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Kvaale K, Synnes O, Lian OS, Bondevik H. "That bastard chose me": the use of metaphor in women's cancer blogs. QUALITATIVE RESEARCH IN MEDICINE & HEALTHCARE 2024; 8:11908. [PMID: 39229353 PMCID: PMC11369856 DOI: 10.4081/qrmh.2024.11908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/02/2024] [Indexed: 09/05/2024] Open
Abstract
Metaphors play a significant role in how cancer is experienced and discussed. This study delves into the utilization of metaphors by women bloggers grappling with colorectal and gynecological cancers. By focusing on cancer types less represented in mainstream media, we aim to shed light on cancer cultures associated with body areas often considered taboo. Our findings reveal that widely recognized expressions and stories about cancer, such as the metaphors of battle and narratives promoting optimism and heroism in the face of illness, are deeply ingrained. However, a notable discovery is the prevalence of personification alongside these conventional expressions. Personifying cancer endows it with human characteristics, providing an outlet for bloggers to express their fear and frustration, including articulating feelings of sadness and anger, diverging from narratives centered on heroism and positive thinking. Furthermore, our analysis reveals a significant emphasis on death, underscoring that despite advancements in treatment, bloggers still perceive cancer as highly lethal. Personification can serve both detrimental and therapeutic purposes for bloggers and for societal perceptions of cancer survivorship, both reinforcing and opposing dominant Western discourses surrounding the illness. These findings enrich our understanding of cognitive and cultural tools used to describe cancer within contemporary Western society.
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Affiliation(s)
- Kaja Kvaale
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo
| | - Oddgeir Synnes
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo
| | - Olaug S. Lian
- Department of Community Medicine, UiT—The Arctic University of Norway, Tromsø, Norway
| | - Hilde Bondevik
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo
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Alinejad Mofrad S, Green H, Sawleshwarkar S, Alananzeh I, Fernandez R. Experiences Relating to Sexual Well-Being Among Muslim Gynecological Cancer Survivors: A Systematic Review of Qualitative Studies. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:530-545. [PMID: 39035138 PMCID: PMC11257125 DOI: 10.1089/whr.2023.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 07/23/2024]
Abstract
Background Gynecological cancers are one of the most important threats to women's health worldwide. The objective of this review is to synthesize and present the best available evidence on the experiences relating to sexual well-being among Muslim women with gynecological cancer. Methods The databases searched included Web of Science, Scopus, SID, Google Scholar, ProQuest, MEDLINE, and CINAHL from the inception of the database until August 2021. The review was guided by the JBI methodology used for qualitative systematic reviews. Findings were collated using the meta-aggregation method through JBI SUMARI. Results Eight studies involving Muslim women cancer survivors were included in the review. Meta-synthesis of the eight included studies generated 59 findings, which were organized into 14 categories and combined into four synthesized findings. Conclusions Gynecological cancer and its treatment results in numerous challenges with sexual well-being among Muslim women cancer survivors. Providing information about sexual activity following gynecological cancer, better communication from health care professionals, and support from the husband is essential to overcome the struggle with intimacy and femininity experienced by the women, thus improving the sexual quality of life of Muslim gynecological cancer survivors.
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Affiliation(s)
- Samaneh Alinejad Mofrad
- Department of Nursing and Midwifery, School of Nursing, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Heidi Green
- Australian Centre for Health Engagement, Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, Wollongong, Australia
| | - Shailendra Sawleshwarkar
- Faculty of Medicine and Health, Sydney Infectious Diseases Institute, The University of Sydney, Westmead, Australia
| | - Ibrahim Alananzeh
- University of Wollongong Dubai, School of Humanities, Social Sciences and Health, Dubai, United Arab Emirates
| | - Ritin Fernandez
- School of Nursing and Midwifery, University of Newcastle, Callaghan, Australia
- Centre for Transformative Nursing, Midwifery, and Health Research: A JBI Affiliate Centre
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Reese JB, Bober SL, Sorice KA, Handorf E, Chu CS, Middleton D, McIlhenny S, El-Jawahri A. Starting the Conversation: randomized pilot trial of an intervention to promote effective clinical communication about sexual health for gynecologic cancer survivors. J Cancer Surviv 2024; 18:800-809. [PMID: 36604391 PMCID: PMC10323044 DOI: 10.1007/s11764-022-01327-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/23/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Gynecologic cancer survivors often hesitate to raise sexual health concerns with their clinicians. We pilot tested Starting the Conversation (STC), a theory-guided intervention aimed at facilitating survivors' clinical communication about sexual health. METHODS Survivors (N = 32) were randomized 2:1 to STC (23-min video and accompanying workbook grounded in social cognitive theory that provides information and skills training for communicating with providers about sexual concerns, and resource guide) or control (resource guide only). Feasibility was assessed through enrollment, retention, and intervention completion rates (benchmarks: 60%, 80%, 70%); acceptability was assessed through post-intervention program evaluations (benchmark: 75%). Preliminary effects were assessed for sexual health communication (self-reported after next clinic encounter), self-efficacy for clinical communication about sexual health (post-intervention and 2-month follow-up), and sexual activity and anxiety/depressive symptoms (2-month follow-up). RESULTS All feasibility/acceptability benchmarks were surpassed; 76% enrolled, 97% retained, ≥ 95% used intervention materials, and 100% endorsed STC as acceptable. Positive STC effects were seen for increases in self-efficacy (Cohen's d's = 0.45 at post-intervention; 0.55 at follow-up). In STC, 35% and 45% of women raised or asked about sexual health concerns during the post-intervention clinic visit, respectively, versus 0 and 27% in the control arm. Other measures showed little change. CONCLUSIONS Data support the STC intervention as feasible and acceptable, with promising effects for gynecologic cancer survivors' communication about sexual health concerns. Because sexual health communication is relevant across the treatment trajectory, we included both on-treatment and post-treatment survivors. While this may be a limitation, it could also enhance sample generalizability. A larger trial is needed to determine efficacy. IMPLICATIONS FOR CANCER SURVIVORS Communication about sexual health is important yet lacking for cancer survivors. Patient-focused interventions may help address concerns and improve survivors' health outcomes.
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Affiliation(s)
- Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA.
| | - Sharon L Bober
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA
| | - Kristen A Sorice
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Elizabeth Handorf
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
- Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Christina S Chu
- Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Danny Middleton
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Sarah McIlhenny
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Areej El-Jawahri
- Department of Hematology/Oncology, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
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Tetteh DA, Dai Z. Making Sense of Gynecologic Cancer: A Relational Dialectics Approach. HEALTH COMMUNICATION 2024:1-13. [PMID: 38528375 DOI: 10.1080/10410236.2024.2333112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
This study used the relational dialectics theory (RDT) as a theoretical lens to examine how the interplay of competing discourses shaped meaning making about gynecologic cancer. A reflexive thematic analysis of the narratives of 12 survivors of cervical cancer, ovarian cancer, and uterine cancer in Arkansas showed two discursive struggles at play, including continuity of care versus change, and voicing versus repressing of feelings. The findings showed that long history of care with physicians contributed to how participants privileged the discourse of continuity of care when faced with a decision to travel for care or receive care locally. We also found that cultural discourses about concealing women's cancer-afflicted bodies, lack of supportive spaces for women to discuss side effects of cancer treatments, and appropriate communication behavior between patients and physicians shaped the interplay of the discursive struggle of voicing versus repressing. The findings extend the RDT by showing that geographic location, disease characteristics, history of care between patients and physicians, and prevailing cultural discourses can contribute to the interplay of discursive struggles in the gynecologic cancer context. Further, the findings suggest to healthcare professionals to address harmful discourses about gynecologic cancer to help create support avenues for survivors.
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Affiliation(s)
| | - Zehui Dai
- School of Communication, Radford University
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Yen KY, Cheng JY, Li JQ, Toh ZA, He HG. The effectiveness of digital psychosocial interventions on psychological distress, depression, anxiety, and health-related quality of life in patients with gynaecological cancer: a systematic review and meta-analysis. Support Care Cancer 2024; 32:240. [PMID: 38512538 DOI: 10.1007/s00520-024-08415-4] [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: 08/28/2023] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE Patients with gynaecological cancer often experience psychological issues due to multiple stressors. Psychological disturbances have debilitating effects on patients with gynaecological cancer. In recent decades, digital psychosocial interventions have rapidly advanced and been incorporated into mental health interventions. Digital psychosocial interventions could provide patients with several benefits over traditional in-person interventions, including convenience, anonymity, flexible scheduling, and geographic mobility. The aim of this systematic review was to synthesize the effectiveness of digital psychosocial intervention in reducing psychological distress, depression, and anxiety and improving health-related quality of life in patients with gynaecological cancer. METHODS Three-step extensive search was performed on 22 December 2022 from nine bibliographic databases, trial registries and grey literature. Experimental studies involving patients with gynaecological cancer utilizing digital psychosocial interventions for the improvement of mental health outcomes were included. Meta-analysis was conducted using RevMan 5.4 software. Heterogeneity was analysed by Cochran's Q test and I2. Subgroup analyses were attempted to evaluate relative effect sizes of subgroup features. RESULTS Meta-analysis of nine studies revealed small effect size in reduction of depression post-intervention (d = 0.24, 95% CI - 0.46 to - 0.02) and medium effect size in reduction of psychological distress post-intervention (d = 0.51, 95% CI - 0.81 to - 0.21) and follow-up (d = 0.65, 95% CI - 1.25 to - 0.05) compared to the control group. The effects of digital psychosocial interventions on anxiety and health-related quality of life were not statistically significant. CONCLUSIONS Digital psychosocial interventions probably reduced psychological distress and slightly reduced depression amongst patients with gynaecological cancer compared to the control group, which can be integrated into clinical practice. Additional trials with rigorous methodology and bigger sample sizes are needed to validate findings. TRIAL REGISTRATION PROSPERO (CRD42023389502).
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Affiliation(s)
- Kai Yoong Yen
- Khoo Teck Puat Hospital, Yishun Health, National Healthcare Group, Singapore, Singapore
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Bock MD11, 10 Medical Drive, Singapore, 117597, Singapore
| | - Jing Ying Cheng
- Khoo Teck Puat Hospital, Yishun Health, National Healthcare Group, Singapore, Singapore
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Bock MD11, 10 Medical Drive, Singapore, 117597, Singapore
| | - Jin-Qiu Li
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Bock MD11, 10 Medical Drive, Singapore, 117597, Singapore
- Department of Nursing, Zhuhai Campus, Zunyi Medical University, Zhuhai, Guangdong, China
| | - Zheng An Toh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Bock MD11, 10 Medical Drive, Singapore, 117597, Singapore
- Division of Nursing, National University Hospital, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Bock MD11, 10 Medical Drive, Singapore, 117597, Singapore.
- National University Health System, Singapore, Singapore.
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Ören EDT, Kiziltaş S. Sexual quality of life between healthy women and women with gynecological cancer: Results of a hospital-based case-control study in Türkiye. J Obstet Gynaecol Res 2024; 50:456-466. [PMID: 38073035 DOI: 10.1111/jog.15847] [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: 06/08/2023] [Accepted: 11/26/2023] [Indexed: 03/04/2024]
Abstract
BACKGROUND Gynecological cancers among women were both chronic and vitally health problems. The increasing prevalence of women with surviving gynecological cancers and the receiving treatments of cancer negatively affected the sexual quality of life. AIM The study was conducted to determine the sexual quality of life of healthy women and women with gynecological cancer and to determine the predictors of sexual quality of life in women with gynecological cancer. METHODS The research is a hospital-based case-control study was conducted. The study was carried out with 65 patients with histologically confirmed gynecological cancer were compared with 75 controls, who were admitted to the different departments of the same hospital in the Izmir, in western Türkiye. RESULTS The Sexual Quality of Life Questionnaire score (SQOL) of cases was 60.12 ± 9.01 and controls was 78.92 ± 7.08. SQOL scores of cases were significantly lower than controls (p < 0.05). Multiple linear regression analysis results showed that age (B = -0.295, p = 0.072), working (B = 4.981, p = 0.016), smoking (B = -4.590, p = 0.035), diagnosed with cervical cancer (B = -4.214, p = 0.045), and receiving chemotherapy (B = -4.722, p = 0.028) were associated with sexual quality of life in women with gynecological cancer (p < 0.05, R2 : 0.40). CONCLUSION Women with gynecological cancer had lower quality of sex life compared with healthy women. Gynecological cancers negatively affect women's sexual quality of life. Health professionals (especially nurses) should be aware of the potential problems that women with gynecological cancer may experience with their sexual lives. They should develop coping strategies and offer solutions for the problems experienced by women with gynecological cancer.
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Affiliation(s)
- Ekin Dila Topaloğlu Ören
- Department of Obstetrics and Gynecology Nursing, Nursing Department, Faculty of Health Science, Izmir Katip Celebi University, Izmir, Türkey
| | - Selin Kiziltaş
- Oncology Department/Surgical Oncology Clinic, Tepecik Training and Research Hospital, Izmir Health Sciences University, Izmir, Türkey
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Roussin M, Hamilton A, Lowe J, Martin L. Sexual quality of life after gynaecological cancer: what young women want. Qual Life Res 2024; 33:679-689. [PMID: 38019323 DOI: 10.1007/s11136-023-03553-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/30/2023]
Abstract
PURPOSE Psychosexual distress is known to be a common complication of treatment for gynaecological cancer (GC), affecting the sexual quality of life (SQoL) for an increasing number of young gynaecological cancer survivors (YGCS). The SQoL in YGCS study aimed to identify strategies that are acceptable and helpful to YGCS in protecting and improving SQoL, using a salutogenic approach. METHODS A qualitative study was undertaken with young women aged 18-45 and pre- or perimenopausal at diagnosis. Semi-structured interviews were conducted on Zoom and a thematic analysis of transcripts was completed in NVivo. RESULTS Fifteen interviews with YGCS revealed three themes for strategy development: psychosexual education, psychosocial support, and healthcare policy and strategy to establish SQoL as standard care in gynaecologic oncology. CONCLUSION The strategies put forward by YGCS showed the need for a holistic, patient-centric, and multidisciplinary approach to SQoL. A better understanding of the strategies acceptable to YGCS, including the importance of using a trauma-informed approach to communication and care, can help healthcare providers play a vital role in protecting and improving SQoL.
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Affiliation(s)
- Melanie Roussin
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia.
| | - Anita Hamilton
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - John Lowe
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - Lisa Martin
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
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Pimsen A, Lin WH, Lin CY, Kuo YL, Shu BC. Healthcare providers' experiences in providing sexual health care to breast cancer survivors: A mixed-methods systematic review. J Clin Nurs 2024; 33:797-816. [PMID: 38108237 DOI: 10.1111/jocn.16943] [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: 01/23/2023] [Accepted: 09/20/2023] [Indexed: 12/19/2023]
Abstract
AIMS To analyse healthcare providers' (HCPs) experiences in sexual health care through the mixed-methods systematic review (MMSR). BACKGROUND Sexual health for breast cancer survivors (BCSs) is becoming increasingly important as survivors live longer. HCPs are critical in providing sexual health care. DESIGN A mixed-methods systematic review. METHODS Literature searches were conducted in databases MEDLINE, CINAHL, Psychology & Behavioral Sciences Collection, Web of Science, Cochrane Library, Scopus, ClinicalTrials.gov and reference lists were searched from inception to 30 December 2022. Two independent reviewers extracted and analysed the data using the JBI guidelines for MMSR. RESULTS After screening for 2849 citations, 19 studies were eligible for MMSR, involving 2068 HCPs. Most HCPs believe that sexual health care is their responsibility. However, sexual health was not adequately addressed. A lack of knowledge was the most significant barrier to providing sexual health care. Moreover, HCPs would like to acquire more knowledge and felt that current sexual healthcare training was inadequate. CONCLUSIONS Findings suggest that HCPs did not frequently address sexual health in BCSs and that lack of knowledge was the most common barrier. Healthcare session administrators should allocate resources for sexual healthcare training that offer multiple formats, accessible content and convenience. They should also be multifaceted and proactive, meet the diverse needs of BCS at different stages and focus on effective communication. RELEVANCE TO CLINICAL PRACTICE This study highlights the importance of addressing sexual health in BCSs and the need for HCPs to receive training in this area. Training should be multifaceted, proactive and meet the diverse needs of BCSs at different stages, with a focus on effective communication. By addressing this issue, HCPs will be better equipped to support the sexual health needs of BCSs, ultimately improving their overall well-being and quality of life. PROSPERO Registration Number: CRD42022327018 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=327018).
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Affiliation(s)
| | - Wen-Hua Lin
- Department of Nursing, Min-Hwei Junior College of Health Care Management, Tainan, Taiwan, ROC
| | - Chung-Ying Lin
- Institution of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Yao-Lung Kuo
- Department of Surgery, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Breast Medical Center, National Cheng Kung University Hospital, Tainan, Taiwan, ROC
| | - Bih-Ching Shu
- Institution of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
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Walsh EA, Safren SA, Penedo FJ, Antoni MH. If we build it, will they come? A scoping review of objective engagement metrics in asynchronous psychosocial telehealth interventions for breast cancer survivors. Clin Psychol Rev 2024; 107:102374. [PMID: 38171138 DOI: 10.1016/j.cpr.2023.102374] [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: 02/14/2023] [Revised: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
Burgeoning technologies and the COVID-19 pandemic resulted in a boom of telehealth for immunocompromised patients, such as those with cancer. Telehealth modalities overcome barriers and promote accessibility to care. Currently, efficacious psychosocial interventions exist to address negative aftereffects of a cancer diagnosis and treatment. Many of these interventions often incorporate asynchronous telehealth (e.g., web-based, smartphone mobile app) features. However, asynchronous platforms are limited by suboptimal engagement. Subjective indicators of perceived engagement in the forms of acceptability, feasibility, and adherence are often captured, yet prior research has found discrepancies between perceived and actual engagement. The FITT (frequency, intensity, time/duration, type of engagement) model, originally developed for use to quantify engagement within exercise trials, provides a framework to assess objective engagement of psychosocial interventions for breast cancer. Using 14 keywords and searching six databases through 11/2023, 56 studies that used asynchronous telehealth interventions in breast cancer were identified. All FITT domains were reported at least once across studies with intensity metrics most commonly reported. Nine metrics were described across FITT domains. Human-centered design principles to guide telehealth development and privacy considerations are discussed. Findings offer suggestions for how to represent and optimize objective engagement in asynchronous telehealth cancer care.
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Affiliation(s)
- Emily A Walsh
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
| | - Steven A Safren
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, Coral Gables, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
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Igerc I, Schrems B. Sexual well-being needs of patients with chronic illness expressed in health care: A scoping review. J Clin Nurs 2023; 32:6832-6848. [PMID: 37323097 DOI: 10.1111/jocn.16773] [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: 09/20/2022] [Revised: 12/22/2022] [Accepted: 05/17/2023] [Indexed: 06/17/2023]
Abstract
AIMS To systematically identify and summarize the needs of chronically ill people concerning their sexual well-being in peer-reviewed published literature, to enable healthcare professionals to provide support in self-management satisfying the needs. DESIGN A scoping review was performed according to the framework of (JBI Manual for Evidence Synthesis. JBI Global Wiki, 2020). Findings are reported in line with the PRISMA extension for scoping reviews. REVIEW METHODS A literature search and thematic analysis were conducted. DATA SOURCES Full research was carried out in 2022 in the search engine BASE and the following databases: Scopus, MEDLINE, Science Citation Index Expanded, Social Sciences Citation Index and CINAHL. Peer-reviewed articles published after 2011 were included. RESULTS Fifty articles could be found. Seven categories of needs could be identified. People with chronic diseases want their providers to initiate discussions about sexual concerns and treat them trustfully and respectfully. Most of the patients would like the issue of sexuality to be included in routine care. They perceive their medical specialists and psychologists as preferred providers to talk to about this issue. Nurses are seen as primary contact persons but in a smaller number of studies. CONCLUSION Although the scoping review included different types of chronic diseases, the needs of chronically ill patients concerning their sexual well-being are not very different. Healthcare professionals, especially nurses, who are often the first point of contact for people with chronic illnesses, should take the initiative for open discussions about sexual issues. That requires a new understanding of the role of nurses, training and further education. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Providing patient education and facilitating an open discussion about sexuality require further training in the new understanding of the role of the nurse and the concept of sexual well-being. IMPACT What problem did the study address? Chronic diseases have an impact on patients' sexuality. Patients want to be informed about sexual issues, but providers often do not address them. What were the main findings? Patients with a chronic condition expect providers to initiate discussions about sexual well-being, regardless of the type of chronic disease. Where and on whom will the research have an impact? The research will impact healthcare professionals', especially nurses', future educational standards and ultimately patients. REPORTING METHOD PRISMA extension for scoping reviews. NO PATIENT OR PUBLIC CONTRIBUTION Not required as it was a literary work (scoping review).
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Affiliation(s)
- Irina Igerc
- Department of Nursing Science, University of Vienna, Vienna, Austria
| | - Berta Schrems
- Department of Nursing Science, University of Vienna, Vienna, Austria
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Knettel B, Minja L, Msoka E, Tarimo C, Katiti V, Pan W, Mwobobia J, Juhlin E, Knippler E, Watt M, Suneja G, Kimani S, Abouelella D, Mmbaga B, Osazuwa-Peters N. Culturally-informed adaptation and psychometric properties of the Cataldo Cancer Stigma Scale in Northern Tanzania. J Psychosoc Oncol 2023; 42:286-298. [PMID: 37534869 PMCID: PMC10837313 DOI: 10.1080/07347332.2023.2241458] [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] [Indexed: 08/04/2023]
Abstract
BACKGROUND Cancer-related stigma impacts patients' emotional health, care engagement, and cancer outcomes, but few measures of cancer stigma exist. We culturally adapted and assessed psychometric properties of the Cataldo Cancer Stigma Scale (CCSS) in Tanzania. METHODS We administered the CCSS short version (21 items), plus 12 locally-derived items, to 146 adult cancer patients. We conducted exploratory factor analysis, examined internal consistency/reliability, and assessed convergent validity with relevant measures. RESULTS We identified a 17-item cancer stigma scale with strong psychometric properties and four subscales: enacted stigma, shame and blame, internalized stigma, and disclosure concerns. Stigma was rare except for disclosure concerns. Stigma was positively associated with depression and anxiety and negatively associated with social support, quality of life, and illness acceptance. CONCLUSIONS The scale provides valid, culturally-informed measurement of cancer stigma in Tanzania. Future studies should assess associations with care engagement, which will inform interventions to reduce stigma and improve outcomes.
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Affiliation(s)
- Brandon Knettel
- Duke University School of Nursing, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Linda Minja
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Elizabeth Msoka
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre Cancer Care Centre, Moshi, Tanzania
| | | | - Victor Katiti
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Wei Pan
- Duke University School of Nursing, Durham, NC, USA
- Department of Population Health Sciences, Duke University, Durham, NC, USA
| | - Judith Mwobobia
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Erika Juhlin
- Department of Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA
| | - Elizabeth Knippler
- Duke University School of Nursing, Durham, NC, USA
- Duke Center for AIDS Research, Duke University, Durham, NC, USA
| | - Melissa Watt
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Gita Suneja
- Department of Radiation Oncology, University of Utah, Salt Lake City, UT, USA
| | - Stephen Kimani
- Department of Medicine, Division of Medical Oncology, University of Utah, Salt Lake City, UT, USA
| | - Dina Abouelella
- Department of Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA
| | - Blandina Mmbaga
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Nosayaba Osazuwa-Peters
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Department of Population Health Sciences, Duke University, Durham, NC, USA
- Department of Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA
- Duke Cancer Institute, Durham, NC, USA
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Cyr MP, Camden C, Dumoulin C, Dostie R, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Mayrand MH, Morin M. Gynecological Cancer Survivors' Experiences of Dyspareunia and Factors Influencing Care-Seeking Behavior: A Qualitative Study. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2669-2681. [PMID: 37058221 DOI: 10.1007/s10508-023-02589-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 01/15/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
Pain during sexual intercourse, also called dyspareunia, affects most women after treatment for gynecological cancer. Previous work adopted a biomedical approach to depict dyspareunia in this population, which provided a narrow perspective of this condition. Taking into account women's experiences of dyspareunia and the factors influencing their care-seeking behaviors would provide insight to improve care in the context of gynecological cancer. The aim of this study was to describe gynecological cancer survivors' experiences of dyspareunia and factors influencing care-seeking behavior. A qualitative study was performed with 28 gynecological cancer survivors with dyspareunia. Individual telephone interviews were conducted based on the Common-Sense Model of Self-Regulation. Interviews were recorded and transcribed for analysis using the interpretative description framework. Concerning their experience, participants reported the oncological treatments as the primary cause of dyspareunia. Loss of libido, lower vaginal lubrication, and smaller vaginal cavity were described as being linked with dyspareunia. Women explained how dyspareunia and these changes had led them to engage less in, and even interrupt, sexual activity. They expressed that they were distressed, felt less of a woman, and experienced low control and/or self-efficacy. Regarding the factors influencing women's care-seeking behaviors, participants emphasized that they were provided with insufficient information and support. Balancing priorities, denial or reluctance, misbeliefs, resignation and acceptance, and negative emotions were reported as barriers, whereas acknowledgement of sexual dysfunction, desire for improvement, awareness of treatment possibilities, willingness to undertake treatment and treatment acceptability were reported as facilitators to seeking care. Findings suggest that dyspareunia is a complex and impactful condition after gynecological cancer. While this study highlights the importance of alleviating the burden of sexual dysfunction in cancer survivors, it identified factors that should be considered in the provision of services to improve care.
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Affiliation(s)
- Marie-Pierre Cyr
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12E Avenue N, Sherbrooke, QC, J1H 5N4, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Chantal Camden
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12E Avenue N, Sherbrooke, QC, J1H 5N4, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Chantale Dumoulin
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Rosalie Dostie
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12E Avenue N, Sherbrooke, QC, J1H 5N4, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Paul Bessette
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Annick Pina
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Walter Henry Gotlieb
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Korine Lapointe-Milot
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Hélène Mayrand
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Departments of Obstetrics and Gynecology and Social and Preventive Medicine, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Mélanie Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12E Avenue N, Sherbrooke, QC, J1H 5N4, Canada.
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
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Roussin M, Lowe J, Hamilton A, Martin L. Sexual quality of life in young gynaecological cancer survivors: a qualitative study. Qual Life Res 2023:10.1007/s11136-023-03386-1. [PMID: 36947327 DOI: 10.1007/s11136-023-03386-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE The impact of cancer diagnosis and treatment on sexual quality of life (SQoL) is a significant and often neglected issue in the treatment and survivorship period of young gynaecological cancer survivors (YGCS). This study sought to explore women's lived experiences to understand how to protect and improve SQoL. METHODS A qualitative study with women aged 18-45 and pre- or perimenopausal at diagnosis (n = 15). A thematic analysis was performed in NVivo. Participants also completed a pre-interview questionnaire and The Female Sexual Distress Scale-Revised (FSDS-R). RESULTS YGCS experienced high psychosexual distress. Notably, seven themes were identified: adjustment, confidence, fear, loss, shame, trauma, and communication. Gynaecological cancer (GC) treatment interfered with everyday life and had a long-term impact on mental, physical, and emotional health, with many reporting an altered sense of self, body image and sexual identity. Single women felt vulnerable in new relationships, while partnered women reported low sexual desire and guilt about sexual difficulties. Open communication, emotional intimacy, and an acceptance of the 'new normal' buffered the trauma of cancer and were vital to relationship satisfaction. Lastly, absent, or blunt patient-clinician communication contributed to psychosexual distress. CONCLUSION GC interferes with sexual function, partner relationships, psychosexual wellbeing, and quality of life. A better understanding of the lived experiences of YGCS can help healthcare providers to adopt a holistic, patient-centric, and multidisciplinary approach to SQoL. YGCS want psychosexual communication and support, across all stages of treatment and care. Healthcare providers should initiate and normalise conversations on the impact of treatment on SQoL.
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Affiliation(s)
- Melanie Roussin
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia.
| | - John Lowe
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - Anita Hamilton
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - Lisa Martin
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
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Powlesland C, MacGregor F, Swainston K. Women's experiences of information, education and support when undergoing pelvic radiotherapy for gynaecological cancer: An exploratory qualitative study. Radiography (Lond) 2023; 29:70-75. [PMID: 36327517 DOI: 10.1016/j.radi.2022.10.004] [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: 03/15/2022] [Revised: 08/29/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION As cancer survival rates increase, so does the importance of preventing and alleviating the late effects of radiotherapy. The effect of long-term problems on patients' physical, social and psychological well-being must be addressed along with the importance of developing an understanding of the late effects of treatment to find ways of maximising the quality of life of cancer survivors. The aim of this service evaluation was to establish what support, information and education on post treatment changes women who have undergone pelvic radiotherapy for gynaecological cancer were provided with, and whether it met their needs. METHODS An interpretative phenomenological analysis was undertaken to explore the support, information and education on post treatment changes women who have undergone pelvic radiotherapy for gynaecological cancer are currently provided with and whether or not it meets their needs. Semi-structured interviews were conducted to gain insight into the experiences of participants. Researcher reflexivity was considered and ethics permissions granted. RESULTS This paper reports the themes from analysis; communication and information provision, abandonment, service provision, and sexual health and intimacy. All patients experienced feelings of abandonment at the completion of treatment and those experiencing ongoing side effects needing greater support, particularly to manage side effects affecting the bowel and bladder. CONCLUSION This study fills a gap in existing knowledge and identifies that patients with a gynaecological cancer require greater communication and support. The introduction of a therapeutic radiographer led late effects clinic and sexual care after radiotherapy clinic could provide the support and information that patients need to cope with the long-term side effects experienced due to pelvic radiotherapy. IMPLICATIONS FOR PRACTICE This service evaluation highlights the importance of including patient perspectives when designing and developing services.
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Affiliation(s)
- Claire Powlesland
- Radiotherapy Department, South Tees Hospitals NHS Foundation Trust, James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, UK.
| | - Fiona MacGregor
- School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, UK.
| | - Katherine Swainston
- School of Psychology, Faculty of Medical Sciences, 4th Floor Margaret Barbour Building, Newcastle Street, Newcastle - Upon - Tyne, NE2 4DR, UK.
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Sears C, Santos-Iglesias P, Millman R, Jacox N, Wiebe E, Walker LM. Implementation of individually tailored treatment plans in a group-based intervention for women with mixed vulvo-vaginal and sexual health concerns following cancer treatment: A feasibility study. Eur J Oncol Nurs 2022; 63:102236. [PMID: 36827834 DOI: 10.1016/j.ejon.2022.102236] [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: 08/29/2022] [Revised: 10/26/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE This study evaluated a professionally-led, group-based vulvo-vaginal and sexual health (VSH) workshop for women diagnosed with cancer. The study goals were to: (1) implement and assess a novel group intervention for diverse VSH concerns; (2) explore post-workshop changes in symptom bother, motivation to use VSH treatments, and frequency of VSH treatment use; (3) examine post-workshop changes in sexual well-being. METHODS A group-based educational workshop to address a variety of VSH concerns was developed and implemented. During the workshop, participants created an individualized treatment plan by selecting from various VSH treatment options presented. Treatment plan follow-ups were administered online at one-, two-, and three-months post-workshop. At baseline and three-month follow-up, participants completed online questionnaires to assess self-reported vulvo-vaginal symptoms, sexual function, sexual distress, and use of VSH strategies. RESULTS 195 participants (age 20-81) attended workshops over a 2.5-year period. Individualized treatment plans were effectively completed by most participants (92%). Preliminary results show decreases in bother severity associated with VSH concerns post-workshop, stabilizing after 2 months. At three-month follow-up, participants reported increased use of VSH treatment strategies. Sexual satisfaction, sexual distress, and emotional impact of vulvovaginal symptoms also improved. CONCLUSIONS Workshop attendance was associated with increased uptake of VSH treatment strategies and improvements in several parameters of sexual well-being. Findings indicate that individualized treatment plans can be implemented effectively in a group setting and that a one-time, group-based educational workshop can meaningfully impact VSH-related behavior change, reduce vulvo-vaginal symptom bother and promote sexual well-being in patients with diverse VSH concerns.
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Affiliation(s)
- Carly Sears
- Department of Oncology, University of Calgary, 1331 - 29th St., NW, Calgary, AB, Canada
| | - Pablo Santos-Iglesias
- Department of Psychology, Cape Breton University, 1250 Grand Lake Rd, Sydney, NS, Canada
| | - Roanne Millman
- Department of Oncology, University of Calgary, 1331 - 29th St., NW, Calgary, AB, Canada; West Coast Centre for Sex Therapy, 2695 Granville St., # 302, Vancouver, BC, Canada
| | - Natalie Jacox
- Department of Oncology, University of Calgary, 1331 - 29th St., NW, Calgary, AB, Canada
| | - Ericka Wiebe
- Department of Oncology, University of Alberta, 11560 University Ave., Edmonton, AB, Canada
| | - Lauren M Walker
- Department of Oncology, University of Calgary, 1331 - 29th St., NW, Calgary, AB, Canada; Arnie Charbonneau Cancer Research Institute, University of Calgary, 3280 Hospital Dr., NW., Calgary, AB, Canada.
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Küçükkaya H, Gönenç IM. An evaluation of the prevalence and predictive factors of sexual dysfunction in women with heart failure: A cross‐sectional survey. J Clin Nurs 2022. [DOI: 10.1111/jocn.16578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/29/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022]
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Benedict C, Shaffer KM, Wirtz MR, Ford JS, Reese JB. Current Considerations in Interventions to Address Sexual Function and Improve Care for Women with Cancer. CURRENT SEXUAL HEALTH REPORTS 2022. [DOI: 10.1007/s11930-022-00343-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mohammadi Z, Maasoumi R, Vosoughi N, Eftekhar T, Soleimani M, Montazeri A. The effect of the EX-PLISSIT model-based psychosexual counseling on improving sexual function and sexual quality of life in gynecologic cancer survivors: a randomized controlled clinical trial. Support Care Cancer 2022; 30:9117-9126. [PMID: 35997810 DOI: 10.1007/s00520-022-07332-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/11/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Psychosexual support has received considerable attention in the improvement of sexuality in gynecologic cancer survivors. The current study was conducted to examine the effect of EX-PLISSIT model-based psychosexual counseling on improving sexual function and sexual quality of life in this group of patients. METHODS One hundred ten eligible women with the most common gynecologic cancers were randomized 1:1 to intervention (EX-PLISSIT-based counseling sessions for 4 weeks) and control groups. Sexual function and sexual quality of life were assessed via FSFI and SQOL-F self-reported questionnaires at baseline and 8 weeks post-intervention. RESULTS One hundred fifty patients were registered; 110 were equally randomized to the intervention and control groups (55 each). Ninety-nine patients completed both questionnaires at baseline and 8 weeks post-intervention. There were no significant differences in the FSFI and SQOL-F scores between the study arms compared to baseline using the independent t-test (P > 0.05). Positive changes in FSFI and SQOL-F scores were observed in patients in both arms at 8 weeks. However, the mean difference was higher in the intervention arm but was statistically significant only in the domains of sexual desire, lubrication, orgasm, pain, overall sexual function, and sexual and relationship satisfaction subscale of SQOL-F (P < 0.05). CONCLUSIONS Based on our findings, by facilitating communication, the EX-PLISSIT-based psychosexual counseling resulted in positive changes in sexual function and sexual quality of life in gynecologic cancer survivors. Therefore, we recommend this type of counseling in combination with other therapeutic and rehabilitative services for survivors of gynecologic cancers. TRIAL REGISTRATION This study was registered in Iran's Clinical Trial Registry under registration code IRCT20160808029255N6 on 29 June 2019.
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Affiliation(s)
- Zohreh Mohammadi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Raziyeh Maasoumi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. .,Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nafiseh Vosoughi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Eftekhar
- Department of Obstetrics and Gynecology, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Soleimani
- Department of Psychiatry, School of Medicine, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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Galica J, Saunders S, Romkey-Sinasac C, Silva A, Ethier JL, Giroux J, Jull J, Maheu C, Ross-White A, Stark D, Robb K. The needs of gynecological cancer survivors at the end of primary treatment: A scoping review and proposed model to guide clinical discussions. PATIENT EDUCATION AND COUNSELING 2022; 105:1761-1782. [PMID: 34865888 DOI: 10.1016/j.pec.2021.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Gynecological cancer (GC) survivors have unmet needs when they complete primary cancer treatment. Despite this, no known research has summarized these needs and survivors' suggestions to address them. We conducted a scoping review to fill these gaps and develop a model useful to guide clinical discussions and/or interventions. METHODS English, full length, and accessible primary studies describing the needs of GC survivors were included. No restrictions on date nor country of publication were applied. Two reviewers screened and extracted data, which was verified by a third reviewer. RESULTS Seventy-one studies met the inclusion criteria for data extraction. Results were thematically grouped into seven dimensions: physical needs, sexuality-related concerns, altered self-image, psychological wellbeing, social support needs, supporting the return to work, and healthcare challenges and preferences. After consulting with a stakeholder group (a GC survivor, clinicians, and researchers), the dimensions were summarized into a proposed model to guide clinical assessments and/or interventions. CONCLUSION Results illuminate the diverse needs of GC survivors as they complete primary cancer treatment and their recommendations for care to meet these needs. PRACTICE IMPLICATIONS The resulting model can be used to guide assessments, discussions and/or interventions to optimally prepare GC survivors for transition out of primary cancer treatment.
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Affiliation(s)
- Jacqueline Galica
- Queen's University School of Nursing, Kingston, Ontario, Canada; Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, Kingston, Ontario, Canada.
| | | | | | - Amina Silva
- Queen's University School of Nursing, Kingston, Ontario, Canada
| | - Josée-Lyne Ethier
- Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, Kingston, Ontario, Canada; Queen's University Department of Oncology; Kingston, Ontario, Canada
| | - Janet Giroux
- Queen's University School of Nursing, Kingston, Ontario, Canada; Kingston Health Sciences Centre, Kingston General Hospital Site and the Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada; Queen's University, Department of Obstetrics and Gynecology, Kingston, Ontario, Canada
| | - Janet Jull
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Christine Maheu
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | | | - Debora Stark
- Kingston Health Sciences Centre, Kingston General Hospital Site and the Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada
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Health belief model in predicting treatment intention among healthy and gynecologic cancer women with sexual dysfunction: Structural equation modeling. Taiwan J Obstet Gynecol 2022; 61:472-478. [PMID: 35595440 DOI: 10.1016/j.tjog.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Few large-scale studies have focused on the effect of gynecologic cancer compared with other biopsychosocial factors on willingness to seek treatment among women with sexual dysfunction. The aim of study was to identify predictors of the intention to treat female sexual dysfunction (FSD) among sociodemographic factors, physiologic factors, psychologic factors, gynecologic cancer, and health belief model (HBM). MATERIALS AND METHODS This study was a cross-sectional, hospital-based survey conducted from October 2013 to September 2019. Participants included healthy women and gynecologic cancer survivors who were aged 20 years or older and had been in a monogamous relationship for at least 12 months. They were enrolled in the gynecologic departments in southern Taiwan. Those who met DSM-5 criteria of sexual dysfunction were analyzed with Structural equation modeling. Intention to seek treatment was the primary outcome. RESULTS 448 of 643 women met DSM-5 sexual dysfunction. The mean age was 42.0 years (range: 21.8-68.1 years). Fifty-eight percent of women reported sexual treatment intention. The model fit was good: χ2 = 367.42, P < .001, χ2/df = 2.83, CFI = 0.933, TLI = 0.921, and RMSEA = 0.066 (95%CI: 0.058-0.074). Perceived severity, perceived benefits, perceived barriers, cue to action, self-efficacy and university education at least significantly predicted treatment intention. There were no significant differences in treatment intention regarding age and gynecologic cancer. Self-efficacy was the strongest predictor, which directly affected treatment intention (P = .001). Perceived severity was the second strongest predictor, mainly affecting treatment intention indirectly (P = .01). Perceived barriers was the third strongest predictor (P = .001), indirectly and negatively affected treatment intention. CONCLUSIONS Five out of six HBM factors and university education at least could significantly predict the intention to treat FSD. Gynecologic cancer was not a significant predictor.
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Venkataramu VN, Ghotra HK, Chaturvedi SK. Management of psychiatric disorders in patients with cancer. Indian J Psychiatry 2022; 64:S458-S472. [PMID: 35602367 PMCID: PMC9122176 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_15_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
| | | | - Santosh K Chaturvedi
- Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India.,Leicestershire Partnership NHS Trust, Thurmaston, Leicestershire, UK E-mail:
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22
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de Souza C, Santos AVDSL, Rodrigues ECG, Dos Santos MA. Experience of Sexuality in Women with Gynecological Cancer: Meta-Synthesis of Qualitative Studies. Cancer Invest 2021; 39:607-620. [PMID: 33826457 DOI: 10.1080/07357907.2021.1912079] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Gynecological cancers have an impact on women's psychosexual health in which results vary from adjuvant cancer therapy, such as loss of pleasure, to anxious symptoms. This study aimed to present a meta-synthesis of qualitative primary studies on the sexual experience of women with gynecological cancer. The SPIDER tool and the PRISMA guidelines were used to recover evidence from the databases Web of Science, SCOPUS, PubMed/MedLine, CINAHL, PsycINFO and LILACS. Twenty articles were included. The thematic synthesis showed that alterations in sexual functions can be mitigated by direct involvement and dialogue with a sexual partner and the resignification of sexual intimacy.
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Affiliation(s)
- Carolina de Souza
- Graduate Program in Psychology, Ribeirão Preto School of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil
| | - André Villela de Souza Lima Santos
- Graduate Program in Psychology, Ribeirão Preto School of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil
| | - Elaine Campos Guijarro Rodrigues
- Graduate Program in Psychology, Ribeirão Preto School of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel Antônio Dos Santos
- Psychology Department, Ribeirão Preto School of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil
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Roussin M, Lowe J, Hamilton A, Martin L. Factors of sexual quality of life in gynaecological cancers: a systematic literature review. Arch Gynecol Obstet 2021; 304:791-805. [PMID: 33847794 PMCID: PMC8325662 DOI: 10.1007/s00404-021-06056-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/27/2021] [Indexed: 12/17/2022]
Abstract
Background The impact of cancer diagnosis and treatment on sexual quality of life (SQoL) is a well-established survivorship issue for gynaecological cancer survivors (GCS), yet little is known on how to intervene. Purpose The aim of this systematic review was to identify the factors explaining the variability in SQoL for GCS. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and the software Covidence. Electronic databases Scopus, Web of Science, PUBMED and CINAHL were searched for original research on GCS published between 2002 and 2018. We performed a two-stage screening process against selection criteria and quality assessment of individual studies. The Salutogenic Theory and the PRECEDE–PROCEED model were used as theoretical frameworks to identify and categorise factors. Results The initial search yielded 3,505 articles resulting in a total of 46 studies used to examine the association between factors of SQoL and gynaecological cancers. Our findings suggested that SQoL varies across subgroups based on age, menopausal status, relationship status, and treatment modality. Protective factors included clinicians’ knowledge and confidence, preventive medical approach, risk and needs assessment, patient–clinician communication, relationship quality, psychosocial support, symptom management, accessibility of psychosexual care, and self-efficacy in the rediscovery of sexuality. Conclusion Despite the high incidence and long-term impact of sexual health issues on quality of life, supportive care needs are not being met. A better understanding of the evidence base around the factors of SQoL can help health professionals take steps to protect and improve SQoL in GCS.
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Affiliation(s)
- Melanie Roussin
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia.
| | - John Lowe
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - Anita Hamilton
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
| | - Lisa Martin
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia
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Walker LM, Wiebe E, Turner J, Driga A, Andrews-Lepine E, Ayume A, Stephen J, Glaze S, Booker R, Doll C, Phan T, Brennan K, Robinson JW. The Oncology and Sexuality, Intimacy, and Survivorship Program Model: An Integrated, Multi-disciplinary Model of Sexual Health Care within Oncology. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:377-385. [PMID: 31797198 DOI: 10.1007/s13187-019-01641-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Cancer-related sexual dysfunction is documented as one of the most distressing and long-lasting survivorship concerns of cancer patients. Canadian cancer patients routinely report sexuality concerns and difficulty getting help. In response to this gap in care, clinical practice guidelines were recently published in the Journal of Clinical Oncology. A sweeping trend is the creation of specialized clinics for patients' sexual health concerns. However, this much-needed attempt to address this service gap can be difficult to sustain without addressing the cancer care system from a broader perspective. Herein, we describe the implementation of a tiered systemic model of cancer-related sexual health programming in a tertiary cancer center. This program follows the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model, used previously for guiding individual practitioners. Visually, the model resembles a pyramid. The top 2 levels, corresponding to Intensive Therapy and Specific Suggestions, are comprised of group-based interventions for common cancer-related sexual concerns and a multi-disciplinary clinic for patients with complex concerns. The bottom 2 levels, corresponding to Permission and Limited Information, consist of patient education and provider education and consultation services. We describe lessons learned during the development and implementation of this program, including the necessity for group-based services to prevent inundation of referrals to the specialized clinic, and the observation that creating specialized resources also increased the likelihood that providers would inquire about patients' sexual concerns. Such lessons suggest that successful sexual health programming requires services from a systemic approach to increase sustainability.
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Affiliation(s)
- Lauren M Walker
- University of Calgary, Calgary, AB, Canada.
- Tom Baker Cancer Centre, Calgary, AB, Canada.
| | - Ericka Wiebe
- University of Alberta, Edmonton, AB, Canada
- Cross Cancer Institute, Edmonton, AB, Canada
| | - Jill Turner
- University of Alberta, Edmonton, AB, Canada
- Cross Cancer Institute, Edmonton, AB, Canada
| | - Amy Driga
- University of Alberta, Edmonton, AB, Canada
- Cross Cancer Institute, Edmonton, AB, Canada
| | | | | | | | - Sarah Glaze
- University of Calgary, Calgary, AB, Canada
- Tom Baker Cancer Centre, Calgary, AB, Canada
| | | | - Corinne Doll
- University of Calgary, Calgary, AB, Canada
- Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Tien Phan
- University of Calgary, Calgary, AB, Canada
- Tom Baker Cancer Centre, Calgary, AB, Canada
| | | | - John W Robinson
- University of Calgary, Calgary, AB, Canada
- Tom Baker Cancer Centre, Calgary, AB, Canada
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Perceptions of Chinese Patients Treated for Gynaecological Cancer about Sexual Health and Sexual Information Provided by Healthcare Professionals: A Qualitative Study. Cancers (Basel) 2021; 13:cancers13071654. [PMID: 33916096 PMCID: PMC8037367 DOI: 10.3390/cancers13071654] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/10/2021] [Accepted: 03/31/2021] [Indexed: 11/17/2022] Open
Abstract
Patients treated for gynaecological cancer (GC) generally experience impaired sexual function. Research on their sexual life experiences and perceptions on the sexuality care they receive is warranted. This study aimed to examine the perceptions of Chinese patients treated for GC regarding the effects of cancer treatment on their sexual function and femininity, their relationships with their partners, and the adequacy of the sexual information received from healthcare professionals during treatment. Individual, semi-structured interviews were conducted with 21 Chinese patients treated for GC, collecting data on their perceptions regarding the effects of cancer treatment on their sexual lives, femininity, and relationships with partners; and their views about the quality of sexuality care received. Data were analysed using content analysis. Participants experienced impaired sexual function, reduced sex drive, and expressed dissatisfaction with their sex lives. They perceived a loss of femininity and poor body image. They desired more information about how to address sexual problems and opted to receive this information from female healthcare professionals in individual counselling sessions during which the professionals could initiate such discussions. Overall, Chinese patients treated for GC have concerns about multiple sexual issues and a strong desire for information about strategies to address these issues. Nurse-led interventions should be implemented via a shared care approach to enhance patients' awareness about managing their sexual and psychological symptoms.
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Spousal sexual life issues after gynecological cancer: a qualitative study. Support Care Cancer 2021; 29:3857-3864. [PMID: 33386988 DOI: 10.1007/s00520-020-05912-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Sexual life is a multidimensional issue that can be affected negatively after gynecological cancer. The aim of this study was to reveal what sexuality life difficulties Iranian women with gynecological cancers experience. METHODS A qualitative approach was conducted through face-to-face semi-structured interviews with 16 Iranian women with gynecological cancer and then analyzed with conventional content analysis. RESULTS Three themes emerged from the data: (1) participant's struggle to maintain the sexual monopoly of the husband, (2) deterioration of intimacy, and (3) unpleasant bed-life experiences. Most women are ashamed to talk about their sexual relationships problems, and on the other hand, nurses and physicians ignore to talk about their sexual problems, so these women are alone in the face of this problem. CONCLUSION Although women with gynecological cancer experience sexual problems such as reluctant to have sex and lack of enjoyment, they struggle to maintain sexual life with their husbands. These women do not have enough support. They believe that sexuality is a shameful issue, and they are reluctant to ask questions about it. Health professionals need to talk about the possibility of sexual problems due to changes in their bodies caused by cancer. These women need to be encouraged to talk about these problems, with consideration to their religious and cultural differences.
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Hatta S, Woon LSC, Nik Sumayyah NMN, Mohamad Nasir S. Psychosocial Determinants of Marital Satisfaction Among Gynecologic Cancer Survivors in Malaysia. Front Psychiatry 2021; 12:744922. [PMID: 34650458 PMCID: PMC8509300 DOI: 10.3389/fpsyt.2021.744922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/01/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Marital issues among gynecologic cancer survivors are common but complex. This study aimed to investigate the relationship between sociodemographic and clinical factors, including sexual dysfunction and marital satisfaction among Malaysian gynecologic cancer survivors. Methods: A cross-sectional survey of married women with gynecologic cancers was conducted at a Malaysian university hospital. Sociodemographic and clinical data were gathered. Sexual dysfunction was measured using the Malay Version Female Sexual Function Index (MVFSFI), while marital satisfaction was evaluated with the Malay Version Golombok Rust Inventory for Marital Satisfaction (MVGRIMS). Results: A total of 116 patients participated in this study. The median age was 59.0 years (Interquartile range, IQR: 49.0-67.0 years); the median duration of marriage was 32 years (IQR: 20.0-40.8 years). 80.2% had a secondary and lower level of education. 37.9% of study subjects (n = 44) reported poor-and below-levels of marital satisfaction, which was equivalent to MVGRIMS transformed scores of >5. The median FSFI total score was 49.9 (IQR: 2.0-63.0). MVGRIMS transformed score correlated significantly with all MVFSFI sub-scores. In logistic regression, lower educational levels were associated with poor marital satisfaction [primary, (adjusted Odds Ratio) aOR = 12.67, 95% CI: 1.40-114.87; secondary: aOR = 11.52, 95% CI: 1.39-95.72], while higher MVFSFI total score reduced the likelihood of poor marital satisfaction (aOR = 0.979, 95% CI: 0.964-0.994). Conclusion: Both sexual dysfunction and low education level may affect marital satisfaction among gynecologic cancer survivors. Targeted efforts focusing on sex education for patients may help to improve marital satisfaction.
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Affiliation(s)
- Sidi Hatta
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Luke Sy-Cherng Woon
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nik Mohd Nor Nik Sumayyah
- Department of Obstetrics and Gynecology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Shafiee Mohamad Nasir
- Department of Obstetrics and Gynecology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
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Perceptions of care after end-of-treatment among younger women with different gynecologic cancer diagnoses - a qualitative analysis of written responses submitted via a survey. BMC WOMENS HEALTH 2020; 20:276. [PMID: 33353541 PMCID: PMC7754585 DOI: 10.1186/s12905-020-01133-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 11/22/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Less attention has been given to younger adults' psycho-oncology care needs than to children and older adults with cancer. The aim was to explore how care following end-of-treatment was perceived by women treated for different gynecologic cancer diagnoses during younger adulthood. METHODS A sample of 207 women diagnosed with gynecologic cancer 2008 to 2016, aged 19-39 at time of diagnosis answered one open-ended question regarding important aspects of care after end-of-treatment. The written responses were analyzed with manifest content analysis and presented in relation to the women's diagnoses, i.e., cervical (n = 130), ovarian (n = 57), and other gynecologic cancer diagnoses (n = 20). RESULTS The analysis resulted in three categories: Unmet long-term supportive care needs, Satisfying long-term supportive care, and Health care organizational difficulties. Over half of the women (66.7%) described unmet care needs. The corresponding figures were 80.7, 63.1 and 50% for women diagnosed with ovarian, cervical and other gynecologic cancer diagnoses, respectively. Satisfying supportive care were described by approximately one quarter of the women (26.1%). Among women diagnosed with ovarian cancer 14% described satisfying supportive care. The corresponding figures were 26.9 and 30% for women diagnosed with cervical cancer and other gynecological diagnoses, respectively. Approximately one quarter of the women, irrespectively of diagnosis, described aspects related to health care organizational difficulties (28%). CONCLUSIONS The results highlight the importance of good quality care linked to the diagnosis and based on an understanding of the woman's need, desire and expectation of support after end-of-treatment.
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Abstract
BACKGROUND Sexuality is a multidimensional subject that can be negatively affected after a diagnosis of gynecological cancer. OBJECTIVE The aim of this study was to reveal what sexuality difficulties Muslim women with gynecological cancers experience and how they overcome them. INTERVENTIONS/METHODS A qualitative approach was used. Data were gathered through semistructured interviews and analyzed by using a content analysis method. Eighteen Muslim women with gynecological cancers participated in the study. RESULTS The study findings were grouped into 3 major categories: situations that make sexual life difficult, impact of cancer on sexual life, and coping. CONCLUSIONS Women with gynecological cancers experience sexual reluctance, orgasmic incapacity, lack of enjoyment of sexual intercourse, and decreased frequency of sexual intercourse. In individuals with cancer, social support is important to facilitate coping; however, some women do not receive sufficient support. Women who consider sexuality to be a taboo topic and feel shame about asking sexuality-related questions are not likely to seek or receive relevant information from health professionals. IMPLICATIONS FOR PRACTICE Health professionals should provide information to women diagnosed with gynecological cancers about changes that they are likely to experience in their bodies and possible difficulties in sexuality. These women should be encouraged to talk about their sexual problems, and religious and cultural differences should be reflected in their cancer care.
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30
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Uysal N, Ünal Toprak F, Soylu Y, Kaya B. Evaluation of Sexual Life in Patients with Gynecologic Cancer Undergoing Radiotherapy. SEXUALITY AND DISABILITY 2020. [DOI: 10.1007/s11195-020-09658-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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31
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Eid K, Christensen S, Hoff J, Drake D, Yadav K, Burtson P, Kuriakose M, Patton H, Nyamathi A. Sexual Health Education: Knowledge Level of Oncology Nurses and Barriers to Discussing Concerns With Patients. Clin J Oncol Nurs 2020; 24:E50-E56. [DOI: 10.1188/20.cjon.e50-e56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dai Y, Cook OY, Yeganeh L, Huang C, Ding J, Johnson CE. Patient-Reported Barriers and Facilitators to Seeking and Accessing Support in Gynecologic and Breast Cancer Survivors With Sexual Problems: A Systematic Review of Qualitative and Quantitative Studies. J Sex Med 2020; 17:1326-1358. [PMID: 32331967 DOI: 10.1016/j.jsxm.2020.03.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/26/2020] [Accepted: 03/05/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Greater understanding of patient-reported barriers and facilitators to seeking and accessing sexual health services will help formulate strategies to assist gynecologic and breast cancer patients to overcome obstacles to accessing sexual health support because they typically do not seek sexual education and/or treatment when confronted with sexual concerns. AIM The objectives of this systematic review were to (i) explore the patient-reported barriers to seeking and accessing support for sexual problems in gynecologic and breast cancer survivors, and (ii) identify strategies used to successfully overcome the barriers to accessing sexual health information and/or treatment. MAIN OUTCOME MEASURES The main outcome measures included factors that prevent and/or facilitate gynecologic and breast cancer patients with sexual concerns seeking and accessing sexual health-related services. METHODS Systematic searches of major electronic databases (Ovid MEDLINE, PsycINFO, CINAHL, ProQuest, and Chinese database CNKI) from January 2009 to July 2019 were used to identify the barriers and facilitators to seeking sexual education/treatment from the perspective of gynecologic and breast cancer survivors. A narrative synthesis was conducted. RESULTS 20 studies met the inclusion criteria including 12 qualitative, 6 quantitative, and 2 mixed methods studies. 4 interconnected themes were derived from 13 subthemes relating to the barriers/facilitators to seeking and accessing sexual health support. The most common barriers were embarrassment/discomfort in discussing sexual concerns, perceived discomfort of healthcare providers in discussing sexual issues, limitations of the healthcare system to address sexual problems, and the multidimensional nature of sexuality. Help-seeking for sexual health concerns was facilitated by: (i) oncology health professionals initiating and conducting open, honest discussions around sexual concerns with patients; (ii) the availability of information in multiple forms; and (iii) appropriate timing of information provision according to women's preferences. CLINICAL IMPLICATIONS Oncology health professionals need to develop an open, honest, accepting communication style and be accessible to women with cancer and their partners within healthcare systems. STRENGTHS & LIMITATIONS The systematic review was conducted in accordance with guidelines. Variability in the primary aims and outcomes of the included studies precluded a meta-analysis. CONCLUSIONS Training programs for providers of oncology care should enhance their knowledge of sexual issues in gynecologic and/or breast cancer, enhance their communication skills with patients, and improve their ability to consult or refer patients to psycho-oncologists or other mental health professionals. Dai Y, Cook OY, Yeganeh L, et al. Patient-Reported Barriers and Facilitators to Seeking and Accessing Support in Gynecologic and Breast Cancer Survivors With Sexual Problems: A Systematic Review of Qualitative and Quantitative Studies. J Sex Med 2020;17:1326-1358.
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Affiliation(s)
- Yunyun Dai
- Nursing School, Guilin Medical University, Guilin, China
| | - Olivia Y Cook
- Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Ladan Yeganeh
- Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Chongmei Huang
- Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Jinfeng Ding
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Claire E Johnson
- Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia; Supportive and Palliative Care, Eastern Health, Melbourne, VIC, Australia.
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Valpey R, Kucherer S, Nguyen J. Sexual dysfunction in female cancer survivors: A narrative review. Gen Hosp Psychiatry 2019; 60:141-147. [PMID: 31030966 DOI: 10.1016/j.genhosppsych.2019.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/25/2019] [Accepted: 04/01/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Due to improvements in earlier detection and expansions in available treatments, the number of individuals surviving with cancer is steadily increasing. Sexual dysfunction is a common and often persistent complication for cancer survivors, affecting >60% of women diagnosed with cancer. Although highly prevalent, issues related to sexual health are often not addressed among survivors, with women reporting less discussion with providers compared to men. METHODS In this narrative review, we present a case series of three women seen in a psycho-oncology clinic who experienced sexual dysfunction following a cancer diagnosis. We then review existing literature on the presentation and management of sexual issues associated with cancer and its treatment. RESULTS The three cases highlight different mechanisms of sexual dysfunction after cancer, including anatomic changes, hormonal alterations, psychiatric conditions and medication side effects. The literature review includes discussion of the prevalence and course of sexual dysfunction in female cancer survivors. Tools for screening and assessment are then reviewed, as well as contributing factors and common presenting symptoms. We conclude with a discussion of both pharmacologic and non-pharmacologic approaches to management. CONCLUSIONS Despite its high prevalence and considerable impact on quality of life, the complication of sexual dysfunction after cancer diagnosis and treatment is still under recognized and undertreated. Improving awareness, communication, and screening, as well as appropriate referral to treatment, could have a profound impact on the ever growing number of women surviving with cancer with sexual health concerns.
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Affiliation(s)
- Robin Valpey
- University of Pittsburgh Medical Center, United States of America.
| | - Shelly Kucherer
- University of Pittsburgh Medical Center, United States of America
| | - Julia Nguyen
- University of Pittsburgh School of Medicine, United States of America
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34
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Quality improvement in sexual health care for oncology patients: a Canadian multidisciplinary clinic experience. Support Care Cancer 2019; 28:2195-2203. [DOI: 10.1007/s00520-019-05040-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 08/12/2019] [Indexed: 02/06/2023]
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35
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Lopez AJ, Butow PN, Philp S, Hobbs K, Phillips E, Robertson R, Juraskova I. Age‐related supportive care needs of women with gynaecological cancer: A qualitative exploration. Eur J Cancer Care (Engl) 2019; 28:e13070. [DOI: 10.1111/ecc.13070] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 03/14/2019] [Accepted: 03/29/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Anna‐Lena J. Lopez
- Centre for Medical Psychology and Evidence‐based Decision‐making, School of Psychology The University of Sydney Sydney Australia
- Psycho‐Oncology Co‐Operative Research Group The University of Sydney Sydney Australia
| | - Phyllis N. Butow
- Centre for Medical Psychology and Evidence‐based Decision‐making, School of Psychology The University of Sydney Sydney Australia
- Psycho‐Oncology Co‐Operative Research Group The University of Sydney Sydney Australia
| | - Shannon Philp
- Lifehouse Gynaecological Oncology Group, and Sydney Nursing School The University of Sydney Sydney Australia
| | - Kim Hobbs
- Department of Gynaecological Cancer Westmead Hospital Sydney Australia
| | - Emily Phillips
- Department of Gynaecological Cancer Westmead Hospital Sydney Australia
| | | | - Ilona Juraskova
- Centre for Medical Psychology and Evidence‐based Decision‐making, School of Psychology The University of Sydney Sydney Australia
- Psycho‐Oncology Co‐Operative Research Group The University of Sydney Sydney Australia
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36
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Beesley VL, Alemayehu C, Webb PM. A systematic literature review of trials of survivorship interventions for women with gynaecological cancer and their caregivers. Eur J Cancer Care (Engl) 2019; 28:e13057. [DOI: 10.1111/ecc.13057] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/11/2019] [Accepted: 03/25/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Vanessa L. Beesley
- Gynaecological Cancers Group QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
- School of Public Health and Social Work Queensland University of Technology Brisbane Queensland Australia
| | - Chalachew Alemayehu
- Gynaecological Cancers Group QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
- Faculty of Medicine University of Queensland Brisbane Queensland Australia
| | - Penelope M. Webb
- Gynaecological Cancers Group QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
- School of Public Health and Social Work Queensland University of Technology Brisbane Queensland Australia
- School of Public Health University of Queensland Brisbane Queensland Australia
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37
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Hubbs JL, Dickson Michelson EL, Vogel RI, Rivard CL, Teoh DGK, Geller MA. Sexual quality of life after the treatment of gynecologic cancer: what women want. Support Care Cancer 2019; 27:4649-4654. [PMID: 30941579 DOI: 10.1007/s00520-019-04756-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 03/18/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE While the incidence of sexual dysfunction after treatment for gynecologic malignancies is well documented, few studies describe how patients want healthcare providers to address these concerns. The objective of this study was to evaluate changes in sexual function and describe patient preferences regarding healthcare provider roles in addressing and treating sexual dysfunction in gynecologic cancer survivors. METHODS Patients undergoing gynecologic cancer treatment from 2013 to 2014 at a single University-based Gynecologic Cancer clinic were surveyed using a modified Changes in Sexual Function Questionnaire (CSFQ), along with questions relating to healthcare provider interactions and preferences. RESULTS Among 277 eligible patients approached to participate, 85 (30.7%) completed the survey. The mean age was 52.2 ± 12.3 years; most were non-Hispanic White (78.8%), partnered (73.2%), had endometrial or ovarian cancer (30.6% and 44.7%, respectively), and were in surveillance (57.3%). Most women (64.7%) reported much or great sexual enjoyment 1 year prior to cancer treatment which decreased to 27.4% currently; 33.3% report only rare sexual activity. There were no statistically significant differences in mean total CSFQ scores by treatment modality. A minority wanted healthcare providers to initiate sexual health discussions (25.3%); the remaining reported not wanting sexual health addressed or preferred raising the issue themselves. The most commonly cited barrier to communication was the feeling that there are more important issues to discuss with their oncology providers (46.2%). CONCLUSIONS While gynecologic cancer patients report changes in sexual function following cancer therapy, many believe there are other issues more paramount to be addressed. Further studies are warranted to develop better strategies for addressing sexual health in women receiving treatment for gynecologic cancers.
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Affiliation(s)
- J L Hubbs
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | | | - R I Vogel
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
- Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - C L Rivard
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - D G K Teoh
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Melissa A Geller
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA.
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Almont T, Bouhnik AD, Ben Charif A, Bendiane MK, Couteau C, Manceau C, Mancini J, Huyghe É. Sexual Health Problems and Discussion in Colorectal Cancer Patients Two Years After Diagnosis: A National Cross-Sectional Study. J Sex Med 2019; 16:96-110. [DOI: 10.1016/j.jsxm.2018.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 11/07/2018] [Accepted: 11/11/2018] [Indexed: 11/30/2022]
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Traumer L, Jacobsen MH, Laursen BS. Patients’ experiences of sexuality as a taboo subject in the Danish healthcare system: a qualitative interview study. Scand J Caring Sci 2018; 33:57-66. [DOI: 10.1111/scs.12600] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/14/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Line Traumer
- Clinical Nursing Research Unit Aalborg University Hospital Aalborg Denmark
| | | | - Birgitte Schantz Laursen
- Clinical Nursing Research Unit Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
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Sexual health and needs for sexology care in digestive cancer patients undergoing chemotherapy: a 4-month cross-sectional study in a French University Hospital. Support Care Cancer 2018. [DOI: 10.1007/s00520-018-4125-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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41
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Beesley VL, Alemayehu C, Webb PM. A systematic literature review of the prevalence of and risk factors for supportive care needs among women with gynaecological cancer and their caregivers. Support Care Cancer 2017; 26:701-710. [DOI: 10.1007/s00520-017-3971-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/09/2017] [Indexed: 01/23/2023]
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Reese JB, Beach MC, Smith KC, Bantug ET, Casale KE, Porter LS, Bober SL, Tulsky JA, Daly MB, Lepore SJ. Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study. Support Care Cancer 2017; 25:3199-3207. [PMID: 28451911 PMCID: PMC5803445 DOI: 10.1007/s00520-017-3729-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 04/17/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE Breast cancer patients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development. METHODS Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis. RESULTS Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions. CONCLUSIONS Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.
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Affiliation(s)
- Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave., 4th Floor, Young Pavilion, Philadelphia, PA, 19111, USA.
| | - Mary Catherine Beach
- Department of Medicine, Johns Hopkins School of Medicine, 2024 E. Monument St., Baltimore, MD, 21205, USA
| | - Katherine Clegg Smith
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 726, Baltimore, MD, 21205, USA
| | - Elissa T Bantug
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, EB-1650 Orleans St CRB-1 189, Baltimore, MD, 21287, USA
| | - Kristen E Casale
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave., 4th Floor, Young Pavilion, Philadelphia, PA, 19111, USA
| | - Laura S Porter
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, DUMC 90399, Durham, NC, 27708, USA
| | - Sharon L Bober
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Avenue, Shields-Warren 320, Boston, MA, 02215, USA
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Avenue, DA-2016A, Boston, MA, 02215, USA
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, 333 Cottman Ave., 4th Floor, Young Pavilion, Philadelphia, PA, 19111, USA
| | - Stephen J Lepore
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B. Moore Ave., Ritter Annex, 9th Floor, Philadelphia, PA, 19122, USA
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Cook O, McIntyre M, Recoche K, Lee S. Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:2087-2112. [PMID: 28800057 DOI: 10.11124/jbisrir-2016-003126] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. OBJECTIVES This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. INCLUSION CRITERIA TYPES OF PARTICIPANTS This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from pre-diagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review. PHENOMENA OF INTEREST Studies that explored how women with gynecological cancer experience the care and interventions of specialist nurses were included. TYPES OF STUDIES Qualitative studies including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for review. This review also considered the qualitative components of mixed method studies. CONTEXT Research conducted in any country was considered for inclusion in this review providing that the study was reported in English. Studies conducted in any setting including, but not limited to, acute hospitals, outpatient/ambulatory clinics, chemotherapy or radiotherapy units, support groups, palliative care units or the patient's home were included. SEARCH STRATEGY A three-step search strategy was utilized in this review. An initial limited search of MEDLINE and CINAHL was undertaken followed by a comprehensive search using all identified keywords and index terms across all included databases. The reference lists of all identified reports and articles were hand searched for additional studies. METHODOLOGICAL QUALITY Each paper was independently assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute the Qualitative Assessment and Review Instrument. When disagreement arose between the reviewers, the given paper was independently appraised by a third reviewer. DATA EXTRACTION Data were extracted from papers included in the review using the standardized data extraction tool from Joanna Briggs Institute the Qualitative Assessment and Review Instrument. Data extraction was completed independently by two reviewers. DATA SYNTHESIS Extracted findings from seven included papers were grouped according to similarity in meaning from which 11 categories were developed. These categories were then subjected to a meta-synthesis that produced a set of three synthesized findings. RESULTS Key findings were extracted from six included papers and classified as unequivocal (U) or credible (C). A total of 30 findings were extracted and aggregated into 11 categories based on similarity in meaning. From the 11 categories, three synthesized findings were developed: i) Tailored care: specialist nurses play a role in understanding and meeting the individual needs of women with gynecological cancer; ii) Accessible care: specialist nurses guide women with gynecological cancer along the continuum of care and are an easily accessed source of knowledge and support; iii) Dependable expertise: women with gynecological cancer express trust and reassurance in the experience and expertise of the specialist nurse. CONCLUSIONS This systematic review synthesized the findings of seven studies that captured the experiences of women with gynecological cancer who received care from a specialist nurse. The specialist nurse offers tailored, accessible and expert care to women with gynecological cancer. From the synthesis it is recommended that women with gynecological cancer have access to the services of a specialist nurse at key points on the continuum of care, that specialist nurses provide information to patients on their disease and treatment in the form preferred by the patient and ensure that this information has been understood, and that specialist nurses are afforded time to spend with patients to enable greater exploration and identification of patient needs and the provision of personalized care. Further study that considers other key stakeholders in the specialist nurse role in gynecological oncology is recommended in order to gain a full understanding of specialist nurses' contribution to the care of women with gynecological cancer. Additionally, it is recommended that further studies be conducted to seek the perspectives of women with gynecological cancer from culturally and linguistically diverse backgrounds and Indigenous populations on specialist nursing care as they appear to be under-represented in current research.
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Affiliation(s)
- Olivia Cook
- 1School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia 2The Centre for Chronic Disease Management: a Joanna Briggs Institute Centre of Excellence, Melbourne, Australia
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McCallum M, Jolicoeur L, Lefebvre M, Babchishin LK, Le T, Lebel S. Filling in the gaps: Sociodemographic and medical predictors of sexual health and other supportive care needs, and desire for help in gynecological cancer survivors. Can Oncol Nurs J 2017; 27:251-258. [PMID: 31148785 PMCID: PMC6516400 DOI: 10.5737/23688076273251258] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
PURPOSE The goal of the present study was to evaluate predictors of unmet supportive care needs and readiness for help among gynecological cancer patients. METHODS A sample of 113 gynecological cancer survivors completed a measure of needs and desire for help. Regression analyses identified sociodemographic and medical predictors of patient needs and desire for help. RESULTS Younger age and shorter time since treatment were the strongest predictors of many unmet needs. Younger age and chemotherapy predicted greater unmet sexual health needs. Shorter time since treatment predicted readiness for help with informational needs. CONCLUSIONS Post-treatment unmet needs are diverse and may be greater in younger and recently treated survivors. Chemotherapy treatment may contribute to greater sexual health needs.
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Affiliation(s)
| | | | | | | | - Tien Le
- Division of Gynecologic-Oncology, The Ottawa Hospital, Ottawa, ON
| | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, ON
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Almont T, Delannes M, Ducassou A, Corman A, Bondil P, Moyal E, Schover L, Huyghe E. Sexual Quality of Life and Needs for Sexology Care of Cancer Patients Admitted for Radiotherapy: A 3-Month Cross-Sectional Study in a Regional Comprehensive Reference Cancer Center. J Sex Med 2017; 14:566-576. [DOI: 10.1016/j.jsxm.2017.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 02/20/2017] [Accepted: 02/23/2017] [Indexed: 10/19/2022]
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Completing a Questionnaire at Home Prior to Needs Assessment in General Practice: A Qualitative Study of Cancer Patients' Experience. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2017; 9:223-30. [PMID: 26518199 DOI: 10.1007/s40271-015-0144-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Systematic assessments of cancer patients' rehabilitation needs are recommended, and questionnaires are considered to be useful tools when making such assessments. OBJECTIVE The aim of this study was to explore patients' experience of completing a questionnaire about their problems and distress at home prior to a needs assessment in general practice. METHODS Sixteen patients were recruited by their general practitioners (GPs). Semi-structured interviews were conducted in the home of the participants and at the general practice, with one interview taking place over the phone. Data were analyzed using systematic text condensation. RESULTS Twelve women and four men aged between 49 and 83 years of age, and diagnosed with various cancers between 1 month and 4 years ago, participated in the study. The results showed how the completion of a questionnaire at home provided patients with an opportunity to reflect on different problems, and the importance of these problems to the patient's everyday life, as well as an opportunity to articulate which problems they wanted to discuss with their GPs. CONCLUSIONS The results demonstrate that completing a questionnaire seems to stimulate patients' ability to reflect on their situation, clarify the importance of different problems to their everyday lives, and articulate these considerations to their GPs. Furthermore, we have shown that a questionnaire has the ability to interact with the patient and instigate a process of awareness. It is important to acknowledge this process of interaction between patient and questionnaire as an important part of understanding how and why questionnaires may support the patient when completing a questionnaire prior to a clinical encounter.
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Sexual Function and Quality of Life Among Patients With Endometrial Cancer After Surgery. Int J Gynecol Cancer 2017; 27:608-612. [DOI: 10.1097/igc.0000000000000905] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Jeppesen MM, Mogensen O, Dehn P, Jensen PT. Needs and priorities of women with endometrial and cervical cancer. J Psychosom Obstet Gynaecol 2016; 36:122-32. [PMID: 26123123 DOI: 10.3109/0167482x.2015.1059417] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Rehabilitation after cancer is important, and efficient rehabilitation requires knowledge of patient's needs. This study aimed to identify short-term rehabilitation needs of women with endometrial and cervical cancer. METHODS Ninety-six women (82.6%) were included in an exploratory questionnaire study from Odense University Hospital from September 2011 to March 2012. Needs were assessed pre-treatment and 3 months later using the three-levels-of-needs questionnaire. Furthermore, 16 women participated in focus group interviews following the treatment. The interviews were audio-recorded, transcribed verbatim and analyzed thematically. RESULTS Forty-four of the included women were diagnosed with cervical cancer (median age 45 years). Of these, 22 had FIGO-stage 1 disease (50%) and 23 received radiation therapy (52.3%). The remaining 52 women (median age 66.5 years) were diagnosed with endometrial cancer. Of these, 38 had FIGO-stage 1 disease (73.1%) and 25 were treated with laparoscopic surgery (48.1%). Emotional functioning was significantly worse prior to treatment in both the cancers (p < 0.001 cervical and p = 0.002 endometrial) and worry constituted an unmet need in 70.7% of cervical and 34.7% of endometrial cancer patients. Both the patient groups experienced significant lymphedema post-treatment [endometrial cancer (p = 0.006) and cervical cancer (p = 0.002)]. Further, urological problems were more prevalent post-treatment in endometrial cancer patients (p = 0.018), while sexual problems were of specific concern for cervical cancer patients (p = 0.029). However, in both cancer groups, the mean problem intensity scores were comparable to normative data, suggesting that the majority of patients will not require extensive rehabilitation. Qualitative analysis indicated that treatment modality and marital status severely impacted on coping, suggesting that irradiated and single women are at higher risk of developing rehabilitation needs. Additionally, women younger than 55 years more often requested help dealing with sexual and psychological complications. DISCUSSION Women with endometrial and cervical cancer experience emotional problems prior to therapy and lymphedema, and urological and sexual problems following treatment. An awareness of these problems may facilitate early identification of women with unmet needs and enable individualized follow-up adjusted for such patient's needs. Interventions aimed at improving sexual and psychological functioning should be available.
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Affiliation(s)
- Mette Moustgaard Jeppesen
- a Department of Gynecology and Obstetrics, Faculty of Health Sciences , Odense University Hospital, Clinical Institute, University of Southern Denmark , Odense , Denmark
| | - Ole Mogensen
- a Department of Gynecology and Obstetrics, Faculty of Health Sciences , Odense University Hospital, Clinical Institute, University of Southern Denmark , Odense , Denmark
| | - Pernille Dehn
- a Department of Gynecology and Obstetrics, Faculty of Health Sciences , Odense University Hospital, Clinical Institute, University of Southern Denmark , Odense , Denmark
| | - Pernille Tine Jensen
- a Department of Gynecology and Obstetrics, Faculty of Health Sciences , Odense University Hospital, Clinical Institute, University of Southern Denmark , Odense , Denmark
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Sekse RJT, Hufthammer KO, Vika ME. Sexual activity and functioning in women treated for gynaecological cancers. J Clin Nurs 2016; 26:400-410. [PMID: 27239803 DOI: 10.1111/jocn.13407] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2016] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES A description and comparison of sexual activity and function in relation to various gynaecological cancer diagnoses, treatment modalities, age groups, psychological distress and health-related quality of life. BACKGROUND Various forms of gynaecological cancer have the potential to negatively influence sexual functioning, but there are few studies that describe and compare sexual activity and functioning according to diagnosis. DESIGN A descriptive cross-sectional study. METHODS The study includes 129 women from an intervention study. The questionnaires addressed sexuality, psychological distress, health-related quality of life and demographics. Disease and treatment characteristics were extracted from medical records. RESULTS Close to two-thirds of the women were sexually active. However, 54% of the sexually active women reported that they were not satisfied or little satisfied with their sexual activity. About half of the women reported dryness in the vagina, and 41% reported pain and discomfort during penetration. There were no significant differences concerning pleasure and discomfort related to treatment modality, diagnoses or FIGO stage. CONCLUSION Health personnel should make a priority of sexuality throughout a patient's cancer treatment and in the follow-up, as sexuality is a vital part of a good life. RELEVANCE TO CLINICAL PRACTICE Since the patients experience relatively low satisfaction with their sexual activity and many report pain during penetration, health personnel need to be sensitive to the woman, her questions, and her needs. Of importance are also the personnel's ability to communicate and their expertise in diagnosing and treating difficulties relating to sexuality.
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Affiliation(s)
- Ragnhild Johanne Tveit Sekse
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Margrethe Elin Vika
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
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Huyghe É, Almont T, Burte C, Marx E, Habold D, Bondil P. Formations en onco-sexologie : existant et perspectives. PSYCHO-ONCOLOGIE 2016. [DOI: 10.1007/s11839-016-0568-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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