KANSER HASTALARINDA CİNSEL PROBLEMLERİN HASTA VE SAĞLIK PERSONELİ ARASINDA PAYLAŞIMI; BEKLENENLER VE KARŞILAŞILANLAR

Abstract

Amaç: Bu çalışmada kanser tanısı almış kadın hastaların tedavi sürecinde cinsel yaşamlarına yönelik yaşadıkları sorunların, bu sorunları sağlık personeli ile paylaşabilme durumlarının ve sağlık personelinden beklentilerinin belirlenmesi amaçlandı. Yöntem: Tanımlayıcı tipte yapılan çalışmanın örneklemini, Şubat 2017- Eylül 2017 tarihleri arasında, bir eğitim araştırma hastanesinin tıbbi onkoloji polikliniğine başvuran, cinsel yönden aktif ve araştırmaya katılmaya gönüllü olan toplam 120 kanser tanısı almış kadın hasta oluşturdu. Veriler araştırmacılar tarafından hazırlanan anket formu ile toplandı. Bulgular: Araştırmaya katılan hastaların yaş ortalaması 45.5±7.80 olup, %35’i meme kanseri, %43.3’ünün tanı süresi 1-2 yıl, %65.8’i 3. veya 4. evrededir. Hastaların %55’inin hastalık sonrası cinsel yaşamlarında sorun yaşadığı ve sorun yaşayanların sadece %29.2’sinin bu durumu sağlık personeliyle paylaştığı saptandı. Hastaların %58.5’inin tedavi sürecinde cinsel yaşamlarını sağlık personeliyle paylaşmak istediği belirlendi. Sonuç: Çalışmamızda kanser hastalığı ve tedavilerinin cinsel yaşamı olumsuz şekilde etkilediği belirlendi. Hastaların cinsel yaşantılarında oluşan sorunları sağlık personeli ile konuşmak istedikleri ancak yeterince ifade edemedikleri bulundu.

Keywords

• cinsellik
• kadın
• kanser
• sağlık personeli

SHARING OF SEXUAL LIFE PROBLEMS OF CANCER PATIENTS TO THE HEALTH PROFESSIONALS: WHAT WAS EXPECTED AND WHAT WAS ENCOUNTERED

Abstract

Objective: This study aims to determine the problems that female cancer patients have with their sexual life during the treatment process and to share these problems with the health professional and to determine the expectations of the patients. Method: A total of 120 female cancer patients sexually active who were voluntarily participated in the study, and who applied to the medical oncology policlinic of a training and research hospital between February- September 2017 formed the sample of this descriptive study. The data were collected with a questionnaire form prepared by the researchers. Results: Of the women, the mean age was 45.5±7.80, 35% were breast cancer, 65.8% were stage 3 or 4. It was determined that 55% of the patients had problems in their sexual lives after the cancer and only 29.2% of those having problems shared with the health personnel. It was determined that 58.5% of the patients wanted to share their sexual lives with health personnel during the treatment process. Conclusion: It was seen that cancer diseases and treatments caused problems in sexual life. We found that patients wanted to talk to the health professional about the problems that occurred in their sexual experiences but they could not express enough.

Keywords

• sexuality
• women
• cancer
• health profesional

References

1. Siegel RL, Miller KD, Jemal A. Cancer statistics 2017. Ca Cancer J Clin. 2017; 67(1):7–30.
2. Türkiye İstatistik Kurumu (TÜİK). Ölüm nedeni istatistikleri, 2018 http://www.tuik.gov.tr/PreHaberBultenleri.do?id=30626 (Erişim tarihi: 02 Mayıs 2019).
3. Orak O, Sezgin S. Kanser hastasına bakım veren aile bireylerinin bakım verme yüklerinin belirlenmesi. Psikiyatri Hemşireliği Dergisi. 2015; 6(1):33-39.
4. Terakye G. Hasta ve akrabaları ile etkileşim. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi. 2011; 4(2):78–82. https://acikerisim.deu.edu.tr/xmlui/bitstream/handle/20.500.12397/4588/78-82_terakye.pdf?sequence=1&isAllowed=y (Erişim tarihi: 23.12.2017)
5. Stabile C, Gunn A, Sonoda Y, Carter J. Emotional and sexual concerns in women undergoing pelvic surgery and associated treatment for gynecologic cancer. Transl Androl Urol. 2015; 4(2):169-185.
6. Bober SL, Varela VS. Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol. 2012; 30(30):3712-3719.
7. Jackson SE, Wardle J, Steptoe A, Fisher A. Sexuality after a cancer diagnosis: a population-based study. Cancer. 2016; 122(24):3883-3891.
8. Demirtas B, Pinar G. Determination of sexual problems of Turkish patients receiving gynecologic cancer treatment: a cross-sectional study. Asian Pacific J Cancer Prev. 2014; 15(16):6657- 6663.

9. Male DA, Fergus KD, Cullen K. Sexual identity after breast cancer: sexuality, body image, and relationship repercussions. Curr Opin Support Palliat Care. 2016; 10(1):66-74.
10. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States. JAMA. 1999; 281(6), 537.
11. Anderson B, Lutgendorf S. Quality of life in gynecologic cancer survivors. CA Cancer J Clin. 1997; 47:218-225.
12. Bond CB, Jensen PT, Groenvold, M, Johnsen AT. Prevalence and possible predictors of sexual dysfunction and self-reported needs related to the sexual life of advanced cancer patients. Acta Oncologica. 2019; 58, 769–775.
13. Acquati C, Zebrack BJ, Faul AC, Embry L, Aguilar C, Block R, Hayes-Lattin B, Freyer DR, Cole S. Sexual functioning among young adult cancer patients: a 2-year longitudinal study. Cancer. 2018; 124(2):398-405.
14. Bilge Ç, Kaydırak MM, Aslan E. Jinekolojik kanserin cinsel yaşam üzerindeki etkileri. SDÜ Sağlık Bilimleri Enstitüsü Dergisi. 2016; 7(3):31-38.
15. Aygin Eti Aslan F. Meme kanserli kadınlarda cinsel işlev bozukluklarının incelenmesi. Meme Sağlığı Dergisi. 2008; 4(2):105-114.
16. Gölbaşı Z, Evcili F. Hasta cinselliğinin değerlendirilmesi ve hemşirelik: engeller ve öneriler. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2013; 16(3):182–189.
17. Wicklander M, Strandquist J, Obol CM, et al. Feasibility of a self-help web-based intervention targeting young cancer patients with sexual problems and fertility distress. Support Care Cancer. 2017; 25(12):675-3682.
18. Flynn KE, Reese JB, Jeffery DD, et al. Patient experiences with communication about sex during and after treatment for cancer. Psychooncology. 2012; 21(6):594–601.
19. Carter J, Stabile C, Seidel B, Baser ER, Goldfarb S, Goldfrank DJ. Vaginal and sexual health treatment strategies within a female sexual medicine program for cancer patients and survivors. J Cancer Surviv. 2017; 11(2):274–283.
20. International Agency For Research on cancer (IARC). Globocan 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012. http://gco.iarc.fr/today/onlineanalysismultibars?mode=cancer&mode_population=continents&population=900&sex=2&cancer=9&type=0&statistic=0&prevalence=0&color_palette=default (Erişim Tarihi: 06 Aralık 2017).
21. T.C. Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu. Türkiye kanser istatistikleri, 2017. http://kanser.gov.tr/Dosya/ca_istatistik/2014-RAPOR._uzun.pdf (Erişim Tarihi: 06 Aralık 2017).
22. Ege E, Akın B, Yaralı Arslan S, Bilgili N. Sağlıklı kadınlarda cinsel fonksiyon bozukluğu sıklığı ve risk faktörleri. TÜBAV Bilim Dergisi. 2010; 3(1):137-44.
23. Buvat J, Glasser D, Neves RC, Duarte FG, Gingell C, Moreira ED. Global study of sexual attitudes and behaviours (GSSAB), investigators' group sexual problems and associated help-seeking behavior patterns: results of a population-based survey in France. Int J Urol. 2009; 16(7):632-638.
24. Buvat J, Glasser D, Neves RC, Duarte FG, Gingell C, Moreira ED. Global study of sexual attitudes and behaviours (GSSAB), investigators' group sexual problems and associated help-seeking behavior patterns: results of a population-based survey in France. Int J Urol. 2009; 16(7):632-638.
25. Bagherzadeh R, Zahmatkeshan N, Gharibi T, et al. Prevalence of female sexual dysfunction and related factors for under treatment in Bushehrian women of Iran. Sex Disabil. 2010; 28(1):39–4.
26. Gölbaşı Z, Tuğut N, Erenel A, Eroğlu K. Jinekoloji polikliniğine başvuran evli kadınlarda cinsel işlev bozukluğu yaygınlığı ve ilişkili bazı faktörler. Cumhuriyet Tıp Dergisi. 2014; 36(1):1-10.
27. Özerdoğan N, Sayıner FD, Köşgeroğlu N, Ünsal A. 40–65 yaş grubu kadınlarda cinsel fonksiyon bozukluğu prevalansı, depresyon ve diğer ilişkili faktörler. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi. 2009; 2(2):46-59.
28. Wilmoth MC, Hatmaker-Flanigan E, LaLoggia V, Nixon T. Ovarian cancer survivors: qualitative analysis of the symptom of sexuality. Oncol Nurs Forum. 2011; 38(6):699-708.
29. Ljungman L, Ahlgren J, Petersson LM, et al. Sexual dysfunction and reproductive concerns in young women with breast cancer: type, prevalence, and predictors of problems. Psychooncology. 2018; 27(12):2770-2777.
30. Levin AO, Carpenter KM, Fowler JM, Brothers BM, Andersen BL, Maxwell GL. Sexual morbidity associated with poorer psychological adjustment among gynecologic cancer survivors. Int J Gynecol Cancer. 2010; 20(3):461–470.
31. Webber K, Mok K, Bennett B, et al. If I am in the mood, I enjoy it: an exploration of cancer-related fatigue and sexual functioning in women with breast cancer. Oncologist. 2011; 16(9):1333-44.
32. Akkuzu G, Ayhan A. sexual functions of Turkish women with gynecologic cancer during the chemotherapy process. Asian Pac J Cancer Prev. 2013; 14(6):3561-3564.
33. Male DA, Fergus KD, Cullen K. Sexual identity after breast cancer: sexuality, body image, and relationship repercussions. Curr Opin Support Palliat Care. 2016; 10(1):66-74.
34. Boquiren VM, Esplen MJ, Wong J, Toner,B, Warner E, Malik N. Sexual functioning in breast cancer survivors experiencing body ımage disturbance. Psychooncology. 2016; 25(1):66-76.
35. Ussher JM, Perz J, Gilbert E. Information needs associated with changes to sexual well-being after breast cancer. J Adv Nurs. 2013; 69(2):327-37.
36. Lindau ST, Surawska H, Paice J, Baron SR. Communication about sexuality and intimacy in couples affected by lung cancer and their clinical-care providers. Psychooncology. 2011; 20(2):179–85.
37. Sporn NJ, Smith KB, Pirl WF, Lennes IT, Hyland KA, Park ER. Sexual health communication between cancer survivors and providers: how frequently does it occur and which providers are preferred? Psychooncology. 2015; 24(9):1167-1173.
38. Hordern AJ, Street AF. Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs. Med J Australia. 2007; 186(5):224-227.
39. Den Ouden MEM, Pelgrum-Keurhorst MN, Uitdehaag MJ, De Vocht HM. Intimacy and sexuality in women with breast cancer: professional guidance needed. Breast Cancer. 2019; 26(3):326-332.
40. Huang LL, Pu J, Liu LH, et al. Cancer department nurses’ attitudes and practices in response to the sexual issues of pelvic radiation patients: a survey in Sichuan, China”. Contemp Nurse. 2013; 43(2):146–51.
41. Mercer CH, Fenton KA, Jhonson AM, et al. Sexual function problems and help seeking behaviour in Britain: national probability sample survey. BMJ. 2003; 327(7412):426-7.
42. Oskay Ü, Beji N, Bal MD, Yılmaz SD. Evaluation of sexual function in patients with gynecologic cancer and evidence- based nursing interventions. Sex Disabil. 2011; 29(1):33-41