Psychosocial Oncology and Clinical Practice Research Group, St James's Institute of Oncology, University of Leeds, Leeds, UK.
Breast Cancer Res Treat. 2011 Dec;130(3):711-24. doi: 10.1007/s10549-011-1722-9. Epub 2011 Sep 9.
Sexual functioning is an important element of quality of life. Many women experience sexual problems as a result of a breast cancer diagnosis and its treatment. Little is known about the availability and the effectiveness of interventions for sexual problems in this patient population. Six electronic databases were searched using Medical Subject Headings and keywords. Additional hand searching of the references of relevant papers was also conducted. The searches were conducted between October 2010 and January 2011. Papers were included if they evaluated interventions for sexual problems caused as a result of breast cancer or its treatment. Studies were only included if sexual functioning was reported using a patient-reported outcome questionnaire. Studies were excluded if sexual functioning was measured but improving sexual problems was not one of the main aims of the intervention. 3514 papers were identified in the initial search. 21 papers were selected for inclusion. Studies were of mixed methodological quality; 15 randomised trials were identified, many included small sample sizes and the use of non-validated questionnaires. Three main types of interventions were identified: Exercise (2), medical (2) and psycho-educational (17). The psycho-educational interventions included skills-based training such as problem-solving and communication skills, counselling, hypnosis, education and specific sex-therapies. Interventions were delivered to individual patients, patients and their partners (couple-based) and groups of patients. The widespread methodological variability hinders the development of a coherent picture about which interventions work for whom. Tentative findings suggest the most effective interventions are couple-based psycho-educational interventions that include an element of sexual therapy. More methodologically strong research is needed before any intervention can be recommended for clinical practice. Improved screening and classification of sexual problems will ensure interventions can be more effectively targeted to suit individual patient needs.
性功能是生活质量的一个重要组成部分。许多女性在被诊断出患有乳腺癌及其治疗后会出现性功能问题。对于该患者群体的性功能问题的干预措施的有效性和可获得性知之甚少。使用医学主题词和关键词对六个电子数据库进行了搜索。还对相关论文的参考文献进行了手工搜索。搜索时间为 2010 年 10 月至 2011 年 1 月。如果评估的干预措施是针对乳腺癌或其治疗引起的性功能问题的，则将论文纳入研究。只有在使用患者报告的结果问卷报告性功能的情况下，研究才被纳入。如果性功能得到测量，但改善性功能问题不是干预的主要目标之一，则将研究排除在外。在最初的搜索中，共发现了 3514 篇论文。选择了 21 篇论文进行纳入。这些研究的方法学质量参差不齐；确定了 15 项随机试验，其中许多试验样本量较小，并且使用了未经验证的问卷。确定了三种主要类型的干预措施：运动（2）、医学（2）和心理教育（17）。心理教育干预措施包括解决问题和沟通技巧等技能培训、咨询、催眠、教育和特定的性治疗。干预措施针对单个患者、患者及其伴侣（夫妻）和患者群体提供。广泛的方法学变异性阻碍了对哪些干预措施对哪些人有效的整体认识。初步研究结果表明，最有效的干预措施是夫妻心理教育干预，其中包括性治疗的元素。需要更具方法学优势的研究，才能推荐任何干预措施用于临床实践。性功能问题的筛选和分类得到改善将确保干预措施能够更有效地针对个别患者的需求。
