Adapting a couple-based intimacy enhancement intervention to breast cancer: A developmental study.

Abstract

Objective Sexual concerns continue to be poorly addressed for women treated for breast cancer and evidence-based interventions that adequately address these concerns are scarce. The objective of this study was to adapt a telephone-based Intimacy Enhancement intervention, previously tested in couples facing colorectal cancer, to the needs of women with breast cancer through qualitative focus groups, cognitive interviews, and expert review. Methods Three semi-structured qualitative focus groups in partnered post-treatment breast cancer survivors (n=15) reporting sexual concerns were conducted to investigate experiences of breast cancer-related sexual concerns and intervention preferences. Focus group data were coded using the framework approach to qualitative analysis; 8 key themes were identified and used to develop the content and format of the intervention. Feedback from cognitive interviews with study-naïve breast cancer survivors (n=4) and expert review of materials were also incorporated in finalizing the intervention materials. Results Qualitative findings centered on the impact of breast cancer and its treatment on women’s sexuality and on the intimate relationship, experiences of helpful and unhelpful coping methods, and explicit intervention preferences. Focus group data were particularly helpful in identifying the scope of educational topics and in determining how to structure intervention skills practice (e.g., intimacy-related communication) to be optimally relevant and helpful for both women and their partners. Cognitive interview feedback helped refine intervention materials. Conclusions An Intimacy Enhancement intervention was adapted for women with breast cancer and their partners. This intervention offers a promising, potentially disseminable approach to addressing breast cancer-related sexual concerns.

A brief intervention to enhance breast cancer clinicians' communication about sexual health: Feasibility, acceptability, and preliminary outcomes

“…Immediately after the clinic visit, patients completed a questionnaire on sociodemographic characteristics, satisfaction with their clinician's care, and sexual problems using an item from the patient care monitor (PCM) assessing problems with sexual interest, enjoyment, or performance over the past week (0‐10 rating scale; higher scores = worse sexual problems). The PCM item is a reliable indicator of sexual problems in cancer populations …”

Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study

“…Commonly reported distressing sexual sequelae of breast cancer treatment include vaginal dryness [4–6], loss of libido [6], and decreased sexual activity [7]. Concerns with body image is also common and associated with worse sexual functioning [4, 8, 9] and disruption in survivors’ intimate relationships [10]. …”

Improvement in sexual function after ovarian cancer: Effects of sexual therapy and rehabilitation after treatment for ovarian cancer

“…13,14 Fortunately, there is a growing interest in developing interventions for cancer-related female sexual dysfunction. 15 Examples include pharmacologic interventions to address the physical side effects of menopause [16][17][18][19] and counseling interventions to address psychosocial adjustments 20,21 (eg, peer counseling 22 or couples counseling 23,24 after breast cancer.…”