收稿日期: 2021-05-13
网络出版日期: 2021-01-28
基金资助
上海市教育委员会护理高原学科项目(Hlgy1844qnhb);上海交通大学医学院科技基金(jyhz1908);上海交通大学医学院附属瑞金医院护理科研基金(RJHK-2019-2)
Experience of sexuality after breast reconstruction in breast cancer survivors: a qualitative study
Received date: 2021-05-13
Online published: 2021-01-28
Supported by
Shanghai Municipal Education Commission Gaoyuan Nursing Grant Support(Hlgyl844qnhb);Science and Technology Fund of Shanghai Jiao Tong University School of Medicine(jyhz1908);Nursing Research Fund of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine(RJHK-2019-2)
目的·了解接受乳房重建术后的乳腺癌患者对于性的认知与态度、性生活状态的改变体验和应对方式。方法·通过目的性抽样，以在上海交通大学医学院附属瑞金医院内接受乳房重建术的乳腺癌患者为研究对象。采用一般资料问卷对于患者的基本信息进行收集。采用现象学研究方法就患者接受乳房重建术后性生活状态的改变体验和应对方式进行半结构式的深入访谈，并根据Colaizzi七步分析法进行资料分析。结果·共纳入12名受访者，中位年龄40（28~51）岁，均接受了腹壁下动脉穿支皮瓣转移术，术后病程中位数为17.5个月。受访者的性生活及情感体验可归纳为3个主题。①受访者对乳房重建术后性生活改变的感知：受访者均对性的重要性有充分的认识；大部分受访者在完成乳腺癌辅助治疗后可恢复性生活；乳房重建术导致的体象改变和皮肤感觉受损影响了患者的性体验。②受访者对乳房重建术后性生活改变的应对：受访者与配偶之间关于性的交流较少；受访者主动启动补偿机制，减轻不良性体验。③受访者术后对恢复性生活的支持需求：受访者对于性健康的需求较高，但医患间关于性问题的沟通较少；受访者期望通过合适的途径得到专业的信息支持。结论·乳房重建术后患者对于性生活和情感体验相对积极，但缺乏与配偶及医护人员关于性问题的沟通。医护人员在临床工作中应针对患者性问题进行有效沟通和评估并及时给予干预，以提高其生活质量。
甘露 , 金玉翡 , 任清 , 董晓晶 , 张男 . 乳房重建术后乳腺癌患者性生活及情感体验的质性研究[J]. 上海交通大学学报（医学版）, 2021 , 41(12) : 1597 -1601 . DOI: 10.3969/j.issn.1674-8115.2021.12.008
·To study the recognization and attitudes regarding sex of the breast cancer patients who underwent breast reconstruction, and their experience of altered sexual status and their coping styles.
·The breast cancer patients who underwent breast reconstruction surgery in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, were selected as the study population through purposive sampling. The general information questionnaire was used to collect the basic information of the patients. A semi-structured in-depth interview on the experience of sexual status change and coping style after breast reconstruction surgery was conducted by using phenomenological research method. The data were analyzed according to seven steps of Colaizzi′s method.
·A total of 12 respondents with a median age of 40 (28?51) years were included, all of whom underwent deep inferior epigastric perforator flap with an median postoperative duration of 17.5 months. Their sexual life and emotional experience could be summarized into 3 themes. ① The patients′ perceptions of changes in sexual life after breast reconstruction surgery: all the respondents had a good understanding of the importance of sex; most of the respondents could resume sexual life after completing adjuvant treatment for breast cancer; the altered body image and the impaired skin sensation resulting from breast reconstruction surgery affected the patients′ sexual experience. ② The patients′ response to the changes in sexual life after breast reconstruction: there was less communication about sex between the patients and their spouses; the patients actively initiated compensatory mechanisms to mitigate adverse sexual experience. ③ The patients′ need for support in resuming sexual life after surgery: the patients had a high demand for sexual health, but there was little communication between the doctors and the patients on sexual issues; the patients expected to receive professional information support through appropriate access.
·After breast reconstruction, the patients are relatively positive about sexual life and emotional experience, but lack of communication with their spouses and medical staff about sexual problems. Health care providers should effectively communicate, assess the patients′ sexual problems, and provide timely interventions in clinical work to improve their quality of life.
Key words： breast reconstruction; breast cancer; sexual experience; qualitative study
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