Author Affiliations: Centre for Health Research, School of Medicine, University of Western Sydney (Drs Ussher, Perz, Gilbert, and Wong); and Department of Gynaecological Cancer, Westmead Hospital, Sydney (Ms Hobbs), Australia.
Cancer Nurs. 2013 Nov-Dec;36(6):454-62. doi: 10.1097/NCC.0b013e3182759e21.
Previous research on sex and intimacy in the context of cancer has focused on documenting sexual changes and difficulties, primarily focusing on heterosexual individuals who have sexual or reproductive cancers. Analyses of sexual renegotiation and the social construction of sex are largely absent from the research agenda.
The objective of this study was to explore renegotiation of sex in individuals with cancer, and in partners, across a broad range of cancer types and relational contexts.
Semistructured interviews were conducted with 44 people with cancer (23 women, 21 men) and 35 partners (18 women, 17 men), 86% of whom identified as heterosexual. The data were analyzed with theoretical thematic analysis, from a material-discursive-intrapsychic perspective.
Renegotiation of sex or intimacy was reported by 70% of participants, reflected in 3 themes: "resisting the coital imperative: redefining 'sex,'" "resisting the coital imperative: embracing intimacy," and "adopting the coital imperative: refiguring the body through techno-medicine." The importance of relational context was reflected in the theme "the inter-subjective nature of sexual re-negotiation: relationship context and communication."
Whereas previous research has focused on embodied changes associated with sexuality after cancer, or their psychological consequences, the findings of the present study suggest that hegemonic constructions of "sex," in particular the coital imperative, are central to the experience and negotiation of sex and intimacy after cancer.
Resistance of the coital imperative should be a fundamental aspect of information and support provided by health professionals who seek to reduce distress associated with sexual changes after cancer.
以前关于癌症背景下的性别和亲密关系的研究主要集中在记录性变化和困难上，主要关注患有性或生殖癌症的异性恋个体。性重新协商和性的社会构建分析在很大程度上没有列入研究议程。
本研究旨在探讨癌症患者及其伴侣在广泛的癌症类型和关系背景下的性重新协商。
对 44 名癌症患者（23 名女性，21 名男性）和 35 名伴侣（18 名女性，17 名男性）进行了半结构化访谈，其中 86%的人被认定为异性恋。数据采用理论主题分析，从物质-话语-内心的角度进行分析。
70%的参与者报告了性或亲密关系的重新协商，反映在 3 个主题中：“抵制交合的冲动：重新定义‘性’”、“抵制交合的冲动：拥抱亲密关系”和“采用交合的冲动：通过技术医学重塑身体”。关系背景的重要性反映在主题“性重新协商的主体间性：关系背景和沟通”中。
以前的研究主要集中在癌症后与性行为相关的身体变化或其心理后果上，而本研究的结果表明，“性”的霸权构建，特别是交合的冲动，是癌症后性和亲密关系体验和协商的核心。
健康专业人员在提供信息和支持时，应将抵制交合的冲动作为基本方面，以减少与癌症后性变化相关的痛苦。
