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Carney LM, Schnur JB, Morgan O, Hyun C, Magin ZE, Martin L, Montgomery GH. Psychosocial interventions to improve sexual functioning in women with cancer: a systematic review of randomized controlled trials. Sex Med Rev 2024; 12:142-153. [PMID: 38185918 PMCID: PMC10986159 DOI: 10.1093/sxmrev/qead052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/01/2023] [Accepted: 11/15/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Many women with cancer struggle with sexual side effects during and after treatment. Although preliminary evidence indicates that psychosocial interventions may be efficacious in improving sexual functioning for women with cancer, no systematic review has summarized the state of the science in this area. OBJECTIVES The primary goal of this review was to narratively synthesize the results of randomized controlled trials (RCTs) testing the efficacy of psychosocial interventions to address sexual dysfunction in women with cancer. A secondary goal was to describe the diversity of the included samples (ie, racial/ethnic and sexual minority). METHODS Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review was conducted examining RCTs of psychosocial interventions to improve sexual functioning for women with cancer. Articles were identified using MEDLINE, Embase, PsycINFO, and Cochrane CENTRAL. Two reviewers independently assessed each article for inclusion, with a third to resolve discrepancies. RESULTS Seventeen studies were included in the review, 12 of which provided sufficient information to calculate effect sizes. Ten of the 12 studies primarily aimed to improve sexual functioning, all of which demonstrated positive effects on at least 1 outcome of sexual functioning. In the 2 RCTs of psychosocial interventions in which sexual function was a secondary aim, effects were negligible (ds = -0.04 and -0.15). Commonalities among the studies with large effect sizes were that they included education, mindfulness/acceptance, and communication/relationship skills as intervention components. Of note, there was an overall lack of sample diversity across studies, and most studies failed to report the race/ethnicity or sexual orientation of the participants. CONCLUSION Results support interventions targeting sexual functioning outcomes for women with cancer and suggest that multimodal interventions including education, mindfulness/acceptance, and communication/relationship skills may be most effective. Future research should also focus on examining the efficacy and potential adaptations of extant sexual functioning interventions for underrepresented groups.
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Affiliation(s)
- Lauren M Carney
- Center for Behavioral Oncology, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Julie B Schnur
- Center for Behavioral Oncology, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Orly Morgan
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL 33101, United States
| | - Christine Hyun
- Center for Behavioral Oncology, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Zachary E Magin
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, United States
| | - Lily Martin
- Levy Library, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Guy H Montgomery
- Center for Behavioral Oncology, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
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Arends SAM, van Rossum CE, Eeltink CM, Robertus JE, Schoonmade LJ, Francke AL, Jongerden IP. Feasibility and effectiveness of communication tools for addressing intimacy and sexuality in patients with cancer: a systematic review. Support Care Cancer 2024; 32:109. [PMID: 38231322 PMCID: PMC10794301 DOI: 10.1007/s00520-024-08308-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/05/2024] [Indexed: 01/18/2024]
Abstract
PURPOSE Patients diagnosed with cancer might experience changes in intimacy and sexuality due to the illness itself, treatment, or psychological and social factors. Healthcare professionals (HCPs) often feel reluctant to discuss these changes. This study aimed to provide an overview of the feasibility and effectiveness of communication tools that support communication regarding changes in intimacy or sexuality among patients with cancer. METHODS This is a systematic review. Databases are PubMed, Embase, CINAHL, PsycInfo, Web of Science and Cochrane Library from inception to June 2023. The Mixed Methods Appraisal Tool was used to assess included studies. Data were summarized in data charting forms. RESULTS In total 35 studies were included, published between 2001 and 2023. Most had a quantitative design and moderate methodological quality. In 11 studies, the PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy) was used. Tools were integrated in counselling sessions or training programmes for individual patients, couples, groups of patients, or HCPs. All tools were considered feasible by patients or HCPs. Twenty studies reported significant improvement in sexual functioning, quality of life, quality of care or combined outcomes. CONCLUSION Tools to support communication about changes in intimacy and sexuality among patients with cancer seem feasible and effective. The most commonly used tool, the PLISSIT model, proved to be feasible for HCPs and to have a positive effect on patients' and partners' sexual functioning and quality of life. Giving attention to changes in intimacy and sexuality seems to be important in itself, regardless of the communication tool or approach used.
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Affiliation(s)
- Susanne A M Arends
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands.
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands.
| | - Carlijn E van Rossum
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
| | - Corien M Eeltink
- Oncology Daycare Center, Dijklander Hospital, Hoorn, the Netherlands
| | - Jantien E Robertus
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
| | | | - Anneke L Francke
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands
- NIVEL. Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Irene P Jongerden
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands
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Harb SI, Fergus KD. Examining engagement in a self-in-relationship observation exercise by couples coping with breast cancer: A qualitative analysis of text-based feedback. JOURNAL OF MARITAL AND FAMILY THERAPY 2023; 49:939-957. [PMID: 37746928 DOI: 10.1111/jmft.12668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/26/2023]
Abstract
Young women with breast cancer (BC) and their partners generally face greater psychosocial difficulties relative to older couples, justifying the need for targeted support for this group. Toward this end, we examined how couples facing BC responded to participating in a self-in-relationship observation exercise intended to improve the relationship. Participants (N = 60) were 30 women and 30 male partners who, over the course of a week, observed and textually described/reported their "turning-towards-and-away-behaviors" deemed to contribute to relationship closeness/distance. Text-based feedback on the exercise was thematically analyzed. Findings suggest an online exercise promoting in vivo awareness of relationship interactions was feasible and acceptable to the majority of couples. Language accounts reflected acting with and through the shared "turning-towards-and-away-framework" with the intention of increasing closeness with one's partner. We discuss differences in exercise engagement and how participants reported changes in their attending, understanding, and acting in relationship, primarily for the better.
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Affiliation(s)
- Sami I Harb
- Department of Psychology, York University, Toronto, Canada
| | - Karen D Fergus
- Department of Psychology, York University, Toronto, Canada
- Sunnybrook Health Sciences Centre, Odette Cancer Centre, Patient and Family Support Program, Ontario, Toronto, Canada
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Nho J, Kim SR, Choi WK. Relationships among sexual function, marital intimacy, type D personality and quality of life in patients with ovarian cancer, with spouses. Eur J Cancer Care (Engl) 2022; 31:e13760. [DOI: 10.1111/ecc.13760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/26/2022] [Accepted: 10/09/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Ju‐Hee Nho
- College of Nursing, Research Institute of Nursing Science Jeonbuk National University Jeonju Republic of Korea
| | - Sung Reul Kim
- College of Nursing, Institute of Nursing Research Korea University Seoul Republic of Korea
| | - Won Ku Choi
- Research Institute of Clinical Medicine of Jeonbuk National University‐Biomedical Research Institute of Jeonbuk National University Hospital, Department of Obstetrics and Gynecology Jeonbuk National University Medical School Jeonju Republic of Korea
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Fergus K, Tanen A, Ahmad S, Gardner S, Warner E, McLeod D, Stephen J, Carter W, Periera A. Treatment Satisfaction With Couplelinks Online Intervention to Promote Dyadic Coping in Young Couples Affected by Breast Cancer. Front Psychol 2022; 13:862555. [PMID: 35783696 PMCID: PMC9245623 DOI: 10.3389/fpsyg.2022.862555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background This study evaluated participant satisfaction with “Couplelinks,” an online psychological intervention designed for younger couples coping with breast cancer. The program included six experiential learning exercises (plus one optional module), psychoeducational information, and support from a personal mental health professional. Objective The primary objectives were to examine participants’ perceptions of: the online intervention’s structure and content; the value of including a professional facilitator; and benefits and drawbacks of the program. Methods A treatment satisfaction questionnaire comprised of Likert indices and open-ended questions pertaining to treatment satisfaction was completed by 26 patients and 27 male partners (N = 53) approximately 1–2 weeks following the intervention which occurred in the context of a randomized controlled trial. Descriptive statistics were used to summarize satisfaction ratings and generalized linear models with fixed effect for gender were used to test for differences in male-female outcomes. A thematic analysis was undertaken in order to understand, organize and summarize the qualitative textual feedback. Results Participants reported an overall satisfaction rating of 4.3 out of 5 (SD = 0.54) with patient satisfaction ratings being higher than that of male partners’ (p = 0.01). The majority of participants considered the facilitator’s role to be necessary 4.6 (SD = 0.60), and found the program to be convenient 4.1 (SD = 0.81) despite some participants struggling to keep up with the modules. Subjective data revealed participants valued the convenience and flexibility of the online intervention and appreciated the program’s involvement of both partners. Participants also reported that including a professional facilitator humanized the intervention, served as motivation to progress through the program, facilitated insight into their relationship, and was reassuring. Experiential gains noted by participants included that the program: helped couples to open channels of communication; prompted them to designate quality time for one another; evoked feelings of unity and togetherness; and inspired new insight in the relationship. Conclusion Such feedback supports the feasibility and acceptability of the Couplelinks program while offering directions for improvement of online couple-based interventions in cancer.
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Affiliation(s)
- Karen Fergus
- Psychosocial Oncology Lab, Department of Psychology, York University, Toronto, ON, Canada
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- *Correspondence: Karen Fergus, ,
| | - Adina Tanen
- School of Medicine, University of Toronto, Toronto, ON, Canada
| | - Saunia Ahmad
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Toronto Psychology Clinic, Toronto, ON, Canada
| | - Sandra Gardner
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ellen Warner
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Deborah McLeod
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Joanne Stephen
- Clinical Neurosciences, Alberta Health Services, Calgary, AB, Canada
| | - Wendy Carter
- Toronto Academic Pain Institute, Women’s College Hospital, Toronto, ON, Canada
| | - Amanda Periera
- Psychosocial Oncology Lab, Department of Psychology, York University, Toronto, ON, Canada
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Lupinacci L, Lamore K, Seyeux AL, Untas A. Facilitators and obstacles to couples' intimacy after hematopoietic stem cell transplantation: a qualitative study. J Psychosoc Oncol 2021; 40:595-613. [PMID: 34872465 DOI: 10.1080/07347332.2021.2004292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
To identify perceived factors related to intimacy following HSCT. Qualitative descriptive design. Patients diagnosed with hematological cancer, 6 months into their HSCT recovery, and their partners. Semi-structured interviews were conducted with 18 participants (nine patients and their partners). A thematic analysis was carried out. Couples reported various obstacles to intimacy, such as emotional obstacles (i.e. negative emotions, emotional mismatch), the length of the disease, its treatments and side effects, and the patient's physical condition. Couples also reported facilitators to intimacy, such as using emotional facilitators (e.g. showing empathy), fostering open communication or sharing common experience of the disease. This study highlights specific factors that influence couples' intimacy in the context of HSCT.Implications for Psychosocial Providers: Couples' intervention delivered in cancer care should be adapted by focusing on specific factors that maintain or enhance couples' intimacy.
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Affiliation(s)
- Laura Lupinacci
- Psychologie et Psychiatrie de liaison, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - Kristopher Lamore
- Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France
| | | | - Aurélie Untas
- Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France.,Institut Universitaire de France
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