Donovan Kristine A, Taliaferro Lindsay A, Alvarez Evelyn M, Jacobsen Paul B, Roetzheim Richard G, Wenham Robert M
Health Outcomes and Behavior Program, Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA.
Gynecol Oncol. 2007 Feb;104(2):428-34. doi: 10.1016/j.ygyno.2006.08.009. Epub 2006 Sep 26.
A large proportion of women with a history of cervical cancer experience sexual problems as a result of treatment. The present study examined whether differences in sexual health between cervical cancer survivors and women with no history of cervical cancer could be explained by selected demographic, clinical, and psychosocial and physical factors.
Women treated between 1 and 5 years previously for stage 0 to II cervical cancer and age- and education-matched women with no history of cancer undergoing routine cervical cancer screening were recruited to participate. All participants had a partner with whom they had ever been sexually active. Women completed measures of sexual health, vaginal changes, partner relationship quality, perceived physical appearance, and sexual self-concept.
Cervical cancer survivors reported significantly (p<.05) less sexual interest, more sexual dysfunction, and lower sexual satisfaction. The most consistent predictors of sexual health after treatment among survivors were time since diagnosis, receipt of radiotherapy, partner relations, and perceived physical appearance, as well as vaginal changes. These variables accounted for about 50% of the variance in sexual health outcomes.
The findings suggest that efforts to improve sexual health in women with a history of cervical cancer must move beyond the direct effects of cancer treatment on vaginal anatomy and physiology. Sexual rehabilitation interventions should consider partner relationships, perceived physical appearance, and women's attitudes toward themselves as sexual beings, in addition to vaginal changes. Future research should use prospective longitudinal research designs incorporating appropriate comparison groups to further explore this issue.
很大一部分有宫颈癌病史的女性因治疗而出现性问题。本研究探讨了宫颈癌幸存者与无宫颈癌病史女性在性健康方面的差异是否可以通过选定的人口统计学、临床、心理社会和身体因素来解释。
招募1至5年前接受0至II期宫颈癌治疗的女性以及年龄和教育程度匹配、无癌症病史且正在接受常规宫颈癌筛查的女性参与研究。所有参与者都有过性活跃的伴侣。女性完成了性健康、阴道变化、伴侣关系质量、自我感知外貌和性自我概念的测量。
宫颈癌幸存者报告的性兴趣明显较少(p<.05),性功能障碍较多,性满意度较低。幸存者治疗后性健康最一致的预测因素是诊断后的时间、放疗情况、伴侣关系、自我感知外貌以及阴道变化。这些变量约占性健康结果方差的50%。
研究结果表明,改善有宫颈癌病史女性性健康的努力必须超越癌症治疗对阴道解剖和生理的直接影响。性康复干预除了考虑阴道变化外,还应考虑伴侣关系、自我感知外貌以及女性对自己作为性存在的态度。未来的研究应采用前瞻性纵向研究设计并纳入适当的对照组,以进一步探讨这个问题。