Reese Jennifer Barsky, Lepore Stephen J, Sorice Kristen A, Zimmaro Lauren A, Hasler Jill, Handorf Elizabeth, Daly Mary B, Zaleta Alexandra K, Westbrook Kelly, Porter Laura S
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA.
Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
Cancer. 2025 Jan 1;131(1):e35685. doi: 10.1002/cncr.35685. Epub 2024 Dec 8.
Sexual concerns are common and problematic for breast cancer survivors. Partner and relationship factors often play a key role in determining survivors' sexual adjustment, making it likely that couple-based interventions that integrate survivors' partners could be especially promising for addressing survivors' sexual concerns. Yet few such interventions have been tested. The objective of this study was to evaluate the efficacy of the Intimacy Enhancement (IE) intervention, a four-session, couple-based intervention addressing breast cancer survivors' sexual concerns by telephone in a randomized controlled trial.
Female posttreatment breast cancer survivors reporting sexual concerns and their intimate partners (N = 120 couples; 240 participants) were randomized either to the IE intervention or to Living Healthy Together (LHT), an active control intervention of equivalent length. Outcomes (measured at baseline, postintervention, and at 3 and 6 months postintervention) included breast cancer survivors' sexual function (primary), partners' sexual function (secondary), and survivors' and partners' psychosocial and relationship outcomes (secondary). Mixed linear regression models examined intervention effects on outcomes at all follow-ups.
Model-based estimates of intervention effects showed greater improvements in survivors' overall sexual function, sexual satisfaction, arousal, lubrication, and orgasm at postintervention (p < .05). Effects on survivors' 3-month and 6-month sexual functioning or other secondary outcomes were minimal. Most couples completed all IE sessions (97%) and LHT (92%), and satisfaction ratings were high.
Compared with an active control intervention, the IE intervention had significant short-term benefits for survivors' sexual function. Efforts may be needed to increase the longevity of the positive effects, such as more frequent or adjunctive treatments.
性方面的问题在乳腺癌幸存者中很常见且颇具困扰。伴侣及关系因素在决定幸存者的性适应方面往往起着关键作用，这使得整合幸存者伴侣的基于夫妻的干预措施在解决幸存者性方面的问题上可能特别有前景。然而，很少有此类干预措施经过测试。本研究的目的是在一项随机对照试验中评估亲密关系增强（IE）干预措施的效果，这是一种通过电话进行的为期四节的基于夫妻的干预措施，旨在解决乳腺癌幸存者的性方面问题。
报告有性方面问题的女性乳腺癌治疗后幸存者及其亲密伴侣（N = 120对夫妻；240名参与者）被随机分配到IE干预组或共同健康生活（LHT）组，LHT是一种长度相当的积极对照干预措施。结果（在基线、干预后以及干预后3个月和6个月进行测量）包括乳腺癌幸存者的性功能（主要指标）、伴侣的性功能（次要指标）以及幸存者和伴侣的心理社会及关系结果（次要指标）。混合线性回归模型检查了所有随访时干预对结果的影响。
基于模型的干预效果估计显示，干预后幸存者的总体性功能、性满意度、性唤起、润滑和性高潮有更大改善（p <.05）。对幸存者3个月和6个月性功能或其他次要结果的影响极小。大多数夫妻完成了所有IE课程（97%）和LHT课程（92%），满意度评分很高。
与积极对照干预相比，IE干预对幸存者的性功能有显著的短期益处。可能需要努力提高积极效果的持久性，例如更频繁或辅助治疗。
