Beck Andrea M, Robinson John W, Carlson Linda E
Tom Baker Cancer Centre - Holy Cross Site, 2202 2nd Ave. SW, Calgary, AB, T2S 3C1, Canada,
Arch Sex Behav. 2013 Nov;42(8):1637-47. doi: 10.1007/s10508-013-0168-z. Epub 2013 Sep 18.
Sexual dysfunction is the most significant long lasting effect of prostate cancer (PrCa) treatment. Despite the many medical treatments for erectile dysfunction, many couples report that they are dissatisfied with their sexual relationship and eventually cease sexual relations altogether. We sought to understand what distinguishes successful couples from those who are not successful in adjusting to changes in sexual function subsequent to PrCa treatment. Ten couples who maintained satisfying sexual intimacy after PrCa treatment and seven couples that did not were interviewed conjointly and individually. Interviews were transcribed and analyzed using grounded theory methodology. The theory that resulted suggests that individuals are motivated to engage in sex primarily because of physical pleasure and relational intimacy. The couples who valued sex primarily for relational intimacy were more likely to successfully adjust to changes in sexual function than those who primarily valued sex for physical pleasure. The attributes of acceptance, flexibility, and persistence helped sustain couples through the process of adjustment. Based on these findings, a new theory, the Physical Pleasure-Relational Intimacy Model of Sexual Motivation (PRISM) is presented. The results elucidate the main motives for engaging in sexual activity-physical pleasure and/or relational intimacy-as a determining factor in the successful maintenance of satisfying sexual intimacy after PrCa treatment. The PRISM model predicts that couples who place a greater value on sex for relational intimacy will better adjust to the sexual challenges after PrCa treatment than couples who place a lower value on sex for relational intimacy. Implications of the model for counselling are discussed. This model remains to be tested in future research.
性功能障碍是前列腺癌（PrCa）治疗最显著的长期影响。尽管针对勃起功能障碍有多种医学治疗方法，但许多夫妻表示他们对性生活不满意，最终完全停止了性行为。我们试图了解成功适应PrCa治疗后性功能变化的夫妻与未成功适应的夫妻之间的区别。对10对PrCa治疗后仍保持满意性亲密关系的夫妻和7对未保持满意性亲密关系的夫妻进行了联合访谈和单独访谈。访谈内容被转录，并使用扎根理论方法进行分析。由此产生的理论表明，个体进行性行为的主要动机是身体愉悦和关系亲密。主要因关系亲密而重视性的夫妻比主要因身体愉悦而重视性的夫妻更有可能成功适应性功能的变化。接纳、灵活性和坚持性等特质有助于夫妻在调整过程中维持关系。基于这些发现，提出了一种新理论——性动机的身体愉悦-关系亲密模型（PRISM）。研究结果阐明了进行性活动的主要动机——身体愉悦和/或关系亲密——是PrCa治疗后成功维持满意性亲密关系的决定性因素。PRISM模型预测，相比那些不太重视因关系亲密而产生的性的夫妻，更重视因关系亲密而产生的性的夫妻在PrCa治疗后能更好地应对性方面的挑战。文中讨论了该模型对咨询的意义。此模型有待在未来研究中进行验证。
