Document Type : Middle East Special Report
Authors
1 Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
2 School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Department of Health Care Sciences, Palliative Research Center, Ersta Sköndal Bräcke University College, Campus Ersta, Stockholm, Sweden
5 Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6 Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: Cancer diagnosis and treatments cause sexual dysfunction in patients. Sexual function is one of the most important aspects of quality of life. However, in previous studies, qualitative methods have been less accentuated to explore in to the sexual experiences and feelings of cancer patients. The aim of the present study was to investigate the experiences of Iranian women affected with cancer about their sexual quality of life.
Method: A qualitative descriptive study with a conventional content analysis approach was performed on a targeted sample of 28 Iranian women with cancer from October 2018 to February 2020. Data were collected through face to face and in depth semi structured interviews until data saturation was attained.
Results: Data analysis revealed four themes and 11 categories. The emerged themes were entitled: “Changing sexual capacity”, “physical consequences”, “sexual self-sacrifice” and “Changing woman’s identity”.
Conclusion: Women with cancer experience many sexual problems such as reduced orgasm, lack of pleasure, and pain during sex. Due to the taboo of sexual issues, especially for women, many of them are embarrassed to ask their questions to the medical staff and for this reason, their problems will remain unresolved. The support of their spouses and the social can play an important role in facilitating coping. Health care providers have an important role in assessing and improving patients’ quality of life. It is recommended to adopt strategies for appropriate interventions, education and counseling to improve sexual quality of life in cancer patients.
Keywords
How to cite this article:
Hosseini SE, Ilkhani M, Rohani C, Nikbakht Nasrabadi A. Sexual experience of Iranian women with cancer: a qualitative content analysis. Middle East J Cancer. 2022;13(4):708-16. doi: 10.30476/mejc.2021.90027.1561.
2. Agboola SO, Ju W, Elfiky A, Kvedar JC, Jethwani K. The effect of technology-based interventions on pain, depression, and quality of life in patients with cancer: a systematic review of randomized controlled trials. J Med Internet Res. 2015;17(3):e65. doi: 10.2196/ jmir.4009.
3. Abad M, Gangy R, Sharifian E, Nikdel R, Jafarzadeh M, Jafarzadeh F. Epidemiologic distribution of cancer in a 10-yearstudy: Retrospective review of hospital records and pathology centers of North Khorasan Province from 2003 to 2012. [In Persian] Journal of North Khorasan University of Medical Sciences (JNKUMS). 2015;6(4):689-96.
4. VanHoose L, Black LL, Doty K, Sabata D, Twumasi-Ankrah P, Taylor S, et al. An analysis of the distress thermometer problem list and distress in patients with cancer. Support Care Cancer. 2015;23(5):1225-32. doi: 10.1007/s00520-014-2471-1.
5. Giuliani M, Cosmi V, Pierleoni L, Recine A, Pieroni M, Ticino A, et al. Quality of life and sexual satisfaction in women suffering from endometriosis: An Italian preliminary study. Sexologies. 2016;25(1):e12-e19.
6. Anderson J, Blue R, Paladino A, Graff C, Eggly S, Martin M, et al. 008 A qualitative exploration of sexual quality of life, medication adherence, and patient-provider sexual communication among black breast cancer survivors with sexual trauma histories. The Journal of Sexual Medicine. 2020;17(7):S4. doi:10.1016/j.jsxm.2020.04.244.
7. Telli S, Gürkan A. Examination of sexual quality of life and dyadic adjustment among women with mastectomy. Eur J Breast Health. 2019;16(1):48-54. doi: 10.5152/ejbh.2019.4969.
8. Maasoumi R, Zarei F, Merghati-Khoei E, Lawson T, Emami-Razavi SH. Development of a sexual needs rehabilitation framework in women post-spinal cord injury: A study from Iran. Arch Phys Med Rehabil. 2018;99(3):548-54. doi: 10.1016/j.apmr.2017.08.477.
9. World Health Organization. Defining sexual health: Report of a technical consultation on sexual health 28-31 January 2002, Geneva: World Health Organization; 2006. Available from: https://www.who.int/reproductivehealth/publications/sexual_health/defining_sh/en/
10.Moghasemi S, Ozgoli G, Ahmadi F, Simbar M. Sexual experience of Iranian women in their middle life: A qualitative approach. Int J Community Based Nurs Midwifery. 2018;6(1):47-55.
11. Simon W, Gagnon, John H. Sexual conduct: The social sources of human sexuality. 2nd ed. British multinational publisher: Routledge; 2017. p.378.
12. World Health Organization. Defining sexual health: report of a technical consultation on sexual health, 28-31 January 2002, Geneva: World Health Organization; 2006. Available from: https://www.who. int/reproductivehealth/publications/sexual_health/defining_sh/en/
13. Zamanzadeh V, Rassouli M, Abbaszadeh A, Hamid Alavi-Majd, Ali-Reza Nikanfar, Farnaz Mirza-Ahmadi, et al. Spirituality in cancer care: a qualitative study. Journal of Qualitative Research in Health Sciences (JQR). 2020; 2(4):366-78.
14.Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12. doi: 10.1016/j.nedt. 2003.10.001.
15.Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-88. doi: 10.1177/1049732305276687.
16. Kyngäs H. The application of content analysis in nursing science research. In: Kyngäs H, Mikkonen K, Kääriäinen M, editors. 1st ed. Springer International Publishing: Cham; 2019.p. 115.
17. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-57. doi: 10.1093/intqhc/mzm042.
18. Lindgren BM, Lundman B, Graneheim UH. Abstraction and interpretation during the qualitative content analysis process. Int J Nurs Stud. 2020;108:103632. doi: 10.1016/j.ijnurstu.2020.103632.
19. Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. Qualitative content analysis: A focus on trustworthiness. SAGE Open. 2014;4(1): 2158244014522633. doi:10.1177/2158244014522633.
20. Guba EG, Lincoln YS. Competing paradigms in qualitative research. In Denzin NK, Lincoln YS, editors. Handbook of qualitative research. Washington: Sage Publications, Inc.; 1994.p.105-117.
21. Hungler BP, Beck C, Polit D. Essentials of nursing research: methods, appraisal, and utilization. Lippincott: Raven; 1997.p.524.
22. Maiorino MI, Chiodini P, Bellastella G, Giugliano 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(2):329-41. doi: 10.1007/s12020-015-0812-6.
23. Falk SJ, Dizon DS. Sexual dysfunction in women with cancer. Fertil Steril. 2013;100(4):916-21. doi: 10.1016/j.fertnstert.2013.08.018.
24. Lewis PE, Sheng M, Rhodes MM, Jackson KE, Schover LR. Psychosocial concerns of young African American breast cancer survivors. J Psychosoc Oncol. 2012;30(2):168-84. doi: 10.1080/07347332.2011. 651259.
25. Fredrickson BL, Roberts TA. Objectification theory: Toward understanding women’s lived experiences and mental health risks. Psychology of Women Quarterly. 1997;21(2):173-206. doi: 10.1111/j.1471-6402. 1997.tb00108.x
26. Holzner B, Kemmler G, Kopp M, Moschen R, Schweigkofler H, Dünser M, et al. Quality of life in breast cancer patients--not enough attention for long-term survivors? Psychosomatics. 2001;42(2):117-23. doi: 10.1176/appi.psy.42.2.117.
27. Hannoun-Levi JM. Treatment of breast and uterus cancer: physiological and psychological impact on sexual function. [Article in French] Cancer Radiother. 2005;9(3):175-82. doi: 10.1016/j.canrad.2004.11.005.
28. Onen Sertöz O, Elbi Mete H, Noyan A, Alper M, Kapkaç M. Effects of surgery type on body image, sexuality, self-esteem, and marital adjustment in breast cancer: a controlled study. [Article in Turkish] Turk Psikiyatri Derg. 2004;15(4):264-75.
29. Wang F, Chen F, Huo X, Xu R, Wu L, Wang J, et al. A neglected issue on sexual well-being following breast cancer diagnosis and treatment among Chinese women. PLoS One. 2013;8(9):e74473. doi: 10.1371/ journal.pone.0074473.
30. Takahashi M, Kai I. Sexuality after breast cancer treatment: changes and coping strategies among Japanese survivors. Soc Sci Med. 2005;61(6):1278-90. doi: 10.1016/j.socscimed.2005.01.013.
31. Gilbert E, Ussher JM, Perz J. Renegotiating sexuality and intimacy in the context of cancer: the experiences of carers. Arch Sex Behav. 2010;39(4):998-1009. doi: 10.1007/s10508-008-9416-z.
32. Jassim GA, Whitford DL. Understanding the experiences and quality of life issues of Bahraini women with breast cancer. Soc Sci Med. 2014;107:189-95. doi: 10.1016/j.socscimed.2014.01.031.
33. Yusuf A, Ab Hadi IS, Mahamood Z, Ahmad Z, Keng SL. Understanding the breast cancer experience: a qualitative study of Malaysian women. Asian Pac J Cancer Prev. 2013;14(6):3689-98. doi: 10.7314/apjcp. 2013.14.6.3689.
34. Kagawa-Singer M, Wellisch DK. Breast cancer patients' perceptions of their husbands’ support in a cross-cultural context. Psychooncology. 2003;12(1):24-37. doi: 10.1002/pon.619.
)