Rottmann Nina, Gilså Hansen Dorte, dePont Christensen René, Hagedoorn Mariët, Frisch Morten, Nicolaisen Anne, Kroman Niels, Flyger Henrik, Johansen Christoffer
a Unit of Medical Psychology, Department of Psychology , University of Southern Denmark , Odense , Denmark.
b National Research Center for Cancer Rehabilitation, Research Unit of General Practice, Department of Public Health , University of Southern Denmark , Odense , Denmark.
Acta Oncol. 2017 Feb;56(2):212-219. doi: 10.1080/0284186X.2016.1266086. Epub 2017 Jan 12.
A breast cancer (BC) diagnosis can profoundly affect the sex life of patient and partner within a couple. The purpose of the present study is to examine whether individual and partner sexual functioning, affectionate behavior, emotional closeness and depressive symptoms are associated with change over time in satisfaction with sex life of sexually active heterosexual couples dealing with BC and to explore whether the associations differ between patients and partners after adjustment for basic sociodemographic characteristics, comorbidity and BC treatment.
Women with BC and their male partners participated in a longitudinal study (Time 1, ≤4 months after surgery; Time 2, 5 months later). Participants completed items from the PROMIS Sexual Function and Satisfaction measure (version 1.0), two items measuring affectionate behavior, a single item measuring emotional closeness and the Center for Epidemiologic Studies-Depression Scale. Registers provided sociodemographic and medical information. Multilevel models were used, which take the interdependency of couples' scores into account.
A total of 287 sexually active couples were included in the analyses. Less vaginal discomfort and more vaginal lubrication were associated with increases in patients' satisfaction with sex life. Patients' and partners' satisfaction increased with higher ratings of their own orgasm ability and of partners' timing of ejaculation. Patients' reports of affectionate behavior were positively associated with their partners' satisfaction, and vice versa for partners. Patients' satisfaction increased the more emotional closeness their partner experienced. Partners' depressive symptoms were negatively associated with their satisfaction. Sociodemographic factors and BC treatment were not significantly associated with change in satisfaction.
Satisfaction with sex life in sexually active couples dealing with BC needs to be seen as a couple issue. Health professionals should take the partner into account when addressing sexuality issues. Couples' functioning and relationship-related factors may be promising targets for couple interventions.
乳腺癌（BC）诊断会对患者及其伴侣在夫妻关系中的性生活产生深远影响。本研究的目的是检验个体及伴侣的性功能、亲昵行为、情感亲密程度和抑郁症状是否与患乳腺癌的性活跃异性恋夫妻性生活满意度随时间的变化相关，并探讨在调整基本社会人口学特征、合并症和BC治疗因素后，患者与伴侣之间的关联是否存在差异。
患有BC的女性及其男性伴侣参与了一项纵向研究（时间1，术后≤4个月；时间2，5个月后）。参与者完成了患者报告结果测量信息系统（PROMIS）性功能和满意度量表（1.0版）中的项目、两项测量亲昵行为的项目、一项测量情感亲密程度的项目以及流行病学研究中心抑郁量表。登记资料提供了社会人口学和医学信息。使用了多水平模型，该模型考虑了夫妻得分的相互依赖性。
共有287对性活跃夫妻纳入分析。阴道不适减轻和阴道润滑增加与患者性生活满意度提高相关。患者和伴侣的满意度随着自身性高潮能力评分及伴侣射精时机评分的提高而增加。患者报告的亲昵行为与伴侣的满意度呈正相关，伴侣的情况反之亦然。伴侣体验到的情感亲密程度越高，患者的满意度越高。伴侣的抑郁症状与他们的满意度呈负相关。社会人口学因素和BC治疗与满意度变化无显著关联。
患BC的性活跃夫妻的性生活满意度应被视为一个夫妻共同的问题。在解决性问题时，健康专业人员应将伴侣纳入考虑。夫妻功能及与关系相关的因素可能是夫妻干预的有前景的目标。
