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Tian Z, Xiaolu Z, Jing Y, Min W, Jiaqian L, Shouli C, Yingyin W, Xiaoyuan D, Xiaoyan L, Guorong W. A longitudinal study of sexual activity and influencing factors in breast cancer patients during treatment in the Southwest of China: a trajectory analysis model. BMC Womens Health 2024; 24:352. [PMID: 38890676 PMCID: PMC11184704 DOI: 10.1186/s12905-024-03150-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/16/2024] [Indexed: 06/20/2024] Open
Abstract
PURPOSE The aim of this study was to describe the longitudinal developmental trajectories and its influencing factors of sexual activity in patients with breast cancer during treatment. METHODS A prospective longitudinal study was conducted, including 225 newly diagnosed breast cancer patients in A tumor specialty three-class hospital in Southwest China. We measured sexual activity at the time of admission and diagnosis (T0) and one month (T1), three months (T2), six months (T3), and nine months (T4) after diagnosis. A trajectory analysis model (GBTM) was used to explore the changes in sexual activity in breast cancer patients. Multivariate binary logistic regression analysis was used to analyse the factors that affected the classification of sexual activity trajectories. RESULTS The ratio of sexual activity abruptly declined from 100% at baseline to 39.1% at T1. The percentage of sexual activity was improved, from 51.4% at T2 to 63.1% at T4. The optimal model was a 2-group trajectory of sexual activity in breast cancer patients,36.6% in the "low activity group" and 63.4% in the "high activity group." The multivariate binary logistic regression analysis revealed statistically significant and positive correlations between sexual activity and age (β = 0.085, OR = 1.089, 95%CI 1.035 ∼ 1.145, P = 0.001),libido(β = 0.774, OR = 2.168, 95%CI 1.337 ∼ 3.515, P = 0.002), vaginal lubrication(β = 1.254, OR = 33.503, 95%CI 2.000 ∼ 6.137, P<0.001). CONCLUSIONS Breast cancer patients exhibited varying levels of sexual activity during treatment; higher age was associated with increased sexual activity, which can contribute to the recovery of sexual function. Therefore, it is crucial to provide appropriate guidance on sexual health for younger patients.
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Affiliation(s)
- Zhang Tian
- Nursing Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, China
| | - Zhang Xiaolu
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yang Jing
- Ward 2, Breast Surgery Center, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, China
| | - Wen Min
- Ward 2, Breast Surgery Center, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, China
| | - Liao Jiaqian
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Chen Shouli
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Wang Yingyin
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Deng Xiaoyuan
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Liu Xiaoyan
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Wang Guorong
- Nursing Department, West China School of Public Health and West China Fourth Hospital,West China Nursing School, Sichuan University, Chengdu, Sichuan, 610041, China.
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Pehlivan MJ, Sherman KA, Wuthrich V, Gandhi E, Zagic D, Kopp E, Perica V. The effectiveness of psychological interventions for reducing poor body image in endometriosis, PCOS and other gynaecological conditions: a systematic review and meta-analysis. Health Psychol Rev 2024; 18:341-368. [PMID: 37675797 DOI: 10.1080/17437199.2023.2245020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/01/2023] [Indexed: 09/08/2023]
Abstract
Gynaecological conditions (e.g., endometriosis, PCOS) result in bodily changes that negatively impact body image. Psychological interventions (e.g., CBT, psychoeducation) have shown promise in reviews with the general population for alleviating body image concerns. This systematic review and meta-analysis aims to provide asynthesis of the impact of psychological interventions for reducing body image concerns for individuals with gynaecological conditions. Electronic databases were searched for relevant psychological intervention studies with body image outcomes. Twenty-one eligible studies were included in the systematic review (ten were included in a random-effects meta-analysis). Studies included participants (N = 1483, M = 71.85, SD = 52.79) with a range of gynaecological conditions, ages (Mage = 35.08, SD = 12.17) and cultural backgrounds. Most included studies reported at least one positive effect with the meta-analysis indicating psychological interventions were moderately superior to control conditions for reducing body image concerns (SMD -.41, 95% CI [-0.20 -0.62]). However, there was a high risk of bias and moderate heterogeneity. Results suggest psychological interventions may hold promise for reducing body image concerns among individuals gynaecological conditions in the short term. Further, preliminary support was found for the use of theory-guided psychological interventions delivered in group settings in particular, with further research needed on optimal intervention length and particular psychotherapeutic approach.
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Affiliation(s)
- Melissa J Pehlivan
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Kerry A Sherman
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Viviana Wuthrich
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Esther Gandhi
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Dino Zagic
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Emily Kopp
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Valentina Perica
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
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McCready JL, McCarty K, Deary V, Collins TL, Hackett KL. A qualitative exploration of internet forum discussions surrounding female sexual function for individuals with Sjögren's syndrome. PLoS One 2023; 18:e0291422. [PMID: 37683042 PMCID: PMC10490940 DOI: 10.1371/journal.pone.0291422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Sexual dysfunction is a common experience for women with the autoimmune rheumatic disease, Sjögren's syndrome (SS); however, the lived experience of how the disease affects sexual functioning and the sexual environment remains unexplored. This qualitative study explores the conversations pertaining to female sexual function and the sexual environment that individuals with SS have on an internet forum. Qualitative data posted on one publicly accessible, worldwide, internet forum was extracted using an automated web scraping tool. A total of 247,694 posts across 23,382 threads were scraped from the forum in July 2019 and June 2022 (from the United Kingdom). A predetermined and theoretically informed keyword search strategy was used to screen the captured data for content relevant to the study aim. The dataset was cleaned to remove duplication and identifying information and screened for topic relevance. The Computer-Assisted Qualitative Data Analysis software tool, ATLAS.ti, was used to facilitate the data analysis process. Thematic analysis was conducted on 1443 female-oriented posts, and four key themes were identified: the symptoms of SS and their impact on the sexual environment; the emotional responses that are commonly evoked in response to sexual difficulties; the strategies that users have implemented to manage sexual problems; and the impact that a partner's behavior may have on the sexual environment. Together these themes provide an insight into the nature of sexual difficulties for females with SS. Our findings provide novel insights to inform clinical discussions between practitioners and patients whilst further outlining the importance of undertaking qualitative research with this population.
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Affiliation(s)
- Jemma L. McCready
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Kristofor McCarty
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Vincent Deary
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Tracy L. Collins
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Katie L. Hackett
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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Bentsen L, Pappot H, Hjerming M, Hanghøj S. Thoughts about fertility among female adolescents and young adults with cancer: a qualitative study. Support Care Cancer 2023; 31:421. [PMID: 37357225 PMCID: PMC10290964 DOI: 10.1007/s00520-023-07887-0] [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: 09/09/2022] [Accepted: 06/13/2023] [Indexed: 06/27/2023]
Abstract
PURPOSE Nine hundred female adolescents and young adults (AYAs) aged 15-39 are diagnosed with cancer in Denmark annually. Advances in cancer therapy have led to increased long-term survival; however, a serious side effect of cancer therapy is reduced fertility. The aim of our study was to explore the thoughts about fertility among female AYAs with cancer. METHODS Our study was conducted from September 2020 to March 2021 at the Copenhagen University Hospital, Rigshospitalet. Inclusion criteria were female AYAs with cancer aged 18-39. Twelve individual, semi-structured, qualitative interviews were performed with female AYAs with cancer (20-35 years). Data were analysed using thematic analysis. RESULTS Four main themes were found: (1) the female AYAs held on to a hope of having children in the future; (2) the female AYAs experienced time pressure and waiting time as a sprint as well as a marathon; (3) the female AYAs faced existential and ethical choices about survival and family formation; and (4) the female AYAs felt a loss of control of their bodies. CONCLUSION Our study contributes with knowledge on how important holding on to the hope of children in the future is among female AYAs with cancer. Meanwhile, they are frustrated by the rushed decision on fertility preservation at diagnosis. The female AYAs also have existential and ethical concerns related to the choice of cancer therapy and fertility preservation. Finally, they suffer from altered body image, loss of femininity, and body control due to hormone therapy.
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Affiliation(s)
- Line Bentsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Helle Pappot
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Maiken Hjerming
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Signe Hanghøj
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
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Chow KM, Porter‐Steele J, Siu KY, Choi KC, Chan CWH. A nurse‐led sexual rehabilitation programme for rebuilding sexuality and intimacy after treatment for gynaecological cancer: Study protocol for a randomized controlled trial. J Adv Nurs 2022; 78:1503-1512. [DOI: 10.1111/jan.15208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/05/2022] [Accepted: 02/13/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Ka Ming Chow
- The Nethersole School of Nursing, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR
| | | | - Ka Yi Siu
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital Hospital Authority Hong Kong SAR
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR
| | - Carmen W. H. Chan
- The Nethersole School of Nursing, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR
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De Leo A, Di Simone E, Spano A, Puliani G, Petrone F. Nursing Management and Adverse Events in Thyroid Cancer Treatments with Tyrosine Kinase Inhibitors. A Narrative Review. Cancers (Basel) 2021; 13:cancers13235961. [PMID: 34885070 PMCID: PMC8656717 DOI: 10.3390/cancers13235961] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/19/2021] [Accepted: 11/24/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Tyrosine kinase inhibitors are an effective and promising therapy in the treatment of advanced differentiated medullary thyroid cancers. The prevention and management of new adverse events of these drugs are important to keep patients on their treatment course, avoiding drug discontinuation or interruption, and are associated with a faster recovery of the disease. The contribution of a multidisciplinary team of healthcare professionals optimizes the management of adverse events, maximizing the benefits and reducing the risks of treatment, consequently improving the quality of life of patients. Abstract Background: The advent of multikinase inhibitors has changed the treatment of advanced, metastatic, unresectable thyroid cancers, refractory to available treatments. These drugs cause new adverse events that should be prevented and treated for long periods, and sometimes beyond their discontinuation. The purpose of this narrative review was the description, prevention, and nursing management of the most frequent adverse events of locally advanced or metastatic differentiated thyroid cancer with sorafenib and lenvatinib, and medullary Thyroid cancer with vandetanib and cabozantinib treatment. Methods: A narrative literature review. Results: Studies included in this narrative review suggest that over 90% of patients treated with tyrosine kinase inhibitors experience at least 1 adverse event of any grade affecting their quality of life. Patients treated with tyrosine kinase inhibitors experienced at least one adverse event at any grade in ≥90% of cases, with a higher incidence in the first 6–8 weeks of treatment. The most frequent adverse events that can affect a patients’ quality of life are dermatological, gastrointestinal, cardiovascular, and metabolic. Conclusions: Early assessment of risk factors and identification of adverse events can help nurses support these patients throughout their clinical-therapeutic pathway, increasing the benefits of treatment and reducing reduction/discontinuation.
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Affiliation(s)
- Aurora De Leo
- Nursing: Technical, Rehabilitation, Assistance and Research Department-IRCCS Istituti Fisioterapici Ospitalieri and Regina Elena National Cancer Institute, 00144 Rome, Italy; (A.D.L.); (E.D.S.); (F.P.)
- Biomedicine and Prevention Department, Tor Vergata University, 00133 Rome, Italy
| | - Emanuele Di Simone
- Nursing: Technical, Rehabilitation, Assistance and Research Department-IRCCS Istituti Fisioterapici Ospitalieri and Regina Elena National Cancer Institute, 00144 Rome, Italy; (A.D.L.); (E.D.S.); (F.P.)
| | - Alessandro Spano
- Nursing: Technical, Rehabilitation, Assistance and Research Department-IRCCS Istituti Fisioterapici Ospitalieri and Regina Elena National Cancer Institute, 00144 Rome, Italy; (A.D.L.); (E.D.S.); (F.P.)
- Correspondence: ; Tel.: +39-0652-666-881
| | - Giulia Puliani
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabrizio Petrone
- Nursing: Technical, Rehabilitation, Assistance and Research Department-IRCCS Istituti Fisioterapici Ospitalieri and Regina Elena National Cancer Institute, 00144 Rome, Italy; (A.D.L.); (E.D.S.); (F.P.)
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Cancer Survivorship Issues: Dissemination and Translation of Evidence-Based Knowledge. Cancers (Basel) 2021; 13:cancers13225794. [PMID: 34830944 PMCID: PMC8616426 DOI: 10.3390/cancers13225794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 11/16/2021] [Indexed: 11/22/2022] Open
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