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探讨乳腺癌患者的亲密关系和伴侣沟通问题:一项随机对照分组干预研究。

Addressing intimacy and partner communication after breast cancer: a randomized controlled group intervention.

机构信息

Office of Cancer Survivorship, National Cancer Institute, Bethesda, MD, USA.

出版信息

Breast Cancer Res Treat. 2009 Nov;118(1):99-111. doi: 10.1007/s10549-009-0398-x. Epub 2009 Apr 24.

Abstract

While quality of life for most breast cancer survivors (BCS) returns to normal by 1 year post-treatment, problems in sexual function and intimacy often persist. The present study tested the efficacy of a 6-week psycho-educational group intervention in improving BCS's sexual well-being. We conducted a mailed survey of BCS 1-5 years post-diagnosis to identify a sample of women who reported moderately severe problems in body image, sexual function or partner communication, and were deemed eligible for the randomized intervention trial. Using a pre-randomized design, 70% (n = 284) were assigned to a 6-week psycho-educational group intervention and 30% (n = 127) were assigned to a control condition (print material only); however, only 83 BCS agreed to participate in the intervention. Four months post-intervention, the intervention and control groups were not significantly different on the primary outcome of emotional functioning; however, BCS randomized to the intervention group were more likely to report improvements in relationship adjustment and communication as well as increased satisfaction with sex compared to controls. Members of the intervention group who were the least satisfied with their sexual relationship appeared to improve the most. Although modest in its effects, this intervention can be delivered in standard clinical settings. Having an identified treatment may help reduce physician reluctance to ask BCS about problems in intimacy and as appropriate, refer them for timely help.

摘要

虽然大多数乳腺癌幸存者(BCS)在治疗后 1 年内的生活质量恢复正常,但性功能和亲密关系问题仍常常持续存在。本研究旨在检验为期 6 周的心理教育团体干预对改善 BCS 性健康的疗效。我们对诊断后 1-5 年的 BCS 进行了邮寄调查,以确定一组报告中度严重的身体形象、性功能或伴侣沟通问题的女性样本,并认为她们符合随机干预试验的条件。采用预随机设计,70%(n=284)被分配到 6 周的心理教育团体干预组,30%(n=127)被分配到对照组(仅提供印刷材料);然而,只有 83 名 BCS 同意参与干预。干预 4 个月后,干预组和对照组在情绪功能的主要结局上没有显著差异;然而,与对照组相比,随机分配到干预组的 BCS 更有可能报告在关系调整和沟通方面的改善,以及对性的满意度增加。对性关系最不满意的干预组成员似乎改善得最多。尽管效果有限,但这种干预可以在标准临床环境中实施。确定有治疗方法可能有助于减少医生对 BCS 亲密问题的回避,并在适当情况下及时转介他们寻求帮助。

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