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社会心理因素和医疗因素与结直肠癌治疗后长期性功能障碍的关系。

The association between psychosocial and medical factors with long-term sexual dysfunction after treatment for colorectal cancer.

机构信息

Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

出版信息

Support Care Cancer. 2013 Mar;21(3):793-802. doi: 10.1007/s00520-012-1582-9. Epub 2012 Sep 5.

Abstract

PURPOSE

Colorectal cancer patients usually receive treatments (e.g., pelvic surgery or radiotherapy, colostomy) that increase their risk for sexual problems. Previous research has mainly focused on demographic and medical risk factors. Because little is known about the role of psychosocial variables in sexual dysfunction, this research sought to identify the contribution of demographic, medical, and psychosocial factors to sexual dysfunction using multivariate analyses.

METHODS

Male and female colorectal cancer survivors (N = 261; mean, 2.5 years post-treatment) completed paper-pencil questionnaires assessing sexual function, psychosocial variables (e.g., depression, social support, body image, and dyadic adjustment), and demographics. Medical information was obtained from patients' self-report and medical records.

RESULTS

Multiple regression analyses revealed that older age, having received destructive surgery (i.e., abdominoperineal resection), and poor social support were uniquely and significantly associated with low international index of erectile function scores in men. For women, low female sexual function index scores were significantly associated with older age and poor global quality of life. Men, but not women, with rectal cancer reported worse sexual function compared to those with colon cancer.

CONCLUSIONS

Sexual dysfunction after colorectal cancer treatment is related to demographic, medical, and psychosocial factors. These associations can help to identify patients at high risk of sexual problems in order to assist restoring sexual functioning if desired.

摘要

目的

结直肠癌患者通常接受增加性问题风险的治疗(如盆腔手术或放疗、结肠造口术)。先前的研究主要集中在人口统计学和医学危险因素上。由于人们对心理社会变量在性功能障碍中的作用知之甚少,因此本研究试图使用多元分析来确定人口统计学、医学和心理社会因素对性功能障碍的贡献。

方法

男性和女性结直肠癌幸存者(N=261;平均治疗后 2.5 年)完成了纸质问卷,评估了性功能、心理社会变量(如抑郁、社会支持、身体形象和对偶调整)和人口统计学信息。医疗信息来自患者的自我报告和病历。

结果

多元回归分析显示,年龄较大、接受破坏性手术(即腹会阴切除术)和社会支持较差与男性国际勃起功能指数评分较低有独特而显著的关联。对于女性,较低的女性性功能指数评分与年龄较大和整体生活质量较差显著相关。与结肠癌患者相比,直肠癌男性患者报告的性功能更差。

结论

结直肠癌治疗后的性功能障碍与人口统计学、医学和心理社会因素有关。这些关联可以帮助识别有性功能问题高风险的患者,如果有需要,有助于恢复性功能。

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