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对194名正在接受治疗或处于随访期的非转移性癌症患者的性满意度评估。

Sexual satisfaction assessment in 194 nonmetastatic cancer patients on treatment or in follow-up.

作者信息

Maruelli Alice, Ripamonti Carla, Bandieri Elena, Miccinesi Guido, Pessi Maria Adelaide, Buonaccorso Loredana

出版信息

Tumori. 2014 Mar-Apr;100(2):232-6. doi: 10.1177/030089161410000219.

Abstract

AIMS AND BACKGROUND

Sexuality is an important aspect of quality of life, but health care professionals still avoid discussing sexual issues with cancer patients.

METHODS AND STUDY DESIGN

We present a secondary analysis of sexuality issues according to the results of a survey on 266 patients with early-stage cancer. The aim of the survey was to ascertain the feasibility and clinical usefulness of questionnaires (Patient Dignity Inventory, PDI; Hospital Anxiety and Depression Scale, HADS; Edmonton Symptom Assesssment Scale, ESAS; FACIT-spiritual well-being scale, FACIT-SP; System of Belief Inventory, SBI-15R) investigating aspects such as dignity, hope and research of meaning in life. The present study is an ancillary analysis of the full sample, and we have focused on the results of FACIT-SP about the correlation between sexual satisfaction and clinical characteristics in 108 patients having solid tumors and 86 having hematological malignancies with no metastases who were on active cancer treatment or in follow-up in four different cancer treatment settings during the first half of 2011.

RESULTS

The median age of the 194 patients was 65 years, 112 were women, 155 were undergoing treatment and 39 were in follow-up. Eighty-three patients were above the cutoff score for HADS. Among the 171 believers, 80 were churchgoers and 91 were nonchurchgoers, whereas the nonbelievers among the patients were 23. Thirty-five percent of the patients did not respond to the sexuality item of the questionnaire. Among the responders (n = 126), 36% reported having no sexual satisfaction (score = 0). Sexual dissatisfaction was greater in older patients (47% vs 31%, not significant [NS]), women (43% vs 27%, NS), patients on treatment (38% vs 25%, NS), patients who requested psychological support (53% vs 25%, P = 0.001), patients with high levels of anxiety and depression, i.e., HADS scores >10 (44% vs 30%, NS), nonbelievers (61% vs 34% among churchgoers, 29% among believers but nonchurchgoers, P = 0.046).

CONCLUSIONS

One out of 3 patients did not respond to the item on sexuality. Among the responders, 1 out of 3 reported having no sexual satisfaction. Half of the patients receiving psychological support considered their sexual life not satisfying. Clinical interviews and specific questionnaires on sexuality should be used to investigate this particular aspect.

摘要

目的与背景

性是生活质量的一个重要方面,但医护人员仍避免与癌症患者讨论性问题。

方法与研究设计

我们根据对266例早期癌症患者的调查结果,对性问题进行了二次分析。该调查的目的是确定问卷(患者尊严量表,PDI;医院焦虑抑郁量表,HADS;埃德蒙顿症状评估量表,ESAS;FACIT精神健康量表,FACIT-SP;信仰体系量表,SBI-15R)在调查尊严、希望和生命意义探索等方面的可行性和临床实用性。本研究是对整个样本的辅助分析,我们重点关注了FACIT-SP关于108例实体瘤患者和86例无转移血液系统恶性肿瘤患者性满意度与临床特征之间相关性的结果,这些患者在2011年上半年处于四种不同癌症治疗环境中的积极治疗或随访阶段。

结果

194例患者的中位年龄为65岁,112例为女性,155例正在接受治疗,39例处于随访中。83例患者HADS得分高于临界值。在171名信徒中,80名经常去教堂,91名不常去教堂,而患者中的非信徒有23名。35%的患者未对问卷中的性项目做出回应。在做出回应的患者(n = 126)中,36%报告无性满意度(得分 = 0)。老年患者(47%对31%,无显著性差异[NS])、女性(43%对27%,NS)、正在接受治疗的患者(38%对25%,NS)、寻求心理支持的患者(53%对25%,P = 0.001)、焦虑和抑郁水平较高即HADS得分>10的患者(44%对30%,NS)、非信徒(经常去教堂者中为61%对34%,信徒但不常去教堂者中为29%,P = 0.046)的性不满情况更严重。

结论

三分之一的患者未对性项目做出回应。在做出回应的患者中,三分之一报告无性满意度。接受心理支持的患者中有一半认为他们的性生活不满意。应使用临床访谈和关于性的特定问卷来调查这一特殊方面。

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