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Patients Treated for Hematologic Malignancies: Affected Sexuality and Health Related Quality of Life
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.ORCID iD: 0000-0002-0944-5650
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.ORCID iD: 0000-0003-1382-4386
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.ORCID iD: 0000-0002-4974-6845
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.ORCID iD: 0000-0003-0417-6161
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. Vol. 38, no 2, 99-110 p.
Keyword [en]
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: urn:nbn:se:kau:diva-31824DOI: 10.1097/NCC.0000000000000141ISI: 000349907900010PubMedID: 25692735OAI: oai:DiVA.org:kau-31824DiVA: diva2:709490
Available from: 2014-04-02 Created: 2014-04-02 Last updated: 2016-10-03Bibliographically approved
In thesis
1. Sexuality in patients treated for hematologic malignancies - Problems and need for support from patients’ and nurses’ perspectives
Open this publication in new window or tab >>Sexuality in patients treated for hematologic malignancies - Problems and need for support from patients’ and nurses’ perspectives
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
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:nbn:se:kau:diva-31827 (URN)978-91-7063-560-1 (ISBN)
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

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Olsson, CeciliaSandin-Bojö, Ann-KristinBjuresäter, KaisaLarsson, Maria
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