Benedict Catherine, Shaffer Kelly M, Wirtz Megan R, Ford Jennifer S, Reese Jennifer Barsky
Stanford University School of Medicine, Palo Alto, CA, USA.
Stanford Cancer Institute, Palo Alto, CA, USA.
Curr Sex Health Rep. 2022 Dec;14(4):222-230. doi: 10.1007/s11930-022-00343-w. Epub 2022 Oct 18.
Sexual problems after cancer are common and multifaceted, particularly among women. The objective of this paper is to review recent and innovative behavioral (non-pharmacologic) interventions that aim to improve the sexual health of women affected by cancer. The review focuses on studies published within the past 5 years, focusing on interventions in three key areas for women with cancer: interventions to facilitate effective patient-provider communication about sexual health concerns, biopsychosocial interventions targeting women specifically, and interventions using a couple-based approach.
Overall, results suggest advancements in all key areas. First, efforts to facilitate effective clinical communication about sexual health concerns in cancer are growing. Findings from pilot studies were particularly encouraging for brief communication interventions in increasing clinicians' awareness and comfort in discussing sexual health with their patients. Second, studies have also begun demonstrating feasibility, acceptability, and efficacy for biopsychosocial interventions for women to improve sexual health, based on a variety of therapeutic approaches; technology-based approaches are gaining particular traction. Finally, consistent with prior reviews, recent research continues to support the use of couple-based interventions, suggesting that including partners in education and counseling about cancer-related sexual changes and solutions can have positive effects on patients, partners, and relationship functioning. Additionally, although efforts are growing to improve clinical communication and sexual health outcomes in special populations (e.g., adolescent and young adult survivors, sexual and gender minorities), greater efforts are needed.
Findings from the review suggest benefit of recent interventions aimed to address sexual concerns and improve outcomes for women affected by cancer. Limitations of studies include small sample sizes and a lack of tailoring to address individual concerns and diverse populations. Future directions should consider existing barriers to participation while leveraging the opportunities for technology and evidence-based digital health strategies to optimize or individualize content and facilitate delivery.
癌症后的性问题很常见且具有多面性,在女性中尤为如此。本文的目的是综述近期旨在改善受癌症影响女性性健康的创新性行为(非药物)干预措施。该综述聚焦于过去5年发表的研究,重点关注针对癌症女性的三个关键领域的干预措施:促进医患就性健康问题进行有效沟通的干预措施、专门针对女性的生物心理社会干预措施以及采用夫妻共同参与方式的干预措施。
总体而言,结果表明在所有关键领域都有进展。首先,促进癌症患者性健康问题有效临床沟通的努力在增加。试点研究的结果对于简短沟通干预措施在提高临床医生与患者讨论性健康问题时的意识和舒适度方面尤其令人鼓舞。其次,基于多种治疗方法的研究也开始证明生物心理社会干预措施对改善女性性健康的可行性、可接受性和有效性;基于技术的方法尤其受到关注。最后,与之前的综述一致,近期研究继续支持采用夫妻共同参与的干预措施,表明让伴侣参与有关癌症相关性变化及解决方案的教育和咨询对患者、伴侣及关系功能有积极影响。此外,尽管在改善特殊人群(如青少年和年轻成年幸存者、性少数群体和性别少数群体)的临床沟通和性健康结果方面的努力在增加,但仍需做出更大努力。
综述结果表明近期旨在解决性问题并改善受癌症影响女性结局的干预措施具有益处。研究的局限性包括样本量小以及缺乏针对个体问题和不同人群的个性化调整。未来方向应考虑参与的现有障碍,同时利用技术和循证数字健康策略的机会来优化或个性化内容并促进其实施。