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Abdulrahman N, Burger NB, van den Broek S, Kaaijk EM, Oudijk MA, de Boer MA, Huirne JAF. Patient perspectives and preferences on cerclage and preterm birth: a focus group study. Qual Life Res 2024; 33:2165-2179. [PMID: 38888673 PMCID: PMC11286660 DOI: 10.1007/s11136-024-03637-9] [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] [Accepted: 02/21/2024] [Indexed: 06/20/2024]
Abstract
AIM This qualitative focus group study aims to asses cerclage-related symptoms, the impact of a cerclage on daily functioning and patient perspectives of their healthcare experience. This study extends beyond the current focus on surgical and obstetric outcomes of a cerclage, thereby contributing to a more comprehensive understanding of the challenges faced by individuals in the context of extreme preterm birth and fetal loss and the impact of a cerclage on multiple facets in life. METHODS Participants were recruited from the Amsterdam University Medical Center, Amsterdam, the Netherlands or via the website of a Dutch patient organization for (extreme) preterm birth. Eligible participants were ≥ 18 years old with a previous vaginal and/or abdominal cerclage with a subsequent delivery at ≥ 34 weeks of gestation with neonatal survival. Two focus group discussions (FGD) were performed. A predefined format was used, which was identical for both the vaginal and abdominal cerclage group. The International Classification of Functioning, Disability and Health (ICF-DH) was used to provide structure. Outcomes were a broad range of participants reported perspectives on physical, emotional, and social-related quality of life. RESULTS In the Vaginal Cerclage Group (VCG) and Abdominal Cerclage Group (ACG), respectively, 11 and 8 participants were included. Fear for a subsequent pregnancy loss was the most limiting factor to perform daily activities during pregnancy in all participants with a cerclage. Fear to conceive again because of prior second-trimester fetal loss was experienced by 27% in the VCG and 13% in the ACG. The majority of participants experienced a reduction in anxiety after placement of their cerclage (VCG = 64%, ACG = 75%). Decreased mobility/bedrest (VCG = 100%, ACG = 75%) and blood loss (VCG = 55%, ACG = 13%) were frequently mentioned complaints during pregnancy with cerclage. Other aspects mentioned in both groups were social isolation, the lack of societal participation, and the perceived need to quit work and sports. All participants in the abdominal cerclage group reported a lack of comprehensible and unambiguous information about obstetric management and expectations during pregnancy in secondary care hospitals. Clear communication between secondary and tertiary care hospitals about obstetric management following an abdominal cerclage, for example, about the need for cervical length measurements by ultrasound, the need for bedrest or advice concerning sexual activity was missing (63%). Psychologic support was desired in half of all participants, but was not offered to them. CONCLUSIONS The fear of a subsequent pregnancy loss was reported as the most limiting factor in daily life by all participants. Cerclage placement resulted in the reduction of anxiety. Participants mentioned a significant impact of bedrest and activity restriction during pregnancy with cerclage on social participation and daily activities. Unfortunately, no high level evidence is available on this matter. Patients might even benefit from appropriate levels of physical activity throughout their pregnancy to promote their overall well-being. More evidence is needed to determine the optimal level of physical activity. There is a need for clear and unambiguous patient information about obstetric management.
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Affiliation(s)
- Nour Abdulrahman
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Reproduction and Development Research Institute, Meibergdreef 9, Amsterdam, The Netherlands.
- Department of Obstetrics and Gynaecology, OLVG, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands.
| | - Nicole B Burger
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Meibergdreef 9, Amsterdam, The Netherlands
| | - Susan van den Broek
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
| | - Eugenie M Kaaijk
- Department of Obstetrics and Gynaecology, OLVG, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands
| | - Martijn A Oudijk
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Meibergdreef 9, Amsterdam, The Netherlands
| | - Marjon A de Boer
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Meibergdreef 9, Amsterdam, The Netherlands
| | - Judith A F Huirne
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Meibergdreef 9, Amsterdam, The Netherlands
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Liu XQ, Wang L, Gu X, Shan X, Xie J, Gao WY, Gu YH, Zhang Y, Gu DM. The Experience of Cervical Cancer Patients Undergoing Hysterectomy: A Qualitative Study. J Transcult Nurs 2024; 35:263-270. [PMID: 38634631 DOI: 10.1177/10436596241246976] [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] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Due to different social and cultural backgrounds, cervical cancer patients' experience of the treatment process and quality of life after treatment will be different. This study sought to gain in-depth understanding of the experiences of Chinese cervical cancer patients as regards their quality of life and physical symptoms. METHODOLOGY Semi-structured interviews were used to collect data. We recruited 15 women with cervical cancer in eastern China for in-depth interviews. All data were entered into the NVivo 12 software program for analysis. RESULTS Four themes emerged from the data: (a) uncertainty; (b) physical suffering; (c) psychological pressure; and (d) challenges of marriage and family. DISCUSSION Cervical cancer patients showed concerns about the disease itself and the physical discomfort it causes, as well as changes in social relations. Health professionals need to talk about these issues and develop strategies to address them accordingly.
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Affiliation(s)
- Xiao-Qin Liu
- Nursing Department of Affiliated Hospital of Nantong University, China
| | - Lan Wang
- College of Health and Social Care, Shanghai Urban Construction Vocational College, China
| | - Xuan Gu
- School of Nursing and Rehabilitation, Nantong University, China
| | - Xiao Shan
- School of Nursing and Rehabilitation, Nantong University, China
| | - Juan Xie
- Nursing Department of Affiliated Hospital of Nantong University, China
| | - Wen-Ying Gao
- School of Nursing and Rehabilitation, Nantong University, China
| | - Yu-Hui Gu
- Nursing Department of Affiliated Hospital of Nantong University, China
| | - Yan Zhang
- Nursing Department of Affiliated Hospital of Nantong University, China
| | - Dong-Mei Gu
- Nursing Department of Affiliated Hospital of Nantong University, China
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Roussin M, Hamilton A, Lowe J, Martin L. Sexual quality of life after gynaecological cancer: what young women want. Qual Life Res 2024; 33:679-689. [PMID: 38019323 DOI: 10.1007/s11136-023-03553-4] [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] [Accepted: 10/23/2023] [Indexed: 11/30/2023]
Abstract
PURPOSE Psychosexual distress is known to be a common complication of treatment for gynaecological cancer (GC), affecting the sexual quality of life (SQoL) for an increasing number of young gynaecological cancer survivors (YGCS). The SQoL in YGCS study aimed to identify strategies that are acceptable and helpful to YGCS in protecting and improving SQoL, using a salutogenic approach. METHODS A qualitative study was undertaken with young women aged 18-45 and pre- or perimenopausal at diagnosis. Semi-structured interviews were conducted on Zoom and a thematic analysis of transcripts was completed in NVivo. RESULTS Fifteen interviews with YGCS revealed three themes for strategy development: psychosexual education, psychosocial support, and healthcare policy and strategy to establish SQoL as standard care in gynaecologic oncology. CONCLUSION The strategies put forward by YGCS showed the need for a holistic, patient-centric, and multidisciplinary approach to SQoL. A better understanding of the strategies acceptable to YGCS, including the importance of using a trauma-informed approach to communication and care, can help healthcare providers play a vital role in protecting and improving SQoL.
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Affiliation(s)
- Melanie Roussin
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia.
| | - Anita Hamilton
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - John Lowe
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - Lisa Martin
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
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Roussin M, Lowe J, Hamilton A, Martin L. Sexual quality of life in young gynaecological cancer survivors: a qualitative study. Qual Life Res 2023:10.1007/s11136-023-03386-1. [PMID: 36947327 DOI: 10.1007/s11136-023-03386-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE The impact of cancer diagnosis and treatment on sexual quality of life (SQoL) is a significant and often neglected issue in the treatment and survivorship period of young gynaecological cancer survivors (YGCS). This study sought to explore women's lived experiences to understand how to protect and improve SQoL. METHODS A qualitative study with women aged 18-45 and pre- or perimenopausal at diagnosis (n = 15). A thematic analysis was performed in NVivo. Participants also completed a pre-interview questionnaire and The Female Sexual Distress Scale-Revised (FSDS-R). RESULTS YGCS experienced high psychosexual distress. Notably, seven themes were identified: adjustment, confidence, fear, loss, shame, trauma, and communication. Gynaecological cancer (GC) treatment interfered with everyday life and had a long-term impact on mental, physical, and emotional health, with many reporting an altered sense of self, body image and sexual identity. Single women felt vulnerable in new relationships, while partnered women reported low sexual desire and guilt about sexual difficulties. Open communication, emotional intimacy, and an acceptance of the 'new normal' buffered the trauma of cancer and were vital to relationship satisfaction. Lastly, absent, or blunt patient-clinician communication contributed to psychosexual distress. CONCLUSION GC interferes with sexual function, partner relationships, psychosexual wellbeing, and quality of life. A better understanding of the lived experiences of YGCS can help healthcare providers to adopt a holistic, patient-centric, and multidisciplinary approach to SQoL. YGCS want psychosexual communication and support, across all stages of treatment and care. Healthcare providers should initiate and normalise conversations on the impact of treatment on SQoL.
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Affiliation(s)
- Melanie Roussin
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia.
| | - John Lowe
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - Anita Hamilton
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - Lisa Martin
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
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Sun Y, Ma Y, Li Q, Ge J. Supportive care needs of women with gynaecological cancer: A systematic review and synthesis of qualitative studies. J Adv Nurs 2023. [PMID: 36811244 DOI: 10.1111/jan.15614] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/23/2023] [Accepted: 02/11/2023] [Indexed: 02/24/2023]
Abstract
AIMS To synthesize existing qualitative research evidence on the supportive care needs of women with gynaecological cancer. DESIGN Qualitative systematic review. DATA SOURCES A comprehensive literature search was performed using nine databases (PubMed, Web of Science, PsycINFO, CINAHL, Embase, CBM, CNKI, VIP and WanFang) without restrictions regarding publication date; qualitative studies published in English or Chinese were included. Initial search in December 2021 and updated in October 2022. REVIEW METHODS This study was conducted according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. The Critical Appraisal Skills Programme tool for qualitative research was used to assess the quality of all included papers. Finally, we adopted a thematic synthesis method, synthesized the main findings, and constructed themes. RESULTS Eleven studies published between 2010 and 2021 were included in the review. Based on the thematic synthesis method, 10 descriptive themes were generated and five analytical themes were derived: psychological support, information support, social support, disease-specific symptom management and form of care. Women with gynaecological cancer expressed a desire for psychological support from empathetic healthcare professionals; information support included access to adequate and appropriate information, as well as communication and involvement; social support highlighted women's desire for peer support, family-related support and financial support; disease-specific symptom management described women's desire for support in coping with reproduction/sexual issues and form of care highlighted the need for continuity of care and holistic care. CONCLUSION The supportive care needs of women with gynaecological cancer are multidimensional and complex. The future care practice should take women's needs as a starting point and provide ongoing holistic and individualized support. Healthcare providers' understanding and support of these needs are critical to improving women's clinical outcomes and quality of care. IMPACT The present findings can help further develop supportive care programmes and make nursing interventions more targeted and effective. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Yue Sun
- School of Nursing, China Medical University, Shenyang, China.,Department of Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yanling Ma
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, China
| | - Qiaoran Li
- School of Nursing, China Medical University, Shenyang, China.,Department of Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jingling Ge
- Department of Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
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Pizetta LM, Reis ADC, Méxas MP, Guimarães VDA, de Paula CL. Management Strategies for Sexuality Complaints after Gynecologic Cancer: A Systematic Review. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2022; 44:962-971. [PMID: 36174653 PMCID: PMC9708405 DOI: 10.1055/s-0042-1756312] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 07/07/2022] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE To explore the main sexuality complaints of gynecologic cancer survivors after treatment and to identify the care strategies provided. DATA SOURCE Searches were conducted in six electronic databases: Scopus, Web of Science, LILACS, MEDLINE, PsychINFO, and EMBASE. STUDY SELECTION Articles published between 2010 and 2020 were selected and the following descriptors were used in the English language: female genital neoplasms and gynaecological cancer. The methodological quality of the studies used the Mixed Methods Appraisal Tool (MMAT). DATA COLLECTION The primary data extracted were: names of the authors, year of publication, country of origin, objective and type of study, data collection instrument, sample size and age range, types of cancer, and symptoms affected with the strategies adopted. DATA SUMMARY A total of 34 out of 2,536 screened articles were included. The main strategies found for patient care were patient-clinician communication, practices for sexuality care, individualized care plan, multiprofessional team support, and development of rehabilitation programs. For sexuality care, the most common practices are pelvic physiotherapy sessions and the use of vaginal gels and moisturizers. CONCLUSION The main complaints identified in the scientific literature were low libido and lack of interest in sexual activity, vaginal dryness, pain during sexual intercourse, and stenosis. Different care strategies may be adopted, such as follow-up with a multidisciplinary health team and sexual health rehabilitation programs, which could minimize these symptoms and ensure the quality of life of patients.
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Affiliation(s)
| | - Augusto da Cunha Reis
- Centro Federal de Educação Tecnológica Celso Suckow da Fonseca, Rio de Janeiro, RJ, Brazil
| | | | | | - Carmen Lucia de Paula
- Centro Federal de Educação Tecnológica Celso Suckow da Fonseca, Rio de Janeiro, RJ, Brazil
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Galica J, Saunders S, Romkey-Sinasac C, Silva A, Ethier JL, Giroux J, Jull J, Maheu C, Ross-White A, Stark D, Robb K. The needs of gynecological cancer survivors at the end of primary treatment: A scoping review and proposed model to guide clinical discussions. PATIENT EDUCATION AND COUNSELING 2022; 105:1761-1782. [PMID: 34865888 DOI: 10.1016/j.pec.2021.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Gynecological cancer (GC) survivors have unmet needs when they complete primary cancer treatment. Despite this, no known research has summarized these needs and survivors' suggestions to address them. We conducted a scoping review to fill these gaps and develop a model useful to guide clinical discussions and/or interventions. METHODS English, full length, and accessible primary studies describing the needs of GC survivors were included. No restrictions on date nor country of publication were applied. Two reviewers screened and extracted data, which was verified by a third reviewer. RESULTS Seventy-one studies met the inclusion criteria for data extraction. Results were thematically grouped into seven dimensions: physical needs, sexuality-related concerns, altered self-image, psychological wellbeing, social support needs, supporting the return to work, and healthcare challenges and preferences. After consulting with a stakeholder group (a GC survivor, clinicians, and researchers), the dimensions were summarized into a proposed model to guide clinical assessments and/or interventions. CONCLUSION Results illuminate the diverse needs of GC survivors as they complete primary cancer treatment and their recommendations for care to meet these needs. PRACTICE IMPLICATIONS The resulting model can be used to guide assessments, discussions and/or interventions to optimally prepare GC survivors for transition out of primary cancer treatment.
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Affiliation(s)
- Jacqueline Galica
- Queen's University School of Nursing, Kingston, Ontario, Canada; Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, Kingston, Ontario, Canada.
| | | | | | - Amina Silva
- Queen's University School of Nursing, Kingston, Ontario, Canada
| | - Josée-Lyne Ethier
- Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, Kingston, Ontario, Canada; Queen's University Department of Oncology; Kingston, Ontario, Canada
| | - Janet Giroux
- Queen's University School of Nursing, Kingston, Ontario, Canada; Kingston Health Sciences Centre, Kingston General Hospital Site and the Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada; Queen's University, Department of Obstetrics and Gynecology, Kingston, Ontario, Canada
| | - Janet Jull
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Christine Maheu
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | | | - Debora Stark
- Kingston Health Sciences Centre, Kingston General Hospital Site and the Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada
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Millet N, McDermott HJ, Moss EL, Edwardson CL, Munir F. Increasing physical activity levels following treatment for cervical cancer: an intervention mapping approach. J Cancer Surviv 2022; 16:650-658. [PMID: 34041674 PMCID: PMC8153850 DOI: 10.1007/s11764-021-01058-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/15/2021] [Indexed: 01/02/2023]
Abstract
PURPOSE The purpose of this study was to utilise the intervention mapping (IM) protocol as a framework with which to develop an intervention underpinned by relevant behaviour change theory to promote physical activity (PA) following treatment for cervical cancer. METHODS The six steps of the IM protocol were followed. A qualitative semi-structured interview study and a rapid review of the literature were conducted along with the development of a logic model of the problem and a logic model of change to inform intervention development. RESULTS An intervention was developed which aims to increase PA levels following treatment for cervical cancer, tailored to address key findings from the IM needs assessment. These include embedding behavioural and social strategies that help participants to overcome perceived barriers to PA participation; goal setting strategies to gradually increase PA levels with a view of reaching relevant PA guidelines for cancer survivors and feedback to encourage self-assessment of well-being and PA capability. CONCLUSION This study maps the development of a novel PA intervention for those who have been treated for cervical cancer. The use of a systematic development framework was necessary as little insight exists regarding PA preferences after treatment for cervical cancer. IMPLICATIONS FOR CANCER SURVIVORS PA behaviour is associated with positive physical and psychological health outcomes for cancer survivors. Optimising targeted promotion of PA behaviour following treatment for cervical cancer may result in an enhanced survivorship experience through increased PA behaviour and improved quality of life (QOL).
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Affiliation(s)
- Nessa Millet
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, LE11 3TU, UK.
| | - Hilary J McDermott
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, LE11 3TU, UK
| | - Esther L Moss
- Diabetes Research Centre, University of Leicester, Leicester, LE54PW, UK
| | - Charlotte L Edwardson
- NIHR Leicester Biomedical Research Centre, Leicester, LE3 9QP, UK
- Leicester Cancer Research Centre, University of Leicester, Leicester, LE2 7Lx, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, LE11 3TU, UK
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Levkovich I, Hamama-Raz Y, Shinan-Altman S. "A kaleidoscope of relationships" - cervical cancer survivors' perspectives on their intimate relationships: A qualitative study. Palliat Support Care 2022; 21:1-10. [PMID: 35130992 DOI: 10.1017/s147895152100198x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cervical cancer is known to affect survivors' intimate relationships, as well as their communication and coping. Yet little is known about the perspectives of these survivors on their intimate relationships in the context of their needs during and after medical treatment. Additionally, only a few studies have focused on survivors' perceived needs or on existing psychosexual support. Understanding these perceptions can help provide a tailored response and improve dyadic interventions. The aim of this study was to examine cervical cancer survivors' perspectives on their intimate relationships during and after their treatment. METHOD The present study adopted a qualitative-phenomenological approach. In-depth, semi-structured interviews were conducted with 15 survivors of cervical cancer between the ages of 38 and 44 who were diagnosed at stages I-II and were treated with radiotherapy or chemo-radiotherapy and surgery. Data collection continued until saturation of concepts was reached. The results underwent thematic analysis. RESULTS Analysis of the findings revealed two key themes: (1) Together and apart in the shadow of cervical cancer. This theme focuses on the recovery period as a potential opportunity for changing and improving the couple relationship, such that men no longer withdraw but rather provide their partners with needed support and encouragement. (2) Changes in sexual life and couple intimacy. This theme focuses on changes in sexual relations, which have become a burden, painful, and something to avoid. SIGNIFICANCE OF RESULTS The study provides a comprehensive picture of intimate relationships during and after cervical cancer treatment and highlights the women's needs and desires for support from their intimate partners. The discussion notes that oncology providers can better facilitate supportiveness on the part of cervical cancer partners by offering better couple-oriented education and interventions to promote couple communication.
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Affiliation(s)
- Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tivon, Israel
| | - Yaira Hamama-Raz
- School of Social Work, Ariel University, Ariel Science Park, Ariel, 40700, Israel
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de Souza C, Santos AVDSL, Rodrigues ECG, Dos Santos MA. Experience of Sexuality in Women with Gynecological Cancer: Meta-Synthesis of Qualitative Studies. Cancer Invest 2021; 39:607-620. [PMID: 33826457 DOI: 10.1080/07357907.2021.1912079] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Gynecological cancers have an impact on women's psychosexual health in which results vary from adjuvant cancer therapy, such as loss of pleasure, to anxious symptoms. This study aimed to present a meta-synthesis of qualitative primary studies on the sexual experience of women with gynecological cancer. The SPIDER tool and the PRISMA guidelines were used to recover evidence from the databases Web of Science, SCOPUS, PubMed/MedLine, CINAHL, PsycINFO and LILACS. Twenty articles were included. The thematic synthesis showed that alterations in sexual functions can be mitigated by direct involvement and dialogue with a sexual partner and the resignification of sexual intimacy.
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Affiliation(s)
- Carolina de Souza
- Graduate Program in Psychology, Ribeirão Preto School of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil
| | - André Villela de Souza Lima Santos
- Graduate Program in Psychology, Ribeirão Preto School of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil
| | - Elaine Campos Guijarro Rodrigues
- Graduate Program in Psychology, Ribeirão Preto School of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel Antônio Dos Santos
- Psychology Department, Ribeirão Preto School of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil
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Vani MF, Lucibello KM, Trinh L, Santa Mina D, Sabiston CM. Body image among adolescents and young adults diagnosed with cancer: A scoping review. Psychooncology 2021; 30:1278-1293. [PMID: 33882162 DOI: 10.1002/pon.5698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cancer and treatment can produce temporary or permanent body changes, which may affect the body image (BI) of adolescents and young adults diagnosed with cancer (AYAs). This evidence has not been comprehensively summarized. A scoping review was conducted to explore the available evidence on BI among AYAs and identify the definitions, theories, models, frameworks, measures, and methods used to assess BI. METHODS Databases MEDLINE, EMBASE, PsycINFO (via Ovid) and CINAHL and Gender Studies (via EBSCO) were searched to identify published studies from 1 January 2000 to 25 November 2019. Inclusion criteria were: qualitative, quantitative, or mixed methodology; at least one BI-related measure or theme; published in English; and majority of the sample between 13 and 39 years at diagnosis and a mean age at diagnosis between 13 and 39 years. Two authors screened the titles, abstracts, and full-text articles and data were extracted and summarized. RESULTS The search yielded 11,347 articles and 82 met inclusion criteria. Articles included 45 quantitative, 33 qualitative, and four mixed-methods studies. The majority of studies used cross-sectional designs, while BI definitions, theories, models, frameworks, and measures were varied. Studies explored descriptive, psychological, physical, coping, and social factors, with BI being described most often as an outcome rather than a predictor. CONCLUSIONS Theory-based research that employs a holistic BI definition and uses longitudinal or intervention study designs or a qualitative methodology is needed to better understand the BI experience of AYAs and inform the development of strategies and programs to reduce BI concerns and increase positive body experiences.
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Affiliation(s)
- Madison F Vani
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Kristen M Lucibello
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Linda Trinh
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Santa Mina
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Catherine M Sabiston
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
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Roussin M, Lowe J, Hamilton A, Martin L. Factors of sexual quality of life in gynaecological cancers: a systematic literature review. Arch Gynecol Obstet 2021; 304:791-805. [PMID: 33847794 PMCID: PMC8325662 DOI: 10.1007/s00404-021-06056-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/27/2021] [Indexed: 12/17/2022]
Abstract
Background The impact of cancer diagnosis and treatment on sexual quality of life (SQoL) is a well-established survivorship issue for gynaecological cancer survivors (GCS), yet little is known on how to intervene. Purpose The aim of this systematic review was to identify the factors explaining the variability in SQoL for GCS. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and the software Covidence. Electronic databases Scopus, Web of Science, PUBMED and CINAHL were searched for original research on GCS published between 2002 and 2018. We performed a two-stage screening process against selection criteria and quality assessment of individual studies. The Salutogenic Theory and the PRECEDE–PROCEED model were used as theoretical frameworks to identify and categorise factors. Results The initial search yielded 3,505 articles resulting in a total of 46 studies used to examine the association between factors of SQoL and gynaecological cancers. Our findings suggested that SQoL varies across subgroups based on age, menopausal status, relationship status, and treatment modality. Protective factors included clinicians’ knowledge and confidence, preventive medical approach, risk and needs assessment, patient–clinician communication, relationship quality, psychosocial support, symptom management, accessibility of psychosexual care, and self-efficacy in the rediscovery of sexuality. Conclusion Despite the high incidence and long-term impact of sexual health issues on quality of life, supportive care needs are not being met. A better understanding of the evidence base around the factors of SQoL can help health professionals take steps to protect and improve SQoL in GCS.
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Affiliation(s)
- Melanie Roussin
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia.
| | - John Lowe
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - Anita Hamilton
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - Lisa Martin
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
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Dogan NU, Kohler C, Pfiffer T, Plaikner A, Le X, Favero G. Prospective assessment of urinary and bowel symptoms, and sexual function between laparoscopic assisted vaginal radical trachelectomy and radical hysterectomy. Int J Gynecol Cancer 2021; 31:484-489. [PMID: 33649018 DOI: 10.1136/ijgc-2020-001757] [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: 10/03/2020] [Revised: 01/16/2021] [Accepted: 01/19/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Radical trachelectomy is a valid alternative to radical hysterectomy in women with a desire to retain their fertility. Data regarding the oncological outcomes of radical trachelectomy are comparable with those of radical hysterectomy but information regarding urinary and sexual function is limited. The aim of this study was to prospectively evaluate and compare quality of life, urinary and bowel symptoms, and sexual dysfunction between patients who underwent laparoscopic assisted vaginal radical trachelectomy versus radical hysterectomy for early-stage cervical cancer. METHODS Patients who underwent laparoscopic assisted vaginal radical trachelectomy or radical hysterectomy along with sentinel or systemic pelvic lymphadenectomy were included between May 2015 and January 2017. Patients were asked to complete a validated questionnaire (German pelvic symptom questionnaire) on bladder, bowel, prolapse, and sexual function, and total pelvic score, at least 48 hours before surgery and 6 months after surgery. RESULTS A total of 51 patients were included. Of these, 26 patients (50.9%) underwent laparoscopic assisted vaginal radical trachelectomy and 25 (49.1%) underwent radical hysterectomy. No patient was converted to laparotomy. The majority of patients (76%) were diagnosed with International Federation of Gynecology and Obstetrics (FIGO 2018) stage 1B1 disease, with squamous cell carcinoma (54%) and grade II tumors (52%). Four patients (7.8 %) experienced perioperative complications (two grade II and two grade III complications according to the Clavien-Dindo classification). In the preoperative evaluation, the median scores for the four items of the questionnaire (bladder, bowel, prolapse, and sexual items) and total pelvic score were comparable between the two groups. The mean scores for radical hysterectomy and radical trachelectomy at the beginning of the study for bladder, bowel, prolapse, and sexual function were 0.93 versus 0.71, 0.71 versus 1.01, 0.12 versus 0.1, and 1.06 versus 1.0, respectively. On preoperative testing, the median scores for all four items of the questionnaire (pbladder=0.821, pbowel=0.126, pprolapse=0.449, psexual=0.965) and the total pelvic score (p=0.756) were comparable between the two groups. The radical hysterectomy group had worse total pelvic scores at the 6 month postoperative survey compared with baseline (p=0.03). There was no difference in bladder (p=0.07) or bowel symptoms (p=0.07) in the radical hysterectomy group comparing baseline with the 6 month assessment. Women undergoing radical hysterectomy experienced more urinary morbidity than women undergoing vaginal trachelectomy at 6 weeks (p=0.025). However, the mean bladder and pelvic scores in the 6 month control were comparable between patients who had and those who had not experienced urinary morbidity (pbladder=0.127, ptotal pelvic score=0.480). CONCLUSION Patients undergoing laparoscopic assisted vaginal radical trachelectomy had similar pelvic scores in both the preoperative and postoperative periods. However, patients undergoing radical hysterectomy showed worse total pelvic scores on the postoperative assessment compared with the baseline evaluation. Urinary dysfunction in the early postoperative phase was more common in the radical hysterectomy group than in trachelectomy group.
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Affiliation(s)
- Nasuh Utku Dogan
- Department of Gynecology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Christhardt Kohler
- Department of Gynecology, University of Cologne, Koln, Germany.,Department of Special Operative and Oncologic Gynecology, Asklepios Clinic Hamburg-Altona, Hamburg, Germany
| | - Tatiana Pfiffer
- Department of Gynecology, Asklepios Clinic Lich, Hessen, Germany
| | - Andrea Plaikner
- Department of Special Operative and Oncologic Gynecology, Asklepios Clinic Hamburg-Altona, Hamburg, Germany
| | - Xin Le
- Gynecological Minimal Invasive Center, Capital Medical University, Beijing, China
| | - Giovanni Favero
- Department of Gynecology, Asklepios Clinic Lich, Hessen, Germany.,Department of Gynecology, University Hospital Giessen-Marburg, Hessen, Germany
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Body Image, Sexuality, and Sexual Functioning in Women With Gynecologic Cancer: An Integrative Review of the Literature and Implications for Research. Cancer Nurs 2020; 44:E252-E286. [PMID: 32332264 DOI: 10.1097/ncc.0000000000000818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cervical and uterine cancers are common in women. Diagnosis and treatment of these cancers can lead to significant issues with body image, sexuality, and sexual functioning. A comprehensive review can improve understanding of these 3 concepts, in turn enhancing identification and management. OBJECTIVES To (1) present the qualitative, descriptive, and correlational research literature surrounding body image, sexuality, and sexual functioning in women with uterine and cervical cancer; (2) identify gaps in the literature; and (3) explore the implications of the findings for future research. METHODS A comprehensive search of the literature was undertaken by searching PubMed, CINAHL, and PsycINFO using predetermined subject headings, keywords, and exploded topics. After a comprehensive evaluation using specific criteria, 121 articles were reviewed. RESULTS Qualitative studies provided information about women's issues with body image, sexuality, and sexual functioning, whereas quantitative studies focused primarily on sexual functioning. The literature lacks correlational studies examining body image and sexuality. Significant issues regarding communication and quality of life were noted, and few studies were based on clear conceptual models. CONCLUSION The state of the science gleaned from this review reveals that while much is known about sexual functioning, little is known about body image and sexuality. IMPLICATIONS FOR PRACTICE Further work is warranted to develop conceptual models and research on body image, sexuality, and sexual functioning as a foundation for interventions to improve quality of life.
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Yahata H, Sonoda K, Okugawa K, Yagi H, Ohgami T, Yasunaga M, Onoyama I, Kaneki E, Asanoma K, Kato K. Survey of the desire to have children and engage in sexual activity after trachelectomy among young Japanese women with early‐stage cervical cancer. J Obstet Gynaecol Res 2019; 45:2255-2259. [DOI: 10.1111/jog.14099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/05/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Hideaki Yahata
- Department of Obstetrics and GynecologyKyushu University Hospital Fukuoka Japan
| | - Kenzo Sonoda
- Department of Obstetrics and GynecologyKyushu University Hospital Fukuoka Japan
| | - Kaoru Okugawa
- Department of Obstetrics and GynecologyKyushu University Hospital Fukuoka Japan
| | - Hiroshi Yagi
- Department of Obstetrics and GynecologyKyushu University Hospital Fukuoka Japan
| | - Tatsuhiro Ohgami
- Department of Obstetrics and GynecologyKyushu University Hospital Fukuoka Japan
| | - Masafumi Yasunaga
- Department of Obstetrics and GynecologyKyushu University Hospital Fukuoka Japan
| | - Ichiro Onoyama
- Department of Obstetrics and GynecologyKyushu University Hospital Fukuoka Japan
| | - Eisuke Kaneki
- Department of Obstetrics and GynecologyKyushu University Hospital Fukuoka Japan
| | - Kazuo Asanoma
- Department of Obstetrics and GynecologyKyushu University Hospital Fukuoka Japan
| | - Kiyoko Kato
- Department of Obstetrics and GynecologyKyushu University Hospital Fukuoka Japan
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Shah JS, Jooya ND, Woodard TL, Ramirez PT, Fleming ND, Frumovitz M. Reproductive counseling and pregnancy outcomes after radical trachelectomy for early stage cervical cancer. J Gynecol Oncol 2019; 30:e45. [PMID: 30887762 PMCID: PMC6424852 DOI: 10.3802/jgo.2019.30.e45] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/30/2018] [Accepted: 12/17/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To evaluate patient perceptions of preoperative reproductive counseling and to evaluate complications and pregnancy outcomes in women who had radical trachelectomy (RT) for early stage cervical cancer. METHODS Patients who underwent RT from January 1, 2004, through July 31, 2017, and had been cancer free for more than 1 year after RT were eligible; consented patients were sent a 16-item online survey. RESULTS Of the 58 eligible patients, 39 patients (67%) completed the questionnaire. Eighteen patients (46%) reported receiving reproductive counseling and 26 (68%) reported receiving counseling about pregnancy risks and complications prior to RT, mainly delivered by gynecologic oncologists. Twenty-nine patients (74%) reported having a complication after RT, and cervical stenosis was the most common complication, occurring in 13 patients (33%). Twenty-four patients actively attempted to conceive after RT, and 20 pregnancies were achieved in 13 patients for a pregnancy rate of 54%. Eight pregnancies were spontaneous and 12 required a fertility treatment. There were 5 spontaneous first-trimester miscarriages; 14 of the 20 pregnancies (70%) resulted in live births. The median time to conception was 13.5 months (range, 1-120). CONCLUSION A significant proportion of women with early stage cervical cancer do not receive adequate reproductive counseling before RT, and many women undergoing RT experience complications that can negatively impact their fertility. We recommend a preoperative consultation with a reproductive endocrinologist for all patients considering RT.
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Affiliation(s)
- Jaimin S Shah
- Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Neda D Jooya
- Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Terri L Woodard
- Division of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, TX, USA
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Pedro T Ramirez
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nicole D Fleming
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Frumovitz
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Beesley VL, Alemayehu C, Webb PM. A systematic literature review of trials of survivorship interventions for women with gynaecological cancer and their caregivers. Eur J Cancer Care (Engl) 2019; 28:e13057. [DOI: 10.1111/ecc.13057] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/11/2019] [Accepted: 03/25/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Vanessa L. Beesley
- Gynaecological Cancers Group QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
- School of Public Health and Social Work Queensland University of Technology Brisbane Queensland Australia
| | - Chalachew Alemayehu
- Gynaecological Cancers Group QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
- Faculty of Medicine University of Queensland Brisbane Queensland Australia
| | - Penelope M. Webb
- Gynaecological Cancers Group QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
- School of Public Health and Social Work Queensland University of Technology Brisbane Queensland Australia
- School of Public Health University of Queensland Brisbane Queensland Australia
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Logan S, Perz J, Ussher JM, Peate M, Anazodo A. Systematic review of fertility-related psychological distress in cancer patients: Informing on an improved model of care. Psychooncology 2018; 28:22-30. [DOI: 10.1002/pon.4927] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 10/09/2018] [Accepted: 10/18/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Shanna Logan
- School of Women and Children's Health, Faculty of Medicine; UNSW Sydney; Sydney Australia
- Fertility & Research Centre; Royal Hospital for Women; Randwick Australia
- Sydney Children's Hospital, Kids Cancer Centre; Sydney Australia
| | - Janette Perz
- Translational Health Research Institute, School of Medicine; Western Sydney University; Sydney Australia
| | - Jane M. Ussher
- Translational Health Research Institute, School of Medicine; Western Sydney University; Sydney Australia
| | - Michelle Peate
- Psychosocial Health and Wellbeing (emPoWeR) Unit, Department of Obstetrics and Gynaecology, Royal Women's Hospital; University of Melbourne; Melbourne Australia
| | - Antoinette Anazodo
- School of Women and Children's Health, Faculty of Medicine; UNSW Sydney; Sydney Australia
- Sydney Children's Hospital, Kids Cancer Centre; Sydney Australia
- Nelune Comprehensive Cancer Centre; Prince of Wales Hospital; Sydney Australia
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Raque-Bogdan TL, Lamphere B, Kostiuk M, Gissen M, Beranek M. Unpacking the layers: a meta-ethnography of cancer survivors' loneliness. J Cancer Surviv 2018; 13:21-33. [PMID: 30414079 DOI: 10.1007/s11764-018-0724-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 10/20/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To review the empirical qualitative literature on cancer survivor's experiences with loneliness to inform assessments and interventions for improving cancer survivors' social well-being. METHODS A rigorous systematic review of qualitative studies published in five databases between 1993 and 2016 was conducted. Three coders reviewed 285 titles and abstracts and, after applying a critical review process, 20 manuscripts were synthesized using meta-ethnography. RESULTS The synthesis of the 20 studies provided a framework for understanding survivors' layers of loneliness at the level of the individual, their social support system, the healthcare system, and society. Internally, survivors described loneliness resulting from feelings of inauthenticity, of being alone in their cancer experience, and of lack of control. In their social networks, survivors attributed loneliness to others' avoidance, misperceptions of cancer, and others' failure to recognize the effects of cancer after active treatment. Unmet needs after treatment contributed to feelings of loneliness within the healthcare system. Further, societal stigma around cancer and pressures to experience growth after cancer created another layer of loneliness. The results suggest the need to move beyond an individual level perspective in assessing and treating loneliness in cancer survivors. CONCLUSIONS This meta-ethnography presents an integrated framework of loneliness in cancer survivors as a multi-layered experience. Implications for Cancer Survivors Conceptualizing loneliness from a systemic perspective adds missing pieces to the loneliness puzzle by encouraging assessment and intervention at interacting levels of functioning; considering how individuals respond to and are affected by their social systems can deepen our understanding of cancer survivorship.
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Affiliation(s)
- Trisha L Raque-Bogdan
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, 1999 E. Evans Avenue, Denver, CO, USA.
| | - Brooke Lamphere
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, 1999 E. Evans Avenue, Denver, CO, USA
| | - Marisa Kostiuk
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, 1999 E. Evans Avenue, Denver, CO, USA
| | - Maura Gissen
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, 1999 E. Evans Avenue, Denver, CO, USA
| | - Megan Beranek
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, 1999 E. Evans Avenue, Denver, CO, USA
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Staneva AA, Gibson AF, Webb PM, Beesley VL. The Imperative for a Triumph-Over-Tragedy Story in Women's Accounts of Undergoing Chemotherapy for Ovarian Cancer. QUALITATIVE HEALTH RESEARCH 2018; 28:1759-1768. [PMID: 29938608 DOI: 10.1177/1049732318778261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We aimed to examine how women construct their experiences of chemotherapy treatment for ovarian cancer. Through semistructured interviews, we explored the accounts of 18 Australian women about their experiences within a broader cultural imperative-or discourse-to "think positively." By applying a critical realist lens to the analysis, we identified two discursive themes that shaped women's accounts. The "feeling different and managing support" theme highlights the identity challenges women faced because of the lack of formal support for ovarian cancer. Conversely, the theme "women's reconstructions of difficult experiences" illustrates the imperative for women to present a positive story as a way of restoring their position of a lucky and stoic survivor. Such speaking served to mask some of the underlying difficulties that were part of these women's experiences. Health care professionals need to consider looking for the hidden stories of vulnerability that lie beneath the triumphant ones.
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Affiliation(s)
| | | | - Penelope M Webb
- 1 QIMR Berghofer Medical Research Institute, Brisbane, Australia
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Beesley VL, Alemayehu C, Webb PM. A systematic literature review of the prevalence of and risk factors for supportive care needs among women with gynaecological cancer and their caregivers. Support Care Cancer 2017; 26:701-710. [DOI: 10.1007/s00520-017-3971-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/09/2017] [Indexed: 01/23/2023]
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Tirlapur A, Willmott F, Lloyd P, Brockbank E, Jeyarajah A, Rao K. The management of pregnancy after trachelectomy for early cervical cancer. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/tog.12415] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anushka Tirlapur
- Whipps Cross University Hospital, Barts Health NHS Trust; Whipps Cross Road London E11 1NR UK
| | - Fredric Willmott
- Whipps Cross University Hospital, Barts Health NHS Trust; Whipps Cross Road London E11 1NR UK
| | - Philippa Lloyd
- Royal London Hospital, Barts Health NHS Trust; Whitechapel Road London E1 1BB UK
| | - Elly Brockbank
- Royal London Hospital, Barts Health NHS Trust; Whitechapel Road London E1 1BB UK
| | - Arjun Jeyarajah
- Royal London Hospital, Barts Health NHS Trust; Whitechapel Road London E1 1BB UK
| | - Kalpana Rao
- Newham University Hospital, Barts Health NHS Trust; Glen Road London E13 8SL UK
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Cook O, McIntyre M, Recoche K, Lee S. Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:2087-2112. [PMID: 28800057 DOI: 10.11124/jbisrir-2016-003126] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. OBJECTIVES This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. INCLUSION CRITERIA TYPES OF PARTICIPANTS This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from pre-diagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review. PHENOMENA OF INTEREST Studies that explored how women with gynecological cancer experience the care and interventions of specialist nurses were included. TYPES OF STUDIES Qualitative studies including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for review. This review also considered the qualitative components of mixed method studies. CONTEXT Research conducted in any country was considered for inclusion in this review providing that the study was reported in English. Studies conducted in any setting including, but not limited to, acute hospitals, outpatient/ambulatory clinics, chemotherapy or radiotherapy units, support groups, palliative care units or the patient's home were included. SEARCH STRATEGY A three-step search strategy was utilized in this review. An initial limited search of MEDLINE and CINAHL was undertaken followed by a comprehensive search using all identified keywords and index terms across all included databases. The reference lists of all identified reports and articles were hand searched for additional studies. METHODOLOGICAL QUALITY Each paper was independently assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute the Qualitative Assessment and Review Instrument. When disagreement arose between the reviewers, the given paper was independently appraised by a third reviewer. DATA EXTRACTION Data were extracted from papers included in the review using the standardized data extraction tool from Joanna Briggs Institute the Qualitative Assessment and Review Instrument. Data extraction was completed independently by two reviewers. DATA SYNTHESIS Extracted findings from seven included papers were grouped according to similarity in meaning from which 11 categories were developed. These categories were then subjected to a meta-synthesis that produced a set of three synthesized findings. RESULTS Key findings were extracted from six included papers and classified as unequivocal (U) or credible (C). A total of 30 findings were extracted and aggregated into 11 categories based on similarity in meaning. From the 11 categories, three synthesized findings were developed: i) Tailored care: specialist nurses play a role in understanding and meeting the individual needs of women with gynecological cancer; ii) Accessible care: specialist nurses guide women with gynecological cancer along the continuum of care and are an easily accessed source of knowledge and support; iii) Dependable expertise: women with gynecological cancer express trust and reassurance in the experience and expertise of the specialist nurse. CONCLUSIONS This systematic review synthesized the findings of seven studies that captured the experiences of women with gynecological cancer who received care from a specialist nurse. The specialist nurse offers tailored, accessible and expert care to women with gynecological cancer. From the synthesis it is recommended that women with gynecological cancer have access to the services of a specialist nurse at key points on the continuum of care, that specialist nurses provide information to patients on their disease and treatment in the form preferred by the patient and ensure that this information has been understood, and that specialist nurses are afforded time to spend with patients to enable greater exploration and identification of patient needs and the provision of personalized care. Further study that considers other key stakeholders in the specialist nurse role in gynecological oncology is recommended in order to gain a full understanding of specialist nurses' contribution to the care of women with gynecological cancer. Additionally, it is recommended that further studies be conducted to seek the perspectives of women with gynecological cancer from culturally and linguistically diverse backgrounds and Indigenous populations on specialist nursing care as they appear to be under-represented in current research.
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Affiliation(s)
- Olivia Cook
- 1School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia 2The Centre for Chronic Disease Management: a Joanna Briggs Institute Centre of Excellence, Melbourne, Australia
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Sexual Consequences of Cancer and Its Treatment in Adolescents and Young Adults. CANCER IN ADOLESCENTS AND YOUNG ADULTS 2017. [DOI: 10.1007/978-3-319-33679-4_24] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Winch CJ, Sherman KA, Smith KM, Koelmeyer LA, Mackie H, Boyages J. "You're naked, you're vulnerable": Sexual well-being and body image of women with lower limb lymphedema. Body Image 2016; 18:123-34. [PMID: 27434105 DOI: 10.1016/j.bodyim.2016.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 12/26/2022]
Abstract
Lower-limb lymphedema is an incurable illness manifesting as visible swelling enlarging the leg(s) and/or feet, buttocks, and genitals. This study used semi-structured interviews and thematic analysis to explore sexual well-being among women with primary (congenital) lymphedema (n=11) or secondary lymphedema associated with gynecological cancer (n=8). Five themes (subthemes) summarized women's responses, with Attractiveness and Confidence (Publicly Unattractive, Privately Unconfident, Lymphedema or Aging?) describing women's central concern. These body image-related concerns accounted for sexual well-being in association with Partner Support (Availability of Support, Languages of Support, Fears About Support) and the degree of Functional Interruptions (Lymphedema in Context, Enduring Impacts, Overcoming Interruptions). Successful Lymphedema Coping (Control, Acceptance) and self-perceived ability to fulfill a valued Sexual Role also affected sexual well-being. Few differences between women with primary versus secondary lymphedema were evident. Lymphedema clinicians should screen for sexual concerns and have referral options available.
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Affiliation(s)
- Caleb J Winch
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Kerry A Sherman
- Centre for Emotional Health, Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
| | - Katriona M Smith
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Louise A Koelmeyer
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Helen Mackie
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia; Mt. Wilga Private Hospital, Sydney, New South Wales, Australia
| | - John Boyages
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
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Fastrez M, Houba C, Vandromme J, Rozenberg S. Fertility-sparing management of gynecological cancers. Maturitas 2015; 82:141-5. [PMID: 26160684 DOI: 10.1016/j.maturitas.2015.06.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 06/09/2015] [Accepted: 06/11/2015] [Indexed: 01/17/2023]
Abstract
Fifteen to 21% of women diagnosed with genital tract tumors are younger than 40. Adequate counseling of these patients must be conducted to decide whether fertility-sparing treatment is allowed and what would be the oncological, fertility and obstetrical outcomes. We performed a comprehensive PubMed literature search using the terms "Uterine Cervical Neoplasms"[Mesh], "Trachelectomy", "Endometrial Neoplasms"[Mesh], "Ovarian Neoplasms"[Mesh] and "Fertility"[Mesh]. The following review reports available evidence for the conservative management of cervical, endometrial and ovarian cancer. Data regarding the selection of patients, surgical techniques, obstetrical issues and cancer prognosis are summarized. The level of evidence is low in most of the available reports. The therapeutic options presented in this paper should not therefore be considered as a standard of care. Nevertheless, fertility-sparing treatments of gynecological malignancies should be discussed in a multidisciplinary team and suggested to eligible patients who are younger than 40 and wish to become pregnant further.
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Affiliation(s)
- M Fastrez
- Department of Obstetrics and Gynecology, CHU Saint Pierre, Université Libre de Bruxelles, Brussels, 1000, Belgium.
| | - C Houba
- Department of Obstetrics and Gynecology, CHU Saint Pierre, Université Libre de Bruxelles, Brussels, 1000, Belgium
| | - J Vandromme
- Department of Obstetrics and Gynecology, CHU Saint Pierre, Université Libre de Bruxelles, Brussels, 1000, Belgium
| | - S Rozenberg
- Department of Obstetrics and Gynecology, CHU Saint Pierre, Université Libre de Bruxelles, Brussels, 1000, Belgium
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Maguire R, Kotronoulas G, Simpson M, Paterson C. A systematic review of the supportive care needs of women living with and beyond cervical cancer. Gynecol Oncol 2015; 136:478-90. [DOI: 10.1016/j.ygyno.2014.10.030] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 10/17/2014] [Accepted: 10/27/2014] [Indexed: 01/29/2023]
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