Determination of Changes in the Sexual Lives of Young Women Receiving Breast Cancer Treatment: A Qualitative Study

Exploring the Important Determinants Shaping Treatment Preferences: Qualitative Insights into Breast Cancer Patient Experiences and Perspectives in New Zealand

Purpose

Despite the importance of acknowledging patient preferences in treatment decision-making, little is known about the treatment preferences and the factors underlying those preferences of breast cancer patients. This study aims explore patient experience and perspective regarding treatment preferences and identify the important determinants that shape these preferences in the context of New Zealand.

Patients and Methods

Semi-structured online interviews comprised of six focus group discussions and five individual interviews were performed with 26 breast cancer patients. The interviews were recorded, transcribed, and analyzed using the reflexive thematic analysis approach.

Results

Four main themes were derived: (1) positive treatment outcomes; (2) the negative impact of treatment-related side effects on quality of life; (3) treatment accessibility, availability, and timeliness; (4) cost of treatment. Patients revealed a strong preference towards treatments that yield longer survival, achieve remission, and prevent cancer recurrence. Additionally, patients favored treatments with minimal side effects that had minimal impact on their quality of life. There was a notable preference for treatments that were easily accessible and available in a timely manner. However, patients faced challenging decisions in balancing the costs of treatments with their benefits, leading to a consistent preference for treatments supported by government funding or medical insurance to alleviate financial burdens.

Conclusion

Our study reveals that breast cancer patients in New Zealand have different perceptions and preferences regarding cancer treatment. Patients frequently find themselves making trade-offs among various attributes of a treatment, aligning these decisions with their personal values and beliefs. By considering these preferences and trade-offs in future studies that measure patient preferences, healthcare professionals can enhance their support for patients in making informed choices that align with their values and priorities. Additionally, healthcare policymakers can develop patient-centered policies that cater to the unique needs and preferences of breast cancer patients.

Changes and challenges in sexual life experienced by the husbands of women with breast cancer: a qualitative study

Background

Breast cancer (BC) in women can bring various problems to their marital and family life. Sexual life based on the experiences of the husbands of women diagnosed with BC has not been fully understood. Therefore, this research aimed to explore changes and challenges in sexual life experienced by the husbands of women diagnosed with BC.

Methods

A qualitative research was carried out on 18 men whose wives had been diagnosed with BC at reproductive age. They were selected using purposeful sampling and were interviewed using in-depth semi-structured interviews. Collected data were analyzed using the conventional content analysis method.

Results

‘Sexual life suspension’ was the main theme of this research. Also, ‘unfulfilled sexual expectations’, ‘perceived barriers to satisfy sexual expectations’, and ‘efforts to adapt to sexual problems’ were subthemes.

Conclusions

The husbands of women with BC need support to improve their sexual and marital relationships. Education and counseling about sexual life during the treatment of BC should be incorporated into the healthcare program.

"I Lost My Gift to Him": The Consequences of Female Sexual Dysfunction on Breast Cancer Survivors in Malaysia

Sexuality is currently neglected in the medical care of cancer patients although female sexual dysfunction (FSD) and sexual problems are highly prevalent among breast cancer patients in Malaysia. This paper explores the consequences of breast cancer and its treatment on the sexuality and sexual health of women with breast cancer using a qualitative design and a phenomenological methodology. Fourteen married women with breast cancer who fulfill the criteria for FSD from Kelantan, Malaysia participated in two interviews: in-depth interview and followed by photo-elicitation interview after two weeks duration. The interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. We identified overlapping themes that can be explained by sexual script theory. Breast cancer treatments disturb the sex response cycle, leading to changes in sexuality, from intimacy in marriage to women preferring physical affection to intercourse. The women struggled with a perceived imperfection about symbol of femininity after noticing changes in their husbands' sexual performance and after experiencing their own sentiments of inadequacy as a wife. Fear and guilt surfaced as part of the journey, accompanied by frustration on the part of the spouse, or him becoming more attentive. This study highlights the problem of breast cancer and its treatment as regards the sexual well-being of patients and their spouses. Hence, recognizing and addressing sexual health will improve the overall experience for survivors.

Construction of an integrated sexual function questionnaire for women with breast cancer

OBJECTIVE

With the increasing incidence of breast cancer in young women, its side effects have extended into the sexual lives of women. However, an appropriate tool to measure the sexual function is nonexistent. The aim of this study was to develop a suitable tool to measure sexual function in women with breast cancer.

MATERIALS AND METHODS

After conducting literature reviews regarding the sexual function characteristics of women with breast cancer, this study designed a set of integrated sexual function questionnaires, which included pertinent information and three scales. The validity of the scales was examined under the guidance of three gender studies experts and two gynecologists who are also professors. Regarding the construct validity, researchers conducted exploratory factor analysis on the measurement results of 196 women with breast cancer.

RESULTS

The integrated sexual function questionnaires included the following three scales: "Breasts' Role Self-Checklist," "Scales for Breasts' Role in the Foreplay," and "Female Sexual Function Scale for BCSs." The questionnaire tool consisted of the longitudinal time change, patients' and their partners' situation, information related to the recovery process, participants' perspective toward objectification of women's breasts, the role of breasts in foreplay during sexual activities, sexual desire, sexual satisfaction, sexual obstacle, and other self-evaluations. We first derived one factor from six questions in "Breasts' Role Self-Checklist" and named it as "The Importance of Breasts for Women." The other two factors were obtained from eight questions in "Scales for Breasts' Role in the Foreplay" and named as "Sexual Attraction to Breasts" and "Function of Breasts in Foreplay." In addition, three factors were derived from 16 questions in "Female Sexual Function Scale for BCSs" and named as "Sexual Desire," "Sexual Satisfaction," and "Sexual Obstacle."

CONCLUSION

This study determined that these integrated scales for breast cancer survivors are suitable due to their content validity, construct validity, and high internal consistency reliability, with a Cronbach's alpha of higher than 0.9 for all the three scales.

Acceptability of an online relational intimacy and sexual enhancement (iRISE) intervention after breast cancer

The purpose of this study was to develop and evaluate an online relational intimacy and sexual enhancement (iRISE) intervention for couples experiencing sexual difficulties following breast cancer (BC). The acceptability of iRISE was evaluated using a single-arm, qualitative design, with 14 couples completing satisfaction surveys and posttreatment interviews. The intervention was found to be acceptable, as demonstrated by high satisfaction ratings and qualitative feedback regarding iRISE and its online delivery. Couples spoke about the helpfulness of iRISE and how the intervention improved their sexual relationship. The use of video conferencing (eTherapy) was widely accepted by participants, who highlighted several advantages of this modality. Overall, the results support the acceptability of this online psychosexual intervention for couples affected by BC. The empirical and theoretical basis for the design of iRISE along with findings from a qualitative analysis of couples' experiences of the intervention's helpfulness to them is discussed.

Validation of the MENQOL for use with women who have been treated for gynecologic or breast cancer

PURPOSE

To conduct a psychometric evaluation of the MENQOL, a condition-specific, self-report instrument to assess menopausal symptoms in women with gynecologic and breast cancers.

METHODS

Identify face and content validity of the MENQOL with experts, and reliability and construct validity with a group of women diagnosed with cancer who are suffering from treatment-induced menopause.

RESULTS

Eighty-two women with treatment-induced menopause completed the MENQOL, EORTC-C30, and the SVQ. The MENQOL was shown to have good face and content validity, and acceptable reliability (homogeneity and test-retest) and validity (concurrent and construct). Additionally, 85.5% of the women reported experiencing hot flashes. However, the most bothersome symptoms were weight gain and fatigue (feeling worn out).

IMPLICATIONS

The MENQOL can be used to assess treatment-induced menopausal symptoms in women diagnosed with breast or gynecologic cancer.

Validation du questionnaire MENQOL avec les femmes ayant été traitées pour un cancer gynécologique ou du sein

Objectif

Vérifier, par une évaluation psychométrique du questionnaire MENQOL (Menopause-Specific Quality of Life Questionnaire), un instrument d’autoévaluation ciblé, s’il peut servir à mesurer les symptômes de la ménopause chez les femmes atteintes d’un cancer gynécologique ou du sein.

Méthodologie

Établir la validité apparente et de contenu du questionnaire MENQOL à l’aide d’experts, ainsi que sa fiabilité et sa validité conceptuelle auprès d’un groupe de femmes ayant reçu un diagnostic de cancer et souffrant d’une ménopause provoquée par le traitement.

Résultats

En tout, 82 femmes ayant une ménopause provoquée par le traitement ont répondu aux questionnaires MENQOL, EORTC-C30 et SVQ. L’évaluation a permis de constater la validité apparente ainsi que la validité de contenu du questionnaire MENQOL, et sa fiabilité (homogénéité et test-retest) et sa validité (concourante et conceptuelle) se sont révélées acceptables. Par ailleurs, 85,5 % des femmes ont rapporté avoir ressenti des bouffées de chaleur. Les symptômes les plus incommodants ont toutefois été la prise de poids et la fatigue (sentiment d’épuisement).

Implications

Le questionnaire MENQOL peut être utilisé pour évaluer les symptômes de ménopause provoquée par le traitement chez les femmes ayant reçu un diagnostic de cancer gynécologique ou du sein.

Barriers for the inclusion of sexuality in nursing care for women with gynecological and breast cancer: perspective of professionals

AIM

qualitative study, which aimed to identify the barriers that influence nursing care practices related to the sexuality of women with gynecological and breast cancer.

METHODS

the study was conducted with 16 professionals of the nursing area (nurses, nursing technicians and nursing assistants) from two sectors of a university hospital situated in the state of São Paulo, Brazil. The data was collected using semi-structured, in-depth individual interviews. All the interviews were recorded and the participants' responses were identified and categorized using Content Analysis.

RESULTS

three major themes were identified. These are as follows: 1) barriers related to the biomedical model; 2) barriers related to institutional dynamics and 3) barriers related to the social interpretations of sexuality.

CONCLUSIONS

the results of this study showed that the systematized inclusion of this issue in nursing care routines requires changes in the health paradigm and in the work dynamic, as well as reflection on the personal values and social interpretations related to the topic. A major challenge is to divest sexuality of the taboos and prejudices which accompany it, as well as to contribute to the nursing team being more aware of the difficulties faced by women with gynaecological and breast cancer.

Women's experiences of sexual functioning in the early weeks of breast cancer treatment

This study describes women's sexual functioning in the early weeks of breast cancer treatment and the possible sexual changes that women may experience compared with pre-treatment functioning. Seventy-five patients filled out a questionnaire on sexual functioning and participated in a semi-structured interview on changes in sexual life and intimacy after treatment. Sixty-two women were sexually active before treatment; three post-treatment patterns of sexual behaviour were identified: 22.6% of these women were as active as before treatment, 35.5% stopped any sexual activity and 41.9% experienced quantitative and qualitative changes. Analyses showed that each pattern had specific characteristics regarding current sexual functioning, the kinds of changes reported (e.g. decreased frequency and increased tenderness) and the reasons for these changes (e.g. tiredness and sex not a priority). Even in the immediate post-surgical period, women may react in very different ways to treatment in terms of sexual functioning. Most women experience changes, but cessation of sexual activity is not inevitable. Positive changes (growing tenderness and affection) also exist. These important interindividual differences require a person-centred approach when the topic of sexuality is being addressed, and practitioners need to be sensitive to individual perceptions of change. Early detection of sexual changes may prevent the crystallisation of difficulties over time.

Life experiences of women with breast cancer in south western Turkey: a qualitative study

PURPOSE

This qualitative study explores the experience of women living with breast cancer.

METHODS

The study was conducted among eight women with ongoing breast cancer chemotherapy treatment, which occurred in an ambulatory unit. The data were collected using semi-structured and in-depth individual interviews. All interviews were tape-recorded, and the results were obtained by analysing the content of the recorded data.

RESULTS

Three major themes related to the experiences of women living with breast cancer were identified. They are as follows: (1) needs (the need for spouse and family support, the need to worship, and the need to receive and share information), (2) living with losses (loss of the breast and of one's hair), and (3) changes (changes in one's normal life, change in self-perception, changes in the perception of the value of health, and a greater appreciation for life).

CONCLUSIONS

This study was conducted to increase awareness concerning women's perceptions of their care and various needs during breast cancer treatment. The results of this study challenge health care providers and educators to be more aware of the difficulties that women face when living with breast cancer.