast cancer patients are dissatisfied with the amount and quality of care they receive from their healthcare providers around sexuality. Although a substantial proportion of women endorse difficulties with sexual functioning, reproduction, and body image, each woman's experience is individual and contextual, influenced by a range of factors (e.g., age, illness stage, treatment type(s), relationship status, and others). SUMMARY: A high proportion of women experience difficulties with sexual health and self-concept secondary to breast cancer, yet an overwhelming number report receiving inadequate or nonexistent care in these domains from their healthcare providers. There remains too wide a gap between the needs of this population and the healthcare system's response to such needs. To bridge this gap, oncology professionals across a range of disciplines must be better trained to identify, assess, and treat such difficulties, preferably using a multimodal approach that includes biological, as well as psychological and social, strategies.

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To date, our understanding of the caregiver experience has been informed primarily by guided inquiry in the form of interviews and surveys, yielding information that is limited by the scope of researchers questions. The intent of this study was to explore the experience of caring for a loved one with advanced-stage cancer by means of participant-determined communication, using interactive, text-based transcripts from synchronous online support groups. Grounded theory analysis of the group transcripts yielded the core category continuous confrontation, characterized by major challenges (unrelenting assault, a new us, and the costs of caregiving) and minor triumphs (refuelling and living more intentionally). This unique method of data collection allowed for an especially candid, intersubjective group account of what it is to be a caregiver for an ill loved one without compromising the details that caregivers themselves consider important.

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OBJECTIVE: This study investigated women's experiences of establishing an intimate relationship with a new partner after breast cancer diagnosis and treatment. METHODS: Fifteen breast cancer survivors, who were either actively dating or in a new intimate relationship that began post-diagnosis, participated in semi-structured interviews. Interview transcripts were analyzed using the grounded theory method. RESULTS: The analysis yielded Wearing My Heart on My Chest as the core category with three underlying categories: (1) Losing and Regaining Self and Bodily Esteem; (2) Taking the Leap: Dating and the Obligation to Disclose; and (3) Reclaiming of Self through the New Relationship. The categories refer to the experience of profound vulnerability invoked by the history of breast cancer and the act of verbally and physically revealing this past to a new intimate partner. Disclosure entailed a series of successive 'tests' of the new partner for his ability to accept the physical and psychological ramifications of breast cancer, with the resulting relationship becoming a vehicle through which women regained self-esteem. CONCLUSIONS: The process of dating and starting a new intimate relationship had the potential to restore women's self and bodily esteem previously diminished by breast cancer. The reconfiguration of self-esteem following breast cancer is thus experienced as an ongoing process that begins with diagnosis and continues well into the new relationship.

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Intimate partners' ability to adopt a "we" outlook in relation to cancer has consistently been associated with optimal adaptation for couples. This investigation adds to the growing body of literature on dyadic coping and resiliency in couples through an in-depth examination of five well-adjusted couples' experiences with prostate cancer. Of specific interest were (1) how the experience of prostate cancer affected the couple's unique intersubjective identity, and how in turn (2) the couple's identity and relationship culture influenced their adjustment to cancer. An ethnographic mode of inquiry was adopted. Marital partners were interviewed together on two separate occasions with the intention of having them deepen their conjoint reflexive processing of their relationship. During the interviews, couples were asked to reflect upon and articulate their sense of themselves as a couple, their experience of "we-ness" and shared identity, and the interaction between the illness and we-ness. Interviews were transcribed verbatim and analyzed using the grounded theory method. The grounded theory analysis yielded three main themes portraying the couples' experience of prostate cancer: (1) riding the vortex, (2) holding the communal body intact, and (3) invincibility and its underbelly. A more broad understanding to arise from this investigation was the notion of a "communal body" and that couples participated in a shared corporeality, to which each partner's identity and sense of self was intricately tied. It is concluded that the intersubjective embodiment displayed by couples in this study was instrumental to the "repair" of the communal body ruptured by prostate cancer.

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OBJECTIVE: Close interpersonal relationships play a crucial role in a woman's adjustment to breast cancer. To date, the literature has focused primarily on characteristics or behaviors of the well spouse that influence a woman's adaptation to the illness. The present qualitative investigation extended this literature by adopting an interactional perspective based on the underlying assumption that relationship partners' coping and distress is mutually influential. The focus of the analysis was patient and partner perceptions of relationship strife or tension over the course of the illness based on the notion that such interactions may be as or more harmful to relationships than supportive exchanges are helpful. METHOD: Nineteen women (at different stages of the illness) and eleven male spouses were interviewed about their experiences in relation to breast cancer. Nine of the men and nine of the women were relationship partners. Interview text was subjected to a thematic analysis and informed by grounded theory principles. RESULTS: Two higher-order categories of Personal Characteristics (both patient and partner) and Relationship Dynamics that impeded couple adjustment defined the overall theme of Relationship Vulnerabilities. CONCLUSIONS: Findings from this study are situated within a broader developmental framework wherein breast cancer is considered a catastrophic life event that challenges the assimilation and accommodation processes of both partners in the relationship. For couples that are able to overcome the relationship challenges associated with the illness, there is the potential for mutual growth, and a deepening and strengthening of the relationship. Implications for clinical practice are discussed.

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OBJECTIVES: This paper demonstrates the value of a narrative approach for health psychology. It focuses on the lives of two Black men with prostate cancer, drawn from a larger study investigating the links between masculinities and prostate cancer. DESIGN: The study was a qualitative, interview-based study. Each participant was interviewed four times. METHODS AND ANALYSIS: The men were asked to describe and discuss their prostate cancer experience, as well as their lives prior to illness. In order to gain a perspective on individual experiences of men with prostate cancer, we took a narrative approach to gathering and analysing data. Results are reported through two descriptive narratives. CONCLUSIONS: The narratives of the men described in the paper show how the interaction of race with health and illness is neither predictable nor consistent at the individual level. Black men, like all men with prostate cancer, have diverse experiences and are influenced by a wide array of personal and societal factors. While the high risk of prostate cancer among Black men makes proactive interventions advisable, such interventions will be most effective if the heterogeneity of men's experiences are taken into account.

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In this study, the authors examine the under-investigated topic of patient-provided support for spouse caregivers. Thirty-four men with prostate cancer and their female partners were interviewed separately three times: before the man's radical prostatectomy, 8 to 10 weeks postsurgery, and 1 year postsurgery. The core category of active consideration encompassed 4 dimensions: easing spousal burden, keeping us up, maintaining connection, and considering spouse. Patient-provided support entails two overlapping tasks: minimizing the practical and emotional impact of the illness and tending to the caregiver's social-emotional needs. A theory expounding on the double bind of being both a patient and an agent in light of masculine socialization practices is articulated and brought to bear on the phenomenon of patient-provided support.

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This study explored the experiences of men living with sexual dysfunction as a consequence of having been treated for prostate cancer. An ethnoculturally diverse sample of 18 men (14 heterosexual, and four homosexual) participated in a series of four to five in-depth interviews. These one-on-one interviews were designed to elicit information pertaining to their beliefs, values and performances regarding masculinity vis-a-vis prostate cancer and its treatment. Interview transcripts were analyzed using the grounded theory method. The core category of 'Preserving Manhood' incorporated five major themes: enhancing the odds; disrupting a core performance; baring an invisible stigma; effortful-mechanical sex; and working around the loss. We conclude that men's performances of sexuality and masculinity were highly interwoven; that loss of sexual functioning constituted a focal disruption for participants; and in some instances, posed a significant threat to their masculine identities.