Sexual Functioning and QOL in Women with Cervical Cancer

描述(由申请人提供)： 性和性行为是女性健康的核心问题。尽管这一主题很重要，但在妇科癌症患者的治疗和治疗后监测过程中，性问题往往被卫生保健提供者忽视。尽管至少从20世纪80年代初就已经证明，性功能障碍可能是宫颈癌治疗中最重要的发病率，但在明确手术和放射治疗的影响方面，或者在研究性功能障碍对宫颈癌幸存者的生活质量(QOL)的更广泛影响方面，进展甚微。几乎所有研究都排除了不会说英语的患者。 这项研究将评估宫颈癌治疗的性结局以及这些问题与生活质量的关系。我们将对144名接受宫颈癌治疗和随访监测的妇女进行前瞻性研究。研究的目的是：1.)评估局部和局部晚期宫颈癌患者在治疗过程和早期随访期间的全面性功能(性欲、性唤醒、性高潮能力、性交困难和性满意度)；评估局部和局部晚期宫颈癌患者在治疗过程和早期随访中与癌症相关的一般生活质量；随着时间的推移，特征性功能障碍与总体癌症相关生活质量之间的关系；以及目的：找出可预测宫颈癌患者的性功能改善的因素。 在基线、治疗后1个月、2个月和4个月，女性将填写标准化问卷，测量性功能和满意度、关系幸福感、与健康相关的生活质量和与癌症相关的生活质量。在每一次评估中，临床医生将使用阴道探头来评估阴道的长度和口径。通过完成问卷调查和测量阴道长度和顺应性，我们计划开发具有文化敏感性的短期干预措施，以改善宫颈癌幸存者的性功能和生活质量。我们的长期目标是在随机试验中评估此类干预措施的有效性。最终，我们希望将我们的发现整合到日常临床实践中。

DESCRIPTION (provided by applicant): Sex and sexuality are issues central to women's health. Despite the important nature of this topic, sexual concerns have often been overlooked by health care providers during the treatment and post-treatment surveillance of women with gynecologic cancer. Although it has been demonstrated at least since the early 1980s that sexual dysfunction is perhaps the most significant morbidity of treatment for cervical cancer, little progress has been made in specifying the impact of surgery vs. radiotherapy, or in studying the broader impact of sexual dysfunction on the quality of life (QOL) of cervical cancer survivors. Virtually all studies have excluded non-English speaking patients. This study will evaluate the sexual outcomes of therapy for cervical cancer and the relationship of these issues to QOL. We will prospectively study 144 women receiving treatment and follow-up surveillance for cervical cancer. The aims of the study are: 1.) To assess the entire range of sexual functioning (desire, arousal, orgasmic capacity, dyspareunia, and sexual satisfaction) over the course of treatment and early follow-up in patients with local and locally advanced cervical cancer; 2.) To assess general cancer-related QOL over the course of treatment and early follow-up in patients with local and locally advanced cervical cancer; 3.) To characterize the relationship between sexual dysfunction and overall cancer-related QOL over time; and 4.) To identify factors that may predict better sexual function outcomes in patients treated for cervical cancer. At baseline, and at 1, 2, and 4 months post-treatment, women will fill out standardized questionnaires measuring sexual function and satisfaction, relationship happiness, health-related QOL, and cancer-related QOL. At each assessment, a clinician will use a vaginal probe to assess length and caliber of the vaginal canal. Through completion of questionnaires and measurement of vaginal length and compliance, we plan to develop culturally sensitive, short-term interventions to improve sexual functioning and QOL of cervix cancer survivors. Our long-term goal is to evaluate the effectiveness of such interventions in randomized trials. Ultimately, we hope to integrate our findings into daily clinical practice.