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一项针对妇科癌症治疗后女性性心理困扰的在线支持小组的随机对照试验。

A randomized controlled trial of an online support group addressing psychosexual distress among women treated for gynecologic cancer.

作者信息

Classen Catherine C, Chivers Meredith L, Brotto Lori A, Barbera Lisa, Carter Jeanne, Koval John, Robinson John W, Ferguson Sarah E

机构信息

Department of Psychiatry, Temerty School of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.

Department of Psychology, Faculty of Arts and Science, Queen's University, Kingston, Ontario, Canada.

出版信息

Gynecol Oncol. 2025 Jan;192:73-79. doi: 10.1016/j.ygyno.2024.10.032. Epub 2024 Nov 14.

Abstract

OBJECTIVE

To assess whether a 12-week, professionally facilitated, asynchronous online support group would reduce sexual distress (primary outcome) and improve sexual function, body image, depression symptoms, relationship satisfaction, and social support (secondary outcomes) in women treated for gynecologic cancer.

METHODS

Participants were 398 women recruited from three Canadian provinces and one American cancer center in cohorts of 40. Participants were randomized (50:50 odds) to either the immediate treatment condition (ITC) or the waitlist control condition (WCC). Eligibility included: completed treatment for gynecologic cancer, disease-free for at least 3 months, no more than 5 years post-diagnosis, met criteria for psychosexual distress, willing to discuss sexual concerns, 18 years or older, English speaking, and access to a computer. Participants in the ITC received a 12-week online group along with psychoeducational material each week to stimulate discussion. Two 90-min synchronous sessions were offered in weeks 4 and 8.

RESULTS

Reductions in sexual distress for ITC were not significantly different compared to WCC. Similarly, no treatment effects were observed for body image, depression, relationship satisfaction, or social support. ITC showed statistically significant improvements in sexual functioning compared to WCC, but these gains were not retained at 4-month follow-up.

CONCLUSION

Treatment effects were modest, although in the expected direction. As this study was underpowered, it offers preliminary evidence that an asynchronous, online psychoeducational support group may confer positive benefits for women's sexual functioning. The efficiency, convenience, and accessibility of online interventions has significant potential to close gaps in women's access to evidence-based sexual health care.

摘要

目的

评估一个为期12周、由专业人员推动的非同步在线支持小组是否会减轻接受妇科癌症治疗的女性的性困扰(主要结果),并改善其性功能、身体形象、抑郁症状、关系满意度和社会支持(次要结果)。

方法

从加拿大三个省份和美国一个癌症中心招募了398名女性,每组40人。参与者被随机分配(50:50概率)到即时治疗组(ITC)或等待名单对照组(WCC)。入选标准包括:完成妇科癌症治疗,至少3个月无疾病,诊断后不超过5年,符合性心理困扰标准,愿意讨论性问题,年龄在18岁或以上,说英语,且能使用电脑。ITC组的参与者每周接受一个为期12周的在线小组以及心理教育材料,以促进讨论。在第4周和第8周提供了两次90分钟的同步会议。

结果

与WCC组相比,ITC组在性困扰方面的降低没有显著差异。同样,在身体形象、抑郁、关系满意度或社会支持方面未观察到治疗效果。与WCC组相比,ITC组在性功能方面有统计学上的显著改善,但这些改善在4个月的随访中没有保持。

结论

尽管治疗效果符合预期方向,但程度有限。由于本研究的样本量不足,它提供了初步证据,表明一个非同步的在线心理教育支持小组可能对女性的性功能有积极益处。在线干预的效率、便利性和可及性有很大潜力弥合女性在获得循证性健康护理方面的差距。

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本文引用的文献

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A manifesto on the preservation of sexual function in women and girls with cancer.一份关于保护癌症女性和女孩性功能的宣言。
Am J Obstet Gynecol. 2015 Aug;213(2):166-74. doi: 10.1016/j.ajog.2015.03.039. Epub 2015 Mar 25.

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