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夫妻为基础的干预对处于癌症积极治疗中的女性的性问题的益处:一项准实验研究。

The Benefit of a Couple-Based Intervention Among Women in Active Cancer Treatment on Sexual Concerns: A Quasi-Experimental Study.

机构信息

Author Affiliations: Landspitali-The National University Hospital of Iceland (Ms Jonsdottir and Dr Svavarsdottir); and School of Health Sciences, Faculty of Nursing, University of Iceland (Ms Jonsdottir and Drs Vilhjalmsson and Svavarsdottir), Reykjavik.

出版信息

Cancer Nurs. 2021;44(6):E589-E599. doi: 10.1097/NCC.0000000000000949.

Abstract

BACKGROUND

Sexuality-related problems are common in women with cancer, threatening their sexual well-being and intimate relationships. Evidence-based interventions addressing the full range of sexual concerns among women in active cancer treatment are scarce.

OBJECTIVE

The aim of this study was to evaluate the benefits of a novel couple-based intervention focusing on sexual concerns among women undergoing cancer treatment, including a subgroup of women with breast cancer. A secondary aim was to assess changes in illness intrusiveness in daily life.

METHODS

A quasi-experimental single-group pre-post follow-up design was used. The study was initially planned as a randomized controlled trial with waitlist control group receiving delayed intervention. However, substantial differences were observed in clinical and demographic variables between the treatment group and control group, resulting in using a single-group pre-post follow-up design. The intervention consists of 3 advanced nurse-led, face-to-face couple-based sessions supported by access to web-based information.

RESULTS

Women in active cancer treatment participated in the study (n = 60) together with their partners (n = 60). The main results showed significant differences between time points in the outcome measures for concerns related to the sexual adverse effects of cancer treatment (T1 vs T2, and T2 vs T3), sexual concerns related to the women's partners (T1 vs T2), and for concerns related to communication with healthcare providers about sexuality-related issues (T1 vs T2). No significant changes were found over time with respect to illness interference on the intimacy or instrumental subscales.

CONCLUSIONS

The results demonstrated that the approach of 3 couple-based therapeutic conversations is beneficial in reducing sexual concerns among women in active cancer treatment.

IMPLICATIONS FOR PRACTICE

Advanced nurse practitioners can develop and offer brief psychoeducational support that is helpful in reducing sexual concerns among women in active cancer treatment.

摘要

背景

癌症患者常存在与性相关的问题,这对其性健康和亲密关系构成威胁。目前针对癌症治疗期女性各种性问题的循证干预措施非常有限。

目的

本研究旨在评估一种新型基于夫妇的干预措施对接受癌症治疗女性(包括乳腺癌女性亚组)性问题的益处,同时评估其对日常生活中疾病侵扰的影响。

方法

采用准实验性单组前后测随访设计。本研究最初计划采用随机对照试验,设置等待对照,接受延迟干预。但治疗组和对照组的临床和人口统计学变量存在显著差异,因此改为采用单组前后测随访设计。干预措施包括 3 次由高级护师主导的、面对面的基于夫妇的访谈,同时提供网络信息支持。

结果

接受积极治疗的癌症女性(n=60)及其伴侣(n=60)参与了本研究。主要结果显示,在与癌症治疗相关的性不良反应、女性伴侣相关的性问题、以及与性健康问题相关的与医护人员沟通问题的测量指标中,治疗后随访时间点与治疗前相比均存在显著差异(T1 与 T2,T2 与 T3)。然而,在亲密关系或工具性方面,未观察到疾病干扰随时间的变化。

结论

结果表明,3 次基于夫妇的治疗性谈话方法有助于减少接受积极治疗的癌症女性的性问题。

实践意义

高级护师可以开发和提供有益的简短心理教育支持,帮助减轻癌症治疗女性的性问题。

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