前列腺癌后男同性恋者的性角色和生活质量的变化：性健康提供者面临的挑战。
Changes in sexual roles and quality of life for gay men after prostate cancer: challenges for sexual health providers.
机构信息
Department of Psychology, Ryerson University, Toronto, ON, Canada.
出版信息
J Sex Med. 2014 Sep;11(9):2308-17. doi: 10.1111/jsm.12598. Epub 2014 May 30.
INTRODUCTION
Gay men with prostate cancer (GMPCa) may have differential health-related quality of life (HRQOL) and sexual health outcomes than heterosexual men with prostate cancer (PCa), but existing information is based on clinical experience and small studies.
AIMS
Our goals were to: (i) describe HRQOL and examine changes in sexual functioning and bother; (ii) explore the psychosocial aspects of sexual health after PCa; and (iii) examine whether there were significant differences on HRQOL and sexual behavior between GMPCa and published norms.
METHODS
A convenience sample of GMPCa completed validated disease-specific and general measures of HRQOL, ejaculatory function and bother, fear of cancer recurrence, and satisfaction with prostate cancer care. Measures of self-efficacy for PCa management, illness intrusiveness, and disclosure of sexual orientation were also completed. Where possible, scores were compared against published norms.
MAIN OUTCOME MEASURES
Main outcome measures were self-reported sexual functioning and bother on the Expanded Prostate Cancer Index.
RESULTS
Compared with norms, GMPCa reported significantly worse functioning and more severe bother scores on urinary, bowel, hormonal symptom scales (Ps < 0.015-0.0001), worse mental health functioning (P < 0.0001), greater fear of cancer recurrence (P < 0.0001), and were more dissatisfied with their PCa medical care. However, GMPCa reported better sexual functioning scores (P < 0.002) compared with norms. Many of the observed differences met criteria for clinical significance. Physical functioning HRQOL and sexual bother scores were similar to that of published samples. GMPCa tended to be more "out" about their sexual orientation than other samples of gay men.
CONCLUSIONS
GMPCa reported substantial changes in sexual functioning after PCa treatment. They also reported significantly worse disease-specific and general HRQOL, fear of recurrence, and were less satisfied with their medical care than other published PCa samples. Sexual health providers must have an awareness of the unique functional and HRQOL differences between gay and heterosexual men with PCa.
简介
患有前列腺癌的男同性恋者（GMPCa）的健康相关生活质量（HRQOL）和性健康结果可能与患有前列腺癌的异性恋男性（PCa）不同，但现有信息基于临床经验和小型研究。
目的
我们的目标是：（i）描述 HRQOL，并检查性行为功能和困扰的变化；（ii）探讨前列腺癌后的性健康的心理社会方面；（iii）检查 GMPCa 与已发表的规范在 HRQOL 和性行为方面是否存在显著差异。
方法
一个方便的 GMPCa 样本完成了经过验证的疾病特异性和一般 HRQOL、射精功能和困扰、对癌症复发的恐惧以及对前列腺癌护理的满意度的测量。还完成了针对前列腺癌管理自我效能、疾病侵扰和性取向披露的测量。在可能的情况下，将分数与已发表的规范进行比较。
主要结果测量
主要结果测量是使用扩展前列腺癌指数报告的自我报告的性行为功能和困扰。
结果
与规范相比，GMPCa 在尿、肠、激素症状量表上报告的功能明显更差，困扰程度更严重（P<0.015-0.0001），心理健康功能更差（P<0.0001），对癌症复发的恐惧更大（P<0.0001），对前列腺癌医疗保健的满意度更低。然而，GMPCa 报告的性行为功能评分（P<0.002）优于规范。许多观察到的差异符合临床意义的标准。身体功能 HRQOL 和性困扰评分与已发表的样本相似。GMPCa 往往比其他男同性恋样本更“公开”自己的性取向。
结论
GMPCa 在前列腺癌治疗后报告了性行为功能的重大变化。他们还报告说，他们的疾病特异性和一般 HRQOL、对复发的恐惧以及对医疗保健的满意度明显低于其他已发表的前列腺癌样本。性健康提供者必须意识到男同性恋和异性恋前列腺癌患者之间功能和 HRQOL 的独特差异。
Zotero 插件