Sexualiteten är en del av varje människas identitet och har varierande innebörd för den enskilda individen. Förmågan att älska och att känna sig älskad är en viktig förutsättning för god hälsa. Den som drabbas av cancer får ofta sexuella problem och det är flera orsaker till detta. Syftet med studien var att beskriva sjuksköterskors uppfattningar av att samtala med cancerpatienter om sexualitet och hur de uppfattar sexualitetens betydelse för patienterna. En kvalitativ metod med fenomenografisk ansats valdes. Sammanlagt 10 sjuksköterskor intervjuades från varierande arbetsplatser, som möter cancerpatienter i olika delar av vårdkedjan. Resultatet utföll i två delar med en varsin huvudkategorier med tillhörande beskrivningskategorier, kvalitativt skilda från varandra. Under huvudkategorin Hinder och möjligheter för samtal finns beskrivningskategorierna Sjuksköterskans professionalism och personliga mognad, Interaktion och relation mellan sjuksköterskan och patienten samt Omgivningens betydelse. Dessa beskriver förutsättningar för att samtalen ska komma till stånd. Den andra delens resultat består av huvudkategorin Cancerpatienternas behov av stöd och information i samtalen om sexualitet med beskrivningskategorierna Livssituationens betydelse, Positionen i vårdkedjan och dess betydelse samt Konsekvenser av sjukdom och behandling. / Sexuality is a part of every human beings identity and it has a varying meaning for the individual person. The ability to love and feel loved is an important part of good health. People suffering from cancer often experience sexual problems due to several reasons. The purpose of this study was to describe nurses’ perception of talking to cancer patients about sexuality and their experiences of what sexuality means for cancer patients. A qualitative method with a phenomenographic approach was used. Ten nurses from different clinics, who met patients in various places during the trajectory of care were interviewed. The nurses’ perceptions are captured in two main categories and six descriptive categories. The first of the two main categories Obstacles and possibilities for the conversation describe the necessary conditions for the dialog together with three descriptive categories: Nurse’s professionalism and individual maturity, Interaction and relationship between the nurse and the patient, and The meaning of the surrounding structure. The second of the two main categories was The cancer patients’ need for support and information. It describes the nurses’ perceptions of how the patients’ need for support and information about sexuality varies during the trajectory of care. Descriptive categories to this main category were: The situation of life, The position in the trajectory of care and its meaning, and Consequences of the illness and its treatment.

No description available.

Thesis (M.S.W.)--University of Hong Kong, 1984.

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

Treatment of head and neck cancer with radiation therapy is associated with adverse side effects to the oral cavity and surrounding areas. These complications include mucositis, mucosal fibrosis and atrophy, salivary gland dysfunction, increased risk of dental caries, increased susceptibility to infections, tissue necrosis, taste dysfunction, and muscular and/or cutaneous fibrosis. The often permanent nature of the radiation-induced damage necessitates the maintenance of a strict oral care program, involving frequent flossing and brushing in addition to daily fluoride applications, for the rest of the patient's life. An additional concern among patients with head and neck cancer is the use of tobacco and alcohol. Both are known risk factors in the development of head and neck cancers and failure to abstain from either after diagnosis increases the risk for relapse and development of secondary cancers. The present study was a longitudinal investigation of several factors that may influence patients' consistency in following their prescribed oral care program and abstaining from alcohol and tobacco use, including, but not limited to, patient satisfaction with the doctor-patient communication, patient coping, and patient illness perceptions. The study examined an integrative model seeking to explain patient adherence to the oral care regimen as well as tobacco and alcohol use. While results were inconclusive with respect to the model, there were several interesting findings, which were consistent with previous literature examining doctor-patient communication and illness perceptions among other cancer populations. Results from this study suggested that both satisfaction with doctor-patient communication and coping play an important role in forming patients’ illness perceptions. Furthermore beliefs about the severity of oral complications emerged as a predictor of oral care at follow-up. / text

A descriptive study was conducted with the purpose of refining the Sexual Adjustment Questionnaire (SAQ) and further establishing reliability and validity. Twelve women receiving treatment for breast cancer and 22 women who were at least three months post-treatment for breast cancer voluntarily participated in the research study. Each was administered the Sexual Adjustment Questionnaire. Findings of the study revealed that the SAQ in its entirety was internally consistent. Repatterning of sexual behavior subsequent to having breast cancer did not occur in either group of women. Both the women receiving cancer treatment and those post-treatment experienced a noticeable change in their sexual behavior since having cancer.

Aim: The overall aim of this thesis was to describe and explore how sexuality, body image and HRQoL were affected in patients treated for hematologic malignancies, and their need for support. A further aim was to describe nurses’ conceptions of dialogues about sexuality. Methods: Ten nurses in cancer care (I) and twelve patients were interviewed (II). Data were analysed according to phenomenography (I-II). Data were also collected from patients (≥45 years) included consecutively: at baseline (n=32), one month (n=25; III-IV) and six months (n=20; IV) after treatment. Three instruments were used: SAQ-S, BIS and EORTC QLQ-C30. The data were analysed statistically. Main findings: The nurses (I) conceived that they should talk about sexuality with cancer patients, but usually did not due to their own attitudes, lack of knowledge about sexuality, communication skills and environmental conditions. The patients (II) experienced negative effects on sexual function and sexual relationship due to affected strength and sexual desire. The patients’ sexuality, body image and HRQoL were affected during (II-III) and one month after treatment (III-IV). Patients recovered with regard to these issues within six months, except for sexual relationship (IV). However, when the disease and side effects were experienced as severe, thoughts about and interest in sexuality were overshadowed, and the need or wish for support related to this issue was low (II). Sexuality and body image seemed to influence changes in HRQoL (IV). Conclusion: Patients above the age of 45 treated for hematologic malignancies with chemoimmunotherapy experienced problems related to sexuality, body image and HRQoL. However, as sexuality was found to be of low priority due to concerns for life when the disease and side effects were severe, support must be timely and individualized. Patient-centered care, with patients continuously meeting a nurse guided by the idea of holistic individual nursing care throughout the care trajectory, is suggested. / Sexuality is to a large extent seen as a private and sensitive topic by both patients and nurses in cancer care. The patients in this thesis were above the age of 45 and treated with chemo- or chemoimmunotherapy for hematologic malignancies. They experienced affected sexuality, body image and HRQoL during and after treatment. The importance of sexuality was low and sexuality seemed to be overshadowed when the disease and side effects were experienced as severe. Few patients described that information might have been helpful.  In order to avoid violating patients’ integrity, one challenge is to identify patients who ascribe importance to sexuality and who also want support regarding sexuality. One way is to organize care in a patient-centered way, with patients continuously meeting a nurse guided by the idea of holistic individual nursing care throughout the care trajectory. Furthermore, nurse educators’ need to acknowledge this area and the health care leaders should provide nurses opportunities to discuss attitudes and personal barriers to sensitive issues such as sexuality

The proposed study is a preliminary investigation of a hypothesized relationship between family therapy and levels of child patient and parent anxiety and depression. Currently, medical practice does not include mental health services and familial support to oncology patients in typical treatment protocol. While anxiety and depression appear to be present during all phases of cancer, providing family therapy at the time of diagnosis is warranted as symptom alleviation at this juncture may mitigate these symptoms throughout subsequent phases and potentially decrease somatic difficulties. Research questions will be addressed by analyzing data, including scores on measures of anxiety and depression. Statistical analyses will include two and three-way analyses of variance (ANOVA) and repeated measures multivariate analysis of variance (MANOVA). / text

published_or_final_version / Applied Statistics / Master / Master of Social Sciences