Bakgrund: I Sverige blir ca 2800 kvinnor diagnostiserade med gynekologisk cancer varje år. Flera kvinnor med gynekologisk cancer får psykiska problem i samband med diagnos och behandling, och den sexuella hälsan påverkas. Efter behandling uppstår ofta fysiska förändringar på kropp och underliv, och för nästan alla kvinnor påverkar det den sexuella hälsan negativt. Information om den sexuella hälsan i samband kan hjälpa kvinnor hantera förändringarna och minska påverkan på den sexuella hälsan. Syfte: Att undersöka hur kvinnor upplever den information de får innan, under eller efter behandlingen av gynekologisk cancer angående den sexuella hälsan samt när de önskar få informationen, hur de önskar få informationen samt vilken information de önskar. Metod: Arbetet är designat som en litteraturstudie och inkluderar 13 artiklar med både kvantitativ och kvalitativ ansats. Resultat: Resultatet visar att kvinnor upplever informationen i samband med behandling för gynekologisk cancer som opersonlig, för medicinsk och ofullständig. Kvinnorna får även för lite information om de fysiska förändringar som kommer efter operationen och inget stöd för att kunna hantera dessa förändringar.  Kvinnorna känner sig sällan bekväma med att själva ta upp ämnet med personal och önskar att personalen talar med dem om sexuell hälsa. Information om följder av behandlingen önskas både fås som skriftligt och muntligt. Slutsats: Resultatet pekar på att kvinnor önskar mer information om hur behandlingen av gynekologisk cancer påverkar den sexuella hälsan. Kvinnorna vill ha information som är anpassad efter hennes behov samt att personalen behöver mer utbildning i ämnet. / Background:  In Sweden, approximately 2800 women are diagnosed with gynecological cancer each year. Several women with gynecological cancer get psychological problems in connection to diagnosis and treatment, and sexual health often affected. Surgical or conservative treatment often result in physical changes in the body and genitals, which affect the sexual health negatively. Information about sexual health before, during and after treatment can help women manage these changes and reduce the impact on the sexual health. Aim: To examine how women experience the information they receive before, during and after treatment of gynecological cancer regarding the sexual health, when they wish to receive information, how they wish to receive the information and which information they would like to receive. Method: The work is designed as a literature review and includes 13 articles with both quantitative and qualitative approaches. Results: The results show that women experience information in connection with the treatment of gynecological cancer as impersonal, too medical and incomplete. Women are given deficient information about the physical changes that come after the operation and no support to manage these changes. Women themselves rarely feels comfortable with bringing up the topic with the staff and wishes that health care-personnel would speak with them about their sexual health. Women want the information both in writing and oral. Conclusion: The results point towards that women would like more information about how the treatment of gynecological cancer affects sexual health. The women want the information to be tailored to her personal needs and that the staff needs more training on the subject.

This descriptive, comparative, correlational study explored the relationships among demographic characteristics, health histories, disease characteristics, body image, anxiety and depression, sexual relationship power, female sexual function, and sexual satisfaction; examined sexual self-schema as a moderator or mediator on female sexual function and sexual satisfaction; and compared the differences in female sexual function and sexual satisfaction between women with gynecological or rectal cancer and women without any cancer. Fifty-five females with gynecological or rectal cancer in the study group and 72 females without any cancer in the comparison group completed seven structured questionnaires. For females in the study group, a significant negative relationship existed between time since surgery and anxiety and depression, between the number of cancer treatments and female sexual function, and between performance status and anxiety and depression. In addition, a significant positive relationship existed between performance status and sexual relationship power and between the number of cancer treatments and sexual satisfaction. Further, body image was significantly related to anxiety and depression, sexual relationship power, sexual self-schema, and sexual satisfaction. The anxiety and depression factor was significantly linked with sexual relationship power, female sexual function, and sexual satisfaction. There was a significant negative relationship between sexual satisfaction and sexual relationship power and between sexual satisfaction and female sexual function. Also, females in the study group reported significantly worse sexual function and sexual satisfaction than females in the comparison group. A hierarchical multiple regression model accounted for 40% of the variance in female sexual function, and gynecological/rectal cancer, body image, and the interaction between sexual relationship power and sexual self-schema were three significant predictors. After controlling for gynecological/rectal cancer, body image, sexual relationship power, sexual self-schema, and the interaction term between sexual relationship power and sexual self-schema, female sexual function accounted for 17% of the variance in sexual satisfaction. In unsolicited comments, females in the study group described the changes in their sexual lives after surgery and treatments, emphasizing that sexual information should be provided promptly and effectively by health care providers. The study findings led to implications and recommendations for the conceptual framework, nursing practice, research, and education. / text

Submitted by Biblioteca da Faculdade de Farmácia (bff@ndc.uff.br) on 2017-03-27T18:04:04Z No. of bitstreams: 1 Capett, Muniqui Scharamm [Dissertação, 2014].pdf: 1658363 bytes, checksum: 4be51a47b3655224f5200be235524e5d (MD5) / Made available in DSpace on 2017-03-27T18:04:04Z (GMT). No. of bitstreams: 1 Capett, Muniqui Scharamm [Dissertação, 2014].pdf: 1658363 bytes, checksum: 4be51a47b3655224f5200be235524e5d (MD5) / Escherichia coli é o principal patógeno associado a infecções do trato urinário (ITU) em pacientes com câncer ginecológico. As taxas de resistência dessas bactérias às fluoroquinolonas parecem elevadas nessa população. O objetivo deste trabalho foi caracterizar geneticamente as cepas de E. coli obtidas de ITU de pacientes com câncer ginecológico, bem como estudar a resistência ao ciprofloxacino nestas cepas. Para tal, 77 cepas de E. coli resistentes e 38 sensíveis ao ciprofloxacino, foram avaliadas. A diversidade clonal das cepas foi determinada pela técnica de PFGE. A tipificação filogenética e a presença dos genes de virulência iucC, fyuA, hlyC e cnf1, foram avaliadas por PCR. O estudo da resistência ao ciprofloxacino foi realizado pela detecção dos genes qnrA, qnrB e qnrS, aac(6’)-Ib-cr, e qepA, utilizando PCR; e pelo sequenciamento dos genes da DNA Girase, gyrA e gyrB, e da Topoisomerase IV, parC e parE, em nove cepas resistentes, do grupo filogenético B2. Testes de Fisher ou Qui-quadrado foram utilizados para análise estatística. Os resultados demonstraram grande variação genética entre as cepas resistentes ao ciprofloxacino analisadas pelo PFGE, no entanto, o grupo filogenético B2 foi o prevalente, tanto na população resistente (46,8%) quanto na população de cepas sensíveis (65,8%) ao ciprofloxacino. As cepas sensíveis tiveram maior detecção dos genes hlyC, cnf1 e fyuA (p<0,0001; p<0,0001; p=0,0008, respectivamente). O grupo B2 apresentou maior número de genes de virulência e foi associado com a presença de fyuA (p= 0,0123) na população resistente, e cnf1 (p=0,0008) na população sensível. Dentre todas as cepas, hlyC (p= 0,0255), cnf1 (p=0,0003) e fyuA (p= 0,0004) foram mais presentes no grupo B2. Com relação à resistência ao ciprofloxacino, os genes qnrA e qepA não foram detectados e o gene qnrS foi encontrado em uma única cepa. Número maior de detecção (6/ 7,8%) deu-se com relação ao gene aac(6’)-Ib-cr; porém, a detecção do gene qnrB foi muito acima do esperado, sendo este gene encontrado em 26% das cepas resistentes e em 13,2% das cepas sensíveis. As mutações encontradas foram Ser-83-Leu e Asp-87-Asn em gyrA, Ser-80-Ile, Glu-84-Val e Glu-84-Lys em parC. O número de mutações não teve correlação direta com a concentração mínima inibitória (CMI) / Escherichia coli is the major pathogen associated with urinary tract infections (UTI) in patients with gynecological cancer. The resistant rates of these bacteria to fluoroquinolones seem to be high in this population. The aim of this study was to genetically characterize and study the resistance to ciprofloxacin in E. coli strains obtained from UTI patients with gynecological cancer. For this purpose, 77 ciprofloxacin-resistant and 38 ciprofloxacin-susceptible E. coli strains were evaluated. The clonal diversity of the strains was determined by PFGE. Phylogenetic typing and the presence of virulence genes iucC, fyuA, hlyC, cnf1, were analyzed by PCR. The study of resistance to ciprofloxacin was performed by detection of qnrA, qnrB, qnrS, aac(6’)-Ib-cr and qepA genes using PCR; and the sequencing of DNA Gyrase genes, gyrA and gyrB, and Topoisomerase IV, parC and parE in nine resistant strains of phylogenetic group B2. Fisher or Chi-square tests were used for statistical analysis. The results showed large genetic variation among the ciprofloxacin-resistant strains analyzed by PFGE, however, the phylogenetic group B2 was the most prevalent in both the ciprofloxacin-resistant (46.8%) and ciprofloxacin-susceptible (65.8%) population of strains. The ciprofloxacin-sensitive strains had a greater detection of hlyC, cnf1 and fyuA (p<0.0001; p<0.0001; p=0.0008, respectively). The phylogenetic group B2 had a greater number of virulence genes and it was associated with the presence of fyuA (p= 0.0123) in the resistant population, and cnf1 (p=0.0008) in the sensitive population. Among all strains, hlyC (p= 0.0255), cnf1 (p=0.0003) and fyuA (p= 0.0004) were more present in phylogenetic group B2. Regarding to the ciprofloxacin-resistance, the qnrA and qepA genes were not detected, the qnrS gene was found in just one (1.3%) strain. A higher number of detection (6/ 7,8%) was found with respect to the aac(6’)-Ib-cr gene; however, the detection of the qnrB gene gene was far higher than expected, with this gene being noticed in 26% of resistant strains and 13.2% of susceptible strains. The mutations found were Ser-83-Leu and Asp-87-Asn in gyrA, Ser-80-Ile, Glu-84-Val and Glu-84-Lys in ParC. The number of mutations had no direct correlation with the Minimum Inhibitory Concentration (MIC)

Bakgrund:Gynekologisk cancer är en cancerform som drabbar uppskattningsvis ca 3000 kvinnor i Sverige varje år. Att drabbas av en livshotande sjukdom som gynekologisk cancer kan ge upphov till en rad reaktioner, förändringar och behov. Det är därför av vikt för sjuksköterskan att förstå kvinnornas upplevelser och utefter detta kunna bistå kvinnorna den personcentrerade omvårdnaden som ligger inom sjuksköterskans kompetensområde. Syfte: Syftet var att beskriva kvinnors upplevelser av att leva med gynekologisk cancer. Metod: En litteraturstudie utfördes baserat på tio kvalitativa artiklar där en analys genomfördes. Artikelsökningarna gjordes i databaserna Pubmed och Cinahl Complete.  Resultat: Analysen resulterade i tre huvudteman; Fysiska upplevelser, emotionella upplevelser och upplevelser av relationernas betydelse. Till dessa huvudteman identifierades tio underteman. Sammanfattning:Kvinnornas upplevelser med gynekologisk cancer beskrevs som fysiskt och psykiskt påfrestande. En rad förändringar beskrevs av kvinnorna efter insjuknandet, där både negativa och positiva aspekter framkom. Den gynekologiska cancerns behandling hade framförallt en negativ påverkan på kvinnornas fysiska hälsa vilket i sin tur påverkade den psykiska hälsan på olika plan. Kvinnorna hade också önskat ett annat bemötande från vårdpersonalen. Rädsla för död och återinsjuknande var andra aspekter som präglade deras upplevelser. Samtidigt beskrev kvinnorna hur insjuknandet lett till medvetandegörandet av hälsosammare vanor och livsstil, stärkta band till familj/vänner och en ny syn på livet. / Background: Gynecological cancer is a type of cancer that involves cancer in the female genitalia and occurs in approximately 3000 women in Sweden each year. To suffer from a life-threatening disease such as gynecological cancer can cause a series of reactions, changes and needs. It is therefore of importance for the nurse to understand the lived experiences of these women and based on that be able to assist them and give them person-centered care that lies within the nurses area of competence. Aim: To describe women’s experiences of living with gynecological cancer.Method:A literature review based on ten qualitative articles where an analysis was performed. Article searches were performed in the databases Pubmed and Cinahl Complete.   Results: The analysis resulted in three main themes; Physical experiences, emotional experiences and experiences of the importance of relationships. To the three main themes ten subthemes were identified.  Summary: The experiences the women had with gynecological cancer were described as psychically and emotionally strenuous. A series of changes were described by the women after falling ill, where both negative and positive aspects emerged. Mainly the treatments of the gynecological cancer had a negative impact on the women’s physical health which then led to a mentally impact on various levels. The women also had wished for another personal treatment from the health professionals, lack of empathy and information from their caregivers were described. A fear of death and recurrence were other aspects that had an impact on their experiences. At the same time the women described how the disease had led to awareness raising on healthier habits and lifestyles, strengthen bonds to family/friends and a new outlook on life.

Bakgrund: Vid gynekologisk cancer involveras organ som är relaterade till kvinnlighet och sexualliv. Sjukdomen och behandlingen kan innebära en negativ inverkan på kvinnans sexuella hälsa vilket är en viktig del av livet och kan ha en stor påverkan på livskvalitén. I sjuksköterskans profession ingår att främja och bevara patientens hälsa och därmed sexuell hälsa. Syfte: Syftet var att belysa kvinnors upplevelser av sexuell hälsa vid gynekologisk cancer. Metod: En litteraturstudie med en kvalitativ ansats baserad på en analys av 10 artiklar genomfördes. Resultat: Kvinnor drabbade av gynekologisk cancer upplevde att sjukdomen och dess behandlingar hade påverkan på den sexuella hälsa. Sex teman identifierades, varav brist på information var det mest framträdande. Slutsats: Kvinnor drabbade av gynekologisk cancer upplevde flera hinder för att uppnå en tillfredsställande sexuell hälsa. Det främsta hindret och den gemensamma nämnaren, var bristen på information om hur behandlingar och dess biverkningar påverkade den sexuella hälsan, vilket medförde onödigt lidande och försämrad livskvalité. Klinisk betydelse: En ökad förståelse av kvinnornas upplevelser kan hjälpa sjuksköterskor att tillgodose en omvårdnad innefattande flera aspekter av sjukdomen, såsom sexuell hälsa. På grund av ämnets känsliga natur behöver det lyftas i grundutbildningen för sjuksköterskor, så att studenterna skall bli bekanta med och känna sig bekväma med ämnet så att det ska bli en naturlig del i den kliniska omvårdnaden. PLISSIT-modellen bör implementeras som ett verktyg för sjuksköterskor att använda vid samtal med patienter om sexuell hälsa. / Background: Gynecological cancer involves organs related to femininity and sexual life. The disease and treatment can have a negative impact on the woman's sexual health, which is an important part of life and can have a major impact on quality of life. The nurse´s profession includes promoting and preserving the health of the patient and thus the sexual health. Aim: The aim of this study was to highlight women's experiences of sexual health in gynecological cancer. Method: A literature review was conducted with a qualitative approach based on an analysis of 10 articles. Results: Women suffering from gynecological cancer experienced that the disease and its treatments had an impact on their sexual health. Six themes were identified of which, lack of information was the most prominent. Conclusion: Women with gynecological cancer experienced several obstacles to achieve satisfactory sexual health. The main obstacle and the common denominator was the lack of information on which impact treatments and their side effects had on sexual health, causing unnecessary suffering and impaired quality of life. Clinical suggestions: An increased understanding of women´s experiences can help nurses to meet the care, such as sexual health. Because of the sensitive nature of the topic, the authors consider that it needs to be emphasized in the nursing education, for students to become familiar with and feel comfortable with the topic to become an integrated part of clinical care. The PLISSIT-model should be implemented as an instrument for nurses to use in conversations with patients about sexual health.

Bakgrund: Sexualitet och sexuell hälsa har olika betydelse för varje individ. Vid gynekologisk cancer förändras upplevelsen av sin sexualitet på grund av kroppsliga förändringar som skapas vid behandling och som innebär både fysiska och psykiska konsekvenser på sexualiteten. Att drabbas av gynekologisk cancer kan skapa oro och funderingar kring individens existens samt oro inför förändringar på sexualitet och livsstil. Syfte: Syftet med studien var att beskriva kvinnors upplevelse av kommunikation om sexualitet i vården vid gynekologisk cancer. Metod: En litteraturöversikt där tio kvalitativa artiklar och en kvantitativ artikel har analyserats. Resultat: Tre teman framkom efter att ha analyserat artiklarna; när kommunikationen brister, skillnader i behov av information och vårdmiljöns påverkan på kommunikationen. Kvinnor upplever brist på kommunikation och information kring deras sexualitet när de drabbas av gynekologisk cancer. Diskussion: Det finns hjälpmedel för sjuksköterskor att tillhandahålla för att öka kommunikation om sexualitet. God kommunikation om sexualitet vid gynekologisk cancer leder till ett ökat välbefinnande, självförtroende och kunskap om sjukdomen. Konklusion: Kvinnor med gynekologisk cancer vårdas inte utifrån ett helhetsperspektiv. Kommunikationen och därmed informationen om sexualitet och sexuell hälsa är bristfällig och det leder till lidande och psykisk ohälsa. Detta bör uppmärksammas och det är ett område som behöver förbättras drastiskt. / Background: Sexuality and sexual health have a different meaning for each individual. Gynecological cancer can change the image of sexuality because of bodily changes created by the treatment and that involves both the physical and psychological impact. Suffering from gynecological cancer causes concerns about changes in sexuality, anxiety and existential questions. Aim: The aim of the study is to describe women's experience of communication about sexuality in their care during gynecological cancer.  Method: A literature review where ten qualitative articles and one quantitative article has been analyzed.  Result: Three themes emerged after analyzing the articles; when communication gaps, differences in information, and the environment ́s impact on communication. Women experience a lack of communication and information about sexuality in their healtcare.  Discussion: There are support-systems for nurses that can help them increase communication about sexuality. Good communication in gynecological cancer leads to increased well-being, confidence and knowledge about the disease. Conclusion: The care for women with gynaecological cancer is not based on a holistic perspective. The communication and information about sexuality and sexual health is poor and it leads to suffering and mental ilness. This should be adressed and it is an area of need that needs to be improved drastically.

2800 kvinnor i Sverige insjuknar i gynekologisk cancer årligen. Vanliga behandlingsmetoder är kirurgi, strål- och cytostatikabehandling. Behandlingarna har visat fysisk och psykisk påverkan och att kvinnor med gynekologisk cancer oroar sig i större grad än andra patienter med andra cancerformer. Syftet var att beskriva kvinnors upplevelser efter avslutad behandling av gynekologisk cancer. Uppsatsen genomfördes som en litteraturstudie där 12 artiklar analyserades. Resultatet visar att kvinnorna upplever att de fortfarande bär på sjukdomen efter behandlingen, på grund av behandlingarnas effekter på det vardagliga livet. Upplevelser av oro för återfall, förändrad kroppsbild, negativ påverkan på fertiliteten och bristfällig information av vårdpersonal var svårt att hantera. Fortsatta uppföljningar och utförligare information, angående symtom, biverkningar och behandlingar, av sjuksköterska hade varit fördelaktigt för kvinnorna för att minska oro och förbättra livskvaliteten.

Bakgrund Kvinnan får ofta någon typ av sexuell dysfunktion av gynekologisk cancer och dess behandling. En gynekologisk cancersjukdom innebär både fysiskt- och psykiskt lidande. Stöd har visat positiv effekt för cancerpatienter. Den omvårdnadsteori som valdes för examensarbetet var Joyce Travelbees omvårdnadsteori. Syfte Att undersöka hur kvinnliga patienter med en gynekologisk cancerdiagnos upplever stöd från vårdpersonal relaterat till sex- och samlevnad. Metod Detta är en litteraturstudie där artiklar granskades från databasen PubMed. Sjutton originalartiklar valdes men två av dessa exkluderades då de ej svarade på inklusionskriterierna. Dessa 15 artiklar kvalitetsgranskades med hjälp av granskningsmallar. Resultatet analyserades med en innehållsanalys. Resultat Kvinnor önskar mer stöd relaterat till sex- och samlevnad. De önskar även att partnern involveras i vården. Kvinnorna upplever otillräckligt stöd relaterat till sex- och samlevnad gånger kvinnan fått stöd har detta varit otillräckligt. De önskar både få muntlig och skriftlig information/rådgivning. Slutsats Att drabbas av gynekologisk cancer påverkar hela kvinnan. Kvinnor upplever att de får för lite stöd relaterad till sex- och samlevnad och önskar mer stöd från vården i dessa frågor. Detta examensarbete skall bidra till att vårdpersonal uppmärksammar dessa kvinnor. / Background Women often get some type of sexual dysfunction of gynecological cancer and its treatment. A gynecological cancer disease involves both physical- and mental suffering. Support has demonstrated efficacy for cancer patients. The nursing theory that was selected to this bachelor’s thesis was Joyce Travelbee. Aim To examine how female patients with a gynecological cancer diagnosis feel support from health professionals related to sex- and relationships Method This is a literature review in which articles were searched from the database PubMed. Seventeen original articles were selected, but two of these were excluded because they did not respond at the inclusion criteria. These 15 articles of quality were assessed using audit templates. The results were analyzed using a content analysis.   Results Women want more support related to sex- and relationships. The women also want their partner to become more involved in care. The women experiencing insufficient support related to sex- and relationships times the woman received support, this has been inadequate. They want both verbal and written information/advice.  Conclusion To suffer from gynecological cancer affects the whole woman. Women feel that they receive little support related to sex- and relationships and want more support from the care in these issues. This bachelor’s thesis will contribute to the health professionals pay attention to these women.

Bakgrund: År 2017 drabbades 2850 kvinnor av gynekologisk cancer. Det finns flertalet behandlingsstrategier där den vanligaste är kirurgi. Efter behandlingen kan många kvinnor befinna sig i ett lidande där den sexuella hälsan påverkas. Syfte: Att undersöka kvinnans upplevelse av sexuell hälsa efter behandling av gynekologisk cancer. Metod: Studien har genomförts som en litteraturöversikt baserad på kvalitativa artiklar där materialet grundades på kvinnors upplevelse av sexuell hälsa efter behandling av gynekologisk cancer. Artiklarna hittades på databaserna CINAHL och MEDLINE. Resultat: Resultatet visar på olikheter gällande kvinnors upplevelser av den sexuella hälsan efter behandling av gynekologisk cancer. De vanligaste förekommande förändringarna till följd av behandlingen var torra slemhinnor och förminskad vagina som ledde till smärta vid samlag och bidrog till minskad sexlust. Självkänslan påverkades hos många kvinnor och konsekvenserna av behandlingen inverkade på deras relationer. Deltagarna upplevde otillräcklig information om behandlingens effekter på den sexuella hälsan från vården. Konklusion: Behandlingen resulterade i förändringar på den sexuella hälsan som drabbade kvinnan både psykiskt och fysiskt. Många kvinnor önskade mer information och ett större stöd från sjukvården under sjukdomsförloppet. Sjuksköterskan har ett ansvar att bryta tystnaden och möta patientens känslor kring den förändrade sexualiteten. En ökad kunskap krävs för att förebygga ohälsa hos dessa patienter. / Background: 2850 women suffered from gynecological cancer year 2017. There are several treatment options and the most common one is surgery. After treatment many women suffer from issues regarding their sexual health. Aim: To explore women’s experiences of sexual health after treatment of gynecological cancer. Method: The study was made as a literature review based on qualitative articles where the women expressed their experience of sexual health after treatment of gynecological cancer. The articles were found on the two databases CINAHL and MEDLINE. Result: The result shows that the women had different experiences of how gynecological cancer and the treatment affected their sexual health. The most common effects of the treatment was dry mucous membrane and shortened vagina that made intercourse painful which decreased their libido. For many of the women their self esteem was affected and the majority expressed that the consequences of the treatment had an impact on their relationship. The women of the study experienced a lack of information about the treatments effects on their sexual health from health care providers. Conclusion: The treatment resulted in a change in the womens’ sexual health that affected them both physically and mentally. The women would have appreciated more information and a greater support from healthcare providers during the time of the disease. Nurses have a responsibility to break the silence and meet the patients’ needs when it comes to the change in sexuality. More knowledge is necessary to prevent illness when it comes to these patients.

Uma das modalidades de tratamento para mulheres acometidas pelo câncer ginecológico é a radioterapia interna, também conhecida como braquiterapia. Caracteriza-se pela colocação de materiais radioativos junto ao tumor. No caso daquele tipo de câncer, para se efetuar a irradiação, é necessário introduzir um aplicador dentro da vagina. Este tratamento pode ser bastante desconfortável para a mulher, tanto no momento da aplicação, quanto após a mesma. Neste sentido, estudos sobre o tema apontam não apenas para efeitos colaterais físicos, mas também para conseqüências psicológicas na qualidade de vida de pacientes tratadas por braquiterapia. Entretanto, tais estudos são ainda incipientes, tendo maior concentração na área de Enfermagem. É quase inexistente uma produção de caráter psicológico que aprofunde o conhecimento a respeito de questões emocionais em mulheres submetidas a esse procedimento invasivo. Sendo assim, esta pesquisa qualitativa objetivou compreender aspectos psicológicos em mulheres com câncer ginecológico submetidas a essa modalidade radioterápica. Para tanto, foram realizadas sete entrevistas abertas com mulheres em tratamento junto ao Serviço de Radioterapia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo. As entrevistas foram áudio-gravadas, transcritas na íntegra e submetidas à análise de acordo com o método clínico-qualitativo, utilizando-se a psicanálise como marco teórico para a interpretação dos dados. Foi elaborado um diário de campo como instrumento auxiliar de pesquisa. Após realização das leituras flutuantes e análise do material, observou-se que a braquiterapia é sentida pelas mulheres como uma agressão, gerando intensa angústia, desespero e raiva. A manipulação na região vaginal, com entradas e saídas de objetos (aplicador, sonda, etc.), desencadeia vivências e efeitos físicos desagradáveis, como dor, ardência urinária, sensação de queimação. Em uma perspectiva psicanalítica, o tratamento é vivido como um objeto hostil e persecutório que é introduzido na intimidade sexual, afetando a mulher em sua feminilidade. A posição física em que as mulheres permanecem para receber a irradiação acarretou sensação de submissão, vergonha e exposição de sua intimidade. Ainda com relação a este tratamento, foram feitas associações e comparações com a experiência anterior de gravidez/parto, possivelmente pela existência de conflitos e questões inconscientes relacionadas ao nascimento, mas também à morte concretizada pela doença grave. As mulheres atribuíram significados ao surgimento do câncer ginecológico relacionados à vivência de depressão, à sexualidade e à gravidez/parto, sendo que se evidenciou uma culpa inconsciente pela doença. Para enfrentarem as vicissitudes do tratamento, as mulheres tiveram que se basear mais no princípio de realidade - buscar a remissão da doença através do tratamento e da confiança na equipe - do que no princípio de prazer (ou evitação do desprazer), mas com considerável sofrimento psíquico. Neste sentido, considera-se relevante pensar numa assistência psicológica às pacientes, com o intuito de minimizar possíveis efeitos psicológicos adversos associados à braquiterapia. / One of the treatment modes for women affected by gynecological cancer is internal radiotherapy, also known as brachytherapy. It is characterized by the placement of radioactive material near the tumor. For that type of cancer, the irradiation requires the introduction of an applicator inside the vagina. This treatment can be quite uncomfortable for the women, both during and after the application. In this sense, research on the theme appoints not only physical collateral effects, but also psychological consequences for the quality of life of patients treated with brachytherapy. However, these studies are still incipient, with a greater concentration in the Nursing area. Production of psychological nature, which deepens knowledge about emotional issues in women submitted to this invasive procedure, almost does not exist. Thus, this qualitative research aimed to understand psychological aspects in women with psychological cancer submitted to this radiotherapeutic modality. Therefore, seven open interviews were held with women under treatment at the Radiotherapy Service of the University of São Paulo at Ribeirão Preto Medical School Hospital das Clínicas. The interviews were tape-recorded, fully transcribed and submitted to analysis according to the clinical-qualitative method, using psychoanalysis as a theoretical framework for data interpretation. A field diary was elaborated as an auxiliary research instrument. After floating reading and analysis of the material, it was observed that the women feel brachytherapy as an aggression, generating intense anguish, despair and rage. Manipulation in the vaginal region, with insertions and withdrawals of objects (applicator, probe, etc.), causes unpleasant experiences and effects, such as pain, urinary burning and a burning feeling. In a psychoanalytical perspective, treatment is experienced as a hostile and persecutory object, which is introduced in the sexual intimacy, affecting the woman in her femininity. The physical position in which women remain to receive the irradiation caused a feeling of submission, shame and exposure of their intimacy. Moreover, with respect to this treatment, associations and comparisons were made with previous experiences of pregnancy/delivery, possibly due to the existence of conflicts and unconscious questions related to birth, but also to death made real by the severe disease. The women attributed meanings to the appearance of gynecological cancer, related to the experience of depression, sexuality and pregnancy/delivery, evidencing an unconscious feeling of guilt about the disease. In order to face the vicissitudes of treatment, the women had to base themselves more on the reality principle - seeking the remission of the disease through treatment and confidence in the team - than on the principle of pleasure (or avoidance of displeasure), but accompanied by considerable mental suffering. In this sense, it is considered relevant to think of psychological care delivery to these patients, with a view to minimizing possible adverse psychological effects associated with brachytherapy.