Attitudes and Behavior of Patients with Gynecologic Malignancy Towards Sexual Issues: a Single-institutional Survey

Abstract

To better understand patients' perspectives and preferences for sexual issues and to provide information to guide medical staff in delivering sexual health care, an anonymous, cross-sectional survey of inpatient gynecologic cancer patients was conducted from April 2017 to March 2018. The questionnaire consisted of three parts: basic information, a history of sexuality discussion, and eight preference questions. A total of 1192 patients were included, and the median age was 43 years. More than half of the patients had a junior high school education or less and low income. Of the patients, 46.2% agreed that, "Doctors should deal with patients' sexual issues," and 56.2% agreed that, "Doctors should raise the topic of sexual issues." While 69.1% of the patients were willing to raise the topic themselves if any sexual problem existed, 35.9% of the patients agreed, "It's not the right time to discuss sex due to my severe disease." Less than 30% of the patients thought that "There's no need to intervene because sex is private" and "I do not feel comfortable discussing sex." A total of 41.1% of the patients were interested in undertaking basic sexual health consultation. Multiple logistic regression analysis demonstrated the following predictive factors for a history of consultation: young age; good education; and agreement with the statements, "Doctors should raise the topic of sexual issues," "If any sexual problem exists, I will raise the topic," and "I have an interest in participating in sex-counseling activities." Patients were willing to discuss sexual issues and were interested in sexual health training. It is important to increase the medical staff awareness of the need to inquire about and address patients' sexual issues.

What factors shape quality of life for women affected by gynaecological cancer in South, South East and East Asian countries? A critical review

“…Studies in China, Thailand, Japan, Indonesia and Hong Kong emphasised the provision of information to support women [ 32 , 33 , 35 , 36 , 41 , 44 , 50 , 51 , 53 , 54 , 56 ]. Psychoeducational and sexual health promotion interventions helped address women’s desire to expand their knowledge to cope with adverse impacts of cancer and treatment [ 33 , 41 ].…”

“…In 31 articles, women reported that having gynaecological cancer, and its treatment, altered sexual function and dampened sexual desire and response [ 21 , 32 – 39 , 41 – 43 , 45 , 47 , 50 , 51 , 56 , 58 , 65 , 68 , 69 , 71 , 73 – 81 ]. This included loss of sexual pleasure, satisfaction and desire, including ability to achieve orgasm [ 21 , 32 , 34 , 37 , 38 , 42 , 43 , 47 , 73 – 77 ]; vulval and vaginal changes, such as lack of lubrication and elasticity, and atrophy [ 32 , 34 , 35 , 47 , 51 , 73 , 74 , 77 ]; and difficult or painful intercourse [ 21 , 32 , 34 , 35 , 37 , 39 , 47 , 69 , 74 , 77 ].…”

“…Two studies in Hong Kong and China reported that women did not necessarily seek health care regarding their sexual function because they felt uncomfortable discussing their sex life with health care providers [ 37 ], feared judgement, or were embarrassed [ 78 ]. However, a study of inpatients in a Chinese hospital found that most were willing to discuss sexual issues and were interested in sexual health education [ 50 ]. More than half agreed that ‘doctors should raise the topic of sexual issues’; more than two-thirds were willing to raise the topic themselves if any sexual problem existed [ 50 ].…”

“…However, a study of inpatients in a Chinese hospital found that most were willing to discuss sexual issues and were interested in sexual health education [ 50 ]. More than half agreed that ‘doctors should raise the topic of sexual issues’; more than two-thirds were willing to raise the topic themselves if any sexual problem existed [ 50 ].…”

Concept Analysis of Sexual Health in Patients with Gynecological Cancer

“…The initial assessment is a door for health workers to find out how the patient feels about discussing their sexuality and sexual health (Cathcart-Rake et al, 2020) comfortably. Patients need more information about sexual health before therapy and counseling to deal with sexual health problems (Chen et al, 2021). Barriers to dealing with patients' sexual problems that have been identified include discomfort and feelings of shame or lack of confidence in dealing with sexual problems, so treatment professionals often fail to effectively inform and educate patients about sexual changes during and after treatment (Gerchow et al, 2021a).…”