0
No votes yet
Journal Club

Ovarian Cancer Survivors: Qualitative Analysis of the Symptom of Sexuality

Margaret C. Wilmoth
Elizabeth Hatmaker-Flanigan
Vanessa LaLoggia
Traci Nixon
ONF 2011, 38(6), 699-708 DOI: 10.1188/11.ONF.699-708

Purpose/Objectives: To better understand treatment-induced changes in sexuality from the patient perspective, to learn how women manage these changes in sexuality, and to identify what information they want from nurses about this symptom.

Research Approach: Qualitative descriptive methods.

Setting: An outpatient gynecologic clinic in an urban area in the southeastern United States served as the recruitment site for patients.

Participants: Eight women, ages 33-69, receiving first-line treatment for ovarian cancer participated in individual interviews. Five women, ages 40-75, participated in a focus group and their status ranged from newly diagnosed to terminally ill from ovarian cancer.

Methodologic Approach: Both individual interviews and a focus group were conducted. Content analysis was used to identify themes that described the experience of women as they became aware of changes in their sexuality. Triangulation of approach, the researchers, and theory allowed for a rich description of the symptom experience.

Findings: Regardless of age, women reported that ovarian cancer treatment had a detrimental impact on their sexuality and that the changes made them feel "no longer whole." Mechanical changes caused by surgery coupled with hormonal changes added to the intensity and dimension of the symptom experience. Physiologic, psychological, and social factors also impacted how this symptom was experienced.

Conclusions: Regardless of age or relationship status, sexuality is altered by the diagnosis and treatment of ovarian cancer.

Interpretation: Nurses have an obligation to educate women with ovarian cancer about anticipated changes in their sexuality that may come from treatment.

References 

American Cancer Society. (2008). <i>Sexuality and cancer: For the woman who has cancer and her partner.</i> Atlanta, GA: Author.

American Cancer Society. (2011). <i>Cancer facts and figures 2011.</i> Atlanta, GA: Author.

Andersen, B.L., Woods, X.A., & Copeland, L.J. (1997). Sexual self-schema and sexual morbidity among gynecologic cancer survivors. <i>Journal of Consulting and Clinical Psychology, 65</i>, 221-229.

Bodurka, D.C., & Sun, C.C. (2006). Sexual function after gynecologic cancer. <i>Obstetrics and Gynecology Clinics of North America, 33</i>, 621-630.

Bruner, D.W., & Boyd, C.P. (1999). Assessing women's sexuality after cancer therapy: Checking assumptions with the focus group technique. <i>Cancer Nursing, 22</i>, 438-447.

Carmack Taylor, C.L., Basen-Engquist, K., Shinn, E.H., & Bodurka, D.C. (2004). Predictors of sexual functioning in ovarian cancer patients. <i>Journal of Clinical Oncology, 22</i>, 881-889.

Ferrell, B.R., Smith, S.L., Juarez, G., & Melancon, C. (2003). Meaning of illness and spirituality in ovarian cancer survivors. <i>Oncology Nursing Forum, 30</i>, 249-257. doi:10.1188/03.ONF.249-257

Hughes, M.K. (2009). Sexuality and cancer: The final frontier for nurses [Online exclusive]. <i>Oncology Nursing Forum, 36</i>, E241-E246. doi:10.1188/09.ONF.E241-E246

Krueger, R.A., & Casey, M.A. (2000). <i>Focus groups: A practical guide for applied research</i> (3rd ed.). Thousand Oaks, CA: Sage.

Lenz, E.R., Pugh, L.C., Milligan, R.A., Gift, A., & Suppe, F. (1997). The middle-range Theory of Unpleasant Symptoms: An update. <i>Advances in Nursing Science, 19</i>(3), 14-27.

Masters, W.H., & Johnson, V. (1966). <i>The human sexual response.</i> Boston, MA: Little Brown and Company.

National Cancer Institute. (n.d.). Dictionary of cancer terms. Retrieved from <a target="_blank" href='http://www.cancer.gov/dictionary?CdrID=346494'>http://www.cancer.gov/dic...

Neuendorf, K.A. (2002). <i>The content analysis guidebook.</i> Thousand Oaks, CA: Sage.

Nishimoto, P.W., & Mark, D.D. (2010). Altered sexuality patterns. In C.G. Brown (Ed.), <i>A guide to oncology symptom management</i> (pp. 423-455). Pittsburgh, PA: Oncology Nursing Society.

Patton, M.Q. (1999). <i>Qualitative evaluation and research methods</i> (2nd ed.). Thousand Oaks, CA: Sage.

Penson, R.T., Gallagher, J., Gioiella, M.E., Wallace, M., Borden, K., Duska, L.A., … Lynch, T.J. (2000). Sexuality and cancer: Conversation comfort zone. <i>Oncologist, 5</i>, 336-344. doi:10.1634/theoncologist.5-4-336.

Southard, N.Z., & Keller, J. (2009). The importance of assessing sexuality: A patient perspective. <i>Clinical Journal of Oncology Nursing, 13</i>, 213-217. doi:10.1188/09.CJON.213-217

Stead, M.L., Brown, J.M., Fallowfield, L., & Selby, P. (2003). Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues. <i>British Journal of Cancer, 88</i>, 666-671.

Stead, M.L., Fallowfield, L., Brown, J.M., & Selby, P. (2001). Communication about sexual problems and sexual concerns in ovarian cancer: Qualitative study. <i>BMJ, 323</i>, 836-837. doi:10.1136/bmj.323.7317.836

Stead, M.L., Fallowfield, L., Selby, P., & Brown, J.M. (2006). Psychosexual function and impact of gynaecological cancer. Best Practice and Research. <i>Clinical Obstetrics and Gynaecology, 21</i>, 309-320.

Stewart, D.E., Wong, F., Duff, S., Melancon, C.H., & Cheung, A.M. (2001). "What doesn't kill you makes you stronger:" An ovarian cancer survivor survey. <i>Gynecologic Oncology, 83</i>, 537-542. doi:10.1006/gyno.2001.6437

Sun, C.C., Bodurka, D.C., Weaver, C.B., Rasu, R., Wolf, J.K., Bevers, M.W., … Rubenstein, E.B. (2005). Rankings and symptom assessments of side effects from chemotherapy: Insights from experienced patients with ovarian cancer. <i>Supportive Care in Cancer, 13</i>, 219-227.

Waterhouse, J.M., & Metcalfe, M.C. (1986). Development of the sexual adjustment questionnaire. <i>Oncology Nursing Forum, 13</i>, 53-59.

Wilmoth, M.C. (2006a). Life after cancer: What does sexuality have to do with it? <i>Oncology Nursing Forum, 33</i>, 905-910. doi: 10.1188/06.ONF.905-910

Wilmoth, M.C. (2006b). Sexuality. In M.L. Lubkin (Ed.), <i>Chronic illness: Impact and interventions</i> (pp. 285-304). Sudbury, MA: Jones and Bartlett.

Wilmoth, M.C., Coleman, E.A., Wahab, H.T., & Kneisl, J. (2009). Preliminary work in validating the symptom cluster of fatigue, weight gain, psychologic distress and altered sexuality. Retrieved from <a target="_blank" href='http://snrs.org/publications/SOJNR_articles2/Vol09Num03Art13.html'>http:...

Wilmoth, M.C., Hester, C., & Laboy, S. (2007). Symptom cluster identification in ovarian cancer patients: A pilot study [Abstract S69]. <i>Psycho-Oncology, 16</i>(Suppl. 1), S69.

Wilmoth, M.C., & Spinelli, A. (2000). Sexual implications of gynecologic cancer treatments. <i>Journal of Obstetric, Gynecologic, and Neonatal Nursing, 29</i>, 413-421.

Wilmoth, M.C., & Tingle, L.R. (2001). Development of psychometric testing of the sexual behaviors questionnaire. <i>Canadian Journal of Nursing Research, 32</i>, 135-151.