Understanding sexuality in women with gynaecological cancer
Section snippets
Background
Cancer survivors are at a high risk of developing altered sexuality (Krychman et al., 2006). Unlike other physiological side effects of cancer which diminish over time, altered sexuality can persist for many years into survivorship (Tierney, 2008). Even though controversy exists surrounding the issue of whether symptoms of cancer can cause alterations in sexuality, there is no dispute that the multimodal therapy which is used to treat cancer has a negative effect on a person’s sexuality (Katz,
Methods
In order to meet this objective a comprehensive literature search was performed in the electronic databases CINAHL, Pubmed and ISI Web of Knowledge. The search terms, limits used and results of this comprehensive search are outlined in Table 1.
The search was limited to articles published within the past 10 years to ensure only the most up to date literature was sourced. Inclusion criteria consisted of publications which were based on primary research published in peer-reviewed journals,
Sexual self concept
In Woods (1987 p. 1) framework of sexuality, sexual self concept refers to:
“the image one has of oneself as a man or a woman and the evaluation of one’s adequacy in masculine or feminine roles. Sexual self concept also includes body image, reflecting the abstract representation of one’s body and the evaluation of that image against personal and cultural standards”.
This definition can be interpreted to suggest that sexual self concept is made up of numerous dimensions, including 1) body image 2)
Sexual relationships
Sexual relationships have the potential to be significantly altered by changes in health status such as a gynaecological cancer diagnosis (Woods, 1987). Sexual relationships are defined as, “the interpersonal relationships in which one’s sexuality is shared with another.” (Woods, 1987, p. 1) Shell et al. (2008) suggest that difficulties in relationships may arise following cancer and its treatment when couples fail to communicate feelings and do not share the same need for intimacy.
Sexual function
In Woods (1987 p. 1) framework, sexual function refers to, “the ability of an individual to give and receive sexual pleasure.” Included in sexual function is a cycle of various physical and psychological stages through which a person progresses during sexual activity known as the sexual response cycle. Kaplan (1979) suggests that the sexual response cycle consists of three stages: desire, arousal/excitement, and orgasm. During the desire phase sexual thoughts and desires cause a woman to become
Implications for practice and research
Sexuality is an important part of a woman’s health and is thus a legitimate concern for healthcare professionals. Lack of knowledge leading to patient misunderstanding can play a contributory role in causing altered sexuality (Maughan et al., 2002). Therefore timely and appropriate information is essential to increase patient satisfaction and promote best sexual health outcomes (Maughan et al., 2002). This is an extremely important issue as the provision of information is recognised as a
Conclusion
In conclusion, sexuality is a multidimensional construct composed of numerous dimensions which have the potential to be negatively affected by a diagnosis of gynaecological cancer. The neo-theoretical framework of sexuality is a relevant and suitable framework for healthcare professionals to use when addressing the concept of sexuality in patients with gynaecological cancer. Healthcare professionals must endeavour to provide information to women on how cancer and its treatment have the
Conflicts of interest
None declared.
Acknowledgement
We acknowledge Professor Nancy F. Woods and Professor Joyce Fitzpatrick for their support of this study and Professor Geraldine McCarthy for her invaluable guidance. We would also like to thank Mrs Helen Donovan, Director of Nursing, and all the medical and nursing staff of the South Infirmary Victoria University Hospital, for their encouragement of research endeavours.
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