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Wu X, Wu L, Han J, Wu Y, Cao T, Gao Y, Wang S, Wang S, Liu Q, Li H, Yu N, Wang H, Li Y, Wang Z, Sun X, Wang J. Evaluation of the sexual quality of life and sexual function of cervical cancer survivors after cancer treatment: a retrospective trial. Arch Gynecol Obstet 2021; 304:999-1006. [PMID: 33616705 DOI: 10.1007/s00404-021-06005-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 02/11/2021] [Indexed: 12/09/2022]
Abstract
OBJECTIVE The purpose of this study was to explore the factors influencing the sexual quality of life of patients with cervical cancer who underwent radical hysterectomy. METHODS This multicenter retrospective cohort study was conducted from June 2013 to June 2018 at nine hospitals in China. In total, 204 women diagnosed with stage IA to stage IIB cervical cancer who underwent radical hysterectomy completed the questionnaire. Sexual function was measured with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ). All analyses were performed with R version 3.4.3 statistical software packages. A two-sided significance level of 0.05 was used to evaluate the statistical significance. RESULTS The mean sexual quality of life score was 37.21 ± 17.28, where a higher PISQ score indicates a better sexual quality of life, and we identified the factors associated with sexual dysfunction. The average follow-up time was 29.0 ± 16.0 months. In addition to radical hysterectomy, 182 (89.2%) patients underwent ovarian suspension, 93 (45.6%) underwent chemotherapy, and 74 (36.3%) underwent concurrent radiotherapy. The univariate analysis confirmed that age represents a protective factor for sexual function (odds ratio (OR) 6.0, 95% confidence interval (CI) 1.1-10.8, p = 0.017). The patients who underwent ovarian suspension were more likely to experience a good sexual quality of life (OR - 7.2, 95% CI [- 14.8, - 0.4], p = 0.035) compared to those who did not undergo ovarian suspension. A significant negative association was observed between radiotherapy and the behavioral-emotive, physical and partner-related domains of the PISQ (behavioral-emotive, OR - 1.5, 95% CI [- 2.6, - 0.4], p = 0.011; physical, OR - 0.9, 95% CI [- 1.5, - 0.3], p = 0.006; partner-related, OR - 0.7, 95% CI [- 1.3, 0.0], p = 0.043). Chemotherapy and radiotherapy were common risk factors for sexual dysfunction, and radiotherapy exerted a stronger effect than chemotherapy. CONCLUSIONS This study shows that the sexual function of cervical cancer patients tends to be related to age, radiotherapy, and chemotherapy. However, across these factors, patients with preserved ovaries tend to return to a satisfactory sexual quality of life after recovering from surgery.
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Affiliation(s)
- Xiaotong Wu
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Female Pelvic Floor Disorders, Beijing, China
- The Research Center of Female Pelvic Floor Dysfunction and Disease, Peking University, Beijing, China
| | - Lingying Wu
- Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Jinsong Han
- Peking University Third Hospital, Beijing, China
| | - Yumei Wu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Tingting Cao
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Female Pelvic Floor Disorders, Beijing, China
- The Research Center of Female Pelvic Floor Dysfunction and Disease, Peking University, Beijing, China
| | - Yunong Gao
- Department of Gynecology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Sha Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Female Pelvic Floor Disorders, Beijing, China
- The Research Center of Female Pelvic Floor Dysfunction and Disease, Peking University, Beijing, China
| | - Shiyan Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Female Pelvic Floor Disorders, Beijing, China
- The Research Center of Female Pelvic Floor Dysfunction and Disease, Peking University, Beijing, China
| | - Qing Liu
- Gansu Provincial Maternity and Child-Care Hospital, Gansu, China
| | - Hongxia Li
- Beijing Shi Ji Tan Hospital, Beijing, China
| | - Na Yu
- Peking University Medical Information Center, Beijing, China
| | - Haibo Wang
- Peking University Clinical Research Institute, Beijing, China
| | - Yi Li
- Peking University Medical Information Center, Beijing, China
| | - Zhiqi Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Female Pelvic Floor Disorders, Beijing, China
- The Research Center of Female Pelvic Floor Dysfunction and Disease, Peking University, Beijing, China
| | - Xiuli Sun
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.
- Beijing Key Laboratory of Female Pelvic Floor Disorders, Beijing, China.
- The Research Center of Female Pelvic Floor Dysfunction and Disease, Peking University, Beijing, China.
| | - Jianliu Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.
- Beijing Key Laboratory of Female Pelvic Floor Disorders, Beijing, China.
- The Research Center of Female Pelvic Floor Dysfunction and Disease, Peking University, Beijing, China.
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Pitcher S, Fakie N, Adams T, Denny L, Moodley J. Sexuality post gynaecological cancer treatment: a qualitative study with South African women. BMJ Open 2020; 10:e038421. [PMID: 32967884 PMCID: PMC7513640 DOI: 10.1136/bmjopen-2020-038421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES This study investigated women's experiences of their sexuality post gynaecological cancer treatment. Using a holistic sexuality framework, the study explored how women felt their sexual functioning, sexual relationships and sexual identity had been affected by treatment. DESIGN The study was qualitative in nature and made use of an interpretive descriptive design. Data were analysed using thematic analysis. SETTING Data collection took place at a follow-up clinic within the gynaeoncology unit at a public-sector tertiary hospital in Cape Town, South Africa. PARTICIPANTS Purposive sampling was used to recruit participants, and the final sample consisted of 34 women aged 29-70 ([Formula: see text]=52). All women had received a gynaecological cancer diagnosis and had been treated with either surgery, chemotherapy, radiation or a combination of these. On average, the participants were between 12 and 30 months post treatment. RESULTS Women expressed how their sexual functioning post treatment was both nuanced and complex, how heteronormative gender expectations influenced their intimate relationships, and how they experienced a re-embodiment of their sexual subjectivity post treatment. Participants felt that more sexual functioning information from healthcare providers, as well as peer support groups, would assist them in navigating the sexuality changes they experienced. CONCLUSIONS The findings of this study broaden conceptualisations of sexuality post treatment by detailing the ways that it is complex, nuanced, relational and ever shifting. More research is needed about how to incorporate holistic psychosexual support post treatment into the public healthcare system in South Africa.
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Affiliation(s)
- Sorrel Pitcher
- UCT/SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Nazia Fakie
- UCT/SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, Western Cape, South Africa
- Radiation Oncology, Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Tracey Adams
- UCT/SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, Western Cape, South Africa
- Obstetrics and Gynaecology, Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Lynette Denny
- UCT/SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, Western Cape, South Africa
- Obstetrics and Gynaecology, Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Jennifer Moodley
- UCT/SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, Western Cape, South Africa
- Cancer Research Initiative, University of Cape Town, Cape Town, Western Cape, South Africa
- Women's Health Research Unit, University of Cape Town, Cape Town, Western Cape, South Africa
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Parton C, Ussher JM, Perz J. Women’s constructions of heterosex and sexual embodiment after cancer. FEMINISM & PSYCHOLOGY 2016. [DOI: 10.1177/0959353516674493] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The significant impact of cancer on women’s sexual well-being has been acknowledged increasingly within research. However, the role of cultural discourse in shaping women’s construction and embodied experience of sexuality has received less attention. In this study, we examined heterosexual women’s constructions of sexual embodiment in the context of cancer. Sixteen women across a range of ages (20–71 years), cancer types and stages took part in in-depth semi-structured interviews. A thematic decomposition analysis was conducted on the interview transcripts, drawing on feminist poststructuralist theory. A main theme was identified in which the women took up subject positions of “Embodying sexuality” and “Embodying the absence of sexuality”. Accounts of “Embodying sexuality” included “Experiencing bodily ease during sex” and “Managing a dysfunctional body during sex”. The women’s positioning of “Embodying the absence of sexuality” included “Asexuality and the absence of desire” and “Unsuccessful attempts to renegotiate sex”. Women’s intrapsychic negotiation of sexual and gendered discourse, the materiality of embodied change and relationship context influenced their constructions of sexual subjectivity. These findings indicate a need for researchers and clinicians to acknowledge cultural discourses of sex and gender that shape the possibilities and constraints for women’s sexual well-being after cancer.
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Parton CM, Ussher JM, Perz J. Women's Construction of Embodiment and the Abject Sexual Body After Cancer. QUALITATIVE HEALTH RESEARCH 2016; 26:490-503. [PMID: 25652196 DOI: 10.1177/1049732315570130] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Cancer and cancer treatments can cause significant changes to women's sexual well-being. We explored how women construct a sense of their bodies and sexual "selves" in the context of cancer. Sixteen women, across a range of ages (20-71 years), cancer types, and cancer stages, took part in in-depth semistructured interviews. We conducted a thematic discourse analysis, drawing on feminist poststructuralist theory, identifying "the abject body" as a dominant theme. Participants constructed abject bodies as being "beyond abnormality," "outside idealized discourses of embodied femininity," and "out of control." The women's accounts varied in management and resistance of the abject body discourse, through bodily practices of concealment, resisting discourses of feminine beauty, and repositioning the body as a site of personal transformation. The corporeality of the cancerous body can be seen to disrupt hegemonic discourses of femininity and sexuality, with implications for how women practice and make meaning of embodied sexual subjectivity.
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Affiliation(s)
- Chloe M Parton
- University of Western Sydney, Penrith, New South Wales, Australia
| | - Jane M Ussher
- University of Western Sydney, Penrith, New South Wales, Australia
| | - Janette Perz
- University of Western Sydney, Penrith, New South Wales, Australia
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Solbrække KN, Bondevik H. Absent organs--present selves: exploring embodiment and gender identity in young Norwegian women's accounts of hysterectomy. Int J Qual Stud Health Well-being 2015; 10:26720. [PMID: 25937002 PMCID: PMC4417683 DOI: 10.3402/qhw.v10.26720] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2015] [Indexed: 11/14/2022] Open
Abstract
In this paper, we explore how younger women in Norway construct their embodiment and sense of self after hysterectomy. To do this, we conducted in-depth interviews with eight ethnic Norwegian women aged between 25 and 43 who had undergone hysterectomy. In line with a broad phenomenological approach to illness, the study was designed to explore the trajectories of the women's illness with a specific focus on concrete human experience and identity claims from a subjective point of view. In analysing the stories, we encountered feelings of suffering due to the loss of the uterus as well as profound side-effects, such as menopause. However, we also found evidence of relief from being treated for heavy bleeding and serious illness. In order to accentuate the individual voices in these illness stories, we chose a case-oriented analysis in line with Radley and Chamberlain (2001) and Riessman (2008). From this, two main seemingly contradictory storylines stood out: They have removed what made me a woman versus Without a uterus, I feel more like a woman. We also identified heteronormativity as an unstated issue in both these storylines and in the research data as a whole. Acknowledging diversity in the way women experience hysterectomy is important for a better understanding of the ways in which hysterectomy may affect women as humans as well as for developing more cultural competent healthcare services for this group.
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Affiliation(s)
| | - Hilde Bondevik
- Institute of Health and Society, University of Oslo, Oslo, Norway
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Ussher JM, Perz J, Gilbert E. Perceived causes and consequences of sexual changes after cancer for women and men: a mixed method study. BMC Cancer 2015; 15:268. [PMID: 25885443 PMCID: PMC4407322 DOI: 10.1186/s12885-015-1243-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 03/23/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Previous research on cancer and sexuality has focused on physical aspects of sexual dysfunction, neglecting the subjective meaning and consequences of sexual changes. This has led to calls for research on cancer and sexuality to adopt an "integrative" approach, and to examine the ways in which individuals interpret sexual changes, and the subjective consequences of sexual changes. METHOD This study examined the nature and subjective experience and consequences of changes to sexual well-being after cancer, using a combination of quantitative and qualitative analysis. Six hundred and fifty seven people with cancer (535 women, 122 men), across a range of reproductive and non-reproductive cancer types completed a survey and 44 (23 women, 21 men) took part in an in-depth interview. RESULTS Sexual frequency, sexual satisfaction and engagement in a range of penetrative and non-penetrative sexual activities were reported to have reduced after cancer, for both women and men, across reproductive and non-reproductive cancer types. Perceived causes of such changes were physical consequences of cancer treatment, psychological factors, body image concerns and relationship factors. Sex specific difficulties (vaginal dryness and erectile dysfunction) were the most commonly reported explanation for both women and men, followed by tiredness and feeling unattractive for women, and surgery and getting older for men. Psychological and relationship factors were also identified as consequence of changes to sexuality. This included disappointment at loss of sexual intimacy, frustration and anger, sadness, feelings of inadequacy and changes to sense of masculinity of femininity, as well as increased confidence and self-comfort; and relationship strain, relationship ending and difficulties forming a new relationship. Conversely, a number of participants reported increased confidence, re-prioritisation of sex, sexual re-negotiation, as well as a strengthened relationship, after cancer. CONCLUSION The findings of this study confirm the importance of health professionals and support workers acknowledging sexual changes when providing health information and developing supportive interventions, across the whole spectrum of cancer care. Psychological interventions aimed at reducing distress and improving quality of life after cancer should include a component on sexual well-being, and sexual interventions should incorporate components on psychological and relational functioning.
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Affiliation(s)
- Jane M Ussher
- Centre for Health Research, University of Western Sydney, Locked Bag 1797, Penrith South, 2751, Australia.
| | - Janette Perz
- Centre for Health Research, University of Western Sydney, Locked Bag 1797, Penrith South, 2751, Australia.
| | - Emilee Gilbert
- School of Social Sciences and Psychology, University of Western Sydney, Locked Bag 1797, Penrith South, 2751, Australia.
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McClelland SI, Holland KJ, Griggs JJ. Vaginal Dryness and Beyond: The Sexual Health Needs of Women Diagnosed With Metastatic Breast Cancer. JOURNAL OF SEX RESEARCH 2014; 52:604-616. [PMID: 25110913 DOI: 10.1080/00224499.2014.928663] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
While research on the sexual health of women with early stage cancer has grown extensively over the past decade, markedly less information is available to support the sexual health needs of women diagnosed with advanced breast cancer. Semistructured interviews were conducted with 32 women diagnosed with metastatic breast cancer (ages 35 to 77) about questions they had concerning their sexual health and intimate relationships. All participants were recruited from a comprehensive cancer center at a large Midwestern university. Three themes were examined: the role of sexual activity and intimate touch in participants' lives, unmet information needs about sexual health, and communication with medical providers about sexual concerns. Findings indicated that sexual activities with partners were important; however, participants worried about their own physical limitations and reported frequent physical (e.g., bone pains) and vaginal pain associated with intercourse. When women raised concerns about these issues in clinical settings, medical providers often focused exclusively on vaginal lubricants, which did not address the entirety of women's problems or concerns. In addition, women diagnosed with metastatic breast cancer reported needing additional resources about specialized vaginal lubricants, nonpenetrative and nongenitally focused sex, and sexual positions that did not compromise their physical health yet still provided pleasure.
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Affiliation(s)
- Sara I McClelland
- a Departments of Psychology and Women's Studies , University of Michigan
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Ussher JM, Perz J, Gilbert E. Women's Sexuality after Cancer: A Qualitative Analysis of Sexual Changes and Renegotiation. WOMEN & THERAPY 2014. [DOI: 10.1080/02703149.2014.897547] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Ussher JM, Perz J, Gilbert E, Wong WKT, Mason C, Hobbs K, Kirsten L. Talking about sex after cancer: a discourse analytic study of health care professional accounts of sexual communication with patients. Psychol Health 2013; 28:1370-90. [PMID: 23805956 DOI: 10.1080/08870446.2013.811242] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
There is consistent evidence that health care professionals (hcps) are not addressing the sexual information and support needs of people with cancer. Thirty-eight Australian hcps across a range of professions working in cancer care were interviewed, to examine constructions of sexuality post-cancer, the subject positions adopted in relation to sexual communication, and the ways in which discourses and subject positions shape information provision and communication about sexuality. Participants constructed sexual changes post-cancer in physical, psychological and relational terms, and positioned such changes as having the potential to significantly impact on patient and partner well-being. This was associated with widespread adoption of a discourse of psychosocial support, which legitimated discussion of sexual changes within a clinical consultation, to alleviate distress, dispel myths and facilitate renegotiation of sexual practices. However, this did not necessarily translate into patient-centred practice outcomes, with the majority of participants positioning personal, patient-centred and situational factors as barriers to the discussion of sex within many clinical consultations. This included: absence of knowledge, confidence and comfort; positioning sex as irrelevant or inappropriate for some people; and limitations of the clinical context. In contrast, those who did routinely discuss sexuality adopted a subject position of agency, responsibility and confidence.
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Affiliation(s)
- Jane M Ussher
- a Centre for Health Research, University of Western Sydney , Sydney , Australia
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Perz J, Ussher JM, Gilbert E. Constructions of sex and intimacy after cancer: Q methodology study of people with cancer, their partners, and health professionals. BMC Cancer 2013; 13:270. [PMID: 23725590 PMCID: PMC3673866 DOI: 10.1186/1471-2407-13-270] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 05/29/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The increasing number of individuals living with cancer has led to a focus on the quality of life of survivors, and their families. Sexual wellbeing is a central component of quality of life, with a growing body of research demonstrating the association between cancer and changes to sexuality and intimacy. However, little is known about patient and professional understanding of cancer and sexuality post-cancer. This study was designed to explore the complex perspectives that people with personal and professional experience with cancer hold about sexuality in the context of cancer. METHODS An interview study using Q methodology was conducted with 44 people with cancer, 35 partners of a person with cancer and 37 health professionals working in oncology. Participants were asked to rank-order 56 statements about sexuality and intimacy after cancer and asked to comment on their rankings in a subsequent semi-structured interview. A by-person factor analysis was performed with factors extracted according to the centroid method with a varimax rotation. RESULTS A three-factor solution provided the best conceptual fit for the perspectives regarding intimacy and sexuality post-cancer. Factor 1, entitled "communication - dispelling myths about sex and intimacy" positions communication as central to the acceptance of a range of satisfying sexual and intimate practices post-cancer. Factor 2, "valuing sexuality across the cancer journey," centres on the theme of normalizing the experience of sex after cancer through the renegotiation of sex and intimacy: the development of alternative sexual practices. Factor 3, "intimacy beyond sex," presents the view that even though sex may not be wanted, desired, or even possible following cancer, quality of life and relationship satisfaction are achieved through communication and non-genital intimacy. CONCLUSIONS This study has demonstrated the complexity of perspectives about sexuality and intimacy post cancer, which has practical implications for those working in cancer care and survivorship. Therapists and other health professionals can play an important role in ameliorating concerns surrounding sexual wellbeing after cancer, by opening and facilitating discussion of sexuality and intimacy amongst couples affected by cancer, as well as providing information that normalizes a range of sexual and intimate practices.
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Affiliation(s)
- Janette Perz
- Centre for Health Research, University of Western Sydney, Locked Bag 1797, Penrith South, 2751, Australia
| | - Jane M Ussher
- Centre for Health Research, University of Western Sydney, Locked Bag 1797, Penrith South, 2751, Australia
| | - Emilee Gilbert
- Centre for Health Research, University of Western Sydney, Locked Bag 1797, Penrith South, 2751, Australia
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Gilbert E, Ussher JM, Perz J, Wong WKT, Hobbs K, Mason C. Men's experiences of sexuality after cancer: a material discursive intra-psychic approach. CULTURE, HEALTH & SEXUALITY 2013; 15:881-895. [PMID: 23656602 DOI: 10.1080/13691058.2013.789129] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Men can experience significant changes to their sexuality following the onset of cancer. However, research on men's sexuality post-cancer has focused almost exclusively on those with prostate and testicular cancer, despite evidence that the diagnosis and treatment for most cancers can impact on men's sexuality. This Australian qualitative study explores the experiences of changes to sexuality for 21 men across a range of cancer types and stages, sexual orientations and relationship contexts. Semi-structured interviews were analysed with theoretical thematic analysis guided by a material discursive intra-psychic approach, recognising the materiality of sexual changes, men's intrapsychic experience of such changes within a relational context and the influence of the discursive construction of masculine sexuality. Material changes included erectile difficulty, decreased desire, and difficulty with orgasm. The use of medical aids to minimise the impact of erectile difficulties was shaped by discursive constructions of 'normal' masculine sexuality. The majority of men reported accepting the changes to their sexuality post-cancer and normalised them as part of the natural ageing process. Men's relationship status and context played a key role managing the changes to their sexuality. We conclude by discussing the implications for clinical practice.
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Affiliation(s)
- Emilee Gilbert
- a Centre for Health Research , University of Western Sydney , Sydney , Australia
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White I, Faithfull S, Allan H. The re-construction of women's sexual lives after pelvic radiotherapy: A critique of social constructionist and biomedical perspectives on the study of female sexuality after cancer treatment. Soc Sci Med 2013; 76:188-96. [DOI: 10.1016/j.socscimed.2012.10.025] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Revised: 10/21/2012] [Accepted: 10/29/2012] [Indexed: 11/29/2022]
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“I'd be just as happy with a cup of tea”: Women's accounts of sex and affection in long-term heterosexual relationships. WOMENS STUDIES INTERNATIONAL FORUM 2012. [DOI: 10.1016/j.wsif.2012.01.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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White ID, Allan H, Faithfull S. Assessment of treatment-induced female sexual morbidity in oncology: is this a part of routine medical follow-up after radical pelvic radiotherapy? Br J Cancer 2011; 105:903-10. [PMID: 21897386 PMCID: PMC3185952 DOI: 10.1038/bjc.2011.339] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 07/28/2011] [Accepted: 08/02/2011] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Oncology follow-up has traditionally prioritised disease surveillance and the assessment and management of symptoms associated with cancer and its treatment. Over the past decade, the focus on late effects of treatment has increased, particularly those that have an adverse effect on long-term function and quality of life. The aim of this research was to explore factors that influence the identification of treatment-induced female sexual difficulties in routine oncology follow-up after radical pelvic radiotherapy. METHODS A structured observation schedule was used to systematically record topics discussed in 69 radiotherapy follow-up consultations observed over a 5-month period. RESULTS Analysis suggests that physical toxicity assessment focused on bowel (81%) and bladder (70%) symptoms. Vaginal toxicity was discussed less frequently (42%) and sexual issues were explored in only 25% of consultations. Formal recording of radiation toxicity through assessment questionnaires was limited to patients participating in clinical trials. Surveillance activity and the management of active physical symptoms predominated and psychosocial issues were addressed in only 42% of consultations. INTERPRETATION Female sexual morbidity after pelvic radiotherapy remains a neglected aspect of routine follow-up and cancer survivorship. Developments in both individual practice and service provision are necessary if the identification and management of treatment-induced female sexual difficulties is to be improved.
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Affiliation(s)
- I D White
- Supportive Cancer Care Research Group, Florence Nightingale School of Nursing and Midwifery, James Clerk Maxwell Building, King's College, 57 Waterloo Road, London SE1 8WA, UK.
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Nursing's silence on lesbian, gay, bisexual, and transgender issues: the need for emancipatory efforts. ANS Adv Nurs Sci 2010; 33:206-18. [PMID: 20520521 DOI: 10.1097/ans.0b013e3181e63e49] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The purpose of this study was to selectively review the nursing literature for publications related to lesbian, gay, bisexual, and transgender health, using (1) a key word search of CINAHL, the database of nursing and allied health publications; (2) from the top-10 nursing journals by 5-year impact factor from 2005 to 2009, counting articles about lesbian, gay, bisexual, and transgender issues; and (3) content analysis of the articles found in those journals. Only 0.16% of articles focused on lesbian, gay, bisexual, and transgender health (8 of nearly 5000 articles) and were biased toward authors outside of the United States. We discuss the impact of this silence.
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