Women's Experiences of Dyspareunia after Gynecological Cancer Treatment and Care-seeking Behavior: An Insight from a Qualitative Study
Notice bibliographique
Résumé
ABSTRACT Introduction Dyspareunia frequently affects women after gynecological cancer treatment. The focus of previous studies has been on the biomedical factors contributing to dyspareunia in this population. To our knowledge, no study has yet examined the biopsychosocial factors associated with women's experiences of dyspareunia after gynecological cancer treatment. Moreover, cancer survivors appear to refrain from seeking care despite the consequences of dyspareunia. Objective The aim of this study is to examine gynecological cancer survivors’ experiences of dyspareunia and factors influencing their care-seeking behavior. Methods A nested qualitative study was performed with the participants of a clinical trial investigating a multimodal pelvic floor physical therapy intervention. This enabled a comprehensive understanding of women's experiences and care-seeking behavior, including factors that could influence whether they seek care as well as their decision to undertake treatment. Women were included in the trial if they had completed endometrial or cervical cancer treatment and if they had experienced a minimum vulvovaginal pain intensity of 5 out of 10 during most intercourse attempts for at least 3 months. Individual semi-structured telephone interviews were conducted. The questions pertaining to women's experiences and factors influencing their care-seeking behavior were constructed based on the Common-Sense Model of Self-Regulation (i.e., identity, timeline, causes, consequences, and control attributes). The interviewer adopted a biopsychosocial perspective of health to approach these topics during the interviews. Interviews were recorded and transcribed for analysis using the interpretative description framework. Results Of the 31 women included in the trial, 28 (90%) participated in the qualitative study. The participants had been diagnosed with different cancer stages and had received various treatments. For all participants, dyspareunia occurred after cancer treatment and persisted for a median time of 3 years (ranging from 3 months to 11 years). Loss of libido, lower vaginal lubrication, and reduced vaginal cavity were reported by women as contributing factors to dyspareunia. Participants explained how dyspareunia and these changes led them to engage in less, and even to interrupt, sexual activity. They also expressed that they were distressed, felt like less of a woman, and experienced low control and/or self-efficacy. Several women described that their condition had an impact on their relationship with their partner. Regarding factors influencing women's care-seeking behavior, participants emphasized that they were provided with insufficient information and support. Other barriers included balancing priorities, denial or reluctance, misbeliefs, resignation and acceptance, and negative emotions. Facilitators reported by women included acknowledgement of sexual dysfunction, desire for improvement, awareness of treatment possibilities, willingness to undertake treatment, and treatment acceptability. Conclusions Women's experiences of dyspareunia after gynecological cancer treatment highlight the complexity of this condition, which involves biopsychosocial factors. The related consequences described by women also stress the importance of appropriate management. As the current study provides insight to guide the provision of services, efforts should focus on promoting the facilitators and overcoming the barriers to seeking care for sexual dysfunction after gynecological cancer treatment. Disclosure No
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,011 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,008 | 0,007 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,002 | 0,005 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».