The Life Quality and Sexual Function of Women Underwent Radical Hysterectomy

Systematic Review of the Literature on Multiple Co-occurring Symptoms in Patients Receiving Treatment for Gynecologic Cancers

OBJECTIVE

Patients with gynecologic cancers experience a very high symptom burden that has a negative impact on their quality of life. This systematic review aims to identify the common co-occurring symptoms, the prevalence of common symptoms, common instruments used to measure symptoms, associated risk factors, and the symptom burden in patients with gynecologic cancers.

DATA SOURCES

A search of four databases (ie, PubMed, Embase, Web of Science, and CINAHL) was done from January 1, 2012, through September 5, 2022. A qualitative synthesis of the extant literature was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA 2020).

CONCLUSION

A total of 118 studies met the prespecified inclusion criteria. Ninety-six symptoms were assessed across these studies. The top six symptoms and their grand mean prevalence rates were lack of energy (64.4%), fatigue (62.1%), abdominal pain (53.3%), depression (52.6%), concentration dysfunction (52.0%), and drowsiness (51.9%). Numerous methodologic challenges were evident across studies. Future research needs to develop a disease-specific symptom assessment measure, evaluate for risk factors associated with a higher symptom burden, and determine the impact of multiple symptoms on patient outcomes.

IMPLICATION FOR NURSING PRACTICE

The results are relevant for oncology clinicians to assess patients with gynecologic cancers for the presence of common symptoms and risk factors for higher symptom burden in the patients and to offer effective management interventions.

Screening for Breast, Cervical and Prostate Cancers in Kazakhstan: Key Factors and Psychological Aspects

OBJECTIVE

Screening is the main method for early detection and reduction of cancer mortality in all countries, including Central Asia and Kazakhstan. However, there is no official data on the awareness of the population about cancer screening in Kazakhstan. In addition, there were no studies on the psycho-emotional state of the patients during the screening procedure conducted yet. The purpose of the study was to assess the potential factors of awareness and psycho-emotional state during screening for breast (BC), cervical (CC), and prostate cancers (PC) in Kazakhstan (using the example of Almaty city).

METHODS

This cross-sectional study was conducted in the period from 01/01/2017 to 05/31/2017. The study was carried out at six polyclinics in Almaty (Kazakhstan). 1 625 volunteers took part in the study. The special questionnaires were employed to assess awareness of the screening procedure and subjective feelings during screening. The survey was conducted on patients who were screened for BC (n=674  or 41.5%), CC (n=565  or 34.8%) and PC (n=386 or 23.8%). Demographic data (age, education, marital status, preferred language of communication, etc.) were collected from participants using in-depth interviews. The internal consistency of the questionnaires was analysed by determining the reliability index (Cronbach's alpha).

RESULTS

The mean age of screening participants was 54.6 ± 3.3 years (BC), 49.2 ± 7.3 years (CC), and 56.6 ± 5.1 years (PC) (p = 0.001). Participants in BC and CC screening had a general knowledge of the procedure (45.1 % and 59.8 % of cases, respectively). Men had no information about PC screening (76.4 % of cases, p = 0.001). On the other hand, women had no sufficient knowledge about mammography (46.4 %) and Papanicolaou (Pap)  test (51.2% of cases). In 40.1 % (BC) and 41.1 % (CC) of cases, the fact of having the test was an unpleasant circumstance. However, in 59.6 % (PC) of cases, men did not have any discomfort associated with undertaking the test (p = 0.001). PC screening participants experienced no discomfort in 58.3 % of cases. At the same time, participants in BC and CC screenings experienced discomfort in 38.1 % and 42.5 % of cases, respectively (p = 0.001). Analysis of internal consistency on the questionnaire on awareness of the screening procedure showed the value of Cronbach's Alpha 0.693. The scores of subjective feelings during screening were 0.702.

CONCLUSIONS

The study's results revealed the reliability and applicability of the questionnaires on awareness of the screening procedure and assessment of subjective feelings. Knowledge of general information about the screening program differed depending on the type of screening. Participants in BC and CC screening were more likely to be aware of the screening program than participants in PC screening. An unpleasant circumstance associated with screening test is most often considered the very fact of having the test, especially for participants in BC and CC screening. The results of this study highlight the importance of providing an information campaign to raise awareness about screening tests. In addition, the results indicate the need to provide patients with full information about the screening process, and possible risks and benefits.

The social and economic impacts of cervical cancer on women and children in low- and middle-income countries: A systematic review

BACKGROUND

There is limited knowledge on the social and economic impacts of a diagnosis of cervical cancer on women and children in low- and middle-income countries (LMICs).

OBJECTIVES

To determine the social and economic impacts associated with cervical cancer among women and children living in LMICs.

SEARCH STRATEGY

The MEDLINE, PsychInfo, CINAHL, Pais International, and CAB Global Health databases were systematically searched to retrieve studies up to June 2021.

SELECTION CRITERIA

Studies were included if they reported on either the social or economic impacts of women or children in a LMIC.

DATA COLLECTION AND ANALYSIS

Data was independently extracted by two co-authors. The authors performed a quality assessment on all included articles.

MAIN RESULTS

In all, 53 studies were included in the final review. Social impacts identified included social support, education, and independence. Economic impacts included employment and financial security. No study reported the economic impact on children. Studies that utilized quantitative methods typically reported more positive results than those that utilized qualitative methods.

CONCLUSIONS

Additional mixed-methods research is needed to further understand the social support needs of women with cervical cancer. Furthermore, research is needed on the impact of a mother's diagnosis of cervical cancer on her children.

Assessment of long-term sexual function of cervical cancer survivors after treatment: A cross-sectional study

OBJECTIVES

This study aimed to investigate the long-term sexual function of patients with cervical cancer who underwent treatment and to explore influential factors.

METHODS

This retrospective cross-sectional study was conducted at Peking University First Hospital in (Beijing, China). A total of 207 patients, who were diagnosed with Stage IA-IIA cervical cancer and had undergone surgical treatment (some patients had also been treated with adjuvant radiotherapy and chemotherapy) between January 2010 and August 2020, completed questionnaires via telephone. The median time since diagnosis was 54 (range, 13-138) months. Sexual function was assessed using the validated short form of Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). The multivariate logistic regression analysis was performed to determine factors influencing sexual function after treatment.

RESULTS

The mean preoperative PISQ-12 score was 39.42 ± 3.922, and the mean postoperative PISQ-12 score was 32.60 ± 6.592, indicating a significant decrease in postoperative PISQ-12 score compared with preoperation (p < 0.001). In total, 49.8% of the patients had sexual dysfunction after treatment. According to the results of the multivariate logistic regression analysis, longer follow-up (months), ovariectomy, lack of hormone replacement therapy after ovariectomy and adjuvant radiotherapy were significantly associated with sexual dysfunction after treatment (p < 0.05). There was no significant correlation among surgical method, tumor stage, adjuvant chemotherapy, and sexual dysfunction after treatment.

CONCLUSIONS

The sexual function of cervical cancer survivors significantly decreased after treatment, which was related to the length of follow-up, ovariectomy, and adjuvant radiotherapy. Hormone replacement therapy after ovariectomy can help patients to improve their sexual function.