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

A multimodal couple-coping intervention for enhancing sexual adjustment among breast cancer women: Study protocol for a randomised controlled trial

AIM

To investigate the effects of a multimodal couple-based sexual health intervention for premenopausal women treated for breast cancer and their partners to provide personalised psychosexual care, and to understand participants' experience of, and adherence to, the intervention.

METHODS

This is an assessor-blinded, randomised controlled trial. Premenopausal women treated for breast cancer (N = 160) and their partners will be recruited. Dyads will be randomised into an intervention (n = 80) or attention control (n = 80) group. The intervention group will receive the multimodal couple-based sexual health intervention over eight weeks. The intervention comprises five face-to-face and virtual individual couple counselling sessions combined with online reading, a chat-based discussion forum, and telephone calls. The intervention is based on level I-II evidence and a robust theoretical framework. The attention control group will receive usual care plus telephone calls comprising general greetings and reminders to complete follow-up surveys. Sexual adjustment, relationship quality and quality of life will be measured at baseline, after completion of the intervention, three months and six months post-intervention. The project will adhere to the CONSORT-EHEALTH checklist. Qualitative interviews will explore the participants' experience of, and adherence to, the intervention.

DISCUSSION

This study will provide the first pragmatic evidence of the effectiveness of a multimodal couple-coping intervention to support premenopausal women and their partners to improve sexuality, relationship quality and quality of life after treatment for breast cancer.

IMPLICATIONS FOR THE PROFESSION AND /OR PATIENT CARE

Sexual health is a neglected area in clinical practice, for patients and partners. The ever-growing population of women treated for breast cancer at younger age has created a more pressing need for the development of tailored sexual health interventions. If effective, this intervention could be incorporated into routine cancer care to provide better support and care for this patient population to enhance sexual health, intimacy and overall well-being.

TRIAL REGISTRATION

ISRCTN35481498; prospectively registered on 08/05/2023.

An investigation of the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer: a randomized controlled trial

BACKGROUND

Breast cancer is an extremely unpleasant and unbearable experience that can have a profound impact on a person's life. Compared to other types of cancer, breast cancer has a more severe psychological impact on women.

PURPOSE

This study aimed to investigate the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer.

METHOD

A sample of 30 women with breast cancer were randomly divided into intervention and control groups. The research was conducted in the oncology division of Imam Reza Hospital in Kermanshah by the clinical trial method with a two-group pretest-posttest design and a 2 month follow-up. Participants in the intervention group received Mindfulness-integrated cognitive behavior therapy for eight sessions. The intervention was carried out individually in weekly 60 min sessions. While the control group received self-help treatment (through an educational book). A demographic questionnaire, Demoralization Scale (DS-II), Body Image Scale (BIS), and Female Sexual Function Index (FSFI) were used to collect data. For data analysis, means and standard deviations were calculated and repeated measures and the Bonferroni test was conducted using SPSS 26.

RESULTS

The results showed the effectiveness of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function (p < 0.05). Concerning demoralization in the intervention group, the pre-test mean was 16.73 ± 3.33, and it reduced to 11.93 ± 1.49 in the post-test. The body image mean score showed a decreasing trend in the intervention group, from 12.47 ± 1.88 in the pre-test to 8.80 ± 3.21 in the post-test. The mean score for sexual function showed an increasing trend, increasing from 18.06 ± 2.29 in the pre-test to 23.07 ± 0.91 in the post-test. There was no significant difference in the mean score of the post-test compared to the pre-test and follow-up in the control group (p < 0.05).

CONCLUSION

MICBT can be used in conjunction with pharmaceuticals and medical treatments to improve the psychological symptoms of women with breast cancer, according to this study's results. Trial registration (IRCT20160103025817N6). 2022-04-06.

An Intelligent Breast Ultrasound System for Diagnosis and 3D Visualization

Background: Ultrasonography is the main examination method for breast diseases. Ultrasound imaging is currently relied upon by doctors to form statements of characteristics and locations of lesions, which severely limits the completeness and effectiveness of ultrasound image information. Moreover, analyzing ultrasonography requires experienced ultrasound doctors, which are not common in hospitals. Thus, this work proposes a 3D-based breast ultrasound system, which can automatically diagnose ultrasound images of the breasts and generate a representative 3D breast lesion model through typical ultrasonography. Methods: In this system, we use a weighted ensemble method to combine three different neural networks and explore different combinations of the neural networks. On this basis, a breast locator was designed to measure and transform the spatial position of lesions. The breast ultrasound software generates a 3D visualization report through the selection and geometric transformation of the nodular model. Results: The ensemble neural network improved in all metrics compared with the classical neural network (DenseNet, AlexNet, GoogLeNet, etc.). It proved that the ensemble neural network proposed in this work can be used for intelligent diagnosis of breast ultrasound images. For 3D visualization, magnetic resonance imaging (MRI) scans were performed to achieve their 3D reconstructions. By comparing two types of visualized results (MRI and our 3D model), we determined that models generated by the 3D-based breast ultrasound system have similar nodule characteristics and spatial relationships with the MRI. Conclusions: In summary, this system implements automatic diagnosis of ultrasound images and presents lesions through 3D models, which can obtain complete and accurate ultrasound image information. Thus, it has clinical potential.

The Perimenopausal Fatigue Self-Management Scale Is Suitable for Evaluating Perimenopausal Taiwanese Women's Vulnerability to Fatigue Syndrome

The purpose of this study was to test the feasibility of utilizing the established perimenopausal fatigue self-management scale (P-MFSMS) to evaluate perimenopausal Taiwanese women's vulnerability to fatigue syndrome. A cross-sectional study design was adopted to survey 220 perimenopausal Taiwanese women with a mean age of 51.8 ± 4.64 years and a mean body mass index of 23.07 ± 3.04 kg/m2, 75.9% of whom were married, 52.3% had a college education or above, 80.4% had salaries, 81.3% had small families, and 96.4% were not using hormone therapy. The P-MFSMS consists of 25 questions based on six categories: (1) strive to maintain work energy and efficiency; (2) seek self-help from medical resources (doctor shopping); (3) strive to maintain the normal operation of the family (seeking help and support from family or significant other); (4) make time for activities or exercise in busy life; (5) slow down or adjust lifestyle; (6) frustration. For all of these six categories, the minimum loading of each question on the factor was calculated to be over 0.50, with a Cronbach's α of 0.78 and a corrected total-item correlation of >0.50. The goodness of fit of the model was determined to be acceptable, with a chi-square/df value of <3.0 (χ2 = 503.45 and df = 260), a root mean square error of approximation (RMSEA) value of 0.065 (<0.08), as well as a Kaiser-Meyer-Olkin (KMO) value of 0.892. The Tucker-Lewis index (TLI = 0.91), Comparative Fit index (CFI = 0.92), and Incremental Fit index (IFI = 0.92) were all >0.90. There was no statistically significant difference in the difficulty between perimenopausal and postmenopausal women utilizing differential item function (DIF) analysis. Taken together, the 25-question P-MFSMS may be a potentially valid and reliable instrument for suitably evaluating perimenopausal Taiwanese women's vulnerability to fatigue syndrome. Future studies will be conducted to test the effectiveness of the P-MFSMS for evaluating perimenopausal Taiwanese women's vulnerability to fatigue syndrome in clinical practice.