Ussher Jane M, Perz Janette, Kellett Andrew, Chambers Suzanne, Latini David, Davis Ian D, Rose Duncan, Dowsett Gary W, Williams Scott
Centre for Health Research, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
Centre for Health Research, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
J Sex Med. 2016 Mar;13(3):425-34. doi: 10.1016/j.jsxm.2015.12.026. Epub 2016 Feb 4.
Decrements in health-related quality of life (HRQOL) and sexual difficulties are a recognized consequence of prostate cancer (PCa) treatment. However little is known about the experience of gay and bisexual (GB) men.
HRQOL and psychosexual predictors of HRQOL were examined in GB and heterosexual men with PCa to inform targeted health information and support.
One hundred twenty-four GB and 225 heterosexual men with PCa completed a range of validated psychosexual instruments.
Functional Assessment of Cancer Therapy-Prostate (FACT-P) was used to measure HRQOL, with validated psychosexual measures, and demographic and treatment variables used as predictors.
GB men were significantly younger (64.25 years) than heterosexual men (71.54 years), less likely to be in an ongoing relationship, and more likely to have casual sexual partners. Compared with age-matched population norms, participants in both groups reported significantly lower sexual functioning and HRQOL, increased psychological distress, disruptions to dyadic sexual communication, and lower masculine self-esteem, sexual confidence, and sexual intimacy. In comparison with heterosexual men, GB men reported significantly lower HRQOL (P = .046), masculine self-esteem (P < .001), and satisfaction with treatment (P = .013); higher psychological distress (P = .005), cancer related distress (P < .001) and ejaculatory concern (P < .001); and higher sexual functioning (P < .001) and sexual confidence (P = .001). In regression analysis, psychological distress, cancer-related distress, masculine self-esteem, and satisfaction with treatment were predictors of HRQOL for GB men (R2Adj = .804); psychological distress and sexual confidence were predictors for heterosexual men (R2Adj = .690).
These findings confirm differences between GB and heterosexual men in the impact of PCa on HRQOL across a range of domains, suggesting there is a need for GB targeted PCa information and support, to address the concerns of this "hidden population" in PCa care.
健康相关生活质量（HRQOL）下降和性功能障碍是前列腺癌（PCa）治疗公认的后果。然而，对于男同性恋和双性恋（GB）男性的经历却知之甚少。
研究GB和异性恋PCa男性的HRQOL及HRQOL的心理性预测因素，为有针对性的健康信息和支持提供依据。
124名GB和225名异性恋PCa男性完成了一系列经过验证的心理性量表。
使用癌症治疗功能评估-前列腺（FACT-P）来测量HRQOL，同时采用经过验证的心理性测量方法，并将人口统计学和治疗变量用作预测因素。
GB男性（64.25岁）比异性恋男性（71.54岁）明显年轻，处于恋爱关系中的可能性较小，有临时性伴侣的可能性较大。与年龄匹配的人群标准相比，两组参与者均报告性功能和HRQOL显著降低、心理困扰增加、二元性交流中断，以及男性自尊、性自信和性亲密程度降低。与异性恋男性相比，GB男性报告HRQOL显著更低（P = 0.046）、男性自尊显著更低（P < 0.001）、对治疗的满意度显著更低（P = 0.013）；心理困扰更高（P = 0.005）、癌症相关困扰更高（P < 0.001）和射精相关担忧更高（P < 0.001）；性功能更高（P < 0.001）和性自信更高（P = 0.001）。在回归分析中，心理困扰、癌症相关困扰、男性自尊和对治疗的满意度是GB男性HRQOL的预测因素（调整后R2 = 0.804）；心理困扰和性自信是异性恋男性的预测因素（调整后R2 = 0.690）。
这些发现证实了GB男性和异性恋男性在PCa对一系列领域的HRQOL影响方面存在差异，表明需要针对GB男性提供PCa信息和支持，以解决PCa护理中这一“隐藏人群”的担忧。
