Cancer in a Dyadic Context

Older adults rarely face the stress of living with§advanced cancer in a social vacuum. Partners and§spouses are §profoundly affected by, and contribute to the§patient s experience §with illness. Partners provide the bulk of emotional§and physical §support and share in medical decision-making, treatment §adherence and psychosocial adjustment.§Psycho-oncology research §primarily emphasizes the individual responses of patients§and partners to§illness. Relatively little empirical attention has§been paid to the§partner relationship, and less to older couples. This§study examined §the subjective and intersubjective experiences, and§communication and support processes of 35 older§couples living§with §advanced cancer. Data collected through focused,§semi-structured §interviews with patients and partners recruited from§an urban cancer §center were analyzed within individual, micro-social§and macro-§social contexts, and systematically coded using§grounded theory §methods. Study findings suggest couples struggle to§integrate §often-conflicting individual and dyadic discourses§across three §contextual domains: dyadic structure and care; dyadic §communication; and dyadic meaning-making.