Questionnaire for Partners Supporting a Partner Through Cancer

Questionnaire for Partners Supporting a Partner Through Cancer
This questionnaire is designed for romantic and relationship partners of individuals who are currently undergoing cancer treatment or are in survivorship. Your experiences, challenges, and needs are often overlooked in cancer care, yet they are vital in shaping meaningful support resources.

Your responses are completely confidential, and we appreciate your time and honesty.
1. Background Information:
What is your current relationship status with your partner? (Select all that apply)

Newly in a relationshipDatingLong-term committed partnershipMarriedSeparated or divorced but still involvedIt’s complicated Other (please specify)
How long have you and your partner been together?

Less than 1 year1–3 years4–7 years8–15 years16+ years
At what stage of the cancer journey is your partner?*

Currently in treatmentRecently completed treatment (within the past year)Long-term survivorship (1+ years post-treatment)Living with advanced/metastatic cancer
What type of cancer has your partner been diagnosed with? (Select all that apply)*

Breast cancerProstate cancerOvarian cancerCervical cancerTesticular cancerColorectal cancerLung cancerLeukemia/LymphomaPrefer not to say Other (please specify)
Section 2: Emotional and Relationship Impact
How has your partner’s cancer journey affected your relationship?(Select all that apply)*

It has brought us closer togetherIt has introduced new challenges in communicationIt has created emotional distance between usIt has changed how we express love and affectionIt has increased stress and anxiety in our relationshipIt has made us reevaluate our priorities as a couple Other (please specify)
What emotions have you personally experienced while supporting your partner through cancer? (Select all that apply)*

Anxiety or worry about their health and futureFear of losing intimacy or emotional closenessGrief over changes in our relationshipPressure to be strong for my partnerGuilt for feeling overwhelmed or frustratedResentment over increased caregiving responsibilitiesLoneliness or feeling unsupportedHope and resilience through our journey Other (please specify)
Have you had access to emotional support (e.g., therapy, support groups, counseling) during your partner’s cancer journey?*

Yes, and it has been helpfulYes, but it was not helpfulNo, but I would like supportNo, I do not feel I need support
Section 3: Intimacy and Sexuality
How has your partner’s cancer journey affected your intimacy and sexual relationship? (Select all that apply)*

We have maintained a fulfilling sexual relationshipWe have struggled with physical intimacy but found new ways to connectPhysical intimacy has decreased significantlyI am unsure how to navigate the changes in our sex lifeI feel a loss of attraction due to treatment-related changesI worry about bringing up intimacy needs for fear of upsetting my partnerI feel emotionally close to my partner, even if physical intimacy has changedOther (please specify)
Would you find resources on intimacy and sexuality during and after cancer helpful?*

Yes, I would like guidance on how to navigate these changesNo, I feel we have adjusted well on our ownUnsure
What kind of support or information would be helpful to navigate intimacy and relationship changes? (Select all that apply)*

Guidance on how to talk about intimacy with my partnerInformation about how cancer treatment affects sexual function and desireResources for alternative ways to connect emotionally and physicallySupport from a sex therapist or intimacy coachA peer support group for partners navigating these changesOther (please specify)
Section 4: Support and Resource Needs
What challenges have you faced in supporting your partner? (Select all that apply)*

Balancing caregiving with my own needsLack of emotional support for myselfDifficulty discussing concerns without feeling guiltyStruggling with burnout or exhaustionFeeling alone in this journeyUncertainty about how to support my partner’s emotional needs Other (please specify)
What types of resources or programs would help you feel more supported as a partner? (Select all that apply)

Online guides or videos on navigating relationships and intimacy after cancerWorkshops or classes on caregiving and relationship resilienceAccess to couples therapy or support groupsCommunity forums or online peer support for partnersMore communication and relationship guidance from medical providersOther (please specify)
Do you feel that medical providers adequately acknowledge the challenges faced by partners of cancer patients?*

Yes, I feel supported and included in the processSomewhat, but I think there could be more support for partnersNo, I often feel overlooked in conversations about my partner’s careUnsure
If you could receive one piece of advice or support to help you through this journey, what would it be?
Thank you for taking the time to share your experiences. Your invaluable insights will will contribute to research aimed at improving relationship and intimacy support for couples navigating cancer.

If you are interested in future resources, programs, or support groups, please let us know how we can keep you informed. Send us an email at info@cancerandintimacy.com
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Questionnaire for Partners Supporting a Partner Through Cancer

1. Background Information:

Section 2: Emotional and Relationship Impact

Section 3: Intimacy and Sexuality

Section 4: Support and Resource Needs