Sexual morbidity associated with poorer psychological adjustment among gynecological cancer survivors.
Sexual morbidity associated with poorer psychological adjustment among gynecological cancer survivors.
复制标题
DOI：
10.1111/igc.0b013e3181d24ce0
复制
发表时间：
2010-04
期刊：
影响因子：
--
通讯作者：
Maxwell GL
中科院分区：
文献类型：
--
作者：
Levin AO;Carpenter KM;Fowler JM;Brothers BM;Andersen BL;Maxwell GL
性发病率是妇科癌症生存中一个令人痛苦和治疗不足的问题，已知发生在早期，并持续到身体恢复期之后。虽然经常作为一个单独的领域进行研究，但性行为是心理调整和生活质量（QoL）的一个组成部分，受到癌症治疗的不利影响。本研究测试性发病率之间的关联，不良心理调整和生活质量的结果。采用横断面设计。参与者是妇科（宫颈，子宫内膜，卵巢和外阴）癌症幸存者，他们有伴侣（N = 186），他们的癌症在2至10年前被诊断出来，并且在任何癌症治疗后至少6个月。大多数患者被发现患有早期疾病（70%），并接受了子宫切除术（77%），化疗（43%）和/或放疗（23%）。性发病率被操作为一个多维度的结构，包括性行为，性功能和主观性满意度，由患者自我报告评估。结果包括自我报告的抑郁症状，创伤应激症状，癌症特异性应激，身体变化的压力和生活质量。收集护士评定的体能状态和治疗毒性的破坏性体征/症状以及相关社会人口统计学和疾病变量作为潜在对照。分层多元回归分析测试性发病率作为预后不良的预测因子。所有统计模型均具有显著性，占心理适应/生活质量方差的12%至53%。性发病率与抑郁症状恶化，身体变化的压力，心理生活质量的负贡献以外的（老）年龄，（差）的性能状态，（更大）疲劳。值得注意的是，疾病和治疗变量的心理调整或生活质量没有统计学意义的相关性。这些研究结果表明，预防或治疗性疾病可能会促进改善心理调整/生活质量。鉴于这一人群的性发病率高，性行为和更广泛的心理调整/生活质量之间的联系，显然需要更好地将性行为康复纳入常规临床护理。
Sexual morbidity is a distressing and undertreated problem in gynecological cancer survivorship known to occur early and persist well beyond the period of physical recovery. Although often studied as a separate domain, sexuality represents an integral component of psychological adjustment and quality of life (QoL) that is adversely affected by cancer treatments. The present study tests the association between sexual morbidity, and adverse psychological adjustment and QoL outcomes. A cross-sectional design was used. The participants were gynecological (cervical, endometrial, ovarian, and vulvar) cancer survivors who were partnered (N = 186), whose cancer was diagnosed 2 to 10 years previously, and who were at least 6 months post any cancer therapy. Most had been found to have early-stage disease (70%) and were treated with hysterectomy (77%), chemotherapy (43%), and/or radiotherapy (23%). Sexual morbidity was operationalized as a multidimensional construct including sexual behavior, sexual functioning, and subjective sexual satisfaction, assessed by patient self-report. Outcomes included self-reported depressive symptoms, traumatic stress symptoms, cancer-specific stress, stress about body changes, and QoL. Nurse-rated of performance status and disruptive signs/symptoms of treatment toxicity, as well as relevant sociodemographic and disease variables were collected as potential controls. Hierarchical multiple regression analyses tested sexual morbidity as a predictor of poor outcomes. All statistical models were significant, accounting for 12% to 53% of the variance in psychological adjustment/QoL. Sexual morbidity covaried with worsened depressive symptoms, body change stress, and psychological QoL beyond the negative contributions of (older) age, (poorer) performance status, and (greater) fatigue. Notably, disease and treatment variables were not statistically significant correlates of psychological adjustment or QoL. These findings suggest that prevention or treatment of sexual morbidity might foster improved psychological adjustment/QoL. Given the high rates of sexual morbidity in this population and the connection between sexuality and broader psychological adjustment/QoL, there is a clear need for better integration of sexuality rehabilitation into routine clinical care.