title: When cancer cannot be cured: A qualitative study on relationship changes in couples facing advanced melanoma.
abstract: The aim of this qualitative study was to gain a deeper understanding about couples' relationship changes over time (the first six months) after one partner is diagnosed with an incurable advanced melanoma (stage III or IV).
  
  
  
  In semistructured interviews, eight patients and their partners were asked separately about potential changes in their relationship since diagnosis. The same questions were asked again six months later, but focusing on relationship changes over the preceding six months. Some 32 audiotaped interviews were analyzed applying qualitative content analysis.
  
  
  
  At baseline (t1), relationship changes were mostly reported in terms of caring, closeness/distance regulation, and communication patterns. While changes in caregiving and distance/closeness regulation remained main issues at six months follow-up (t2), greater appreciation of the relationship and limitations in terms of planning spare time also emerged as major issues. Unexpectedly, 50% of patients and partners reported actively hiding their negative emotions and sorrows from their counterparts to spare them worry. Furthermore, qualitative content analysis revealed relationship changes even in those patients and partners who primarily reported no changes over the course of the disease.
  
  
  
  Our findings revealed a differentiated and complex picture about relationship changes over time, which also might aid in the development of support programs for couples dealing with advanced cancer, focusing on the aspects of caring, closeness/distance regulation, and communication patterns.
authors.affiliation: Department of Psychiatry and Psychotherapy,University Hospital Zürich, University of Zürich,Zürich,Switzerland.
authors.forename: Natalie
authors.initials: N
authors.lastname: Drabe
authors.affiliation: Department of Psychiatry and Psychotherapy,University Hospital Zürich, University of Zürich,Zürich,Switzerland.
authors.forename: Josef
authors.initials: J
authors.lastname: Jenewein
authors.affiliation: Department of Psychiatry and Psychotherapy,University Hospital Zürich, University of Zürich,Zürich,Switzerland.
authors.forename: Steffi
authors.initials: S
authors.lastname: Weidt
authors.affiliation: Department of Psychosomatic Medicine,University Hospital of Basel,Basel,Switzerland.
authors.forename: Lucia
authors.initials: L
authors.lastname: Engeli
authors.affiliation: Department of Psychiatry and Psychotherapy,University Hospital Zürich, University of Zürich,Zürich,Switzerland.
authors.forename: Caroline
authors.initials: C
authors.lastname: Meier
authors.affiliation: Clinic for Psychotherapy and Psychosomatic "Hohenegg," Meilen,Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Büchi
authors.affiliation: Department of Dermatology,University Hospital Zürich, University of Zürich,Zürich,Switzerland.
authors.forename: Karin
authors.initials: K
authors.lastname: Schad
authors.affiliation: Department of Psychiatry and Psychotherapy,University Hospital Zürich, University of Zürich,Zürich,Switzerland.
authors.forename: Verena
authors.initials: V
authors.lastname: Schönbucher
authors.affiliation: Institute for Complementary and Integrative Medicine, University Hospital Zürich, University of Zürich,Zürich,Switzerland.
authors.forename: Claudia
authors.initials: C
authors.lastname: Canella
authors.affiliation: Department of Psychiatry and Psychotherapy,University Hospital Zürich, University of Zürich,Zürich,Switzerland.
authors.forename: David Garcia
authors.initials: DG
authors.lastname: Nuñez
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008545:Melanoma / Q000150:complications / Q000523:psychology*; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods / Q000523:psychology; D036301:Qualitative Research; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000150:complications / Q000209:etiology; D011795:Surveys and Questionnaires; D013557:Switzerland
keywords: Cancer; Melanoma; Palliative care; Qualitative study; Relationship changes