Department of Medical Oncology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Cancer Research Institute Ghent (CRIG), Ghent, Belgium.
Qual Life Res. 2024 May;33(5):1401-1414. doi: 10.1007/s11136-024-03603-5. Epub 2024 Feb 24.
To assess experiences of sexuality and of receiving sexual healthcare in cervical cancer (CC) survivors.
A qualitative phenomenological study using semistructured one-on-one interviews was conducted with 15 Belgian CC survivors recruited in 5 hospitals from August 2021 to February 2022. The interviews were audiotaped and transcribed verbatim. Data were analyzed using inductive thematic analysis. COREQ and SRQR reporting guidelines were applied.
Most participants experienced an altered sexuality after CC treatment with often long-term loss/lack of sex drive, little/no spontaneity, limitation of positions to avoid dyspareunia, less intense orgasms, or no sexual activity at all. In some cases, emotional intimacy became more prominent. Physical (vaginal bleeding, vaginal dryness, dyspareunia, menopausal symptoms) and psychological consequences (guilt, changed self-image) were at the root of the altered sexuality. Treatment-induced menopause reduced sex drive. In premenopausal patients, treatment and/or treatment-induced menopause resulted in the sudden elimination of family planning. Most participants highlighted the need to discuss their altered sexual experience with their partner to grow together toward a new interpretation of sexuality. To facilitate this discussion, most of the participants emphasized the need for greater partner involvement by healthcare providers (HPs). The oncology nurse or sexologist was the preferred HP with whom to discuss sexual health. The preferred timing for information about the sexual consequences of treatment was at treatment completion or during early follow-up.
Both treatment-induced physical and psychological experiences were prominent and altered sexuality. Overall, there was a need for HPs to adopt proactive patient-tailored approaches to discuss sexual health.
评估宫颈癌(CC)幸存者的性体验和性健康护理体验。
采用半结构式一对一访谈,对 2021 年 8 月至 2022 年 2 月在 5 家医院招募的 15 名比利时 CC 幸存者进行了定性现象学研究。访谈进行了录音,并逐字转录。使用归纳主题分析对数据进行分析。应用了 COREQ 和 SRQR 报告指南。
大多数参与者在 CC 治疗后经历了性体验的改变,通常表现为长期丧失/缺乏性欲、缺乏自发性、为避免性交痛而限制姿势、性高潮不那么强烈或根本没有性行为。在某些情况下,情感亲密变得更加突出。性体验改变的根源是身体(阴道出血、阴道干燥、性交痛、绝经症状)和心理(内疚、自我形象改变)后果。治疗引起的绝经降低了性欲。对于绝经前患者,治疗和/或治疗引起的绝经突然消除了计划生育。大多数参与者强调需要与伴侣讨论性体验的改变,以便共同朝着对性的新理解发展。为了促进这种讨论,大多数参与者强调需要医疗保健提供者(HPs)更多地参与伴侣。首选与肿瘤科护士或性治疗师讨论性健康问题。治疗结束时或早期随访期间是提供有关治疗性后果的信息的首选时机。
治疗引起的身体和心理体验都很突出,导致性体验改变。总体而言,医疗保健提供者需要采取主动的、针对患者的方法来讨论性健康问题。