Benoot Charlotte, Saelaert Marlies, Hannes Karin, Bilsen Johan
Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
Centre for Sociological Research, Catholic University of Leuven, Parkstraat 45, 3000, Louvain, Belgium.
Arch Sex Behav. 2017 Oct;46(7):2059-2083. doi: 10.1007/s10508-016-0868-2. Epub 2016 Dec 30.
When confronted with cancer, a prominent challenge for patients and their partners is their changed sexual relationship. An empirically based theoretical model of the sexual adaptation process during cancer might be helpful in guiding the development of adequate interventions for couples who struggle with their sexual relationship. Therefore, the purpose of this study was to synthesize evidence from primary qualitative research studies and to arrive at a detailed description of the process of sexual adjustment during cancer. We conducted a qualitative evidence synthesis of a purposeful sample of 16 qualitative papers, using the meta-ethnography approach to synthesis. We found that the subsequent studies used different theoretical approaches to describe the sexual adaptation process. This led to three divergent sexual adaptation processes: (1) the pathway of grief and mourning, depicting sexual changes as a loss; (2) the pathway of restructuring, depicting the adjustment process toward sexual changes as a cognitive process with a strong focus on the social and cultural forces that shape the values and experiences of sexuality; and (3) the pathway of sexual rehabilitation, depicting sexual changes as a bodily dysfunction that needs treatment and specific behavioral strategies. All three pathways have their own opportunities and challenges. A greater awareness of these different pathways could help healthcare providers to better understand the ways a particular couple might cope with changed sexuality, offering them opportunities to discover alternative pathways for sexual adjustment.
面对癌症时，患者及其伴侣面临的一个突出挑战是他们的性关系发生了变化。一个基于实证的癌症期间性适应过程的理论模型，可能有助于指导为在性关系方面存在困扰的夫妻制定适当的干预措施。因此，本研究的目的是综合来自原始定性研究的证据，并详细描述癌症期间的性调整过程。我们使用元民族志综合方法，对16篇定性论文的有目的样本进行了定性证据综合。我们发现，后续研究使用了不同的理论方法来描述性适应过程。这导致了三种不同的性适应过程：（1）悲伤与哀悼途径，将性变化描述为一种丧失；（2）重构途径，将对性变化的调整过程描述为一个认知过程，强烈关注塑造性价值观和经历的社会和文化力量；（3）性康复途径，将性变化描述为一种需要治疗和特定行为策略的身体功能障碍。所有这三种途径都有各自的机遇和挑战。对这些不同途径有更深入的了解，有助于医疗保健提供者更好地理解特定夫妻应对性变化的方式，为他们提供发现性调整替代途径的机会。
