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克服乳腺癌幸存者的生殖和心理问题:一项随机对照试验。

Overcoming Reproductive and Psychological Concerns of Breast Cancer Survivors: A Randomized Controlled Trial.

作者信息

Barjasteh Samira, Farnam Farnaz, Elsous Aymen, Nedjat Saharnaz, Razavi Dizaji Saeid, Khakbazan Zohreh

机构信息

School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

2 Faculty of Medical Sciences, Israa University - Gaza, Gaza strip, Palestine.

出版信息

J Family Reprod Health. 2022 Mar;16(1):52-60. doi: 10.18502/jfrh.v16i1.8594.

Abstract

After developing breast cancer, women experience changes in their sexuality, femininity, and fertility. These changes lead to poor mental health and increased psychological stress. Therefore, this study aimed to investigate the effects of Good Enough Sex (GES)-based, couple-centered group counseling on reproductive and sexual concerns of breast cancer survivors. This was a quantitative randomized controlled clinical trial (RCT) conducted at Omid Hospital, West Azerbaijan, Urmia, Iran from March 2018 to October 2020. After completing the informed consent forms, 100 women were assigned to the intervention and control groups (50 individuals per group) using a randomized block design. The intervention included four 90-120-minute sexual counseling sessions with 2 and 3 month follow-ups. The data were collected using the socio-demographic and clinical characteristics, the Persian version of Depression, Anxiety and Stress Scale (DASS-21), Reproductive Concerns after Cancer (RCAC) scale, and Female Sexual Function Index adaptation for Breast Cancer patients (FSFI-BC). Data were collected, from control and intervention groups, at three intervals; before, besides two months and three months post intervention, then were analyzed in SPSS 20 using descriptive and repeated measures analysis of variance (ANOVA) test. Significant reduction in the mean score of DASS-21, RCAC and improvement of FSFI-BC is reported between the intervention and control groups in favor of intervention group (P<0.001). However, no significant differences are observed within intervention group over two- and three-months post intervention (P > 0.05). The designed Good Enough Sex (GES)-based, couple-centered group counseling effectively reduced reproductive and sexual concerns of females' breast cancer survivors. Therefore, these training and counseling programs can be organized by relevant service centers to promote the reproductive health of women with breast cancer.

摘要

患乳腺癌后,女性在性、女性特质和生育能力方面会发生变化。这些变化会导致心理健康状况不佳以及心理压力增加。因此,本研究旨在调查基于“足够好的性”(GES)的、以夫妻为中心的团体咨询对乳腺癌幸存者生殖和性方面问题的影响。这是一项于2018年3月至2020年10月在伊朗乌尔米耶西阿塞拜疆省奥米德医院进行的定量随机对照临床试验(RCT)。在完成知情同意书后,采用随机区组设计将100名女性分配到干预组和对照组(每组50人)。干预措施包括四次90 - 120分钟的性咨询课程,并在2个月和3个月后进行随访。使用社会人口统计学和临床特征、波斯语版的抑郁、焦虑和压力量表(DASS - 21)、癌症后的生殖问题(RCAC)量表以及乳腺癌患者的女性性功能指数改编版(FSFI - BC)收集数据。在三个时间点从对照组和干预组收集数据,分别是干预前、干预后两个月和三个月,然后在SPSS 20中使用描述性和重复测量方差分析(ANOVA)进行分析。干预组和对照组之间,DASS - 21和RCAC的平均得分显著降低,FSFI - BC有所改善,支持干预组(P < 0.001)。然而,干预组在干预后两个月和三个月内未观察到显著差异(P > 0.05)。基于“足够好的性”(GES)设计的、以夫妻为中心的团体咨询有效降低了女性乳腺癌幸存者的生殖和性方面问题。因此,相关服务中心可以组织这些培训和咨询项目,以促进乳腺癌女性的生殖健康。

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