Brakiterapi Alan Serviks ve Endometrium Kanserli Hastalarda Cinsel İşlevsellik ve Etkileyen Faktörler

Giriş ve Amaç: Bu araştırmanın amacı, brakiterapi alan serviks ve endometium kanserli hastalarda cinsel fonksiyonunu değerlendirmek ve cinsel fonksiyonu etkileyen faktörleri incelemektir. Gereç ve Yöntemler: Araştırma, katitatif ve kantitatif araştırma tekniğinin kullanıldığı bir çalışmadır. Bu araştırmaya bir Üniversite Uygulama ve Araştırma Hastanesi’nin Radyasyon Onkoloji Ünitesi’nde 26.10.2018-01.03.2019 tarihleri arasında serviks ve endometrium kanseri nedeniyle brakiterapi alan ve araştırma kritelerine uygun yirmi bir hasta ile yürütülmüştür. Bulgular: Katılımcıların Kadın Cinsel İşlev Ölçeği (FSFI) puan ortalaması 19.28±22.72 olup, %66,7’sinde cinsel işlev bozukluğu olduğu belirlenmiştir. Cinsel fonksiyonu etkileyen faktörler; hastalığa verilen tepki, cinsellik ve eşlerin yaklaşımı olmak üzere üç ana tema altında incelenmiştir. Hastalığa verilen tepki temasının altında üzüntü, çaresizlik, hastalığı kabullenme alt temaları; cinsellik ana temasında; cinsel isteksizlik, cinsel ilişkiyi red etme alt temaları; eşlerin yaklaşımı ana temasında ise; hoşgörü ve anal seks alt temaları belirlenmiştir. Sonuç: Brakiterapi alan servikal ve endometrium kanserli hastalar cinsel fonksiyon bozukluğu yaşamakta ve buna yönelik danışmanlık hizmeti alamamaktadır.

Sexual Function and Influencing Factors in Individuals Receiving Brachytherapy for Cervical and Endometrial Cancers

Introduction: The aim of this study was to assess sexual function in individuals receiving brachytherapy for cervical and endometrial cancer and to examine influencing factors. Materials and Methods: Qualitative and quantitative tecniques are used in this study. It was conducted at a University Research and Application Hospital Radiation Oncology Unit. Twenty-one brachytherapy patients with cervical and endometrial cancer were included in the research in accordance with inclusion and exclusion criteria during the period October 26, 2018- March 1, 2019. Results: The mean score of the participants on the Female Sexual Function Index was 19.28±22.72; 66.7% were found to be experiencing sexual dysfunction. The factors influencing sexual function were examined under the three main themes of the reaction given to the illness, sexuality, and the approach of the spouse. The subthemes of the reaction theme were sadness, hopelessness and acceptance of the illness. Subthemes of the sexuality main theme were lack of sexual desire, rejection of sex. Grouped under the main theme of the approach of the spouse were the subthemes of tolerance and anal sex. Conclusion: Patients with cervical and endometrial cance receiving brachytherapy experience sexual function problems and do not receive conseling.

PDF

___

1. Aydogdu, S.G.M, Ozsoy, U, Cervical cancer and HPV, Andrology Bullen,2018, 20, 25-29.
2.Turkey Cancer Statistics. Accessed 1 February 2019. http://www.kanser.gov.tr/Dosya/ca_istatistik/ANA_rapor_20 12sooonn.pdf.
3. Siegel, R.L, Miller, D.K, Jemal, A, Cancer Statistics. CA, A Cancer Journal For Clinicians,2017, 67(1), 7-30.
4. Public Health Agency of Turkey, Accessed 22 February 2019. http://kanser.gov.tr/dairefaaliyetleri/ kanseristatistikleri. html.
5. Irmak, P, Oskay, U, The effect of pelvic radiotherapy on sexual life and the role of nursing approach in gynecologic cancers, Turkish Andrology Association, Andrology Bulletin, 2013, 15(55), 279-283.
6.Frumovitz, M, Sun, C.C, Schover, L.R, Munsell, M.F, Jhingran, A, Wharton, J.T, Eifel, P, Bevers, T.B, Levenback, C.F, Gershenseon, D.M, Bodurka, D.C, Quality of life and sexual functioning in cervical cancer survivors, Journal of Clinical Oncology,2005, 23(30), 7428- 36.
7. Taşkın, L, Maternity and Women's Health Nursing, Sistem Ofset Printing, 2016, Ankara, Turkey.
8. Kanbur, A, Capık, C, Cervical Cancer Prevention, Early DiagnosisScreening Methods and Midwiwes/ Nurses Role, Hacettepe University Faculty of Health Sciences Nursing Journal, 2011, 61-72.
9. Rosen, R, Brown, C, Heiman, J, Leiblum, S, Meston, C, Shabsigh, R, Ferguson, D, D’agostino, R, The Female Sexual Function Index (FSFI): A Multidimensional self-report ınstrument for the assessment of female sexual function, Journal of Sex Marital Therapy, 2000, 26, 191-208.
10. Aygin, D, Eti Aslan, F, The Turkish Adaptation of female Sexual Function, Jornal of Medical Science, 2005, 25(3), 393-399.
11. Ege, E, Akın, B, Yaralı Arslan, S, Bilgili, N, Prevalence and risk factors of female sexual dysfunction among healthy women, Turkish Science-Research Foundation Science,2010, 3(1), 137-144.
12. Akkuzu, G, Ayhan, A, Sexual functions of turkish women with gynecologic cancer during the chemotherapy process, Asian Pacific Journal of Cancer Prevention, 2013, 14(6), 3561-3564.
13. Guner, O, Gumussoy, S, Celik, N, Saruhan, A, Kavlak, O, An examination of sexual functions of patients who underwent a gynecologic cancer operation and received brachyterapy, Pakistan Journal Medical Sciences, 2018, 34(1), 15-19.
14. Maiorino, MI, Chiodini, P, Bellastella, G, Guigliano, D, Esposito, K, Sexual dysfunction in women with cancer: a systematic review with meta-analysis of studies using the Female Sexual Function Index, Endocrine, 2016, 54, 329-341.
15. Damast, S, Alektiar, K, Eaton, A, Gerber, N.K, Goldfarb, S, Patil, S, Jia, R, Leitao, M, Carter, J, Basch, E, Comparative patient-centered outcomes (health state and adverse sexual symptoms) between adjuvant brachytherapy versus no adjuvant brachytherapy in early stage endometrial cancer, Annual Surgecal Oncology, 2014, 21, 2740–2754.
16. Reis, N, Beji Kızılkaya, N, Coşkun, A, Quality of Life and Sexual Functioning in Gynaecological Cancer Patients: Results From Quantitative and Qualitative Data, European Journal of Oncology Nursing 2010, 14(2), 137-146.
17. Stead, M, Fallowfield, L, Selby, P, Brown, J.M, Psychosexual function and impact of gynaecological cancer, Best Practice & Research Clinical Obstetrics and Gynecology, 2007, 21(2), 309-320.
18. Mc Callum, M, Lefebvre, M, Jolicoeur, L, Maheu, C, Lebel, S, Sexual health and gynecological cancer: conceptualizing patient needs and overcoming barriers to seeking and accessing services, Journal of Psychosomatic Obstetrics & Gynecology, 2012, 33 (3), 135-142.
19. Hautamaki, K, Miettinen, M, Kellokumpu-Lehtinen, P.L, Aalto, P, Lehto, J, Opening communication with cancer patients about sexuality-related issues. Cancer Nursing, 2007, 30 (5), 399-404.
20. Southard, N.Z, Keller, J, The importance of assessing sexuality: A patient perspective, Clinical Journal of Oncology Nursing, 2009, 13 (2), 213-7.
21. Kavradim, S.T, Ozer, Z, Hope in patients with cancer, Current Approcahes in Psychiatry, 2014, 6(2), 154-164.
22. Ozkan, M, Akın, S, Evaluation of the effect of fatigue on functional Quality of Life in Cancer Patients, Florence Nightingale Journal of Nursing, 2017, 25(3), 177-192.
23. Laumann, E.O, Paik, A, Glasser, D.B, Kang, J.H, Wang, T, Levinson, B, Moreira, E.D, Jr, Nicolosi, A, Gingell, C, A cross-national study of subjective sexual well-being among older women and men: findings from the global study of sexual attitudes and behaviors, Archives Sexual Behavior. 2006, 35(2), 145-161.
24. Tangjitgamol, S, Manusirivithaya, S, Hanprasertpong, J, Kasemsarn, P, Soonthornthum, T, Leelahakorn, S, Thawaramara, T, Lapcharoen, O, Sexual dysfunction in Thai women with early-stage cervical cancer after radical hysterectomy, International Journal of Gynecological Cancer, 2007, 17(5), 1104-12.
25. Reis, N, Coşkun, A, Beji, N.K, Quality of Life anf Effective Factors in Gynaecologic Cancers, Journal of Anatolia Nursing and Health Sciences, 2006, 9(2), 25-35.
26. Zomkowski, K, Machado Toryi, A, Sacomori, C, Dias, M.C, Fabiana Flores Sperandio, Sexual function and quality of life in gynecological cancer preand post-short-term brachytherapy: a prospective study.” Archives of Gynecology and Obstetrics. 2016, 294, 833–840.
27. Park, HS, Ratner, E.S, Lucarelli, L, Polizzi, S, Higgins, S.A, Damast, S, Predictors of vaginal stenosis after intravaginal high-dose-rate brachytherapy for endometrial carcinoma, Brachytherapy, 2015, 14, 464-470.
28. Turgut, A, Özler, A, Sak, M.E, Evsen, M.S, Ender Soydinç, H, Başaranoğlu, S, Retrospective Analysis of the patients with gynecological cancer, Journal of Clinical and Experimental Investigations, 2012, 3(2), 209-213.
29. Gershenson, D.M, Miller, A.M, Champion, V.L, Monahan, P.O, Zhao, Q, Wiliams, S.D, Gynecologic Oncology Group, Reproductive and sexual function after platinumbased chemotherapy in long-term ovarian germ cell tumor survivors, Journal of Clinical Oncology, 2007, 25(19), 2792-7.
30. Kvale, K, Bondevik, M, What is important for patient centred care? A qualitative study about the perceptions of patients with cancer, Scandinavian Journal of Caring Sciences, 2008, 22 (4), 582–589.
31. Oshima, S, Kisa, K, Terashita, T, Habara, M, Kawabata, H, Maezawa, E, A qualitative study of Japanese patients’ perspectives on posttreatment care for gynecological cancer, Asian Paific Journal of Cancer Prevention,2011, 12, 2255-61.
32. Akyuz, A, Guvenc, G, Ustunsoz, A, Kaya, T, Living with gynecologic cancer: experience of women and their partner, Journal of Nursing Scholarship,2008, 40, 241-247.
33. Mellon, S, Northouse, L, Weiss, L.A, Population-based study of quality of life cancer survivors and their family caregiver, Cancer Nursing, 2006, 29(2), 120-131.