title: A Qualitative Investigation of Health Care Professionals', Patients' and Partners' Views on Psychosocial Issues and Related Interventions for Couples Coping with Cancer.
abstract: BACKGROUND
  There is growing evidence that cancer affects couples as an interdependent system and that couple-based psychosocial interventions are efficacious in reducing distress and improving coping skills. However, adoption of a couples-focused approach into cancer care is limited. Previous research has shown that patients and partners hold differing views from health care professionals (HCPs) regarding their psychosocial needs, and HCPs from different disciplines also hold divergent views regarding couples' psychosocial needs. This study aimed to explore the perspectives of HCPs and couples on the provision of couple-focused psychosocial care in routine cancer services.
  
  
  METHODS
  A qualitative study using semi-structured interviews was undertaken with 20 HCPs (medical oncologists, nurses, psycho-oncology professionals) and 20 couples where one member had been diagnosed with cancer (breast, prostate, head/neck, bowel, multiple myeloma). Interviews were analysed using the framework approach.
  
  
  RESULTS
  Three core themes were identified: "How Do Couples Cope with Cancer?" emphasised the positive and negative coping strategies used by couples, and highlighted that partners perceived a lack of engagement by HCPs. "What Is Couple-focused Psychosocial Care for People with Cancer?" described varying perspectives regarding the value of couple-focused psychosocial care and variation in the types of support couples need among HCPs and couples. Whereas most couples did not perceive a need for specialist couple-focused support and interventions, most HCPs felt couple-focused psychosocial care was necessary. "How Can Couple-Focused Psychosocial Care be Improved?" described couples' view of a need for better provision of information, and the importance of their relationship with oncology clinicians. HCPs identified a lack of confidence in responding to the emotional needs of couples, and barriers to providing psychosocial care, including challenges identifying distress (through screening) and referring distressed individuals/couples for specialist assessment.
  
  
  CONCLUSIONS
  The three core themes revealed discrepancies about couple-focused psychosocial care between HCPs and couples, and HCPs from different professional backgrounds, and several barriers to the provision of psychosocial care for couples. Despite HCPs and couples acknowledging that a couple-focused approach to psycho-social support was potentially beneficial, the majority of couples did not feel they needed specific couple-focused interventions. These issues and recommendations for future research are discussed.
authors.affiliation: Health Behaviour Research Group, Faculty of Health, School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia; Centre for Translational Neuroscience and Mental Health, School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Regan
authors.affiliation: Centre for Oncology Education and Research Translation (CONCERT)-Psycho-Oncology, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, The University of New South Wales, Sydney, NSW, Australia.
authors.forename: Janelle V
authors.initials: JV
authors.lastname: Levesque
authors.affiliation: Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.
authors.forename: Sylvie D
authors.initials: SD
authors.lastname: Lambert
authors.affiliation: Centre for Translational Neuroscience and Mental Health, School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Brian
authors.initials: B
authors.lastname: Kelly
mesh_terms: D000223:Adaptation, Psychological; D032921:Consensus; D055317:Evidence-Based Practice; D005191:Family Characteristics; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology*; D012944:Social Support; D013315:Stress, Psychological