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Ek AS, Holmström C, Elmerstig E. Unmet Need for Sexual Rehabilitation after Acquired Brain Injury (ABI): A Cross-Sectional Study Concerning Sexual Activity, Sexual Relationships, and Sexual Rehabilitation after ABI. SEXUALITY AND DISABILITY 2023. [DOI: 10.1007/s11195-023-09788-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
AbstractIn relation to brain injury rehabilitation, research has stressed the importance of including sexuality issues due to increased risk for sexual dysfunctions after Acquired Brain Injury (ABI). This study aims to explore experiences after non-stroke ABI concerning individual and relational aspects of sexuality, received information about sexuality at rehabilitation, and gender differences. A postal nationwide survey was conducted in Sweden, 2018–2019. The sample included individuals who had participated in brain injury rehabilitation 2014–2016, response rate 40% (250/624). Among all participants 78% had resumed sexual activity, and there was a significant difference between males (84%, 118/140) and females (69%, 76/110, p = 0.004). Among all participants, 95% reported physical intimacy as important, 80% considered sex as important on an individual level, and 91% stated sexuality as important for the relationship (no gender differences). Significantly more females (52%) than males (22%) reported that they had tried sexual aids (p = 0.000), and more males (29%) than females (16%) reported that professionals addressed sexuality issues during brain injury rehabilitation (p = 0.024). However, only a few participants were offered specific sexual counseling during brain injury rehabilitation, such as individual counseling (3%), couples counseling (2%), and group counseling (3%). To conclude, the vast majority valued both individual and relational aspects of sex and sexuality highly, and more males than females had resumed sexual activity. Few had received information about sexuality after ABI, and even fewer females compared to males reported that the issue was raised during rehabilitation. Clinical implications are discussed in relation to sexual rehabilitation.
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Carmen A, Anne O, Monika S, Daniel E, Johannes G, Verena M, Michael H, Christine B. Does the toxicity of endocrine therapy persist into long-term survivorship?: Patient-reported outcome results from a follow-up study beyond a 10-year-survival. Breast Cancer Res Treat 2023; 198:475-485. [PMID: 36418518 PMCID: PMC10036266 DOI: 10.1007/s10549-022-06808-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Endocrine treatment (ET) is a highly effective breast cancer treatment but can distinctly impair breast cancer patients' quality of life (QOL). In a patient-reported outcome (PROs) study conducted by the authors in 2011, patients reported higher ET-induced symptom levels than known from the registration trials, and was underestimated. Based on these study results, we investigated the long-term sequelae of ET reported by breast cancer survivors (BCS) in a follow-up study conducted 5-10 years after an earlier assessment. METHODS BCS who had participated in the earlier study (n = 436) were approached for study participation either at one of their routine follow-up appointments or via mail; consenting patients were asked to completed the same PRO assessment used in the original study (FACT-B + ES). BCS with relapse/ progressive disease were excluded from the analysis. We compared long-term endocrine symptomatology and overall QOL outcome (i.e. FACT-G and -ES sum score). RESULTS A final sample of 268 BCS was included in the analysis. BCS reported a significant improvement of the overall endocrine symptomatology (baseline mean = 59 vs. follow-up mean = 62, p < 0.001), physical (baseline = 23.9 mean vs. follow-up mean = 24.8, p < 0.01) and functional well-being (baseline mean = 21.7 vs. follow-up mean = 22.7, p = 0.013) and overall QOL (mean baseline = 88.3 vs. mean follow-up = 90.9, p = 0.011). However, the prevalence of particular symptoms, well-known to be ET induced, did not change over time such as joint pain (baseline = 45.5% vs. 44.2%, n.s. difference), lack of energy (36.4% vs 33.8%, n.s. difference), weight gain (36.8% vs. 33.9%, n.s. difference) or vaginal dryness (30.2% vs. 33%, n.s. difference) and the proportion reporting lack of interest in sex increased (40.4% vs. 48.7%, p < 0.05). CONCLUSION Presented results indicate that BCS recover well in terms of overall endocrine symptomatology and quality of life but experience some clinically relevant and unfavorable ET-related long-term effects.
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Affiliation(s)
- Albertini Carmen
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - Oberguggenberger Anne
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, CL Service, University Hospital of Psychiatry II, Medical University of Innsbruck, Innrain 52, A-6020, Innsbruck, Austria.
| | - Sztankay Monika
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, CL Service, University Hospital of Psychiatry II, Medical University of Innsbruck, Innrain 52, A-6020, Innsbruck, Austria
| | - Egle Daniel
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - Giesinger Johannes
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, CL Service, University Hospital of Psychiatry II, Medical University of Innsbruck, Innrain 52, A-6020, Innsbruck, Austria
| | - Meraner Verena
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, CL Service, University Hospital of Psychiatry II, Medical University of Innsbruck, Innrain 52, A-6020, Innsbruck, Austria
| | - Hubalek Michael
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - Brunner Christine
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
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Johnsson A, Fugl-Meyer K, Bordas P, Åhman J, Von Wachenfeldt A. Side Effects and Its Management in Adjuvant Endocrine Therapy for Breast Cancer: A Matter of Communication and Counseling. Breast Cancer (Auckl) 2023; 17:11782234221145440. [PMID: 36699826 PMCID: PMC9869185 DOI: 10.1177/11782234221145440] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/26/2022] [Indexed: 01/22/2023] Open
Abstract
Objective Women with a newly diagnosed hormone receptor-positive breast cancer are offered adjuvant endocrine therapy (AET). Although the treatment reduces the risk of relapse and death not all women are adherent to it. Many factors, including the therapy's menopausal side effects, can adversely affect adherence to the treatment. This study explores the extent to which women treated with AET perceived that health care providers addressed their side effects. Methods Ten focus groups were set up, containing between four to nine women. In total, 58 women participated in the study-45 from the Stockholm metropolitan region and 13 from the scarcely populated Norrbotten region. The interviews were analyzed using qualitative content analysis with an inductive approach. Results The women were usually satisfied with the care they received from the health care providers. However, their experiences were more complex when it came to their satisfaction with the care in terms of the menopausal side effects of therapy, sexuality in particular. The participants reported that their healthcare providers rarely asked about sex life-related side effects of the treatment. Conclusions Health care providers need to communicate and consult about issues related to their patients' sex lives following their breast cancer diagnosis and during their treatment.
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Affiliation(s)
- Aina Johnsson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden,Aina Johnsson, Department of Oncology-Pathology, Karolinska Institutet, 171 77 Stockholm, Sweden.
| | - Kerstin Fugl-Meyer
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden,Department of Function Area Social Work in Healthcare, Karolinska University Hospital, Stockholm, Sweden
| | - Pal Bordas
- Department of Radiology, Norrbotten Mammography Screening Program, Sunderby Hospital, Luleå, Sweden,Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Janet Åhman
- Department of Radiology, Norrbotten Mammography Screening Program, Sunderby Hospital, Luleå, Sweden
| | - Anna Von Wachenfeldt
- Department of Oncology, Södersjukhuset, Stockholm, Sweden,Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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Alananzeh I, Green H, Meedya S, Chan A, Chang HC(R, Yan Z, Fernandez R. Sexual activity and cancer: A systematic review of prevalence, predictors and information needs among female Arab cancer survivors. Eur J Cancer Care (Engl) 2022; 31:e13644. [PMID: 35816027 PMCID: PMC9786682 DOI: 10.1111/ecc.13644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 02/27/2022] [Accepted: 06/06/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The objective of this review is to synthesise and present the best available evidence on the prevalence, predictors and information needs about sexual health among female Arab cancer survivors. METHODS The databases searched included MEDLINE, Embase and CINAHL from inception of the database until March 2020. The review was undertaken according to the JBI guidelines. Proportional meta-analysis using a random effects model was used for statistical pooling through JBI SUMARI. RESULTS Seven studies involving female Arab cancer survivors were included in the review. The overall prevalence of sexual dysfunction ranged from 16.7 to 67% (pooled estimate 51%, 95% CIs 21.7% to 80.2%). Dyspareunia and erectile dysfunction were the two main types of sexual dysfunction reported after diagnosis, and the overall prevalence ranged from 42.5% to 65% and 38% to 61%, respectively. The prevalence of vaginal dryness was ranged from 19.8% to 54.2%, and dyspareunia ranged from 22.2% to 65%. The lack of sexuality information and communication with health care providers (HCPs) was also reported in the included studies. CONCLUSION Cancer and its treatment may result in significant difficulties with sexual activity and sexual functioning among cancer survivor. Communication between the health care professionals and cancer survivors is essential to overcome this problem and improve the quality of life of female Arab cancer survivors.
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Affiliation(s)
- Ibrahim Alananzeh
- School of Nursing and MidwiferyUniversity of WollongongLiverpoolNew South WalesAustralia
| | - Heidi Green
- Centre for Research in Nursing and HealthSt George HospitalKogarahNew South WalesAustralia
| | - Shahla Meedya
- School of Nursing and MidwiferyUniversity of WollongongLiverpoolNew South WalesAustralia
| | - Alex Chan
- School of Nursing and MidwiferyUniversity of WollongongLiverpoolNew South WalesAustralia
| | - Hui Chen (Rita) Chang
- School of Nursing and MidwiferyUniversity of WollongongLiverpoolNew South WalesAustralia
| | - Zhoumei Yan
- School of Nursing and MidwiferyUniversity of WollongongLiverpoolNew South WalesAustralia
| | - Ritin Fernandez
- School of NursingUniversity of WollongongWollongongNew South WalesAustralia
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Campos LS, De Nardi SP, Limberger LF, Caldas JM. Sexual function and disease progression in women with advanced cancer. Support Care Cancer 2022; 30:5093-5098. [DOI: 10.1007/s00520-022-06797-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/31/2021] [Indexed: 11/30/2022]
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Sexual health and wellbeing among female pelvic cancer survivors following individualized interventions in a nurse-led clinic. Support Care Cancer 2022; 30:8981-8996. [PMID: 35931832 PMCID: PMC9633476 DOI: 10.1007/s00520-022-07294-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/21/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Treatment-induced sexual and intestinal dysfunctions coexist among women after pelvic radiotherapy. We aimed to explore if sexual health and wellbeing may be improved after radiotherapy following nurse-led interventions and if an association exists between improved intestinal health and sexual health. METHODS A population-based cohort of women treated with pelvic radiotherapy underwent interventions at a nurse-led clinic at Sahlgrenska University Hospital, Sweden, from 2011 to 2017. Self-reported questionnaires were used, pre- and post-intervention, to compare self-reported changes in sexual health and wellbeing. A regression model was performed to explore the association between intestinal and wellbeing variables. RESULTS Among the 260 female pelvic cancer survivors included in the study, more women reported increased than decreased satisfaction with overall sexual health post-intervention (26.0% vs. 15.3%, p = 0.035). They also reported significantly reduced superficial genital pain (25.8% vs. 13.1%, p ≤ 0.025), reduced deep genital pain (23.1% vs. 8.0%, p ≤ 0.001), increased QoL (42.7% vs. 22.4%, p < 0.001), and reduced levels of depression (43.1% vs. 28.0%, p = 0.003) or anxiety (45.9% vs. 24.4%, p < 0.001) post-intervention. We found a significant association between reduced urgency to defecate and improved satisfaction with overall sexual health (RR 3.12, CI 1.27-7.68, p = 0.004) and between reduced urgency to defecate with fecal leakage and reduced anxious mode (RR 1.56, CI 1.04-2.33, p = 0.021). CONCLUSION Sexual health and wellbeing can be improved by interventions provided in a nurse-led clinic focusing on physical treatment-induced late effects. Further research to optimize treatment strategies in female pelvic cancer survivors is needed.
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Abstract
CONTEXT Men generally seek healthcare less often than women and, other than traditional gender norms, less is known about the explanation. The aim was to identify knowledge gaps and factors influencing men regarding sexual and reproductive healthcare (SRHC) in the Nordic countries. METHODS We searched PubMed and SveMed+ for peer-reviewed articles published between January 2010 and May 2020. The analyses identified factors influencing men's experiences of and access to SRHC. RESULTS The majority of the 68 articles included focused on pregnancy, birth, infertility and sexually transmitted infections including HIV. During pregnancy and childbirth, men were treated as accompanying partners rather than individuals with their own needs. The knowledge and attitudes of healthcare providers were crucial for their ability to provide SRHC and for the experiences of men. Organisational obstacles, such as women-centred SRHC and no assigned healthcare profession for men's sexual and reproductive health issues, hindered men's access to SRHC. Lastly, the literature rarely discussed the impact of health policies on men's access to SRHC. CONCLUSIONS The literature lacked the perspectives of specific groups of men such as migrants, men who have sex with men and transmen, as well as the experiences of men in SRHC related to sexual function, contraceptive use and gender-based violence. These knowledge gaps, taken together with the lack of a clear entry point for men into SRHC, indicate the necessity of an improved health and medical education of healthcare providers, as well as of health system interventions.
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Affiliation(s)
- Mazen Baroudi
- Department of Epidemiology and Global Health, Umeå University Faculty of Medicine, Umea, Sweden
| | - Jon Petter Stoor
- Department of Epidemiology and Global Health, Umeå University Faculty of Medicine, Umea, Sweden
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Hanna Blåhed
- Department of Epidemiology and Global Health, Umeå University Faculty of Medicine, Umea, Sweden
| | - Kerstin Edin
- Department of Epidemiology and Global Health, Umeå University Faculty of Medicine, Umea, Sweden
| | - Anna-Karin Hurtig
- Department of Epidemiology and Global Health, Umeå University Faculty of Medicine, Umea, Sweden
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Åkeflo L, Dunberger G, Elmerstig E, Skokic V, Steineck G, Bergmark K. Cohort profile: an observational longitudinal data collection of health aspects in a cohort of female cancer survivors with a history of pelvic radiotherapy-a population-based cohort in the western region of Sweden. BMJ Open 2021; 11:e049479. [PMID: 34290070 PMCID: PMC8296786 DOI: 10.1136/bmjopen-2021-049479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The study 'Health among women after pelvic radiotherapy' was conducted in response to the need for more advanced and longitudinal data concerning long-term radiotherapy-induced late effects and chronic states among female cancer survivors. The objective of this paper is to detail the cohort profile and the study procedure in order to provide a sound basis for future analyses of the study cohort. PARTICIPANTS Since 2011, and still currently ongoing, participants have been recruited from a population-based study cohort including all female patients with cancer, over 18 years of age, treated with pelvic radiotherapy with curative intent at Sahlgrenska University Hospital in Gothenburg, in the western region of Sweden, which covers 1.7 million of the Swedish population. The dataset presented here consists of baseline data provided by 605 female cancer survivors and 3-month follow-up data from 260 individuals with gynaecological, rectal or anal cancer, collected over a 6-year period. FINDINGS TO DATE Data have been collected from 2011 onwards. To date, three studies have been published using the dataset reporting long-term radiation-induced intestinal syndromes and late adverse effects affecting sexuality, the urinary tract, the lymphatic system and physical activity. These projects include the evaluation of interventions developed by and provided in a nurse-led clinic. FUTURE PLANS This large prospective cohort offers the possibility to study health outcomes in female pelvic cancer survivors undergoing a rehabilitation intervention in a nurse-led clinic, and to study associations between demographics, clinical aspects and long-term late effects. Analysis focusing on the effect of the interventions on sexual health aspects, preinterventions and postinterventions, is currently ongoing. The cohort will be expanded to comprise the entire data collection from 2011 to 2020, including baseline data and data from 3-month and 1-year follow-ups after interventions. The data will be used to study conditions and treatment-induced late effects preintervention and postintervention.
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Affiliation(s)
- Linda Åkeflo
- Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gail Dunberger
- Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Eva Elmerstig
- Centre for Sexology and Sexuality studies, Malmö Universitet, Malmo, Sweden
| | - Viktor Skokic
- Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnar Steineck
- Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karin Bergmark
- Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Stentagg M, Skär L, Berglund JS, Lindberg T. Cross-Sectional Study of Sexual Activity and Satisfaction Among Older Adult's ≥60 Years of Age. Sex Med 2021; 9:100316. [PMID: 33676227 PMCID: PMC8072140 DOI: 10.1016/j.esxm.2020.100316] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction Despite the rapidly increasing population of older adults, little is currently known about sexual activity and sexual satisfaction among the oldest people. Aim The present study aimed to investigate sexual activity and sexual satisfaction among people of ≥60 years of age. We also examined whether sexual activity and sexual satisfaction were influenced by age, gender, cohabiting, socioeconomic factors, education, functional ability, and self-reported health. Methods We performed a descriptive analysis of self-stated sexual activity and sexual satisfaction among 1680 participants who were 60 years and older from the Swedish National Study on Aging and Care. Chi-square tests and logistic regression were used to analyze relationships between factors. Main Outcome Measure Sexual activity and sexual satisfaction. Results Among participants aged ≥90 years, about 10% were sexually active. Within the total study population, 46% (654/1680) were sexually active. Overall, sexually activity was more commonly reported by men (55%) than women (40%). However, men in all age cohorts reported sexual dissatisfaction more commonly than women. In the total sample, 24% (246/1680) reported dissatisfaction with their sex life. Sexual activity and sexual satisfaction were positively associated with self-reported health and cohabitation. Conclusion The present results suggest that sexual activity is present throughout life. For persons older than 90 years, about 10% of participants were sexually active, regardless of gender. Every third man reported dissatisfaction with his sex life. Women were more satisfied with their sex lives than men, and this difference varies more widely among age cohorts. These findings confirm that it is important that health professional take sexuality into account during caring encounters with older persons. M Stentagg, L Skär, JS Berglund, et al. Cross-Sectional Study of Sexual Activity and Satisfaction Among Older Adult's ≥60 Years of Age. Sex Med 2021;9:100316.
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Affiliation(s)
- Magnus Stentagg
- Department of Care Sciences, Malmö University, Malmö, Sweden; Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Lisa Skär
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | | | - Terese Lindberg
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
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Expectations of patients with colorectal cancer towards nursing care- a thematic analysis. Eur J Oncol Nurs 2019; 44:101699. [PMID: 31821932 DOI: 10.1016/j.ejon.2019.101699] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 11/18/2019] [Accepted: 11/24/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of this study was to explore comprehensively expectations of patients with colorectal cancer towards nursing care in the chemotherapy context. METHODS A purposive sample of patients with colorectal cancer (n = 15) was interviewed individually at the outpatient clinic in one university hospital chemotherapy unit. The data were analysed with thematic analysis. RESULTS Three main themes were identified in the data. Firstly, patients expected to be empowered with knowledge of disease process, side effects and their self-management and peer support. Secondly, patients expected to be humanely encountered, which included being encountered with support, compassion and hope. Thirdly, patients expected to be skillfully cared for with systematic assessment, expertise, continuity and advocacy. CONCLUSIONS Besides reliable knowledge of cancer treatment and care, patients expected the sympathetic presence of a nurse whose professional skills they can trust. The results may be utilised in intervention development by focusing on themes significant to these patients. The results may help nurses to enhance person-centred care as well as to encounter patients according to their expectations.
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Tirgari B, Rafati F, Mehdipour Rabori R. Effect of Sexual Rehabilitation Program on Anxiety, Stress, Depression and Sexual Function among Men with Coronary Artery Disease. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:632-642. [PMID: 30912471 DOI: 10.1080/0092623x.2019.1599091] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background: Patients with coronary artery disease suffer from diminished sexual activity leading to anxiety, stress, and depression. Sexual rehabilitation is the key to the care and treatment process of such patients. Purpose: The present study aimed to examine the effect of sexual rehabilitation program on anxiety, stress, depression and sexual function in men with coronary artery disease. Methods: This was a clinical trial study conducted on 80 male patients suffering from coronary artery disease referred to CCU (Coronary Care Unit) wards in Kerman, Iran. Sample was randomly assigned into two intervention and control groups. The intervention consisted of the sexual rehabilitation program which included two components of education and exercise. Using IIEF (International Index of Erectile Function) and DASS21 (Depression, Anxiety, Stress Scale) anxiety, stress, depression and sexual function have been examined before and one-month after intervention in the two groups. The collected data were analyzed with SPSS version 19 (IBM, Armonk, New York), using descriptive and inferential statistics (such as Pearson correlation coefficient, independent t test, and analysis of variance). Results: Result showed that the intervention group had significantly lower mean scores in anxiety, stress, depression and sexual function compared to the control group (p < 0.0001). Conclusion: According to the results, sexual rehabilitation reduced anxiety, stress, and depression and improved sexual function among men with coronary artery disease. Therefore, it is recommended sexual rehabilitation be an integral part of cardiac rehabilitation.
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Affiliation(s)
- Batool Tirgari
- Nursing Research Center, School of Nursing And Midwifery, Kerman University of Medical Sciences , Kerman , Iran
| | - Fatemeh Rafati
- Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences , Kerman , Iran
| | - Roghayeh Mehdipour Rabori
- Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences , Kerman , Iran
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Lynch O, O'Donovan A, Murphy PJ. Addressing treatment-related sexual side effects among cancer patients: Sub-optimal practice in radiation therapy. Eur J Cancer Care (Engl) 2019; 28:e13006. [PMID: 30740795 DOI: 10.1111/ecc.13006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/27/2018] [Accepted: 01/17/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Sexual side effects of treatment are common among cancer patients receiving radiation therapy. Little attention has been given to the role of radiation therapists (RTs) in managing sexual issues. The current study sought to address this by assessing the provision of care for sexual issues by RTs in Ireland. METHODS Cross-sectional data were collected using an online questionnaire. Measures included: participant characteristics; sexuality-related practice; knowledge, awareness and confidence in dealing with sexual issues; the sexual attitudes and beliefs survey; and opinions as to the "ideal" management of sexual issues. RESULTS Discussion of sexual issues with patients was rare, and most participants (N = 46) did not feel these issues were addressed effectively in their departments. Barriers to the discussion of sexual issues included low knowledge, awareness and confidence; perceptions of professional role boundaries; and concerns about personal and patient discomfort. Nonetheless, participants indicated that RTs should ideally be equipped to discuss sexual side effects of treatment, as they would any other side effect. CONCLUSION This study has identified a sub-optimal provision of care for sexual issues by RTs. Training is needed if RTs are to effectively support the work of the multidisciplinary team in this area.
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Affiliation(s)
- Orlaith Lynch
- Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland
| | - Anita O'Donovan
- Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland
| | - Patrick J Murphy
- Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland.,Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Ireland
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Percat A, Elmerstig E. “ We should be experts, but we’re not ”. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 14:85-90. [DOI: 10.1016/j.srhc.2017.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/24/2017] [Accepted: 10/02/2017] [Indexed: 11/25/2022]
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Wendt C. Perception and Assessment of Verbal and Written Information on Sex and Relationships after Hematopoietic Stem Cell Transplantation. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:681-689. [PMID: 27278129 DOI: 10.1007/s13187-016-1054-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This study aimed to investigate experiences of verbal and written information about sex and relationships among men and women treated with hematopoietic stem cell transplantation. The study also aimed to investigate the demand for information and assessment of the quality of written patient information material entitled "Sex and relationships in the treatment of blood diseases." Few studies exist that shed any light on the demand for information about sex and relationships on the part of patients with hematological diseases before, during, and after their treatment. A total of 216 patients undergoing treatment for malignant blood diseases between 2000 and 2010 participated in this study. Patients' experiences of information about sex and relationships, and their opinions about the written patient information, were assessed using a questionnaire created specifically for this study. Most patients (81 %) had not received information about sex and relationships from a healthcare professional. Almost 90 % of men felt that verbal information was important, compared with 82 % of women. The majority also held that written information was important. These results indicate that patients, regardless of gender, age, and treatment, consider oral and written information about sex and relationships to be important and that the healthcare system should provide the information. The written patient information was considered to play an important role in creating an opening for a conversation about a sensitive topic such as sexuality, and also as a source of reference and support for the patient and his/her partner.
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Affiliation(s)
- Christel Wendt
- Faculty of Health and Society, Malmö University, 205 06, Malmö, Sweden.
- Skåne University Hospital, 221 85, Lund, Sweden.
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Leonardi-Warren K, Neff I, Mancuso M, Wenger B, Galbraith M, Fink R. Sexual Health: Exploring Patient Needs and Healthcare Provider Comfort and Knowledge. Clin J Oncol Nurs 2017; 20:E162-E167. [PMID: 27857260 DOI: 10.1188/16.cjon.e162-e167] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Sexual health is an important quality-of-life issue for many cancer survivors; however, this issue remains inadequately discussed by healthcare providers (HCPs) and patients. OBJECTIVES The purpose of this study is to explore whether clinical oncology HCPs have adequate knowledge and are comfortable addressing sexual health issues, and to explore and describe patients' attitudes, beliefs, and informational needs regarding sexual health. METHODS A survey was completed by HCPs and three patient focus groups were conducted to learn more about sexual health. Survey data were analyzed using descriptive statistics, and qualitative responses were analyzed using content analysis. FINDINGS The majority of survey respondents reported on the importance of discussing sexual concerns with patients, lacked sexual health training, and were uncomfortable discussing sexual health with patients. Focus group participants wanted access to timely information during treatment, online educational resources, and brochures and handouts; involvement of significant others; support from providers, peers, and survivors; and expert consultation.
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Affiliation(s)
| | - Ian Neff
- University of Colorado Cancer Center
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17
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Klaeson K, Hovlin L, Guvå H, Kjellsdotter A. Sexual health in primary health care - a qualitative study of nurses’ experiences. J Clin Nurs 2017; 26:1545-1554. [DOI: 10.1111/jocn.13454] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Kicki Klaeson
- School of Health and Education; University of Skövde; Skövde Sweden
- Oncology Department; Skaraborgs Hospital; Skövde Sweden
| | | | - Hanna Guvå
- Psychiatric Department; Skaraborgs Hospital; Skövde Sweden
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18
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Patient-provider communication about sexual concerns in cancer: a systematic review. J Cancer Surviv 2016; 11:175-188. [PMID: 27858322 DOI: 10.1007/s11764-016-0577-9] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 10/04/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE Cancer survivors' needs around sexual concerns are often unmet. The primary objective of this systematic review was to examine the prevalence of and factors associated with patient-provider communication about sexual concerns in cancer. METHODS Using PRISMA guidelines, we searched PubMed/MEDLINE, PsychInfo, and CINAHL databases for peer-reviewed quantitative research papers (2000-2015) in cancer samples. Search terms across three linked categories were used (sexuality, communication, and cancer). The National Comprehensive Cancer Network (NCCN) Sexual Function Guidelines were used as a framework to categorize communication reported in each study. RESULTS Twenty-nine studies from 10 countries (29 % in USA) were included. Studies assessed patients only (21), providers only (4), and both (4). Communication measures differed across studies and many lacked validity data. When reported by patients or providers, the average prevalence of discussing potential treatment effects on sexual function was 50 (60 % for men and 28 % for women) and 88 %, respectively. As reported by patients or providers, respectively, assessing patients' sexual concerns (10 and 21 %) and offering treatments (22 and 17 %) were measured in fewer studies and were reported less frequently. Both patients and providers (28 and 32 %, respectively) reported a low prevalence of other non-specific communication. Greater prevalence of communication was associated with male patient gender and more years of provider experience. CONCLUSIONS Sexual issues go unaddressed for many cancer survivors, particularly women. Both patient and provider interventions are needed. IMPLICATIONS FOR CANCER SURVIVORS Enhancing patient-provider communication about sexual concerns through evidence-based interventions could improve patient sexual function and quality of life.
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19
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Lundin U, Elmerstig E. “Desire? Who needs desire? Let's just do it!”– a qualitative study concerning sexuality and infertility at an internet support group. SEXUAL AND RELATIONSHIP THERAPY 2015. [DOI: 10.1080/14681994.2015.1031100] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Bouhnik AD, Bendiane MK, Cortaredona S, Sagaon Teyssier L, Rey D, Berenger C, Seror V, Peretti-Watel P. The labour market, psychosocial outcomes and health conditions in cancer survivors: protocol for a nationwide longitudinal survey 2 and 5 years after cancer diagnosis (the VICAN survey). BMJ Open 2015; 5:e005971. [PMID: 25805526 PMCID: PMC4386221 DOI: 10.1136/bmjopen-2014-005971] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Today, a growing need exists for greater research into cancer survivorship, focusing on different spheres of the day-to-day life of diagnosed patients. This article describes the design and implementation of VICAN (VIe après le CANcer), a national survey on French cancer survivors. METHOD AND ANALYSIS The target population included patients aged 18-82, diagnosed with cancer between January and June 2010, and registered in one of the three main French Health Insurance Schemes. It was restricted to 12 tumour sites. Sampling was stratified using a non-proportional allocation, based on age at diagnosis (18-52 and 53-82) and tumour site. Data were collected from telephone interviews with patients 2 and 5 years after diagnosis, a medical survey completed by the physician who initiated cancer treatment, and information from the national medicoadministrative database on reimbursement data and hospital discharge records. First data collection, 2 years after diagnosis, occurred between March and December 2012. Second data collection, 5 years after diagnosis, will be conducted in 2015. Analyses will be conducted on various outcomes: quality of life, health status and psychosocial conditions, with a particular focus on the impact of cancer diagnosis on the labour market. The variety of measurements included in the survey will enable us to control a wide range of factors. ETHICS AND DISSEMINATION The methodology of the VICAN survey was approved by three national ethics commissions. Results of the study will be disseminated through national and international research conferences, and in articles published in international peer-reviewed journals.
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Affiliation(s)
- Anne-Deborah Bouhnik
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
| | - Marc-Karim Bendiane
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Sebastien Cortaredona
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Luis Sagaon Teyssier
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Dominique Rey
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Cyril Berenger
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Valerie Seror
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
| | - Patrick Peretti-Watel
- INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), Marseille, France
- Aix Marseille University, UMR_S912, IRD, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
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21
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Sekse RJT, Råheim M, Gjengedal E. Shyness and openness--common ground for dialogue between health personnel and women about sexual and intimate issues after gynecological cancer. Health Care Women Int 2015; 36:1255-69. [PMID: 25424412 DOI: 10.1080/07399332.2014.989436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In this article we explore shyness and openness related to sexuality and intimacy in long-term female survivors of gynecological cancer, and how these women experienced dialogue with health personnel on these issues. Further analysis on two core themes, based on empirical data presented elsewhere, inspired continued theoretical and philosophical thinking drawing on Løgstrup's expressions of life and unified opposites. The findings show that gynecological cancer survivors and health personnel share common ground as human beings because shyness and openness are basic human phenomena. Health personnel's own movement between these phenomena may represent a resource because it can help women to handle sexual and intimacy challenges following gynecological cancer.
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Affiliation(s)
- Ragnhild J T Sekse
- a Department of Obstetrics and Gynaecology , Haukeland University Hospital , Bergen , Norway
| | - Målfrid Råheim
- b Department of Public Health and Primary Health Care , University of Bergen , Bergan , Norway
| | - Eva Gjengedal
- b Department of Public Health and Primary Health Care , University of Bergen , Bergan , Norway.,c Faculty of Health and Social Care , Molde University College , Molde , Norway
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22
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Solbakk JH. What is it to do good medical ethics? On the concepts of 'good' and 'goodness' in medical ethics. JOURNAL OF MEDICAL ETHICS 2015; 41:12-16. [PMID: 25516925 DOI: 10.1136/medethics-2014-102310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In his book The Varieties of Goodness Georg Henrik von Wright advocates that a useful preliminary to the study of the word 'good' is to compile a list of familiar uses and try to group them under some main headings. The present paper aims at exploring the question, 'What is it to do good medical ethics?', and notably from the vantage point of everyday expressions of the word 'good' and von Wright's grouping of them into six different types of goodness.
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23
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Psychosexual support for gynecological cancer survivors: professionals’ current practices and need for assistance. Support Care Cancer 2014; 23:831-9. [DOI: 10.1007/s00520-014-2433-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 09/02/2014] [Indexed: 10/24/2022]
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24
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Gilbert E, Perz J, Ussher JM. Talking about sex with health professionals: the experience of people with cancer and their partners. Eur J Cancer Care (Engl) 2014; 25:280-93. [PMID: 25040442 DOI: 10.1111/ecc.12216] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2014] [Indexed: 12/31/2022]
Abstract
Changes to sexuality can be one of the most difficult aspects of life following cancer. This study examines the experience of discussing sexuality post cancer with health care professionals (HCPs), from the perspective of women and men with cancer (PWC), and their partners (PPWC), across a range of cancer types. A total of 657 PWC (535 women, 122 men) and 148 PPWC (87 women, 61 men) completed a survey containing closed and open-ended items, analysed by analysis of variance and thematic analysis. Discussions about sexuality with a HCP were more likely to be reported by men (68%) compared to women PWC (43%), and by women (47%) compared to men PPWC (28%), as well as by those with a sexual or reproductive cancer. Men PWC and women PPWC were most likely to want to discuss sexuality with a HCP, with men PWC and PPWC reporting highest levels of satisfaction with such discussions. Open-ended responses revealed dissatisfaction with the unwillingness of HCPs to discuss sexuality, unhappiness with the nature of such discussion, and positive accounts of discussions about sexuality with HCPs. These findings lend support to the notion that people with cancer and their partners may have unmet sexual information and support needs.
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Affiliation(s)
- E Gilbert
- Centre for Health Research, University of Western Sydney, Sydney, New South Wales, Australia
| | - J Perz
- Centre for Health Research, University of Western Sydney, Sydney, New South Wales, Australia
| | - J M Ussher
- Centre for Health Research, University of Western Sydney, Sydney, New South Wales, Australia
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Symptom prevalence, frequency, severity, and distress during chemotherapy for patients with colorectal cancer. Support Care Cancer 2013; 22:1171-9. [DOI: 10.1007/s00520-013-2069-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 11/25/2013] [Indexed: 10/25/2022]
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