1
|
Barjasteh S, Lopez V, Farnam F. Group Sex Counseling Based on a Modified "Good Enough Sex" Model: A Randomized Trial on Sexual Health Variables among Breast Cancer Survivors in Iran. JOURNAL OF SEX & MARITAL THERAPY 2024:1-16. [PMID: 38818773 DOI: 10.1080/0092623x.2024.2357141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
A randomized controlled clinical trial conducted in Iran from April 2020-2021 involved 100 eligible breast cancer survivors (BCSs). The study examined the impact of sexual counseling using a modified "Good Enough Sex" (GES) model on BCSs' sexual health variables. The intervention group, consisting of BCSs and their spouses, participated in four weekly group counseling sessions lasting 90-120 min each. The control group attended routine medical checkups. The intervention was designed based on a previous qualitative study assessing sexual needs and concerns in BCSs, as well as the GES model. Sexual satisfaction, function, and communication were evaluated at baseline, two, and three months follow-ups. Most participants (77%) had undergone a mastectomy, with diagnoses typically occurring between ages 39-49 and 5-7 years post-diagnosis. Initially low sexual satisfaction and function significantly improved in the intervention group (p < 0.001), reaching high satisfaction and moderate function levels. After three months, significant differences in sexual health variables were observed between the intervention and control groups (p < 0.001), indicating substantial positive effects, particularly in sexual satisfaction (0.99). Given the challenges in improving sexual function due to cancer complications, sex education based on sexual dialogue and realistic expectations can promote sexual well-being. RCT Number: IRCT20120609009975N8, dated 2020-04-18, https://en.irct.ir/trial/42030.
Collapse
Affiliation(s)
- Samira Barjasteh
- Midwifery, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Violeta Lopez
- Nursing, Central Queensland University, Sydney, Australia
| | - Farnaz Farnam
- Reproductive Health and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Battistello CZ, da Silva NW, Remor E. What is the relationship between body image and the quality of life of women who underwent surgery for breast cancer? A scoping review. Psychooncology 2024; 33:e6329. [PMID: 38502048 DOI: 10.1002/pon.6329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/19/2024] [Accepted: 03/07/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE This review aimed to identify, characterize, map, and summarize existing knowledge about the relationship of perceived body image with the quality of life (QoL) of women who have undergone surgical treatment for breast cancer. METHODS A scoping review was conducted following the PRISMA-ScR guidelines. PubMed, PsycINFO and Scopus databases were searched, and articles published until August 2022 were included. RESULTS The search resulted in 796 records, and 51 articles were included for analysis. A significant negative impact on body image perception and QoL after surgical treatment for breast cancer was found in the majority of studies. Sociodemographic variables such as age, education, socioeconomic status, unstable attachment styles and time after the surgery may have an effect on a worsening of the overall body image and QoL score of women. It was found that there was greater dissatisfaction with body image in women who underwent mastectomy compared to those who underwent conservative surgery. CONCLUSION Evidence has shown that breast cancer surgery affects the perceived body image and QoL of patients worldwide. Age, education, socioeconomic status, and the type of surgery are potential factors influencing these outcomes. It is worth noting that the review encompassed articles from various countries, reflecting a significant cultural diversity among the studied populations. However, most of these articles did not delve into an analysis of these cultural disparities. This review also indicated insufficient details regarding the assessment instruments used to assess perceived body image.
Collapse
Affiliation(s)
| | | | - Eduardo Remor
- Institute of Psychology, Social Work, Health and Human Communication, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
3
|
Vesentini L, Hoeylaerts L, Van Overmeire R, Vanhoeij M, Bauwens S, Bilsen J. Optimizing sexuality of young women with breast cancer: how can the breast clinic help? Support Care Cancer 2023; 31:613. [PMID: 37796309 DOI: 10.1007/s00520-023-08077-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/25/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Breast cancer treatment can lead to sexual dysfunction which, in general, impacts younger women more. Being well informed and having good social support are important elements in dealing with this dysfunction. AIMS This study aims to explore how specialized breast clinics can help young women with questions or problems regarding their sexual health by fulfilling their information and social support needs. METHOD A thematic analysis was used for 16 interviews with young women (18-45 years) diagnosed with breast cancer, in Belgium. RESULTS Participants report a lack of information on sexual issues and find the information insufficiently tailored to young women. The empathy of healthcare providers and their communication skills play an important role in whether sexual issues can be discussed. Finally, they indicate that more attention should be paid to their partner (relationship). CONCLUSION The breast clinic might help young women by giving more specific advice on what is sexually allowed (or not) during treatment, by informing them about lubricants and sex toys, by adapting brochures and information sessions to young women, by investing in the partner's well-being and their relationship, and by training healthcare providers better.
Collapse
Affiliation(s)
- Lara Vesentini
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Laura Hoeylaerts
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Roel Van Overmeire
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Marian Vanhoeij
- Breast Clinic, University Hospital Brussels, Brussels, Belgium
| | | | - Johan Bilsen
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| |
Collapse
|
4
|
Lee H, Yoon HG. Body change stress, sexual function, and marital intimacy in korean patients with breast cancer receiving adjuvant chemotherapy: A cross-sectional study. Asia Pac J Oncol Nurs 2023; 10:100228. [PMID: 37213807 PMCID: PMC10193161 DOI: 10.1016/j.apjon.2023.100228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/27/2023] [Indexed: 05/23/2023] Open
Abstract
Objective A crucial factor influencing the quality of life of patients with breast cancer is marital intimacy, which, along with emotional support, helps them overcome difficult treatments. This study aimed to elucidate and confirm the effects of body change stress and sexual function in marital intimacy. Methods We conducted a cross-sectional survey on 190 patients with breast cancer. They completed the breast-impact of treatment scale, female sexual function index, and revised dyadic adjustment scale. Results The patients' average age was 46.27 (6.84), and the age distribution ranged from 25 to 59 years. These variables showed statistically significant differences according to the chemotherapy period (P < 0.05) and type of surgery (P < 0.05). Body change stress negatively correlated with sexual function (r = -0.523, P < 0.001) and marital intimacy (r = -0.545, P < 0.001). Sexual function positively correlated with marital intimacy (r = 0.363, P < 0.001). Marital intimacy was affected by the changes in body stress (β = -0.473, P < 0.001). Sexual function did not affect marital intimacy (β = 0.084, P = 0.289). Conclusions Changes in body stress and chemotherapy treatment should be considered in patients with breast cancer for better marital intimacy. Intervention strategies that consider the characteristics discussed could improve marital intimacy for patients with breast cancer.
Collapse
Affiliation(s)
- Hyesoon Lee
- Department of Nursing, Semyung University, Chungbuk, South Korea
| | - Hyeon Gyeong Yoon
- College of Nursing, Eulji University, Seongnam Campus, Gyeonggi-do, South Korea
- Corresponding author.
| |
Collapse
|
5
|
Boing L, de Bem Fretta T, Stein F, Lyra VB, Moratelli JA, da Silveira J, Dos Santos Saraiva PS, Bergmann A, Lynch BM, de Azevedo Guimarães AC. Can mat Pilates and belly dance be effective in improving body image, self-esteem, and sexual function in patients undergoing hormonal treatment for breast cancer? A randomized clinical trial. Arch Womens Ment Health 2023; 26:141-151. [PMID: 36715766 DOI: 10.1007/s00737-023-01294-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/18/2023] [Indexed: 01/31/2023]
Abstract
The purpose of this study is to examine the effects of a 16-week exercise intervention (mat Pilates or belly dance) on body image, self-esteem and sexual function in breast cancer survivors receiving hormone therapy. Seventy-four breast cancer survivors were randomly allocated into mat Pilates, belly dance, or control group. The physical activity groups received a 16-week intervention, delivered 3 days a week, and 60 min a session. The control group received three education sessions. Data collection occurred at baseline, post-intervention, 6 and 12 months of follow-up with a questionnaire including body image (Body Image After Breast Cancer Questionnaire), self-esteem (Rosenberg Self-Esteem Scale), and sexual function (Female Sexual Function Index) measures. The belly dance group significantly improved body image on limitations scale in the short term and long term, the mat Pilates significantly improved body image on limitations only in the long term, and the control group significantly decreased body image on limitations in the long term. The belly dance group experienced reduced discomfort and pain during sexual relations in the short and long term. All groups showed a significant improvement in self-esteem, but orgasm sub-scale scores declined over time. No adverse events were found for any of the exercise intervention groups. Belly dance seem to be more effective than mat Pilates and control group in improving limitations of body image and sexual discomfort in the short term for breast cancer survivors. ClinicalTrials.gov (NCT03194997) - "Pilates and Dance to Breast Cancer Patients Undergoing Treatment".
Collapse
Affiliation(s)
- Leonessa Boing
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | | | - Francine Stein
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil
| | - Vanessa Bellani Lyra
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil
| | - Jéssica Amaro Moratelli
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil
| | - Juliana da Silveira
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil.
| | - Patrícia Severo Dos Santos Saraiva
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil
| | - Anke Bergmann
- Clinical Epidemiology, National Institute of Cancer, Rio de Janeiro, Brazil
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | | |
Collapse
|
6
|
Álvarez-Pardo S, De Paz JA, Montserrat Romero-Pérez E, Portilla-Cueto KM, Horta-Gim MA, González-Bernal JJ, Fernández-Solana J, Mielgo-Ayuso J, García-Valverde A, González-Santos J. Factors Associated with Body Image and Self-Esteem in Mastectomized Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5154. [PMID: 36982062 PMCID: PMC10048946 DOI: 10.3390/ijerph20065154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/04/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Body image (BI) and self-esteem (SE) are two fundamental aspects in the evolution of breast cancer (BC), mainly due to surgery, treatment, and the patient's conception of BI. A dissatisfaction with BI and low SE decreases the subject's quality of life and increases the risk of recurrence and mortality by BC. The aim of this study is to find out if there is any degree of association between the sociodemographic data of the sample and their BI and SE. A cross-sectional, descriptive study was conducted with 198 women diagnosed with BC, aged 30-80 years, in Mexico. Women's BI and SE were assessed using two questionnaires, Hopwood Body Image Scale (S-BIS) and Rosenberg Self-Esteem Scale (RSES). The results show significant differences in several items when the variable sense of humor is taken into account, indicating that women with a sense of humor report higher satisfaction with their BI and higher SE. The age also indicates a significantly better BI in women over 50 years of age, as well as the education level variable, where those women who had studied up to secondary reported higher satisfaction with their BI; the family history shows that those women without a family history report better SE. All these data are supported by stepwise regression, which shows that educational level and sense of humor are predictors of BI, and family history along with breast reconstruction and sense of humor are predictors as of SE. In conclusion, it is important to take into account the characteristics of women with BC, particularly age and sense of humor, in order to reduce the impact of the disease on their BI and SE with the help of a multidisciplinary team.
Collapse
Affiliation(s)
| | | | | | | | - Mario A. Horta-Gim
- Division of Biological Sciences and Health, University of Sonora, Hermosillo 83000, Mexico
| | | | | | - Juan Mielgo-Ayuso
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
| | | | | |
Collapse
|
7
|
Azizi M, Ebrahimi E, Moghadam ZB, Shahhosseini Z, Modarres M. Pregnancy Health Among Breast Cancer Survivors: Development and Validation of an Educational Package in Iran. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023:10.1007/s13187-023-02275-y. [PMID: 36856948 DOI: 10.1007/s13187-023-02275-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Reproductive-aged breast cancer (BC) survivors are concerned about their fertility potential after BC treatment. No specific and comprehensive educational and clinical package examines pregnancy health in BC survivors. This study aimed to develop and validate a pregnancy health educational package for BC survivors who intend to experience pregnancy after completing cancer treatment. The present study is a mixed methods study conducted in three phases. The researchers, in phase 1, performed a qualitative content analysis study to explore the perceived needs and experiences of pregnancy among Iranian BC survivors. Then in the second phase, the authors conducted a systematic literature review to search all available packages, guidelines, documents, and published papers on pregnancy or fertility status among BC survivors worldwide. In the third phase, the intervention type was selected according to the opinions of the expert's team during two sessions of online meetings using the Delphi technique. The package quality was assessed by an expert team using the Appraisal of Guidelines for Research and Evaluation Instrument II (AGREE II) tool. The pregnancy health package for BC survivors was developed in seven separate chapters based on the qualitative study and literature review findings. The results of the validity or quality assessment of the package according to the six domains of the AGREE II tool were reported as follows: the score for the scope and purpose domain was 95.55%, the stakeholder involvement domain was 89.16%, the score for the rigor of development domain was 92.97%, clarity of presentation domain was 94.44%, the score of applicability domain was 87.06%, and the score of editorial independence domain was calculated 93.75%. The pregnancy health package was designed with high quality and validity and, as an excellent cost-effective resource, is proposed to BC survivors to increase their awareness regarding their fertility issues before attempting to conceive.
Collapse
Affiliation(s)
- Marzieh Azizi
- Department of Midwifery and Reproductive Health, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ebrahimi
- Department of Midwifery and Reproductive Health, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Behboodi Moghadam
- Department of Midwifery and Reproductive Health, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Shahhosseini
- Department of Midwifery, School of Nursing and Midwifery, Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
| | - Maryam Modarres
- Department of Midwifery and Reproductive Health, Researcher of Nursing and Midwifery Care Research Center, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
8
|
Solikhah S, Perwitasari DA, Rejeki DSS. Cross-cultural adaptation and psychometric properties of the Indonesian version for quality of life among breast cancer patients. Front Public Health 2023; 11:1069422. [PMID: 36926172 PMCID: PMC10011654 DOI: 10.3389/fpubh.2023.1069422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/09/2023] [Indexed: 03/08/2023] Open
Abstract
Background Breast cancer is one of the most important health problems worldwide. Quality of life (QoL) is an important indicator to evaluate symptoms in cancer patients, including those with breast cancer. Culturally suitable, valid, reliable, and appropriate instruments to measure the QoL of breast cancer patients are needed, which is still rare in Indonesia. This study aimed to translate the EORTC QLQ-BR45 instrument into Indonesian and evaluate its psychometrics. Methods A cross-sectional study was performed on 635 patients conveniently selected from the oncology department in referral hospital. The first phase of this study involved translation of the existing EORTC QLQ-BR45 into Indonesian, and in the second phase, we evaluated its psychometric properties. Construct validity was evaluated using confirmatory factor analysis (CFA). Criterion validity was examined according to the association between disease stage and Karnofsky Performance Scale (KPS). Results A total of 635 (99.00%) completed the EORTC QLQ-BR45 successfully. The instrument indicated good readability and high content validity. All Cronbach's alpha coefficients were satisfactory (overall value, 0.87). For construct validity, patients with KPS ≥80% did better than those with KPS ≤70% as did two multi-item scales in functional scales (body image and breast satisfaction) and five multi-item scales in symptom scales (systemic therapy side effects, endocrine therapy, and arm, breast, and endocrine sexual symptoms). Body image score of late-stage patients was significantly higher. CFA indicated that the nine-factor structure of the Indonesian EORTC QLQ-BR45 was a good fit for the data. Conclusion The Indonesian EORTC QLQ-BR45 questionnaire is reliable and valid with good psychometric properties, thus can be used for breast cancer patients in Indonesia.
Collapse
Affiliation(s)
- Solikhah Solikhah
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | | | - Dwi Sarwani Sri Rejeki
- Department of Public Health, Faculty of Health Sciences, Universitas Jenderal Soedirman, Purwokerto, Indonesia
| |
Collapse
|
9
|
Hamidi F, Elyasi F, Mousavinasab SN, Ghasemi A, Keshavarz Z, Shahhosseini Z. Effect of a social network-based supportive program (WhatsApp) on the sexual self-concept of women with breast cancer: A single-blind-randomized controlled trial. Palliat Support Care 2023; 21:27-37. [PMID: 35257652 DOI: 10.1017/s1478951522000220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Sexual self-concept has an influence on the sexual behaviors of women with breast cancer. Supportive programs for these women have demonstrable empirical efficacy; however, their effectiveness has not been examined. The aim of this study was to investigate the effect of a supportive program based on social networks on the sexual self-concept of women with breast cancer. METHODS In this randomized controlled single-blind trial, 60 women were assigned to the intervention (n = 30) and control (n = 30) groups using permuted block randomization. Overall, eight 45-min intervention sessions were held (twice a week). The primary outcome was sexual self-concept, and the secondary outcomes were women's sexual quality of life and participants' satisfaction. The questionnaires were completed by patients before the intervention and immediately and 1 month after the intervention. RESULTS The generalized equation estimation test showed that the positive sexual self-concept score of the intervention group versus the control group had increased by 15.67 points (P < 0.001, effect size = 2.00) 1 month after the intervention. The negative sexual self-concept score had decreased by 2.65 points (P < 0.001, effect size = 0.74), and the situational sexual self-concept score had upturned by 6.82 points (P < 0.001, effect size = 2.08) in the intervention group at the same period. Also, the sexual quality of life score in the intervention group compared to the control group generally increased by 13.82 points (P < 0.001, Effect size = 2.08) 1 month following the intervention. SIGNIFICANCE OF THE RESULTS A social networking support program can be a promising approach to improve the sexual self-concept of women with breast cancer. CLINICAL TRIALS.GOV IDENTIFIER Iranian Clinical Trial Register, IRCT20150608022609N8. Registered on 2 July 2020.
Collapse
Affiliation(s)
- Fatemeh Hamidi
- Student of Midwifery Counseling, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Sexual and Reproductive Health Research Center, Department of Psychiatry, Psychiatric and Behavioral Sciences Research Center, Addiction Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed-Nouraddin Mousavinasab
- Department of Biostatistics, Health Sciences Research Center, Research Institute of Traditional and Complementary Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Arash Ghasemi
- Department of Radiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zohre Keshavarz
- Department of Reproductive Health and Midwifery, Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Shahhosseini
- Department of Reproductive Health and Midwifery, Faculty of Nursing and Midwifery, Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
10
|
Vegunta S, Kuhle CL, Vencill JA, Lucas PH, Mussallem DM. Sexual Health after a Breast Cancer Diagnosis: Addressing a Forgotten Aspect of Survivorship. J Clin Med 2022; 11:6723. [PMID: 36431200 PMCID: PMC9698007 DOI: 10.3390/jcm11226723] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/12/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
Breast cancer is the most common cancer in women. The life expectancy after a breast cancer diagnosis is improving steadily, leaving many more persons with the long-term consequences of treatment. Sexual problems are a common concern for breast cancer survivors yet remain overlooked in both the clinical setting and the research literature. Factors that contribute to sexual health concerns in breast cancer survivors are biopsychosocial, as are the barriers to addressing and treating these health concerns. Sexual health needs and treatment may vary by anatomy and gender. Multidisciplinary management may comprise lifestyle modifications, medications, sexual health aids such as vibrators, counseling, and referrals to pelvic health physical therapy and specialty care. In this article, we review the contributing factors, screening, and management of sexual difficulties in cisgender female breast cancer survivors. More information is needed to better address the sexual health of breast cancer survivors whose sexual/gender identity differs from that of cisgender women.
Collapse
Affiliation(s)
- Suneela Vegunta
- Division of Women’s Health Internal Medicine, Mayo Clinic, 13400 Shea Blvd, Scottsdale, AZ 85259, USA
| | - Carol L. Kuhle
- Menopause and Women’s Sexaul Health Clinic, Mayo Clinic, Rochester, MN 55905, USA
| | - Jennifer A. Vencill
- Menopause and Women’s Sexaul Health Clinic, Mayo Clinic, Rochester, MN 55905, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Pauline H. Lucas
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Dawn M. Mussallem
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL 32224, USA
| |
Collapse
|
11
|
Rodrigues-Machado N, Quintana MJ, Gómez-Gómez R, Bonfill-Cosp X. Sexual Function in Women with Breast Cancer: An Evidence Map of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13976. [PMID: 36360854 PMCID: PMC9654538 DOI: 10.3390/ijerph192113976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/20/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
Breast cancer (BC) is the leading cause of cancer in women, and has implications for sexual function (SF). In this study, we used an evidence map to identify, describe, and organise the current available evidence regarding SF in women with BC. We searched the MEDLINE, PsycINFO, and CINAHL databases for observational studies assessing SF in women with BC published in English, Spanish, Portuguese, and French between 2000 and 2021 (sample ≥ 50 women). Of the 64 included studies (13,257 women with BC), 58 were published since 2010. Women who were married, partnered, or in relationships represented 74.1% of the entire sample. Only a single study was conducted on women representing a sexual minority. We identified 22 assessment instruments and 40 sexual dysfunction (SdF) domains. The number of publications on SF in women with BC has increased in the last 10 years, but still remains low. Some groups of women are underrepresented, and some SdF domains are underdiagnosed, with the assessment instrument used affecting which domains are studied. Women with BC need to be better screened, as their quality of life (QoL) is affected by SdF.
Collapse
Affiliation(s)
- Nelson Rodrigues-Machado
- Department of Paediatrics, Obstetrics & Gynaecology and Preventive Medicine, Universtitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
| | - M. Jesús Quintana
- Department of Paediatrics, Obstetrics & Gynaecology and Preventive Medicine, Universtitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain
- Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
- Centro Cochrane Iberoamérica, 08025 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | | | - Xavier Bonfill-Cosp
- Department of Paediatrics, Obstetrics & Gynaecology and Preventive Medicine, Universtitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain
- Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
- Centro Cochrane Iberoamérica, 08025 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| |
Collapse
|
12
|
A Negative Body Image among Adolescent and Young Adult (AYA) Cancer Survivors: Results from the Population-Based SURVAYA Study. Cancers (Basel) 2022; 14:cancers14215243. [PMID: 36358662 PMCID: PMC9655157 DOI: 10.3390/cancers14215243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 12/05/2022] Open
Abstract
Simple Summary Adolescent and young adult (AYA) cancer survivors diagnosed with cancer between ages 18–39 years often experience negative body changes, such as scars, amputation, hair loss, disfigurement, body weight changes, skin buns, and physical movement limitations. A negative body image could have negative implications for the self-esteem, self-identity, and social relationships of AYAs. Despite the possible long-term effects of cancer on body image, within the AYA literature, limited studies focus on AYA cancer survivors in a quantitative way. Therefore, the aim of our population-based cross-sectional study was to examine the prevalence, and association of a negative body image with sociodemographic, clinical, and psychosocial factors, among AYA survivors 5–20 years after diagnosis. Raising awareness and integrating supportive care for those who experience a negative body image into standard AYA survivorship care is warranted. Future longitudinal research could help to identify when and how this support for AYA survivors can be best utilized. Abstract Adolescent and young adult (AYA) cancer survivors (18–39 years at diagnosis) often experience negative body changes such as scars, amputation, and disfigurement. Understanding which factors influence body image among AYA survivors can improve age-specific care in the future. Therefore, we aim to examine the prevalence, and association of a negative body image with sociodemographic, clinical, and psychosocial factors, among AYA cancer survivors (5–20 years after diagnosis). A population-based cross-sectional cohort study was conducted among AYA survivors (5–20 years after diagnosis) registered within the Netherlands Cancer Registry (NCR) (SURVAYA-study). Body image was examined via the EORTC QLQ-C30 and QLQ-SURV100. Multivariable logistic regression models were used. Among 3735 AYA survivors who responded, 14.5% (range: 2.6–44.2%), experienced a negative body image. Specifically, AYAs who are female, have a higher Body Mass Index (BMI) or tumor stage, diagnosed with breast cancer, cancer of the female genitalia, or germ cell tumors, treated with chemotherapy, using more maladaptive coping strategies, feeling sexually unattractive, and having lower scores of health-related Quality of Life (HRQoL), were more likely to experience a negative body image. Raising awareness and integrating supportive care for those who experience a negative body image into standard AYA survivorship care is warranted. Future research could help to identify when and how this support for AYA survivors can be best utilized.
Collapse
|
13
|
Zhu M, Sun S, Zhang Y, Chen L, He H, Chen J, Zhang N, Zhang M. Effects of the appearance care on psychosocial outcomes for breast cancer: a systematic review and meta-analysis. Support Care Cancer 2022; 30:8805-8817. [PMID: 35835903 DOI: 10.1007/s00520-022-07274-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/29/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To synthesize the evidence for the immediate and short-term effects of appearance care on psychosocial outcomes in breast cancer patients in order to inform the design of future research and clinical practice. METHODS A search of four databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science). The JBI Critical Appraisal Checklists were used by two reviewers to assess methodology quality. Subgroup analysis was conducted for the different time points measured after intervention. RESULTS Seven studies were eligible for the meta-analysis, including two RCTs and five quasi-experimental studies, from 1994 to 2022. The type of intervention was mainly grouped education, led by beauty specialists, and the dose and frequency varied. The quality of included studies was moderate to high. The results showed that appearance care had positive immediate effect on self-esteem (SMD = 0.63, 95% CI 0.37 to 0.89), anxiety (SMD = - 0.46, 95% CI - 0.60 to - 0.31), and depression (SMD = - 0.41, 95% CI - 0.62 to - 0.19), with short-term effects on anxiety (SMD = - 0.42, 95% CI - 0.54 to - 0.34), depression (SMD = - 0.41, 95% CI - 0.55 to - 0.26), and sexual function (SMD = 0.50, 95% CI 0.18 to 0.81).The effect of appearance care on body image and quality of life was uncertain. CONCLUSION Appearance care could be a promising intervention to improve self-esteem, anxiety, depression, and sexual function among patients with breast cancer. More high-quality RCTs are needed to validate these findings. Online appearance care programs and exploration of long-term effects should also be considered.
Collapse
Affiliation(s)
- Mengyao Zhu
- School of Nursing, Sun Yat-Sen University, 74, Zhongshan 2nd Rd., 510080, Guangzhou, China
| | - Shihao Sun
- School of Nursing, Sun Yat-Sen University, 74, Zhongshan 2nd Rd., 510080, Guangzhou, China
| | - Yiheng Zhang
- School of Nursing, Sun Yat-Sen University, 74, Zhongshan 2nd Rd., 510080, Guangzhou, China
| | - Lili Chen
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Haiyan He
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Juanjuan Chen
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ni Zhang
- School of Nursing, Sun Yat-Sen University, 74, Zhongshan 2nd Rd., 510080, Guangzhou, China
| | - Meifen Zhang
- School of Nursing, Sun Yat-Sen University, 74, Zhongshan 2nd Rd., 510080, Guangzhou, China.
| |
Collapse
|
14
|
Victoria M, Marie B, Dominique R, Caroline A, Marc-Karim BD, Julien M, Sophie L, Anne-Déborah B. Breast reconstruction and quality of life five years after cancer diagnosis: VICAN French National cohort. Breast Cancer Res Treat 2022; 194:449-461. [PMID: 35608713 DOI: 10.1007/s10549-022-06626-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 05/03/2022] [Indexed: 12/26/2022]
Abstract
PURPOSE Women with breast cancer (BC) who have a mastectomy may subsequently undergo breast reconstruction (BR). This study aimed to identify (1) factors associated with having BR, (2) factors associated with immediate BR (IBR) and delayed BR (DBR), and (3) associations between no BR, IBR and DBR and physical and mental quality of life (QoL) 5 years after diagnosis. METHODS Analyses were based on data from the national French cancer cohort VICAN, which followed a representative sample of cancer survivors, including BC survivors, for 5 years after diagnosis. BR and BR type (IBR/DBR) were identified using medico-administrative databases. The SF12 scale was used to measure mental and physical QoL. Multivariate logistic regressions were used to identify factors associated with BR, and linear models to evaluate associations between BR and BR type with QoL. RESULTS Of the 1192 BC survivors in VICAN, 32.6% (n = 388) had a mastectomy. Among them, 60.1% (n = 233) had BR. Of these, 38.6% (n = 90) and 61.4% (n = 143) had IBR and DBR, respectively. Compared with women who had BR, women who did not were more likely to be older and to have a lower level of health literacy. Compared with women who did not have BR, those with IBR had better mental QoL, while those who had either IBR or DBR had better physical QoL. CONCLUSION Older women and those with inadequate health literacy were less likely to have BR. This may reflect women's preferences, inequalities in care options offered after a mastectomy, and socioeconomic barriers to accessing BR. These issues need further exploration. Furthermore, BR was associated with a better long-term physical QoL. IBR was associated with better mental QoL and should be promoted when possible.
Collapse
Affiliation(s)
- Memoli Victoria
- Aix Marseille Univ, INSERM, IRD, SESSTIM, ISSPAM, Cancer Biomedicine & Society Group, Equipe Labellisée Ligue 2019, 13009, Marseille, BDR, France
| | - Bannier Marie
- Department of Surgery, Institut Paoli-Calmettes, Marseille, France
| | - Rey Dominique
- Aix Marseille Univ, INSERM, IRD, SESSTIM, ISSPAM, Cancer Biomedicine & Society Group, Equipe Labellisée Ligue 2019, 13009, Marseille, BDR, France
| | | | - Ben Diane Marc-Karim
- Aix Marseille Univ, INSERM, IRD, SESSTIM, ISSPAM, Cancer Biomedicine & Society Group, Equipe Labellisée Ligue 2019, 13009, Marseille, BDR, France
| | - Mancini Julien
- Aix Marseille Univ, INSERM, IRD, SESSTIM, ISSPAM, Cancer Biomedicine & Society Group, Equipe Labellisée Ligue 2019, 13009, Marseille, BDR, France.
- APHM, BIOSTIC, Hop Timone, Marseille, France.
| | - Lauzier Sophie
- Université Laval, Québec, Canada
- CHU de Québec-Université Laval Research Center, Québec, Canada
| | - Bouhnik Anne-Déborah
- Aix Marseille Univ, INSERM, IRD, SESSTIM, ISSPAM, Cancer Biomedicine & Society Group, Equipe Labellisée Ligue 2019, 13009, Marseille, BDR, France
| |
Collapse
|
15
|
Smedsland SK, Vandraas KF, Bøhn SK, Dahl AA, Kiserud CE, Brekke M, Falk RS, Reinertsen KV. Sexual activity and functioning in long-term breast cancer survivors; exploring associated factors in a nationwide survey. Breast Cancer Res Treat 2022; 193:139-149. [PMID: 35226237 PMCID: PMC8993724 DOI: 10.1007/s10549-022-06544-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/13/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Sexual health is a key quality of life issue. Knowledge concerning sexual health in long-term breast cancer survivors (BCSs) is limited. Within a nationwide sample, we aimed to assess the prevalence of sexual inactivity and to explore factors associated with sexual inactivity and reduced sexual functioning among long-term BCSs. METHODS Long-term BCSs aged 20-65 years when diagnosed with early-stage breast cancer in 2011-2012 were identified by the Cancer Registry of Norway in 2019 (n = 2803) and invited to participate in a nationwide survey. Sexual health was measured using the multidimensional Sexual Activity Questionnaire. Factors associated with sexual inactivity and reduced sexual functioning were explored using multivariable logistic- and linear regression analyses with adjustments for relevant sociodemographic, health-, and cancer-related variables. RESULTS The final sample consisted of 1307 BCSs with a mean age of 52 years at diagnosis. Fifty-two percent of the BCSs were sexually inactive. Lack of interest was the most common reason for sexual inactivity. Treatment with aromatase inhibitor (OR 1.73, 95% CI 1.23, 2.43) and poor body image (OR 0.99, 95% CI 0.99, 0.995) were associated with sexual inactivity. Among sexually active BCSs, depression (B - 1.04, 95% CI - 2.10, - 0.02) and physical inactivity (B - 0.61, 95% CI - 1.21, - 0.02) were inversely related to sexual pleasure. Treatment with aromatase inhibitor (B 0.61, 95% CI 0.20, 1.01), sleep problems (B 0.37, 95% CI 0.04, 0.70), breast symptoms (B 0.01, 95% CI 0.003, 0.02), and chronic fatigue (B 0.43, 95% CI 0.05, 0.81) were associated with sexual discomfort. Chemotherapy (OR 1.91, 95% CI 1.23, 2.97), current endocrine treatment (OR 1.98, 95% CI 1.21, 3.25), and poor body image (OR 0.98, 95% CI 0.98, 0.99) were associated with less sexual activity at present compared to before breast cancer. CONCLUSION Treatment with aromatase inhibitor seems to affect sexual health even beyond discontinuation. Several common late effects were associated with sexual inactivity and reduced sexual functioning. To identify BCSs at risk of sexual dysfunction, special attention should be paid to patients treated with aromatase inhibitor or suffering from these late effects.
Collapse
Affiliation(s)
- Solveig K Smedsland
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway.
| | - Kathrine F Vandraas
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Synne K Bøhn
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Alv A Dahl
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Mette Brekke
- General Practice Research Unit, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ragnhild S Falk
- Research Support Services, Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Kristin V Reinertsen
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
16
|
Li Y, Guo J, Sui Y, Chen B, Li D, Jiang J. Quality of Life in Patients with Breast Cancer following Breast Conservation Surgery: A Systematic Review and Meta-Analysis. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:3877984. [PMID: 35140901 PMCID: PMC8820849 DOI: 10.1155/2022/3877984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 01/29/2023]
Abstract
To evaluate the health-related quality-of-life (QOL) outcomes in surgical breast cancer survivors who received breast conservation therapy (BCT) compared to mastectomy, we utilized a systematic review to conduct observational studies of QOL in patients with breast cancer following breast conservation therapy from their inception until October 2021. The PubMed, the Cochrane Library, and the Web of Science databases were systematically searched to retrieve the observational studies. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were applied as an effect estimate and calculated using Stata 15 software. Nine studies comprising 2301 patients were included. The results showed that no significant differences compared to mastectomy were detected for global health status (P=0.971 and P=0.613), physical function (P=0.099), emotional function (P=0.096), cognitive function (P=0.377), social function (P=0.602), sexual functioning (P=0.072), and sexual enjoyment (P=0.142), while role function (P=0.036), body image (P=0.000), and future perspective (P=0.012) showed a significant difference for BCT when compared to mastectomy. When compared to breast reconstruction (BR), the BCT group was inferior at physical function (P=0.002) and cognitive function (P=0.040) but superior at body image (P=0.001). When used the Functional Assessment of Cancer Therapy (FACT) tool, BCT has better results in physical function (P=0.000), emotional function (P=0.000), and social function (P=0.000) than mastectomy. QOL outcomes after BCT were better than mastectomy in body image, future perspective, and role function. BCT may be an acceptable option in the study setting for breast cancer patients who pursue high QOL.
Collapse
Affiliation(s)
- Yue Li
- Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin City, Heilongjiang Province, China
| | - Jianming Guo
- Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin City, Heilongjiang Province, China
| | - Yuan Sui
- Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin City, Heilongjiang Province, China
| | - Baihui Chen
- Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin City, Heilongjiang Province, China
| | - Dalin Li
- Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin City, Heilongjiang Province, China
| | - Jiakang Jiang
- Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, Heilongjiang Province, China
| |
Collapse
|
17
|
Sexual quality of life assessment in young women with breast cancer during adjuvant endocrine therapy and patient-reported supportive measures. Support Care Cancer 2022; 30:3633-3641. [PMID: 35028721 PMCID: PMC8857103 DOI: 10.1007/s00520-022-06810-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/03/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE Sexual quality of life (QoL) is affected during and after breast cancer (BC) treatment. The purpose was to investigate sexual and global QoL and patient-reported measures to address this issue in young women (< 51 years) with BC after the acute treatment phase, during adjuvant endocrine therapy. METHODS Three EORTC questionnaires and an additional specific questionnaire, developed for the study, were used to assess sexual and global QoL and patient-reported supportive measures in BC patients who had received their endocrine therapy for at least 24 months. Among the 54 eligible patients, 45 (83%) agreed to participate in the study. RESULTS We showed a deterioration in sexual QoL and poor communication with healthcare professionals. Most patients (88.9%) declared that it was important that sexuality should be discussed with caregivers and that the partner should also be involved. Most patients (60%) had taken at least one action to overcome their sexual problems. Most of these interventions (63%) originated from the patient herself. CONCLUSIONS Sexual QoL is a major issue in young BC patients and is poorly addressed by healthcare professionals. Most of the supportive methods used by the patients to overcome these side effects were on their own initiative. Communication and counseling on sexuality by healthcare professionals need to be improved during BC treatment. Patients suggested supportive measures they would find useful and appropriate to develop in the clinic. The final goal is to improve the sexual QoL of BC patients with the appropriate intervention and support.
Collapse
|
18
|
Xu J, Xue B, Li L, Qiao J, Redding SR, Ouyang YQ. Psychological interventions for sexual function and satisfaction of women with breast cancer: A systematic review and meta-analysis. J Clin Nurs 2022; 32:2282-2297. [PMID: 34985158 DOI: 10.1111/jocn.16194] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To systematically evaluate the effectiveness of psychological interventions for women with breast cancer on sexual function, sexual satisfaction, sexual relationships, sexual distress and sexual quality of life. BACKGROUND Sexual dysfunction is common in women with breast cancer and seriously affects their quality of life and marital harmony. Several studies have explored the effects of psychological interventions related to sexual function of women with breast cancer, but results were inconclusive. DESIGN A systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. METHOD A search of PubMed, EMBASE, PsycINFO, Web of Science, the Cochrane Library, Scopus, CINAHL, ProQuest Dissertations and Theses Global, ClinicalTrials.gov. and Open Grey was conducted from inception to 9 May 2021. Two reviewers independently screened studies, extracted data and conducted a quality appraisal of included studies using the Joanna Briggs Institute critical appraisal checklists. RESULTS Fifteen studies involving 1307 participants were included. The current study showed that psychological interventions made statistically significant improvements in sexual function (SMD = 0.82; 95% CI = [0.43, 1.20]; p < .001), sexual satisfaction (SMD = 0.95; 95% CI = [0.19, 1.72]; p = .01), sexual relationships (SMD = 0.37; 95% CI = [0.15, 0.60]; p = .001) and sexual distress (MD = -5.05; 95% CI = [-7.88, -2.22]; p = .0005) of women with breast cancer. A subgroup analysis regarding the types of psychological interventions indicated that cognitive behavioural therapy and psychoeducational therapy were beneficial to sexual function and satisfaction, and psychosexual counselling could also improve sexual function. CONCLUSION Psychological interventions, especially psychoeducational therapy and cognitive behavioural therapy, are effective for improving the sexual health of women with breast cancer. RELEVANCE TO CLINICAL PRACTICE This current study provides evidence for the application of psychosexual interventions in women with breast cancer. REGISTRATION The study has been registered on the PROSPERO on 6 June 2021, with the registration number CRD42021253493.
Collapse
Affiliation(s)
- Jing Xu
- School of Nursing, Wuhan University, Wuhan, China
| | - Bing Xue
- School of Nursing, Wuhan University, Wuhan, China
| | - Lu Li
- School of Nursing, Wuhan University, Wuhan, China
| | - Jia Qiao
- School of Nursing, Wuhan University, Wuhan, China
| | | | | |
Collapse
|
19
|
The indirect effect of body image on distress in women with breast cancer undergoing chemotherapy. HEALTH PSYCHOLOGY REPORT 2022. [DOI: 10.5114/hpr.2022.113381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
20
|
Jonsdottir JI, Vilhjalmsson R, Svavarsdottir EK. Effectiveness of a couple-based intervention on sexuality and intimacy among women in active cancer treatment: A quasi-experimental study. Eur J Oncol Nurs 2021; 52:101975. [PMID: 34020136 DOI: 10.1016/j.ejon.2021.101975] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the effectiveness of a strenghts-oriented therapeutic conversation intervention on confidence about how illness beliefs affect sexuality and intimacy and on perceived relationship quality among women in active cancer treatment and their partners. METHODS A quasi-experimental single-group pre-post-follow-up design was used. Women in active cancer treatment and their intimate partners were randomly assigned to a nurse-managed couple-based intervention (experimental group, n = 30 couples) or wait-list (delayed intervention) control group (n = 27 couples) plus 4 additional couples who pilot tested feasibility of the intervention, prior to the RCT. However, baseline differences in demographic and clinical variables prevented comparisons between groups. Therefore, a repeated-one-group pre-post test setup was used, comparing women with cancer and their partners over three time points. The intervention consisted of three Couple-Strengths-Oriented Therapeutic Conversations (CO-SOTC) sessions. The participants also had access to web-based evidence-based educational information. Data were collected before intervention (T1, baseline), one to two weeks post-intervention (T2), and after a follow-up session at three months (T3). Data from 60 couples (N = 120) were analyzed. RESULTS Significant differences were observed, for both women and intimate partners, over time in more confidence about how illness beliefs affected sexuality and intimacy (T1 versus T2, and T1 versus T3), and increased overall quality of the relationship (T1 versus T2, and T1 versus T3). No differences were found between dyad members' scores on illness beliefs or relationship quality at any time point. CONCLUSIONS The CO-SOTC intervention was effective in supporting sexual adjustment among women in cancer treatment and their intimate partners. TRIAL REGISTRATION NUMBER NCT03936400 at clinicaltrials.gov.
Collapse
Affiliation(s)
- Jona Ingibjorg Jonsdottir
- Landspitali-The National University Hospital of Iceland, Hringbraut, 101, Reykjavik, Iceland; School of Health Sciences, Faculty of Nursing, University of Iceland, Eirberg, Eiríksgata 34, 101, Reykjavík, Iceland.
| | - Runar Vilhjalmsson
- School of Health Sciences, Faculty of Nursing, University of Iceland, Eirberg, Eiríksgata 34, 101, Reykjavík, Iceland.
| | - Erla Kolbrun Svavarsdottir
- Landspitali-The National University Hospital of Iceland, Hringbraut, 101, Reykjavik, Iceland; School of Health Sciences, Faculty of Nursing, University of Iceland, Eirberg, Eiríksgata 34, 101, Reykjavík, Iceland.
| |
Collapse
|
21
|
Wu Q, Yin Y, Wang Q, Wang S, Jia X. Body image and hopelessness among early-stage breast cancer survivors after surgery in China: A cross-sectional study. Nurs Open 2021; 8:3384-3393. [PMID: 33939319 PMCID: PMC8510705 DOI: 10.1002/nop2.884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 02/14/2021] [Accepted: 03/15/2021] [Indexed: 11/29/2022] Open
Abstract
Aim To examine the body image and hopelessness status of early‐stage breast cancer survivors who received a one‐time dressing change after surgery and were ready to be discharged from a hospital in China. Design A cross‐sectional study. Methods Participants were 211 women with breast cancer who had received a one‐time dressing change postsurgery. Spearman's correlation and structural equation modelling were used for data analysis. Results Participants in the 35–45 age group and those who underwent bilateral mastectomy presented higher scores for hopelessness. Married participants showed lower scores for the feelings about the future subscale compared to other subscales. Body image was significantly and positively associated with and had a positive effect on hopelessness. Women with a more positive appraisal of their body image tended to report lower levels of hopelessness. Healthcare providers should evaluate patients’ distress levels after a mastectomy to identify women who may require early psychosocial intervention.
Collapse
Affiliation(s)
- Qiong Wu
- The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Yongtian Yin
- Academic Affairs Office, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qing Wang
- The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Shiyuan Wang
- Scientific Research Department, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xinjie Jia
- The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| |
Collapse
|
22
|
Gong N, Zhang Y, Suo R, Dong W, Zou W, Zhang M. The role of space in obstructing clinical sexual health education: A qualitative study on breast cancer patients' perspectives on barriers to expressing sexual concerns. Eur J Cancer Care (Engl) 2021; 30:e13422. [PMID: 33565165 DOI: 10.1111/ecc.13422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 12/07/2020] [Accepted: 01/11/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Breast cancer patients report hoping to receive professional medical advice on sexual health and sexuality, but only few of them actively seek help from medical professionals. This study aims to gain clear understanding about barriers to patients' sexual health education seeking from the patient perspective. METHODS A qualitative study using in-depth interviews was conducted in an urban hospital in Guangdong Province. China. 20 female breast cancer patients were selected and interviewed. The interview was recorded and transcribed verbatim. Content analysis was used for the data analysis. RESULTS Four main barriers participants experienced to expressing sexual health education need to medical personnel included: (1) Avoiding discussion of sexuality due to the inappropriate space. (2) Avoiding sexual activity due to the disease treatment. (3) Avoiding sexual activity due to the body related distress. (4) Sexuality as a metaphor. CONCLUSIONS It is found that breast cancer patients' expression about sexuality was constrained by the hospital, disease, body space and the cultural logic behind the three spaces. Clinical staff should provide an appropriate space for discussing sexual concerns, increase sexual health knowledge, comprehensively evaluate patients' condition and develop a culturally adaptable sexual health education.
Collapse
Affiliation(s)
- Ni Gong
- School of Nursing, Jinan University, Guangzhou, China
| | - Yiheng Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Rongfei Suo
- The fifth affiliated hospital Sun Yat-sen University, Zhuhai, China
| | - Willa Dong
- School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wenjie Zou
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Meifen Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
23
|
Aptecar L, Fiteni F, Jarlier M, Delaine S, Guillerme V, Jacot W, D'Hondt V. Prospective evaluation of sexual health in breast cancer women during the first year of adjuvant hormonal treatment using a cancer patient's dedicated questionnaire: A glaring gap of communication between health professionals and patients. Breast Cancer Res Treat 2021; 186:705-713. [PMID: 33452553 DOI: 10.1007/s10549-020-06062-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/15/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Sexual quality of life (QoL) is affected during and after breast cancer (BC) treatment and is not specifically evaluated with the general health-related quality-of-life questionnaires EORTC QLQ-C30 or QLQ-BR23. A specific questionnaire, the EORTC SHQ-C22, including physical, psychological, and social aspects of sexuality, was recently developed to address this issue in cancer patients. METHODS A prospective bicentric study was conducted to evaluate the sexual QoL of women with BC during the first year of adjuvant hormonal treatment. RESULTS A total of 106 women completed the 3 questionnaires at baseline and 92 of them, at 12 months. At baseline, we showed low sexual satisfaction and importance given to sexual activity and a very low communication with healthcare professionals about this issue. Twelve months later, the importance given to sexuality had increased. While the communication with professionals had improved, it remained at a very low level. We were unable to identify specific clinical factors (chemotherapy, menopausal status, type of surgery or radiotherapy) that would negatively affect the global sexual well-being in BC patients. CONCLUSION The analysis of sexual QoL of BC patients during the first year of hormonal treatment with a recently developed, cancer-dedicated, standardized tool pointed out the need for deeper communication between professionals and patients regarding sexual issues to fill the current gap in care of cancer patients and help patients with adequate intervention and support.
Collapse
Affiliation(s)
- Leticia Aptecar
- Medical Oncology Department, Institut du Cancer de Montpellier, Montpellier, France
| | - Frederic Fiteni
- Medical Oncology Department, Centre Hospitalier Universitaire de Nimes, Nimes, France.,Institut Desbrest d'Epidemiologie et de Sante Publique, University of Montpellier, Montpellier, France
| | - Marta Jarlier
- Biometrics Unit, Institut du Cancer de Montpellier, Montpellier, France
| | - Stephanie Delaine
- Medical Research Unit, Institut du Cancer de Montpellier, Montpellier, France
| | | | - William Jacot
- Medical Oncology Department, Institut du Cancer de Montpellier, Montpellier, France.,Institut de Recherche en Cancerologie de Montpellier (IRCM), INSERM, University of Montpellier, Montpellier, France
| | - Veronique D'Hondt
- Medical Oncology Department, Institut du Cancer de Montpellier, Montpellier, France. .,Institut de Recherche en Cancerologie de Montpellier (IRCM), INSERM, University of Montpellier, Montpellier, France.
| |
Collapse
|
24
|
Lewis-Smith H, Diedrichs PC, Bond R, Harcourt D. Psychological and sociocultural influences on body image among midlife women with and without a history of breast cancer: Testing the Tripartite Influence Model of Body Image. Body Image 2020; 35:114-125. [PMID: 33010788 DOI: 10.1016/j.bodyim.2020.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/24/2020] [Accepted: 08/24/2020] [Indexed: 12/25/2022]
Abstract
Body image concerns are common among breast cancer survivors and women in midlife. However, effective interventions are lacking for breast cancer survivors. This may be related to prior research having examined non-modifiable and medicalised influences on body image, instead of modifiable sociocultural and psychological influences. An adaptation of the 'Tripartite Influence Model of Body Image' was tested among women with (n = 169; mean age = 49.9) and without (n = 323; mean age = 47.6) a history of breast cancer, to investigate whether psychological and sociocultural influences on body image were similar between groups. Structural equation modelling revealed the model fit was satisfactory. Media pressure had an indirect effect on body image among both groups, and a direct effect among women treated for breast cancer. An additional influence of relevance only to women without breast cancer was pressure from friends. Overall, findings indicate common influences of media pressure and appearance comparisons on body image among both groups of women. This suggests that with some tailoring, existing evidence-based body image interventions designed for midlife women targeting these factors may also be relevant and beneficial for breast cancer survivors.
Collapse
Affiliation(s)
- Helena Lewis-Smith
- Centre for Appearance Research, University of the West of England, United Kingdom.
| | | | - Rod Bond
- University of Sussex, United Kingdom
| | - Diana Harcourt
- Centre for Appearance Research, University of the West of England, United Kingdom
| |
Collapse
|
25
|
The Predictive Role of Body Image and Sexual Function in Quality of Life After Modified Radical Mastectomy Regarding the Mediating Role of Emotion; A Cross Sectional Study. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2020. [DOI: 10.5812/ijcm.101371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Mastectomy has negative effects on body image, sexual function, and quality of life (QOL). Additionally, maladaptive emotion regulation strategy is considered a trans-diagnostic mechanism underlying the psychiatric syndrome in these patients. Objectives: The predictive role of body image and sexual function in QOL regarding the mediating role of difficulty in emotion regulation has not been studied yet. Methods: In a correlational study, from March to December 2016, among patients undergoing modified radical mastectomy (MRM) at Early-stage Breast Cancer (BC), 90 patients were selected, using respondent-driven sampling (RDS). To collect the data, the Multidimensional Body-Self Relations Questionnaire (MBSRQ), the Persian language version of the Female Sexual Function Index (P-FSFI), QOL questionnaire, and Difficulties in Emotion Regulation Scales (DERS) were used. Data were analyzed through Pearson's correlation coefficient, regression analysis, and path analysis, using AMOS and SPSS software version 22 and the significance criterion was considered 0.05. Results: Data analysis showed a direct relationship between body image and sexual function with QOL, and it had an inverse relationship with difficulty in emotion regulation (P < 0.01). Also, body image, sexual function, and difficulty in emotion regulation were predictors of QOL (P < 0.01). Besides, in predicting QOL based on sexual function and body image, the difficulty in emotion regulation has a mediating role (P < 0.01). Conclusions: In patients with breast cancer under mastectomy, proper sexual function, sexual attraction depending on body image, and QOL were influenced by emotion regulation. Reducing the difficulty in emotion regulation through emotion-focused interventions can improve QOL in patients.
Collapse
|
26
|
Ghaffari F, Ghahramanian A, Zamanzadeh V, Onyeka TC, Davoodi A, Mazaheri E, Asghari-Jafarabadi M. Patient-centred communication for women with breast cancer: Relation to body image perception. J Clin Nurs 2020; 29:4674-4684. [PMID: 32956571 DOI: 10.1111/jocn.15508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 08/26/2020] [Accepted: 09/06/2020] [Indexed: 12/27/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to determine the predictive values of patient-centred communication (PCC) and patient's characteristics on the body image (BI) perception in postmastectomy patients. BACKGROUND Patient-centred communication has been touted as a means of addressing BI issues, especially for postmastectomy patients. DESIGN AND METHODS This predictive correlational study was conducted on 275 surgically treated breast cancer patients admitted to the Oncology Departments of two hospitals in Tabriz, Iran. These patients were selected using a convenience sampling method. The Body Image after Breast Cancer Questionnaire (BIBCQ) and patient-centred communication questionnaire (PCCQ) were used for collecting the data. Descriptive and inferential statistics were applied to the data. Reporting was in accordance with the STROBE guideline. RESULTS A multivariable model significantly predicted BI perception in participants using surgery type and time elapsed following surgery. Participants' limitations were significantly affected by surgery type and participants' perception of the nurses' PCC skills. Arm concern was significantly affected by surgery type and nurses' PCC skills. CONCLUSION Patient-centred skills in nurse-patient communication are critical for resolving BI difficulties such as arm concerns and limitations regarding the disease and its treatment. RELEVANCE TO CLINICAL PRACTICE Patient-centred communication skills can be taught nurses in the clinical setting to help alleviate patients' BI problems.
Collapse
Affiliation(s)
- Fariba Ghaffari
- Department of Medical Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Akram Ghahramanian
- Medical Surgical Department, Nursing and Midwifery Faculty, Hematology & Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zamanzadeh
- Medical Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tonia C Onyeka
- Department of Anaesthesia/Pain and Palliative Care Unit, Multidisciplinary Oncology Centre, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Arefeh Davoodi
- Department of Medical Surgical, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Effat Mazaheri
- Department of Medical Surgical, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Department of Statistics and Epidemiology, Faculty of Health, Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
27
|
Sexual functioning and self-esteem in women after mastectomy - a single-centre, non-randomised, cross-sectional study. Contemp Oncol (Pozn) 2020; 24:106-111. [PMID: 32774135 PMCID: PMC7403762 DOI: 10.5114/wo.2020.95876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/30/2020] [Indexed: 11/30/2022] Open
Abstract
Aim of the study The goal of our study was to assess the sexual functioning of patients undergoing mastectomy, five years after surgery, compared to a control group. Material and methods A cross-sectional study included 170 patients five years post mastectomy (group A1) and 149 healthy women (group A2) who had never been diagnosed with breast cancer. The study was conducted at the Oncology Centre in Bydgoszcz, at the Amazon Clubs, and at the University of the Third Age by the University of Economy in Bydgoszcz. Standardised questionnaires: the Female Sexual Function Index (FSFI) and Rosenberg’s SES (self-esteem scale) were used. Results Our study results show significantly worse sexual functioning in the domains pertaining to desire (p = 0.0015), arousal (p = 0.0052), lubrication (p = 0.0026), ability to reach orgasm (p = 0.0417), sexual satisfaction (p = 0.0142), and the presence of clinically significant sexual dysfunction (p = 0.0028) among patients after amputation of the mammary gland. On the scale of pain relating to sexuality, there were no significant differences between the two groups (p> 0.05). The overall score in the FSFI questionnaire was also lower (p = 0.0066) among women after mastectomy. Highly statistically significant (p < 0.0001) differences in self-esteem were also noted between the two groups, with worse results observed in patients after mastectomy. Conclusions Diagnosis of sexual dysfunction in patients treated for breast cancer allows timely implementation of counselling and interventional therapy depending on the causal factors and individual preferences of patients.
Collapse
|
28
|
Zhang J, Xia H, Zhang A, Zhu Y, Pan L, Gu P, Ma J. Circular RNA Expression Profiles in Vaginal Epithelial Tissue of Women With Lubrication Disorders. J Sex Med 2019; 16:1696-1707. [PMID: 31551192 DOI: 10.1016/j.jsxm.2019.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 08/15/2019] [Accepted: 08/19/2019] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Recently, circular RNA (circRNA) has been proved to occupy a vital pathological position in many diseases by acting as microRNAs sponges. However, the role of circRNA in female sexual dysfunction (FSD), especially in lubrication disorders (LDs), remains unclear. AIM The aim of this study was to detect circRNA expression in LDs, analyzed target genes, and pathways regulated by the differently expressed circRNAs. METHODS In this study, next-generation sequencing was first conducted to produce circRNA expression profiles of FSD groups and normal control groups. Furthermore, differences in expression of 6 randomly selected circRNAs were confirmed through real-time quantitative polymerase chain reaction. Kyoto Encyclopedia of Genes and Genomes biological pathway analysis and Gene Ontology showed that immune processes and infection could be involved in the development of FSDs. MAIN OUTCOME MEASURE CircRNA expression in vaginal epithelial tissue obtained from women with LDs have been detected. Gene Ontology, Kyoto Encyclopedia of Genes and Genomes biological pathway analysis, and circRNA-microRNA interaction predictions were investigated. RESULTS Totally, 7,746 circRNAs of vaginal epithelial tissue from women of 2 groups were sequenced. Preliminary judgment revealed that there were 73 circRNAs that have significant differential expression, including 53 downregulated circRNAs and 20 upregulated circRNAs. Research results also displayed that the majority of circRNAs has multiple binding sites of microRNAs, including miR-137, which has been reported to be linked to FSD. CLINICAL IMPLICATIONS We predicted 10 circRNAs paired with hsa-miR-137-5p, but the mechanism of circRNA involvement in disease development remains to be further explored. STRENGTHS & LIMITATIONS For the first time, the research disclosed the potential pathogenesis of LDs. However, we only analyzed the expression profile of circRNA in FSD, no specific mechanism was further confirmed or proposed. We still have a preliminary understanding, and more research is needed to explore the target of FSD treatment. CONCLUSION The results suggest that circRNAs have different expression in the FSD groups and play a vital part in the occurrence and development of FSD. Zhang J, Xia H, Zhang A, et al. Circular RNA Expression Profiles in Vaginal Epithelial Tissue of Women With Lubrication Disorders. J Sex Med 2019;16:1696-1707.
Collapse
Affiliation(s)
- Jingjing Zhang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | | | - Aixia Zhang
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Yuan Zhu
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Lianjun Pan
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Ping Gu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Jiehua Ma
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China.
| |
Collapse
|
29
|
Kuehn R, Casaubon J, Raker C, Edmonson D, Stuckey A, Gass J. Sexual Dysfunction in Survivorship; the Impact of Menopause and Endocrine Therapy. Ann Surg Oncol 2019; 26:3159-3165. [PMID: 31342358 DOI: 10.1245/s10434-019-07552-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sexual dysfunction is common for breast cancer survivors. Premenopausal women with breast cancer are increasingly offered ovarian suppression and aromatase inhibitor (AI) therapy. We evaluated the association of menopausal status and treatment modalities on sexual dysfunction. METHODS We conducted a cross-sectional anonymous Female Sexual Function Index (FSFI) survey of breast cancer survivors between 2000 and 2016. Analysis utilized Kruskal-Wallis test for FSFI scores, Chi square, or Fisher's exact test for categorical data, and regression analysis for associations. RESULTS Of 585 respondents, 278 (47.5%) had complete FSFI scores. Of these, 24 (8.6%) were premenopausal and 80 (28.8%) were pre/perimenopausal at survey completion. Median FSFI scores for premenopausal (31.2, interquartile range [IQR] 26.8-33.6) and pre/perimenopausal (29.2, IQR 25.9-32.2) were similar, whereas postmenopausal women (25.9, IQR 21.0-30.3) were significantly lower (p = 0.0007 and p = 0.0002, respectively). Premenopausal women were less likely to meet criteria for sexual dysfunction (FSFI score ≤ 26.55) than postmenopausal women (21 versus 55%, p < 0.0001, univariate analysis [odds ratio (OR) 0.32, 95% confidence interval (CI) 0.18-0.56]). Adjusting for treatment modality did not impact the significance (OR 0.43, 95% [CI] 0.23-0.80) but revealed that AIs independently are associated with sexual dysfunction (OR 2.41, 95% CI 1.32-4.40). The interaction between menopausal status and AIs was not significant (p = 0.24). CONCLUSIONS Our study demonstrates that menopausal status is associated with sexual dysfunction in breast cancer patients and sexual dysfunction in premenopausal women is not impacted by treatment modality outside of aromatase inhibitor therapy. As more premenopausal patients are treated with ovarian suppression, these data may guide clinicians in counseling patients regarding sexual dysfunction expectations.
Collapse
Affiliation(s)
- Reed Kuehn
- Breast Health Center, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA.
| | - Jesse Casaubon
- Breast Health Center, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA
| | - Christina Raker
- Division of Research, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA
| | - David Edmonson
- Breast Health Center, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA.,Department of Surgery, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA
| | - Ashley Stuckey
- Breast Health Center, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA.,Gynecologic Oncology, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA
| | - Jennifer Gass
- Breast Health Center, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA.,Department of Surgery, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA
| |
Collapse
|
30
|
Kim S, Ahn S. Influencing Factors of Sexual Intimacy and Satisfaction among Women within 1 Year after Mastectomy. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2019; 25:219-231. [PMID: 37684858 DOI: 10.4069/kjwhn.2019.25.2.219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/12/2019] [Accepted: 06/12/2019] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this study was to identify the levels of body image, sexual intimacy, and sexual satisfaction, and to explore factors affecting sexual intimacy and satisfaction among women within one year of mastectomy. METHODS The present study was a cross-sectional survey and involved 101 women who had undergone mastectomy at a University hospital of D city, Korea. Measurement included the scales of body image, sexual intimacy, and sexual satisfaction. RESULTS Mean age of the subjects was 51 years. Scores of the body image, sexual intimacy, and sexual satisfaction were 59.62, 90.69, and 69.04, respectively. Body image, sexual intimacy, and sexual satisfaction were significantly related to each other. Sexual intimacy was higher when women were of young age (β=-.32), had a shorter period since surgery (β=-.24), and with higher levels of body image (β=.37). Sexual satisfaction was higher when women had higher levels of body image (β=.19) and greater levels of sexual intimacy (β=.74). CONCLUSION Higher levels of body image and greater levels of sexual intimacy were identified as the significant factors influencing sexual satisfaction among these women. Future research with a mixed-method research is needed to gain a deep understanding of the sexuality between women and their husbands.
Collapse
Affiliation(s)
- Sunyoung Kim
- Nurse, Chungnam National University Hospital, Daejeon, Korea
| | - Sukhee Ahn
- Nurse, Chungnam National University Hospital, Daejeon, Korea
| |
Collapse
|