Comprehensive Cancer Center, University of Virginia Health System, Charlottesville, VA, USA.
Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA.
Support Care Cancer. 2022 Jun;30(6):4935-4944. doi: 10.1007/s00520-022-06917-7. Epub 2022 Feb 17.
Ensuring there are clear standards for addressing cancer-related sexual side effects is important. Currently, there are differences in two leading sets of clinical guidelines regarding the inclusion of survivors' romantic partners into clinical discussions between survivors and their providers about this issue. To help refine guidelines, we examine breast cancer survivor, partner, and oncology provider perspectives about including partners in discussions about cancer-related sexual side effects in a secondary analysis of a broader qualitative study.
Partnered female breast cancer survivors (N = 29) completed online surveys, and intimate partners of breast cancer survivors (N = 12) and breast oncology providers (N = 8) completed semi-structured interviews. Themes were derived from thematic content analysis.
Among survivors who reported a discussion with their provider, fewer than half indicated their partner had been present, despite most survivors expressing it was - or would have been - helpful to include their partner. Partners also largely indicated being included was or would have been helpful, when welcomed by the survivor. Providers similarly emphasized the importance of survivors' autonomy in deciding whether to discuss sexual concerns in the presence of a partner.
Partners were infrequently included in conversations about cancer-related sexual side effects, even though survivors, partners, and providers alike expressed value in these discussions occurring with the couple together - when that is the survivor's preference. Findings suggest future clinical guidelines should emphasize that incorporating partners into clinical discussions about sexual concerns is important for many breast cancer patients. Soliciting and enacting patients' preferences is essential for truly patient-centered care.
确保针对癌症相关的性功能障碍有明确的处理标准非常重要。目前,在两套主要的临床指南中,对于将幸存者的伴侣纳入幸存者及其提供者之间关于这一问题的临床讨论存在差异。为了帮助完善指南,我们在对一项更广泛的定性研究的二次分析中,考察了乳腺癌幸存者、伴侣和肿瘤学提供者对将伴侣纳入关于癌症相关性功能障碍的讨论的观点。
有伴侣的女性乳腺癌幸存者(N=29)完成了在线调查,乳腺癌幸存者的伴侣(N=12)和乳腺癌肿瘤学提供者(N=8)完成了半结构化访谈。主题来源于主题内容分析。
在报告与提供者进行过讨论的幸存者中,不到一半的人表示其伴侣在场,尽管大多数幸存者表示将伴侣纳入讨论是有帮助的,或者本来会有帮助。当幸存者表示欢迎时,伴侣也大多表示将伴侣纳入讨论是有帮助的。提供者同样强调了幸存者在决定是否在伴侣在场的情况下讨论性问题时的自主权的重要性。
即使幸存者、伴侣和提供者都表示希望在伴侣在场的情况下一起讨论与癌症相关的性功能障碍,但伴侣很少被纳入这些讨论中——当这是幸存者的偏好时。研究结果表明,未来的临床指南应强调将伴侣纳入关于性问题的临床讨论对于许多乳腺癌患者很重要。征求并执行患者的偏好对于真正以患者为中心的护理至关重要。