Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • apa.csl
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Sexuality in patients treated for hematologic malignancies - Problems and need for support from patients’ and nurses’ perspectives
Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.ORCID-id: 0000-0002-0944-5650
2014 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
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

Ort, förlag, år, upplaga, sidor
Karlstad: Karlstads universitet, 2014.
Serie
Karlstad University Studies, ISSN 1403-8099 ; 2014:28
Nyckelord [en]
cancer patients, hematologic malignancies, nursing, nurse-patient communication, support, sexuality, body image, health related quality of life
Nationell ämneskategori
Omvårdnad
Forskningsämne
Omvårdnad
Identifikatorer
URN: urn:nbn:se:kau:diva-31827ISBN: 978-91-7063-560-1 (tryckt)OAI: oai:DiVA.org:kau-31827DiVA, id: diva2:713392
Disputation
2014-05-28, Lagerlöfsalen, Universitetsgatan 2, Karlstad, 10:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2014-05-08 Skapad: 2014-04-02 Senast uppdaterad: 2015-08-03Bibliografiskt granskad
Delarbeten
1. Patient's sexuality: A neglected area of cancer nursing?
Öppna denna publikation i ny flik eller fönster >>Patient's sexuality: A neglected area of cancer nursing?
2012 (Engelska)Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 16, nr 4, s. 426-431Artikel i tidskrift (Refereegranskat) 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.

Ort, förlag, år, upplaga, sidor
Elsevier, 2012
Nationell ämneskategori
Omvårdnad
Forskningsämne
Omvårdnad
Identifikatorer
urn:nbn:se:kau:diva-12137 (URN)10.1016/j.ejon.2011.10.003 (DOI)000308770200012 ()22036773 (PubMedID)
Tillgänglig från: 2012-03-12 Skapad: 2012-03-12 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
2. Sexuality is not a priority when disease and treatment side effects are severe: conceptions of patients with malignant blood diseases
Öppna denna publikation i ny flik eller fönster >>Sexuality is not a priority when disease and treatment side effects are severe: conceptions of patients with malignant blood diseases
2013 (Engelska)Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, s. 3503-3512Artikel i tidskrift (Refereegranskat) 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.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2013
Nyckelord
cancer patients, malignant blood diseases, nursing, phenomenography, sexuality, support
Nationell ämneskategori
Omvårdnad
Forskningsämne
Omvårdnad
Identifikatorer
urn:nbn:se:kau:diva-30520 (URN)10.1111/jocn.12333 (DOI)000326650400028 ()24003940 (PubMedID)
Tillgänglig från: 2013-12-02 Skapad: 2013-12-02 Senast uppdaterad: 2020-04-03Bibliografiskt granskad
3. Patients Treated for Hematologic Malignancies: Affected Sexuality and Health Related Quality of Life
Öppna denna publikation i ny flik eller fönster >>Patients Treated for Hematologic Malignancies: Affected Sexuality and Health Related Quality of Life
2015 (Engelska)Ingår i: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 38, nr 2, s. 99-110Artikel i tidskrift (Refereegranskat) 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.

Ort, förlag, år, upplaga, sidor
Wolters Kluwer, 2015
Nyckelord
cancer patients, hematologic malignancies, longitudinal study, nursing, sexuality, sexual activity, sexual function, sexual interest, health related quality of life
Nationell ämneskategori
Omvårdnad
Forskningsämne
Omvårdnad
Identifikatorer
urn:nbn:se:kau:diva-31824 (URN)10.1097/NCC.0000000000000141 (DOI)000349907900010 ()25692735 (PubMedID)
Tillgänglig från: 2014-04-02 Skapad: 2014-04-02 Senast uppdaterad: 2017-12-05Bibliografiskt granskad
4. Affected Sexuality, Body Image and Health Related Quality of Life in Patients Treated for Hematologic Malignancies: A Longitudinal Study
Öppna denna publikation i ny flik eller fönster >>Affected Sexuality, Body Image and Health Related Quality of Life in Patients Treated for Hematologic Malignancies: A Longitudinal Study
(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
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.

Nyckelord
cancer patients, chemoimmunotherapy, hematologic malignancies, longitudinal study, nursing, sexuality, sexual activity, sexual function, sexual interest, body image, health related quality of life
Nationell ämneskategori
Omvårdnad
Forskningsämne
Omvårdnad
Identifikatorer
urn:nbn:se:kau:diva-31826 (URN)
Anmärkning

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.

Tillgänglig från: 2014-04-02 Skapad: 2014-04-02 Senast uppdaterad: 2015-10-07Bibliografiskt granskad

Open Access i DiVA

fulltext(1725 kB)1073 nedladdningar
Filinformation
Filnamn FULLTEXT01.pdfFilstorlek 1725 kBChecksumma SHA-512
837a38924b868775134f38ef6f4496a4ee65933a145d5f9860102d27972a3476ed87f77f9fba8a4317cfd0adfc00acd9d885e3e3507a3dc11dfbf4af9d7130f7
Typ fulltextMimetyp application/pdf

Person

Olsson, Cecilia

Sök vidare i DiVA

Av författaren/redaktören
Olsson, Cecilia
Av organisationen
Institutionen för hälsovetenskaper
Omvårdnad

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 1084 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

isbn
urn-nbn

Altmetricpoäng

isbn
urn-nbn
Totalt: 2251 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • apa.csl
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf