Research Brief: Couples Dealing With Breast Cancer - The Role Of Husbands In Supporting Their Wives (Poland)

Research Briefs BoxCompared to their western counterparts, Polish researchers devote considerably less attention to men’s roles as carers. Indeed, the Polish health care system’s relative inattention to patients’ informational, instrumental or emotional needs in general helps to render loved ones barely noticeable. BCC member Edyta Zierkiewicz of the University of Wroclaw and her colleague Emilia Mazurek of Wroclaw University of Technology in Poland wanted to find out how spouses, both of them, cope with a wife’s breast cancer diagnosis and what kinds of support they provide. They were particularly interested in how men whose wives were active members of breast cancer support groups (Amazon clubs) take up and perform the carer role and how their wives perceived these efforts.

The Study

Zierkiewicz and Mazurek interviewed eight couples, wives and husbands separately, to explore the gender differences in how women and men give meaning to the illness and deal with its unceasing presence in their relationship and lives. Whereas cancer took on an “ideologically neutral” meaning for the men interviewed (as a basic biological condition like any other aging-associated disease), the women tended to blame themselves (especially their level of stress) for getting breast cancer. The medicalized explanation seemed to make it easier for men to assume the role of a caregiver for their wives. However, a lack of open communication about the types of social supports needed led to misunderstandings that limited the efficacy of the carer role and the couples’ coping abilities overall.

Impact of the Illness on the Relationship

The interviewees concurred that cancer was not a source of conflict within their relationships, nor did it shatter their intimacy. However, the brevity of their responses was notable – “as if they wanted to avoid exploring this specific topic.” The support group setting also fostered the social mandate to be a (s)heroic survivor. The husbands, too, felt responsible for helping their wives to “restore normalcy,” which manifested in pressure to avoid confrontation and keep their wives calm. Both spouses agreed that the treatment adversely affected their love life, but the women felt added shame from the physical scarring and other effects of their treatment on their libido. Both spouses tried to mitigate these effects by avoiding or downplaying the impact of breast cancer on their lives.

In terms of the individual and shared responses to breast cancer, the women interviewed experienced the physical and mental suffering stemming from treatment, body changes and associated feelings of (un)/attractiveness, and fear of death. At the same time their spouses dealt with the accumulated stress of caring for their wives, taking over household duties (like caring for children), responding appropriately to changes in their wife’s appearance, and fear of losing their loved one and facing premature loneliness.

While both spouses were under emotional stress, both the men and women preferred to speak about the ill spouse’s psychological state whereas men’s emotions were rarely seen as worthy of discussion. Social norms dictate that emotions are a feminine domain. Shying away from emotional conversations to focus on actions aimed at “helping” the patient seemed to distract men from their fears and reduce their feelings of helplessness. But it left wives to conjecture about what was really going on. Since men did not seek explanations for their wives’ emotional states, a lack of open communication thwarted their capacity to adapt and function efficiently.

Men’s attempts to take a supportive role that they thought would help to “restore normalcy” for their wives meant that they were not always capable of understanding their wives needs and expectations, thereby limiting the social support the women could attain. Such misunderstandings about the kinds of support needed led to men feeling frustrated and unappreciated, dissatisfied with the carer role and women feeling irritated or disappointed when their needs were not met.

Background and Implications

Despite the increased visibility of cancer in Poland, the medicalized focus on the disease is so strong that there is little information available to the public about its impact on family life or what is most useful when performing the caregiver role. Yet the lack of social support systems from health professionals, within public institutions, and even within the breast cancer support groups themselves place the full burden of care within the family domain. As a result, families become isolated and overloaded, often experiencing feelings of incompetence, frustration, and helplessness. What’s more, ubiquitous stereotypical gender expectations about women’s and men’s caregiving roles, solidly lodged in Polish culture, do not prepare men to take care of their sick wives and young children. The resultant miscommunications inhibit social support further.

Seventeen thousand new cases of breast cancer were diagnosed in Poland in 2012. But the diagnosis affects many more people when considering those who help the diagnosed bear the heaviest burdens of the disease. In addition to providing social supports to help families to handle the activities of daily life following a cancer diagnosis, this research suggests that educational programs and campaigns within the health care system and advocacy realm must sensitize the public to the needs of spousal caregivers, with a focus on improved communication in the face of illness.

Source: Zierkiewicz, Edyta and Mazurek, Emilia. 2015. “Dealing with breast cancer – the role of husbands in supporting their wives.” STUDIA HUMANISTYCZNE AGH. [http://dx.doi.org/10.7494/human.2015.14.2.95]. Click here to read the full article (English Translation, PDF).

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