JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)

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Experience of sexuality after breast reconstruction in breast cancer survivors: a qualitative study

GAN Lu, JIN Yu-fei, REN Qing, DONG Xiao-jing, ZHANG Nan   

  1. 1.Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2. Shanghai Jiao Tong University School of Nursing,Shanghai 200025, China①
  • Received:2021-05-13 Published:2021-10-29
  • Contact: ZHANG Nan, E-mail: zn21076@rjh.com.cn.
  • Supported by:
    Shanghai Municipal Education Commission Gaoyuan Nursing Grant Support (Hlgyl844qnhb); Science and Technology Fund of Shanghai Jiao TongUniversity School of Medicine (jyhz1908); Nursing Research Fund of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine (RJHK-2019-2).

Abstract: Objective·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. Methods·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. Results·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. Conclusion·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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