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Newcomb R, Traeger L, Jones B, Reynolds M, Tse A, Reese JB, Dizon D, Bober SL, Greer JA, Vanderklish J, Pensak N, DeFilipp Z, Chen YB, Temel JS, El-Jawahri A. Design and Development of a Multimodal Digital Intervention (SHIFT App) to Address Sexual Dysfunction in Hematopoietic Stem Cell Transplant (HSCT) Survivors. Transplant Cell Ther 2024:S2666-6367(24)00605-5. [PMID: 39181537 DOI: 10.1016/j.jtct.2024.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 08/11/2024] [Accepted: 08/17/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Hematopoietic stem cell transplant (HSCT) survivors frequently experience persistent sexual dysfunction, which is associated with impaired quality of life (QOL) and increased psychological distress. The lack of availability of clinicians with expertise in sexual health limits the capacity to address sexual health concerns in HSCT survivors. Digital health applications may offer a patient-centered and scalable solution to address sexual health concerns in cancer survivors. The objective of this report is to delineate the iterative process of adapting an in-person sexual health intervention into a self-administered digital application called "Sexual Health and Intimacy Following Transplant (SHIFT)" and the refinement of SHIFT using stakeholder feedback. METHODS We used a five-step development model to adapt SHIFT that included: 1) implementation of a multimodal bio-psycho-social conceptual framework, 2) development of a comprehensive intervention manual and SHIFT content, 3) translation of the intervention manual into an interactive storyline with a focus on enhancing patient engagement, 4) creation of initial SHIFT wireframes, and 5) refinement of SHIFT through iterative alpha and beta testing. At each step, key stakeholders including HSCT survivors, HSCT clinicians, and experts in sexual health, psychology, and digital health provided iterative feedback. RESULTS We adapted SHIFT based on our conceptual framework, prior in-person intervention work, and iterative stakeholder feedback in each application development stage. SHIFT incorporates medical information, educational materials, intimacy exercises, and activities to address the multiple etiologies of sexual health concerns in HSCT survivors. SHIFT includes strategies to enhance engagement including gamification, personalization, and incorporation of video from HSCT survivors and clinicians. Based on stakeholder feedback, SHIFT was refined with a focus on inclusivity of gender, sexual orientation, relationship status, and body image concerns. CONCLUSIONS SHIFT is novel, patient-centered digital application to address sexual dysfunction in HSCT survivors. Iterative feedback from key stakeholders including HSCT survivors guided SHIFT adaptation and refinement, to optimize patient engagement and ensure inclusivity. The final prototype of SHIFT was initially acceptable to key stakeholders and is now under further testing in a pilot randomized trial to assess its feasibility and preliminary efficacy for improving sexual health outcomes in HSCT survivors.
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Affiliation(s)
- Richard Newcomb
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134; Harvard Medical School, Boston, Massachusetts, 02114
| | - Lara Traeger
- Department of Psychology, University of Miami Sylvester Comprehensive Cancer Center, Miami, Florida 33124
| | - Bailey Jones
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134; Harvard Medical School, Boston, Massachusetts, 02114
| | - Mathew Reynolds
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134; Harvard Medical School, Boston, Massachusetts, 02114
| | - Alexandra Tse
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134; Harvard Medical School, Boston, Massachusetts, 02114
| | - Jennifer B Reese
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111
| | - Don Dizon
- Department of Medical Oncology, Lifespan Cancer Institute, Brown University, Providence, Rhode Island 02903
| | - Sharon L Bober
- Department of Psychooncolgy and Palliative Care, Dana Farber Cancer Institute, Boston Massachusetts 02215; Harvard Medical School, Boston, Massachusetts, 02114
| | - Joseph A Greer
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134; Harvard Medical School, Boston, Massachusetts, 02114
| | - Julie Vanderklish
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134; Harvard Medical School, Boston, Massachusetts, 02114
| | - Nicole Pensak
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134; Harvard Medical School, Boston, Massachusetts, 02114
| | - Zachariah DeFilipp
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134; Harvard Medical School, Boston, Massachusetts, 02114
| | - Yi-Bin Chen
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134; Harvard Medical School, Boston, Massachusetts, 02114
| | - Jennifer S Temel
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134; Harvard Medical School, Boston, Massachusetts, 02114
| | - Areej El-Jawahri
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134; Harvard Medical School, Boston, Massachusetts, 02114.
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2
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Kang D, Kim IR, Choi HJ, Jung CW, Yoon SS, Kim JS, Lee CH, Jang JH, Cho J. Association between body image dissatisfaction and poor quality of life and depression among patients with hematopoietic stem cell transplantation. Support Care Cancer 2020; 29:3815-3822. [PMID: 33241506 DOI: 10.1007/s00520-020-05884-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/05/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE This study aims to evaluate the association between body image dissatisfaction and quality of life and depression among patients after hematopoietic stem cell transplantation (HSCT). METHODS We conducted a cross-sectional survey at three university-based HSCT outpatient clinics and the Korea Blood Cancer Association. We assessed the body image using the body image scale; quality of life and depression were measured using the World Health Organization Quality of Life-BREF and the Patient Health Questionnaire 9, respectively. Univariate and multivariate linear regression models were used to find an association between body image, quality of life, and depression. RESULTS Among 163 study participants, 71.8% were male, and the mean age of the participants was 48.3 (SD = 11.2). Over 70% of the participants reported that they felt less physically and sexually attractive due to HSCT, and 39.3% of the patients were dissatisfied with their body image. In fully adjusted models, patients with dissatisfied body image had significantly poorer quality of life (- 13.68, 95% confidence interval [CI] = - 18.16, - 9.21). Moreover, patients with body image dissatisfaction were 8.59 times (95% CI = 3.79, 19.48) more likely to have depressive symptoms than patients without it. CONCLUSION The majority of HSCT patients experienced body image dissatisfaction, which was significantly associated with poor quality of life and depression. It would be essential to evaluate body image after HSCT and provide appropriate interventions for preventing further psychological consequences.
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Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Im-Ryung Kim
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Jin Choi
- Department of Nursing (Cancer center), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chul Won Jung
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung-Soo Yoon
- Division of Hematology/Oncology, Department of Internal Medicine, Seoul National University School of Medicine, Seoul, South Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | | | - Jun Ho Jang
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea. .,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. .,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. .,Departments of Epidemiology and Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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3
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Al-Wassia R, Al-Zaben F, Gamal Sehlo M, Koenig HG. Beliefs of cancer patients in Saudi Arabia. J Psychosoc Oncol 2019; 38:358-374. [PMID: 31347469 DOI: 10.1080/07347332.2019.1642284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives: To examine oncology patients' beliefs about the transmissible nature of cancer or its treatments and to determine the correlates thereof.Design: Cross-sectional.Participants: Sixty-nine hospital outpatients completed the questionnaire.Methods: Beliefs about the spread of cancer, chemotherapy, and radiation therapy with physical contact, along with demographic, social, psychological, health-related characteristics were assessed by questionnaire. Bivariate and multivariate analyses identified correlations between these beliefs and patient characteristics.Findings: A percentage (5.8%) believed their cancer could spread like an infection or be transmitted through sexual or nonsexual contact and 15.9% were unsure. Even more (13.0%) believed that chemotherapy could spread through sexual or nonsexual contact and 18.8% were unsure. Likewise, many believed (10.1%) that radiation therapy could spread through sexual or nonsexual contact and 21.7% were unsure. Obsessions with contamination were most strongly associated with such beliefs (B = 0.73, SE = 0.09, p < .0001).Conclusions: Beliefs about the spread of cancer or its treatments are not uncommon in Saudi Arabia, where cultural beliefs and tradition strongly influence healthcare decisions.
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Affiliation(s)
- Rolina Al-Wassia
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faten Al-Zaben
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Gamal Sehlo
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Psychiatry, Zagazig University, Zagazig, Egypt
| | - Harold G Koenig
- Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, USA.,Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia.,School of Public Health, Ningxia Medical University, Yinchuan, PR China
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4
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Al-Wassia R, Al-Zaben F, Sehlo MG, Koenig HG. Religiosity and Beliefs About the Transmission of Cancer, Chemotherapy, and Radiation Through Physical Contact in Saudi Arabia. JOURNAL OF RELIGION AND HEALTH 2019; 58:221-235. [PMID: 30554303 DOI: 10.1007/s10943-018-00745-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We examined relationships between religiosity and Saudi cancer patients' beliefs about the spread of cancer, chemotherapy, and radiation therapy through close physical contact. Surveyed were 64 patients seen in university oncology clinics. Assessed were beliefs about the spread of cancer and its treatments, along with religious, demographic, social, psychological, and cancer-related characteristics. Greater religiosity was related to older age, non-Saudi nationality, less anxiety, earlier cancer stage, and greater time since initial diagnosis. Non-significant trends suggested that religious practices were associated with less, but intrinsic religious beliefs with more concern about contagiousness, although the findings were limited by low statistical power.
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Affiliation(s)
- Rolina Al-Wassia
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faten Al-Zaben
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Gamal Sehlo
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
- King Abdulaziz University, Jeddah, Saudi Arabia
- Zagazig University, Zagazig, Egypt
| | - Harold G Koenig
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia.
- King Abdulaziz University, Jeddah, Saudi Arabia.
- Duke University Medical Center, Box 3400, Durham, NC, 27710, USA.
- School of Public Health, Ningxia Medical University, Yinchuan, People's Republic of China.
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5
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CESNIK VM, ZERBINI T. Sexuality education for health professionals: A literature review. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2017. [DOI: 10.1590/1982-02752017000100016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The objective of this study was to review the scientific literature addressing educational actions related to the training of health professionals in sexuality between 2003 and 2013. The results obtained show that college seniors, recent college graduates, or those working in hospitals and other health care facilities are not adequately prepared to meet patients' needs regarding sexuality. Several studies have shown improvement in the health practitioners' ability to deal with patients' sexuality issues after participating in training programs in sexuality, regardless of the course load. According to the articles reviewed, in order to improve the performance and comfort level of health practitioners to deal with patients' sexuality concerns, investments in educational actions are necessary.
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6
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Vieira EM, Santos DB, Santos MAD, Giami A. Experience of sexuality after breast cancer: a qualitative study with women in rehabilitation. Rev Lat Am Enfermagem 2016; 22:408-14. [PMID: 25029051 PMCID: PMC4292614 DOI: 10.1590/0104-1169.3258.2431] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 02/12/2014] [Indexed: 11/22/2022] Open
Abstract
Objective to comprehend the psychosocial and cultural repercussions of breast cancer
and its treatment on the sexuality of women. Method this is a qualitative study grounded in the Sexual Scripts Theory with the
participation of 23 women who were interviewed and participated in focus
groups discussion. Results each category was related to a level of the sexual scripts. At the cultural
scenario level a discourse on sexuality that includes definitions of sexual
attractiveness and sexuality was highlighted. The interpersonal scripts
level focused on the communication regarding sexuality established with the
partner and with healthcare professionals category; and at the subjectivity
scripts level the reports of improvement, deterioration and no change in the
sexual life after cancer were analyzed. Conclusion the experience of cancer involves cultural, relational, and subjective
aspects that affect the sexual life, therefore, healthcare professionals
should be aware of them to improve integral healthcare.
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Affiliation(s)
- Elisabeth Meloni Vieira
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Daniela Barsotti Santos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Manoel Antônio dos Santos
- Departamento de Psicologia, Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Alain Giami
- Centre de recherche en Epidémiologie e Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Le Kremlin, Bicêtre, France
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Astarita S, Caruso L, Barron AM, Rissmiller P. Experiences in Sexual Health Among Women After Hematopoietic Stem Cell Transplantation. Oncol Nurs Forum 2016. [DOI: 10.1188/16.onf.754-759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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8
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Paiva CE, Rezende FF, Paiva BSR, Mauad EC, Zucca-Matthes G, Carneseca EC, Syrjänen KJ, Schover LR. Associations of Body Mass Index and Physical Activity With Sexual Dysfunction in Breast Cancer Survivors. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:2057-2068. [PMID: 27260627 DOI: 10.1007/s10508-016-0758-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 02/24/2016] [Accepted: 04/08/2016] [Indexed: 06/05/2023]
Abstract
Sexual dysfunction is a common and distressing consequence of breast cancer (BC) treatment. In the present study, we investigated the sexual functioning of BC patients and its association with women's personal characteristics and cancer treatments. In this cross-sectional study, sexual function was assessed using the Female Sexual Function Index (FSFI). The health-related quality of life (HRQOL) was measured using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and its breast module BR-23. Of the 235 participants approached, 216 participants were included in the study. Of these, 63 patients reported no sexual activity in the last month and thus were analyzed only in relation to the sexual desire domain of FSFI. A total of 154 (71.3 %) patients were classified with hypoactive sexual desire disorder (HSDD). From those patients reporting sexual activity in the last month, 63.3 % (97 out of 153) were classified with sexual dysfunction. Using hierarchical logistic regression, the variance explained (change in R 2) by the addition of body mass index (BMI) and mild to moderate physical activity in the prediction models of sexual dysfunction and HSDD were 6.8 and 7.2 %, respectively. Age, BMI, and physical activity were independently associated with sexual dysfunction and HSDD. Additionally, BC patients with sexual dysfunction reported lower scores on global HRQOL, role functioning, and fatigue. Based on our findings, BC survivors should be encouraged to practice regular physical activity and to lose weight in order to avoid sexual dysfunction. However, future clinical trials are needed to confirm these findings.
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Affiliation(s)
- Carlos Eduardo Paiva
- Breast and Gynecology Division, Department of Clinical Oncology, Barretos Cancer Hospital, Rua Antenor Duarte Villela, 1331, Barretos, SP, 14784-400, Brazil.
- Research Group for Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, SP, Brazil.
- Teaching and Research Institute, Barretos Cancer Hospital, Barretos, SP, Brazil.
| | | | - Bianca Sakamoto Ribeiro Paiva
- Research Group for Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, SP, Brazil
- Teaching and Research Institute, Barretos Cancer Hospital, Barretos, SP, Brazil
| | | | - Gustavo Zucca-Matthes
- Department Mastology and Breast Reconstruction, Barretos Cancer Hospital, Barretos, SP, Brazil
| | | | | | - Leslie R Schover
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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9
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Sexual function 1-year after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2016; 51:833-40. [PMID: 26878660 DOI: 10.1038/bmt.2015.342] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 11/23/2015] [Accepted: 12/08/2015] [Indexed: 01/12/2023]
Abstract
Treatment with allogeneic hematopoietic stem cell transplantation (HSCT) is associated with short and long-term toxicities that can result in alterations in sexual functioning. The aims of this prospective evaluation were to determine: (1) associations between HSCT and increased sexual dysfunction 1 year after treatment; and (2) associations between sexual dysfunction, body image, anxiety and depression. This controlled prospective cohort study was conducted from October 2010 to November 2013. Patients completed assessments 2-3 weeks before HSCT (N=124) and 1 year after treatment (N=63). Assessment included descriptive data, Sexual Functioning Questionnaire, Body Image Scale and Hospital Anxiety and Depression Scale. The results showed a significant decline in overall sexual function in both men and women (P=<0.001, P=0.010, respectively), although men generally scored higher than women. Forty-seven percent of men and 60% of women reported at least one physical sexual problem 1 year after HSCT. Patients with chronic GVHD trended toward reporting lower levels of sexual function. Finally, women with chronic GVHD scored lower than those without chronic GVHD on the sexual function problem subscale (P=0.008). Sexual dysfunction remains a major problem for men and women 1 year after HSCT and requires routine evaluation and treatment after HSCT.
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10
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11
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Sekse RJT, Råheim M, Gjengedal E. Shyness and openness--common ground for dialogue between health personnel and women about sexual and intimate issues after gynecological cancer. Health Care Women Int 2015; 36:1255-69. [PMID: 25424412 DOI: 10.1080/07399332.2014.989436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In this article we explore shyness and openness related to sexuality and intimacy in long-term female survivors of gynecological cancer, and how these women experienced dialogue with health personnel on these issues. Further analysis on two core themes, based on empirical data presented elsewhere, inspired continued theoretical and philosophical thinking drawing on Løgstrup's expressions of life and unified opposites. The findings show that gynecological cancer survivors and health personnel share common ground as human beings because shyness and openness are basic human phenomena. Health personnel's own movement between these phenomena may represent a resource because it can help women to handle sexual and intimacy challenges following gynecological cancer.
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Affiliation(s)
- Ragnhild J T Sekse
- a Department of Obstetrics and Gynaecology , Haukeland University Hospital , Bergen , Norway
| | - Målfrid Råheim
- b Department of Public Health and Primary Health Care , University of Bergen , Bergan , Norway
| | - Eva Gjengedal
- b Department of Public Health and Primary Health Care , University of Bergen , Bergan , Norway.,c Faculty of Health and Social Care , Molde University College , Molde , Norway
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12
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Santos DB, Santos MAD, Vieira EM. Sexualidade e câncer de mama: uma revisão sistemática da literatura. SAUDE E SOCIEDADE 2014. [DOI: 10.1590/s0104-12902014000400018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi compreender como o câncer de mama e seus tratamentos afetam a vivência da sexualidade da mulher acometida. Foi realizada uma revisão sistemática qualitativa de artigos científicos, publicados entre 2000 e 2010, disponíveis nas bases de dados PubMed, Web of Science, LILACS e SciELO. Foram obtidos 50 artigos cujos textos foram categorizados segundo análise de conteúdo temática. Foram identificadas seis categorias temáticas: a cirurgia mamária e os demais tratamentos para o câncer de mama; a experiência da mulher acometida; o relacionamento afetivo-sexual; estudos sobre relação entre sexualidade e características específicas do câncer; os profissionais de saúde e a atenção à sexualidade; e propostas para amenizar as consequências negativas dos tratamentos na sexualidade. Há necessidade de novos estudos a respeito dos aspectos culturais da sexualidade, diversidade sexual, relacionamento com o parceiro, formação do profissional de saúde e intervenções em sexualidade no contexto do câncer de mama.
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13
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Pillai-Friedman S, Ashline J. Women, breast cancer survivorship, sexual losses, and disenfranchised grief – a treatment model for clinicians. SEXUAL AND RELATIONSHIP THERAPY 2014. [DOI: 10.1080/14681994.2014.934340] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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14
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Vieira EM, Ford NJ, Santos MAD, Junqueira LCU, Giami A. Representations of nurses regarding sexuality of women treated for breast cancer in Brazil. CAD SAUDE PUBLICA 2013; 29:2049-56. [DOI: 10.1590/0102-311x00158512] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 04/24/2013] [Indexed: 11/22/2022] Open
Abstract
The development of new treatments has improved survival and quality of life among cancer patients. Nurses are expected to answer questions and to provide orientation regarding patients' sexuality since it is an important aspect of life. The main objective of this paper is to understand the representations of sexuality among nurses working with women who survive breast cancer after diagnosis and during treatment assuming that their representations may affect communication with the patient. This is a qualitative study using an in-depth guideline which involved interviews with 28 nurses living and working in the southeast of Brazil. The narratives were submitted to a content analysis and categories of representations were identified and are discussed here. Several representations of sexuality were found in the nurses' discourses. Some of the nurses' representations may be expected to hinder their ability to provide helpful orientation regarding the sexual lives of these patients.
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Affiliation(s)
| | | | | | | | - Alain Giami
- Institut National de la Santé et de la Recherche Médicale, France
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15
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Olsson C, Athlin E, Sandin-Bojö AK, Larsson M. Sexuality is not a priority when disease and treatment side effects are severe: conceptions of patients with malignant blood diseases. J Clin Nurs 2013; 22:3503-12. [PMID: 24003940 DOI: 10.1111/jocn.12333] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2013] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To describe how patients with malignant blood diseases conceive the influence of chemo- or chemoimmunotherapy on sexuality, and their need of support related to this issue. BACKGROUND Sexuality is often negatively affected in cancer patients with sex-specific diagnoses. For patients with malignant blood diseases, the research is limited with regard to the effect on sexuality. Knowledge about their need for support related to sexuality is also needed as nurses are found to often avoid this area of their responsibility. DESIGN Qualitative design. METHODS Twelve patients treated for malignant blood diseases were interviewed twice. Phenomenography was used for the analysis. RESULTS The analyses revealed an outcome space consisting of two main categories: 'Sexuality is overshadowed by the cancer experience' and 'No need of support but timely information might be helpful', both comprehensively related to three interrelated description categories 'Affected strength', 'Affected sexual desire' and 'Affected body image', which describe conceptions of how sexuality was affected. CONCLUSION Patients experienced negative effects on sexual function and sexual relationship during and after treatment period due to affected strength, sexual desire and negatively body image. However, when disease and side effects were experienced as severe, thoughts and interest of sexuality were overshadowed, and the need or wish for support related to this issue was very low. It is important to note that some patients expressed that pre- or post-treatment information might have been helpful. RELEVANCE TO CLINICAL PRACTICE It is acknowledged in the cancer care of today that cancer follow-up should address psychosocial support in which sexuality is an important area. Therefore, it is imperative that cancer care is organised in a patient centred way, with adequate time for nurses to provide continuity in the nurse-patient relation and supportive care also during cancer rehabilitation.
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Affiliation(s)
- Cecilia Olsson
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
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Ferreira SMDA, Panobianco MS, Gozzo TDO, Almeida AMD. A sexualidade da mulher com câncer de mama: análise da produção científica de enfermagem. TEXTO & CONTEXTO ENFERMAGEM 2013. [DOI: 10.1590/s0104-07072013000300033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Revisão integrativa que objetivou analisar o conhecimento produzido pela enfermagem brasileira sobre a sexualidade de mulheres com câncer de mama, visando a melhoria do cuidado de enfermagem. Foi utilizada a busca simultânea por palavras, em todas as bases de dados indexadas na Biblioteca Virtual da Saúde. Incluíram-se 10 artigos publicados a partir do ano 2000, cuja autoria fosse atribuída ao profissional enfermeiro. Os resultados mostraram que a sexualidade das mulheres, muitas vezes, está restrita à prática sexual, e apenas alguns relatos mostram a sexualidade como algo mais abrangente. As mulheres acometidas pelo câncer de mama apresentam comprometimento no exercício da sexualidade, e o apoio do companheiro auxilia no enfrentamento, sendo percebido como muito significativo em todas as etapas da doença. A análise dos estudos evidencia uma assistência de enfermagem que não contempla esse aspecto do cuidado, necessitando de reestruturação. Essa assistência deve ser estendida aos parceiros e deve ultrapassar a dimensão biológica.
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Cesnik VM, Vieira EM, Giami A, Almeida AMD, Santos DB, Santos MAD. The sexual life of women with breast cancer: meanings attributed to the diagnosis and its impact on sexuality. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2013. [DOI: 10.1590/s0103-166x2013000200005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Breast cancer is the main neoplasm which affects women. It brings emotional problems in addition to physical and social problems due to affecting a bodily symbol of femininity. The aim of this study was to investigate the sexual life of women with breast cancer in the first year after the surgical procedure, seeking the meanings they attributed to the diagnosis and its repercussions on sexuality. Ten women who participated in a rehabilitation program were interviewed. In addition to the face to face interview their medical record were analyzed. Two categories emerged from the thematic analysis highlighting the negative and the positive impacts of this disease on the sexual life. This variety of meanings encountered shows that there no single pattern of sexual life after breast cancer. The way each woman reacts to the disease makes the way she experiences her sexuality unique. It follows that issues of sexuality must be incorporated in interventions offered in the context of care for these women.
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Affiliation(s)
| | | | - Alain Giami
- Institut National de la Santé et de la Recherche Médicale, France
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Cleary V, McCarthy G, Hegarty J. Development of an Educational Intervention Focused on Sexuality for Women with Gynecological Cancer. J Psychosoc Oncol 2012; 30:535-55. [DOI: 10.1080/07347332.2012.703767] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cesnik VM, Santos MAD. Desconfortos físicos decorrentes dos tratamentos do câncer de mama influenciam a sexualidade da mulher mastectomizada? Rev Esc Enferm USP 2012; 46:1001-8. [DOI: 10.1590/s0080-62342012000400031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 12/02/2011] [Indexed: 11/22/2022] Open
Abstract
Este trabalho é uma revisão integrativa, que objetiva analisar a produção científica dedicada à sexualidade da mulher com câncer de mama após a mastectomia, com foco na interferência dos desconfortos físicos decorrentes dos tratamentos sobre sua vida sexual. O estudo abrangeu trabalhos publicados no período de 2000 a 2009, utilizando as bases MEDLINE, LILACS e PsycINFO, por meio dos descritores mastectomy, breast neoplasms, sexuality, sexual behavior, amputation, psychossexual development, marital relations. Foram selecionados nove artigos, que abordavam as repercussões dos desconfortos físicos provenientes dos tratamentos oncológicos na vivência da sexualidade. Os achados evidenciaram que, mesmo quando existe intensa e satisfatória vida sexual no período prévio à doença, fatores como estresse, dor, fadiga, insulto à imagem corporal e baixa autoestima, decorrentes dos tratamentos, podem desorganizar o funcionamento sexual da mulher acometida. É necessário sensibilizar os profissionais para acolherem o tema em políticas e estratégias preventivas, diagnósticas e terapêuticas.
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Sexual Health During Cancer Treatment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2012; 732:61-76. [DOI: 10.1007/978-94-007-2492-1_5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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The impact of hematopoietic stem cell transplantation on sexuality: a systematic review of the literature. Bone Marrow Transplant 2011; 47:716-24. [PMID: 21874054 DOI: 10.1038/bmt.2011.169] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In this paper we review evidence concerning the impact of hematopoietic SCT (HSCT) on sexuality. The aims are to determine: (1) the sexual changes experienced by patients following allogeneic or autologous HSCT, and its consequences; (2) changes in the sexual function over time and (3) the impact of physiological changes induced by intensive treatment with radiation and chemotherapy on sexual functioning. Four databases were searched for articles published between January 1995 and May 2011. A total of 14 studies were identified and analyzed. We found that (1) multiple aspects of sexuality were affected, and the impact and etiology of these sexual alterations were different between genders, and (2) recovery of sexual activity and pleasure occurred in the first 2 years after HSCT, although it appears that some survivors are more likely to experience sexual dysfunction even 5-10 years after HSCT as compared with controls; and (3) there was contradictory evidence concerning possible differences between allogeneic and autologous HSCT, although there was a significant relation between the sexual dysfunctions and the type of chemotherapy administrated as conditioning and chronic GVHD. Future prospective research in sexual dysfunction with specific reliable validated instruments and more adequate sample sizes will be required to definitively evaluate the impact of HSCT on sexuality.
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22
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A Feminist Perspective on Sexuality and Body Image in Females With Colorectal Cancer. J Wound Ostomy Continence Nurs 2010; 37:519-25. [DOI: 10.1097/won.0b013e3181edac2c] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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