The High Cost of Risk Reduction: Addressing Sexual Dysfunction after Oophorectomy

降低风险的高昂成本：解决卵巢切除术后的性功能障碍

• 批准号: 8228027
• 负责人: Sharon L. Bober
• 金额: $ 8.75万
• 依托单位: DANA-FARBER CANCER INST
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-01 至 2013-08-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8228027
• 关键词: Address; Adverse effects; Affect; Age; Anxiety; Arousal; Attention; BRCA1 Mutation; BRCA2 Mutation; Behavior Therapy; Behavioral; Bilateral; Cancer Center; Cancer Survivor; Child; Cognitive Therapy; Counseling; Development; Distress; Dose; Dryness; Education; Educational Intervention; Educational Materials; Elements; Estrogens; Excision; Family; Feeling; Frustration; Goals; Guidelines; Health education; High Risk Woman; Home environment; Intervention; Interview; Knowledge; Lead; Left; Libido; Life; Link; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Malignant neoplasm of ovary; Menopause; Mental Depression; Mental Health; Operative Surgical Procedures; Ovariectomy; Ovary; Pain; Patients; Penetration; Phase; Pilot Projects; Population; Premature Menopause; Premenopause; Procedures; Quality of life; Randomized Controlled Trials; Recommendation; Recording of previous events; Recruitment Activity; Reporting; Risk; Risk Reduction; Salpingo-Oophorectomy; Screening procedure; Self Efficacy; Sex Behavior; Sex Functioning; Sexual Dysfunction; Sexual Health; Sexuality; Symptoms; Telephone; Testing; Thinking; Time; Translating; Treatment Efficacy; Vagina; Woman; cancer risk; cancer therapy; child bearing; clinically significant; coping; cost; effective intervention; efficacy testing; flexibility; follow-up; group support; high risk; improved; innovation; intimate behavior; malignant breast neoplasm; multi-component intervention; mutation carrier; post intervention; programs; prophylactic; psychoeducational; psychoeducational intervention; satisfaction; young woman

DESCRIPTION (provided by applicant): Ovarian cancer is the most lethal form of gynecologic cancer. For the 750,000 US women at significantly high risk for ovarian cancer due to either BRCA1 or BRCA2 mutation or family history, the standard recommendation is to undergo prophylactic bilateral salpingo-oophorectomy (PBSO) after age 35 or after completion of childbearing. Although surgical removal of ovaries dramatically reduces risk of ovarian cancer, this potentially life-saving surgery also causes sudden, premature menopause and women are often left with severe and distressing sexual problems. Common sexual side effects include severe vaginal dryness, pain with sexual activity and loss of desire. Sexual dysfunction due to surgical menopause has been related to a sense of lowered self-efficacy and powerlessness, factors that are also linked to anxiety, depression and lower quality of life. Despite the fact that these profound sexual side effects are long lasting and decrease quality of life, sexual health interventions have not yet been developed for women after PBSO. This study will develop and test the first psychoeducational intervention for managing sexual dysfunction in women after PBSO. We hypothesize that sexual dysfunction can be improved by providing a state-of-the-art sexual health intervention that brings together cognitive-behavioral therapy (CBT) and educational innovations in treating sexual dysfunction. Components of the intervention include targeted sexual health education for managing sexual problems such as vaginal dryness, CBT strategies for recognizing and coping with automatic negative thoughts, strategies for increasing self-efficacy and developing an individualized action plan. Using a multi- modal approach that combines a group psychoeducational session with tailored telephone counseling, the intervention offers women the combination of education, group support and individualized behavioral counseling that is brief, flexible, easily accessible and easy to replicate and disseminate to other settings. The aims of this pilot study are to assess the intervention's acceptability and feasibility, and investigate the intervention's impact on sexual function, sexual health knowledge, and self-efficacy to manage sexual dysfunction at 2 months post-intervention. This intervention has the potential to make a significant and lasting impact on the lives of high-risk women who are affected every day by the distressing and disruptive sexual side effects caused by PBSO, and the study findings will lead directly to development of a full-scale randomized controlled trial to test the efficacy of the intervention. Results from this study will also have broad implications for creating effective interventions for a wide range of women who suffer from sexual side effects after cancer treatment.

描述（由申请人提供）：卵巢癌是妇科癌症中最致命的形式。对于因BRCA1或BRCA2突变或家族史而具有显著高卵巢癌风险的750，000名美国女性，标准建议是在35岁或生育结束后进行预防性双侧输卵管卵巢切除术（PBSO）。虽然手术切除卵巢大大降低了患卵巢癌的风险，但这种可能挽救生命的手术也会导致突然的过早绝经，女性往往会留下严重和令人痛苦的性问题。常见的性副作用包括严重的阴道干燥，性活动疼痛和性欲丧失。手术绝经导致的性功能障碍与自我效能感降低和无力感有关，这些因素也与焦虑，抑郁和生活质量降低有关。尽管这些深刻的性副作用是持久的，并降低生活质量，但PBSO后的妇女尚未制定性健康干预措施。这项研究将开发和测试第一个心理教育干预措施，用于管理PBSO后妇女的性功能障碍。我们假设性功能障碍可以通过提供最先进的性健康干预来改善，这种干预将认知行为疗法（CBT）和教育创新结合在一起治疗性功能障碍。干预措施的组成部分包括有针对性的性健康教育，以管理性问题，如阴道干燥，认知和应对自动消极思想的CBT策略，提高自我效能的策略和制定个性化的行动计划。采用多模式方法，将小组心理教育会议与量身定制的电话咨询相结合，干预措施为妇女提供了教育、小组支持和个性化行为咨询的组合，这种咨询简短、灵活、容易获得，易于复制和传播到其他环境。本研究的目的是评估干预措施的可接受性和可行性，并在干预后2个月调查干预措施对性功能、性健康知识和管理性功能障碍的自我效能的影响。这种干预有可能对高危妇女的生活产生重大而持久的影响，这些妇女每天都受到PBSO引起的令人痛苦和破坏性的性副作用的影响，研究结果将直接导致全面随机对照试验的发展，以测试干预的有效性。这项研究的结果也将对为癌症治疗后遭受性副作用的广泛女性创造有效的干预措施产生广泛的影响。

项目成果

Addressing sexual dysfunction after risk-reducing salpingo-oophorectomy: effects of a brief, psychosexual intervention.

• DOI: 10.1111/jsm.12713
• 发表时间: 2015-01
• 期刊: The journal of sexual medicine
• 作者: Bober SL;Recklitis CJ;Bakan J;Garber JE;Patenaude AF
• 通讯作者: Patenaude AF