Center for Behavioral Oncology, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL 33101, United States.
Sex Med Rev. 2024 Mar 26;12(2):142-153. doi: 10.1093/sxmrev/qead052.
Many women with cancer struggle with sexual side effects during and after treatment. Although preliminary evidence indicates that psychosocial interventions may be efficacious in improving sexual functioning for women with cancer, no systematic review has summarized the state of the science in this area.
The primary goal of this review was to narratively synthesize the results of randomized controlled trials (RCTs) testing the efficacy of psychosocial interventions to address sexual dysfunction in women with cancer. A secondary goal was to describe the diversity of the included samples (ie, racial/ethnic and sexual minority).
Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review was conducted examining RCTs of psychosocial interventions to improve sexual functioning for women with cancer. Articles were identified using MEDLINE, Embase, PsycINFO, and Cochrane CENTRAL. Two reviewers independently assessed each article for inclusion, with a third to resolve discrepancies.
Seventeen studies were included in the review, 12 of which provided sufficient information to calculate effect sizes. Ten of the 12 studies primarily aimed to improve sexual functioning, all of which demonstrated positive effects on at least 1 outcome of sexual functioning. In the 2 RCTs of psychosocial interventions in which sexual function was a secondary aim, effects were negligible (ds = -0.04 and -0.15). Commonalities among the studies with large effect sizes were that they included education, mindfulness/acceptance, and communication/relationship skills as intervention components. Of note, there was an overall lack of sample diversity across studies, and most studies failed to report the race/ethnicity or sexual orientation of the participants.
Results support interventions targeting sexual functioning outcomes for women with cancer and suggest that multimodal interventions including education, mindfulness/acceptance, and communication/relationship skills may be most effective. Future research should also focus on examining the efficacy and potential adaptations of extant sexual functioning interventions for underrepresented groups.
许多癌症患者在治疗期间和治疗后都面临着性副作用的困扰。尽管初步证据表明,心理社会干预可能对改善癌症患者的性功能有效,但尚无系统评价总结该领域的科学现状。
本综述的主要目标是叙述性综合测试心理社会干预对改善癌症女性性功能障碍的随机对照试验(RCT)的结果。次要目标是描述纳入样本的多样性(即种族/族裔和性少数群体)。
根据 PRISMA(系统评价和荟萃分析的首选报告项目)指南,对旨在改善癌症女性性功能的心理社会干预 RCT 进行了系统评价。使用 MEDLINE、Embase、PsycINFO 和 Cochrane CENTRAL 检索文章。两名评审员独立评估每篇文章的纳入情况,如有分歧则由第三名评审员解决。
共纳入 17 项研究,其中 12 项提供了足够的信息来计算效应量。12 项研究中有 10 项主要旨在改善性功能,所有研究至少有 1 项性功能结果显示积极影响。在 2 项将性功能作为次要目标的心理社会干预 RCT 中,效果可以忽略不计(ds = -0.04 和 -0.15)。具有较大效应量的研究有一些共同之处,即它们将教育、正念/接受和沟通/关系技巧作为干预组成部分。值得注意的是,研究总体上缺乏样本多样性,大多数研究未能报告参与者的种族/族裔或性取向。
结果支持针对癌症女性性功能结果的干预措施,并表明包括教育、正念/接受和沟通/关系技巧的多模式干预可能最有效。未来的研究还应关注检查现有性功能干预措施对代表性不足群体的疗效和潜在适应性。