The Sexual Adjustment Process of Cancer Patients and Their Partners: A Qualitative Evidence Synthesis

Abstract

Whenconfrontedwithcancer,aprominentchallenge for patients and their partners is their changed sexual relationship. An empirically based theoretical model of the sexual adaptation process during cancer might be helpful in guiding the development of adequate interventions for couples who struggle with their sexual relationship. Therefore, the purpose ofthisstudywastosynthesizeevidencefromprimaryqualitative research studies and to arrive at a detailed description of the process of sexual adjustment during cancer. We conducted a qualitative evidence synthesis of a purposeful sample of 16 qualitative papers, using the meta-ethnography approach to synthesis. We found that the subsequent studies used different theoreticalapproachestodescribethesexualadaptationprocess. This led to three divergent sexual adaptation processes: (1) the pathway of grief and mourning, depicting sexual changes as a loss; (2) the pathway of restructuring, depicting the adjustment process toward sexual changes as a cognitive process with a strong focus on the social and cultural forces that shape the values and experiences of sexuality; and (3) the pathway of sexual rehabilitation, depicting sexual changes as a bodily dysfunction thatneeds treatment and specific behavioral strategies. All three pathways have their own opportunities and challenges. A greater awareness of these different pathways could help healthcare providers to better understand the ways a particular couple might cope with changed sexuality, offering them opportunities to discover alternative pathways for sexual adjustment.

Coping Strategies for Sexual Problems and Sexual Dysfunction Amongst Malay Women With Breast Cancer. A Qualitative Study

“… 11 , 12 Negative emotional effects, including depression and anxiety, have also been associated with these changes. 13 It is noteworthy that, despite major sexual changes, the impact of these changes on the quality of patients’ relationships may vary: Some women report persistent sexual problems that lead to complicated sexual activities and marital conflict, 14 , 15 , 16 , 17 while a few describe positive increases in non-intercourse intimacy and manage to restore satisfactory sexual relationships after their diagnoses. 7 , 14 , 15 , 16 …”

Psychosexual morbidity in women with ovarian cancer

“…6 Socially, intimate relationships may struggle to navigate cancer treatments and symptoms, as roles may shift from partner to patient or partner to primary caregiver. 7 This can lead to patient and partner emotional withdrawal from the relationship and contribute to anxiety and depression. 8 Overall, these changes mean that women with epithelial ovarian cancer can encounter increased difficulty with sexual desire, arousal, orgasm, and sexual satisfaction compared with a healthy age-matched population.…”

Long-Term Follow-Up of Sexual Dysfunction in Women Following Allogeneic Hematopoietic Stem Cell Transplantation

“…Current information holds that oncological diseases pose prominent challenges for patients and their partners. The diagnosis of cancer can significantly change their sexual relationship (Benoot, Saelaert, Hannes, & Bilsen, 2017 ). Since genital symptoms and sexual impairments are rarely reported spontaneously by patients, it is of pivotal importance that hematologists should ask patients about such symptoms.…”