Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Sexuality in patients treated for hematologic malignancies - Problems and need for support from patients’ and nurses’ perspectives
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.ORCID iD: 0000-0002-0944-5650
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis was to describe and explore how sexuality, body image and HRQoL were affected in patients treated for hematologic malignancies, and their need for support. A further aim was to describe nurses’ conceptions of dialogues about sexuality.

Methods: Ten nurses in cancer care (I) and twelve patients were interviewed (II). Data were analysed according to phenomenography (I-II). Data were also collected from patients (≥45 years) included consecutively: at baseline (n=32), one month (n=25; III-IV) and six months (n=20; IV) after treatment. Three instruments were used: SAQ-S, BIS and EORTC QLQ-C30. The data were analysed statistically.

Main findings: The nurses (I) conceived that they should talk about sexuality with cancer patients, but usually did not due to their own attitudes, lack of knowledge about sexuality, communication skills and environmental conditions. The patients (II) experienced negative effects on sexual function and sexual relationship due to affected strength and sexual desire. The patients’ sexuality, body image and HRQoL were affected during (II-III) and one month after treatment (III-IV). Patients recovered with regard to these issues within six months, except for sexual relationship (IV). However, when the disease and side effects were experienced as severe, thoughts about and interest in sexuality were overshadowed, and the need or wish for support related to this issue was low (II). Sexuality and body image seemed to influence changes in HRQoL (IV).

Conclusion: Patients above the age of 45 treated for hematologic malignancies with chemoimmunotherapy experienced problems related to sexuality, body image and HRQoL. However, as sexuality was found to be of low priority due to concerns for life when the disease and side effects were severe, support must be timely and individualized. Patient-centered care, with patients continuously meeting a nurse guided by the idea of holistic individual nursing care throughout the care trajectory, is suggested.

Abstract [en]

Sexuality is to a large extent seen as a private and sensitive topic by both patients and nurses in cancer care. The patients in this thesis were above the age of 45 and treated with chemo- or chemoimmunotherapy for hematologic malignancies. They experienced affected sexuality, body image and HRQoL during and after treatment. The importance of sexuality was low and sexuality seemed to be overshadowed when the disease and side effects were experienced as severe. Few patients described that information might have been helpful.  In order to avoid violating patients’ integrity, one challenge is to identify patients who ascribe importance to sexuality and who also want support regarding sexuality. One way is to organize care in a patient-centered way, with patients continuously meeting a nurse guided by the idea of holistic individual nursing care throughout the care trajectory. Furthermore, nurse educators’ need to acknowledge this area and the health care leaders should provide nurses opportunities to discuss attitudes and personal barriers to sensitive issues such as sexuality

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2014.
Series
Karlstad University Studies, ISSN 1403-8099 ; 2014:28
Keyword [en]
cancer patients, hematologic malignancies, nursing, nurse-patient communication, support, sexuality, body image, health related quality of life
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-31827ISBN: 978-91-7063-560-1 (print)OAI: oai:DiVA.org:kau-31827DiVA: diva2:713392
Public defence
2014-05-28, Lagerlöfsalen, Universitetsgatan 2, Karlstad, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2014-05-08 Created: 2014-04-02 Last updated: 2015-08-03Bibliographically approved
List of papers
1. Patient's sexuality: A neglected area of cancer nursing?
Open this publication in new window or tab >>Patient's sexuality: A neglected area of cancer nursing?
2012 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 16, no 4, 426-431 p.Article in journal (Refereed) Published
Abstract [en]

PurposeThe purpose of this study was to describe nurses' conceptions of dialogues about sexuality with cancer patients.

MethodsThe study was carried out using phenomenographic method. Ten nurses from different care contexts where nurses meet cancer patients in various phases of trajectory of care were interviewed.

ResultsThe analysis revealed one main category 'We should talk about sexuality – but we usually don't' and three descriptive categories consisting of nurses' qualitatively different conceptions of talks about sexuality: (1) nurses' attitudes, knowledge and skills are impacting, (2) patients' sexual problems are the basis for dialogues and (3) the ward environment is impacting. The main category was hierarchically ranged and could be further understood by the descriptive categories.

ConclusionThe study showed that cancer patients' need of talks about and support regarding sexuality were conceived as being low during the whole trajectory of care. Despite this the nurses conceived that they should talk about sexuality with the patients, but due to own attitudes, knowledge and skills, as well as conditions in the ward environment they usually did not. Further studies are needed to clarify how cancer patients especially with non-sex specific diagnosis describe their sexual problems and needs of support in regard to sexuality. About what, when, how and by whom, cancer patients and their partners want information and supportive care related to sexuality need to be clarified.

Place, publisher, year, edition, pages
Elsevier, 2012
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-12137 (URN)10.1016/j.ejon.2011.10.003 (DOI)000308770200012 ()22036773 (PubMedID)
Available from: 2012-03-12 Created: 2012-03-12 Last updated: 2017-12-07Bibliographically approved
2. Sexuality is not a priority when disease and treatment side effects are severe: conceptions of patients with malignant blood diseases
Open this publication in new window or tab >>Sexuality is not a priority when disease and treatment side effects are severe: conceptions of patients with malignant blood diseases
2013 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, 3503-3512 p.Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES:

To describe how patients with malignant blood diseases conceive the influence of chemo- or chemoimmunotherapy on sexuality, and their need of support related to this issue.

BACKGROUND:

Sexuality is often negatively affected in cancer patients with sex-specific diagnoses. For patients with malignant blood diseases, the research is limited with regard to the effect on sexuality. Knowledge about their need for support related to sexuality is also needed as nurses are found to often avoid this area of their responsibility.

Place, publisher, year, edition, pages
John Wiley & Sons, 2013
Keyword
cancer patients, malignant blood diseases, nursing, phenomenography, sexuality, support
National Category
Medical and Health Sciences
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-30520 (URN)10.1111/jocn.12333 (DOI)000326650400028 ()24003940 (PubMedID)
Available from: 2013-12-02 Created: 2013-12-02 Last updated: 2017-12-06Bibliographically approved
3. Patients Treated for Hematologic Malignancies: Affected Sexuality and Health Related Quality of Life
Open this publication in new window or tab >>Patients Treated for Hematologic Malignancies: Affected Sexuality and Health Related Quality of Life
2015 (English)In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 38, no 2, 99-110 p.Article in journal (Refereed) Published
Abstract [en]

Background: Sexuality in relation to Health- Related Quality of Life (HRQoL) is mostly studied with younger patients as participants who have undergone bone marrow transplantation and concerns fertility and/or sexual function. However, patients with hematologic malignancies such as DLBCL, CLL or AML most often are above their fifties and are treated with chemo- or chemoimmunotherapy.

Objective: The aim was to examine how sexuality and HRQoL was affected in patients with hematologic malignancies, at baseline compared to one month after chemo- or chemoimmunotherapy.

Methods:  Data were collected twice with a longitudinal design, using The Sexual Adjustment Questionnaire - S and EORTC QLQ C30.

Results:  Thirty-two patients responded. The importance of sexuality, sexual desire and sexual ability decreased one month after treatment and distressing symptoms such as feelings of tiredness occurred more frequently, compared to baseline. At the same time improvement in Global health status/QoL as well as affected functions in HRQoL was reported.

Conclusion:

The findings are of significance for nurses in cancer care as it highlights that sexuality and HRQoL needs to be considered also in older patients with hematologic malignancies when fertility issues are of less importance. 

Implication for practice:

In order to meet these patients’ needs regarding sexuality and HRQoL the care must provide greater consistency and continuity. One way is to organize the care in a patient-centered way where patients continuously meet a nurse guided by the idea of holistic individual nursing care throughout the care trajectory.

Place, publisher, year, edition, pages
Wolters Kluwer, 2015
Keyword
cancer patients, hematologic malignancies, longitudinal study, nursing, sexuality, sexual activity, sexual function, sexual interest, health related quality of life
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-31824 (URN)10.1097/NCC.0000000000000141 (DOI)000349907900010 ()25692735 (PubMedID)
Available from: 2014-04-02 Created: 2014-04-02 Last updated: 2017-12-05Bibliographically approved
4. Affected Sexuality, Body Image and Health Related Quality of Life in Patients Treated for Hematologic Malignancies: A Longitudinal Study
Open this publication in new window or tab >>Affected Sexuality, Body Image and Health Related Quality of Life in Patients Treated for Hematologic Malignancies: A Longitudinal Study
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background:  Longitudinal studies exploring sexuality, body image and health-related quality of life (HRQoL) are lacking in older patients treated with chemo- or chemoimmunotherapy for hematologic malignancies.

Objective: The aim was to describe and explore changes in sexuality, body image and HRQoL in patients treated for hematologic malignancies, from baseline until six months after treatment.

Methods: Twenty patients above 45 years treated for DLBCL, CLL or AML participated. Data were collected at baseline, one- and six months after treatment by means of three instruments: SAQ-S, BIS and EORTC QLQ-C30.

Keyword
cancer patients, chemoimmunotherapy, hematologic malignancies, longitudinal study, nursing, sexuality, sexual activity, sexual function, sexual interest, body image, health related quality of life
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-31826 (URN)
Note

Results in the abstract will be published when the manuscript have been submitted to an nursing science journal. Planned to be submitted during the spring of 2014.

Available from: 2014-04-02 Created: 2014-04-02 Last updated: 2015-10-07Bibliographically approved

Open Access in DiVA

fulltext(1725 kB)475 downloads
File information
File name FULLTEXT01.pdfFile size 1725 kBChecksum SHA-512
837a38924b868775134f38ef6f4496a4ee65933a145d5f9860102d27972a3476ed87f77f9fba8a4317cfd0adfc00acd9d885e3e3507a3dc11dfbf4af9d7130f7
Type fulltextMimetype application/pdf

Search in DiVA

By author/editor
Olsson, Cecilia
By organisation
Department of Health Sciences
Nursing

Search outside of DiVA

GoogleGoogle Scholar
Total: 475 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 920 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf