Romantische relaties na kanker:  singles en nieuwe partners Fellowship  KWF Kankerbestrijding Marrit Tuinman
<ul><li>Ph.D thesis </li></ul><ul><li>Unexpected findings </li></ul><ul><li>Relevance </li></ul><ul><li>Idea for some more...
 
Testicular cancer <ul><li>Most common malignancy young men (18-35) </li></ul><ul><li>600 diagnoses per year (NL) </li></ul...
Testicular cancer (2) <ul><li>Possible after effects: </li></ul><ul><li>One testis (2-5% double sided) </li></ul><ul><li>L...
Study on couples:  old and new <ul><li>Cross-sectional study: 1977-2003 </li></ul><ul><li>(longitudinal study in first yea...
<ul><li>The women </li></ul>
Old vs new No other illness or demographic differences All further analyses age-corrected 7.5 1 - 21 20.9 1 – 48 Duration ...
Functioning of spouses <ul><li>Quality of life: RAND-36 </li></ul><ul><li>Marital and sexual satisfaction: MMQ </li></ul><...
Old vs new: QoL
New vs referencegroup: QoL
Marital & sexual satisfaction Higher scores indicate  less  satisfaction
In words <ul><li>Both old & new spouses report better physical functioning and similar marital satisfaction as compared to...
<ul><li>The men </li></ul>
Single & a new relationship <ul><li>Fleer et.al. Supp Care Cancer (2004): review on QoL in testicular cancer survivors </l...
Functioning of survivors <ul><li>Marital & sexual satisfaction: MMQ </li></ul><ul><li>Self esteem: Rosenberg </li></ul><ul...
Marital & sexual satisfaction new relationship < old relationship < reference
Survivors: marital problems <ul><li>Marital dissatisfation (above cut-off): </li></ul><ul><li>In general: 5% </li></ul><ul...
Singles included * Random sample from 219 survivors with old relationship: size and age-matched.  No differences in functi...
Comparison lower scores indicate more self-esteem Singles and survivors with a new relationship: worse mental health than ...
In words <ul><li>Single < new relationship < old relationship </li></ul><ul><li>Effect sizes moderate to large (0.48 – 0.8...
The couples <ul><li>Is functioning in couples related? </li></ul><ul><li>In old couples: yes, but moderately (only sexual ...
Conclusion testicular cancer <ul><li>Both spouses and survivors who develop a relationship after completion of treatment a...
Relevance <ul><li>In the Netherlands: </li></ul><ul><li>74.500 new cancer diagnoses </li></ul><ul><li>31.983 divorces (34%...
Relevance (2) <ul><li>Divorce after (due to?) cancer: women at risk: </li></ul><ul><li>Divorce in female patients 21%, mal...
Previous studies <ul><li>Very little studies focus on forming  new  romantic relationships </li></ul><ul><li>Problems dete...
Fellowship: questions <ul><li>How do romantic/significant relationships start and develop normally and does this process d...
Fellowship: questions (2) <ul><li>Do survivors and partners who met after completion of treatment encounter problems as a ...
Compare  <ul><li>Those who do not yet have an important intimate </li></ul><ul><li>relationship vs those who did have: </l...
When and where <ul><li>2010-2014: Health Psychology at the UMCG </li></ul><ul><li>Internships  </li></ul><ul><li>(evolutio...
Request  <ul><li>Speak with therapists: way of working, clinical experience with this type of complaints </li></ul><ul><li...
<ul><li>THANK YOU! </li></ul>
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Romantic relationships after cancer

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Presentation for the outline of my research on romantic relationships after cancer.

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Romantic relationships after cancer

  1. 1. Romantische relaties na kanker: singles en nieuwe partners Fellowship KWF Kankerbestrijding Marrit Tuinman
  2. 2. <ul><li>Ph.D thesis </li></ul><ul><li>Unexpected findings </li></ul><ul><li>Relevance </li></ul><ul><li>Idea for some more research: Fellowship! </li></ul><ul><li>How and where and aims </li></ul>
  3. 4. Testicular cancer <ul><li>Most common malignancy young men (18-35) </li></ul><ul><li>600 diagnoses per year (NL) </li></ul><ul><li>Highly curable: 90% </li></ul><ul><li>Treatment: orchiectomy, CT, RT and/or abdominal surgery </li></ul>
  4. 5. Testicular cancer (2) <ul><li>Possible after effects: </li></ul><ul><li>One testis (2-5% double sided) </li></ul><ul><li>Large abdominal scar </li></ul><ul><li>Infertility </li></ul><ul><li>Low testosterone </li></ul><ul><li>Metabolic syndrome </li></ul><ul><li>Neurocognitive (chemobrain) </li></ul><ul><li>Sexuality </li></ul><ul><li>Psychological </li></ul>
  5. 6. Study on couples: old and new <ul><li>Cross-sectional study: 1977-2003 </li></ul><ul><li>(longitudinal study in first year) </li></ul><ul><li>259 couples of long-term testicular cancer survivors & spouses </li></ul><ul><li>Included: 40 newly formed couples </li></ul><ul><li>Also: single survivors </li></ul>
  6. 7. <ul><li>The women </li></ul>
  7. 8. Old vs new No other illness or demographic differences All further analyses age-corrected 7.5 1 - 21 20.9 1 – 48 Duration relationship*** Range 13.6 1 - 24 9.3 1 – 24 Time since diagnosis * (yrs) Range 36.7 43.1 Age spouses*** New relationship N=40 Old relationship N=219  
  8. 9. Functioning of spouses <ul><li>Quality of life: RAND-36 </li></ul><ul><li>Marital and sexual satisfaction: MMQ </li></ul><ul><li>reference data women general population </li></ul>
  9. 10. Old vs new: QoL
  10. 11. New vs referencegroup: QoL
  11. 12. Marital & sexual satisfaction Higher scores indicate less satisfaction
  12. 13. In words <ul><li>Both old & new spouses report better physical functioning and similar marital satisfaction as compared to reference women </li></ul><ul><li>New spouses function worse on psychological QoL domains than old spouses á nd reference women </li></ul><ul><li>Probably also less sexual satisfaction (n.s.) </li></ul><ul><li>Effect sizes ( d ) moderate </li></ul>
  13. 14. <ul><li>The men </li></ul>
  14. 15. Single & a new relationship <ul><li>Fleer et.al. Supp Care Cancer (2004): review on QoL in testicular cancer survivors </li></ul><ul><li>‘ Future research should pay attention to body image, issues concerning intimate relationships and singles.’ </li></ul>
  15. 16. Functioning of survivors <ul><li>Marital & sexual satisfaction: MMQ </li></ul><ul><li>Self esteem: Rosenberg </li></ul><ul><li>Social support: SSL </li></ul><ul><li>Mental health: RAND-36 </li></ul><ul><li>All analyses controlled for age differences, time since treatment completion and presence of children </li></ul>
  16. 17. Marital & sexual satisfaction new relationship < old relationship < reference
  17. 18. Survivors: marital problems <ul><li>Marital dissatisfation (above cut-off): </li></ul><ul><li>In general: 5% </li></ul><ul><li>Old relationship: 12% </li></ul><ul><li>New relationship: 25% </li></ul>
  18. 19. Singles included * Random sample from 219 survivors with old relationship: size and age-matched. No differences in functioning between sample and original group (5.4) 7.5 1 - 21 (11.1) 14.2 1 – 48 Duration relationship (yrs) Range (5.7) 13.6 1 - 24 (7.0) 9.3 1 – 24 (6.1) 8.3 1 – 23 Time since diagnosis (yrs) Range (8.5) 40.0 24 – 55 (11.5) 40.4 23 - 73 (12.9) 38.8 19 - 76 Age (yrs) Range (SD) Mean (SD) Mean (SD) Mean New Relationship n = 40 Old relationship * n = 49 Single n = 40
  19. 20. Comparison lower scores indicate more self-esteem Singles and survivors with a new relationship: worse mental health than reference men Survivors with an old relationship: similar mental health as reference men
  20. 21. In words <ul><li>Single < new relationship < old relationship </li></ul><ul><li>Effect sizes moderate to large (0.48 – 0.83) </li></ul><ul><li>Lowered self esteem in singles clinically relevant? ( d =0.83) </li></ul><ul><li>However: in singles self esteem not a predictor for mental health </li></ul>
  21. 22. The couples <ul><li>Is functioning in couples related? </li></ul><ul><li>In old couples: yes, but moderately (only sexual satisfaction highly) </li></ul><ul><li>Moderate correlations are in line with findings of a recent meta-analysis </li></ul><ul><li>In new couples: no </li></ul><ul><li>Functioning more independent in new couples? </li></ul>
  22. 23. Conclusion testicular cancer <ul><li>Both spouses and survivors who develop a relationship after completion of treatment appear to function less well as couples who experienced the cancer together </li></ul><ul><li>Singles function less well than men in a relationship </li></ul><ul><li>But: existing problems or result? </li></ul><ul><li>Selection? </li></ul>
  23. 24. Relevance <ul><li>In the Netherlands: </li></ul><ul><li>74.500 new cancer diagnoses </li></ul><ul><li>31.983 divorces (34%, mean age 44) </li></ul><ul><li>1,5 mln currently single (30-64 jaar) </li></ul><ul><li>second marriages: mostly 50-60 yrs </li></ul><ul><li>After effects of cancer important for intimate relationships: </li></ul><ul><li>Fertility, fatigue, neurological damage, hormonal imbalance, sexuality, body image … </li></ul>
  24. 25. Relevance (2) <ul><li>Divorce after (due to?) cancer: women at risk: </li></ul><ul><li>Divorce in female patients 21%, male patients 3% (partner abandonment ?) </li></ul><ul><li>Better adjustment when in a relationship: physical & psychological (sometimes even survival) </li></ul><ul><li>Social support within intimate relationship more important than support from other sources </li></ul>
  25. 26. Previous studies <ul><li>Very little studies focus on forming new romantic relationships </li></ul><ul><li>Problems detected in childhood cancer survivors </li></ul><ul><li>Besides testicular cancer study no other data on newly formed couples </li></ul>
  26. 27. Fellowship: questions <ul><li>How do romantic/significant relationships start and develop normally and does this process differ after cancer? </li></ul><ul><li>Which problems do survivors face when looking for and building a significant relationship? </li></ul><ul><li>Do specific patient chracteristics (such as gender, age/developmental phase, diagnosis/prognosis) account for specific problems in this area? </li></ul>
  27. 28. Fellowship: questions (2) <ul><li>Do survivors and partners who met after completion of treatment encounter problems as a result of the cancer history? </li></ul><ul><li>What are the wishes for support on this matter and what type of help fits these needs best? </li></ul>
  28. 29. Compare <ul><li>Those who do not yet have an important intimate </li></ul><ul><li>relationship vs those who did have: </li></ul><ul><li>Young adults (20-35) vs middle-aged (40-60) </li></ul>
  29. 30. When and where <ul><li>2010-2014: Health Psychology at the UMCG </li></ul><ul><li>Internships </li></ul><ul><li>(evolutionary psychology, Comprehensive Cancer Centres, Nationwide Children's Hospital Ohio, oncologic therapeutic centres , patient associations) </li></ul><ul><li>learn from IPSO institutes about psycho-oncologic interventions & type of problems encountered in singles / new relationships </li></ul>
  30. 31. Request <ul><li>Speak with therapists: way of working, clinical experience with this type of complaints </li></ul><ul><li>Sit in with client conversations? </li></ul><ul><ul><li>Singles </li></ul></ul><ul><ul><li>Couples (new couples?) </li></ul></ul>
  31. 32. <ul><li>THANK YOU! </li></ul>

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