Sexual function, psychosocial adjustment to illness, and quality of life among Chinese gynaecological cancer survivors

Psychooncology. 2018 Apr;27(4):1257-1263. doi: 10.1002/pon.4663. Epub 2018 Mar 1.

Abstract

Background: Disrupted sexual function is a prevalent and sustained side effect of gynaecological cancer and its related treatment. This problem may pose challenges to the survivors in the process of illness adjustment, leading to elevated psychological distress and impaired quality of life. However, care and interventions in this area have been neglected in most countries.

Objectives: To investigate sexual function, psychosocial adjustment to illness, and quality of life among Chinese gynaecological cancer survivors in Hong Kong and to explore their associations.

Methods: A cross-sectional design was adopted. Gynaecological cancer survivors were recruited from a gynaecological oncology outpatient clinic at a regional hospital in Hong Kong.

Results: A total of 225 Chinese gynaecological cancer survivors were recruited. Their sexual function was found to be impaired. They had satisfactory performance in psychosocial adjustment to illness, but the worst domain was sexual relationships. Their quality of life was fair, with physical and social functioning performing best. Path analysis demonstrated that psychosocial adjustment to illness played a significant mediating role in the relationship between sexual function and quality of life among those who were married or had a regular sex partner.

Conclusions: Impaired sexual function was prevalent among Chinese gynaecological cancer survivors, and psychosocial adjustment to illness mediates the relationship between sexual function and quality of life. In Chinese clinical settings without routine sexuality assessments, early sexual function and psychosocial adjustment assessment should be integrated into routine nursing practice. In addition, a culturally appropriate practice model should be developed to guide sexuality care delivery.

Keywords: cancer; gynaecological cancer; oncology; psychosocial adjustment to illness; quality of life; sexual function.

MeSH terms

  • Adult
  • Asian People / psychology
  • Cancer Survivors / psychology*
  • Cross-Sectional Studies
  • Female
  • Genital Neoplasms, Female / psychology*
  • Hong Kong
  • Humans
  • Marriage / psychology
  • Middle Aged
  • Quality of Life / psychology*
  • Sexual Behavior / psychology*
  • Social Adjustment