The Supportive Care Landscape for Young Women with Breast Cancer: A Broad Overview and a Focused Investigation of the Couplelinks Intervention

Objectives: This two-study dissertation broadly investigated supportive care interventions for young women with breast cancer (YWBCs). Study 1 aimed to overview the types of psychosocial programming for YWBCs in English-speaking regions developed in both academic/hospital and community domains. Study 2 examined an online, couple-based, YWBC intervention called Couplelinks. The purpose of this study was to identify mechanisms underlying change observed in couples with improved outcomes.

Methods: Study 1 consisted of a scoping review and environmental scan of supportive care resources. In addition to describing the models of care available, we compared and contrasted the different types of support developed in hospital versus community settings, and explored the differing praxis associated with each that underlies the development of YWBC care. Study 2 consisted of a task analysis, a psychotherapy process method, to differentiate between successful and unsuccessful participation in Couplelinks as defined by scores on relationship adjustment post-treatment as measured by the Revised Dyadic Adjustment Scale.

Results: The findings of Study 1 showed a high focus on education pertaining to age-related side effects of breast cancer treatment, as well as various types of content and methods of delivery for psychosocial support in both academic and community-based programs. A hybrid-type model of care was identified and deemed to be optimal because of its comprehensiveness and ability to integrate both domains. The findings of Study 2 revealed themes that were distinguishing of successful couples, such as high utilization, a sense of alignment, and new learning in relation to the intervention, which led to concrete “tangible dyadic changes.”

Conclusion(s): Together, these dual studies highlight the tailored and unique supportive care being developed for the YWBC population. Individually, Study 1 provided a descriptive review of the interventions that currently exist that were developed from hospital-based and community-based paradigms. Study 2 identified the mechanisms which account for successful outcomes following participation in the Couplelinks intervention with implications for other couple-based programming for this population.