Bakgrund: Varje år drabbas 1,3 miljoner kvinnor i världen av gynekologisk cancer. Gynekologisk cancer innefattar corpus-, cervix- och ovarialcancer. Prognosen och överlevnaden är god vid behandling av cancern. Behandlingsformer som används vid gynekologisk cancer kan innefatta kirurgi, strålning och cytostatika. De flesta kvinnor är sexuellt aktiva under sina liv och en konsekvens av behandling för gynekologisk cancer är att sexualiteten förändras, både ur ett fysiskt och psykiskt perspektiv. Syfte: Att beskriva kvinnors upplevelser av sexualitet efter gynekologisk cancer. Metod: Metaetnografi användes som analysmetod i denna kvalitativa metasyntes. PubMed och CINAHL användes till datainsamlingen. Artiklarna kvalitetsgranskades enligt Joanna Briggs granskningsmall. Resultatet i metasyntesen har baserats på 12 vetenskapliga artiklar. Resultat: Tre huvudteman fastställdes: Förändrad sexualitet, Kunskapsbrist hämmar sexualitet och Att vara kvinna, en upplevelse av skuld och tvång. Huvudtema Förändrad sexualitet följdes av tre underteman; komplikationer efter cancerbehandlingen påverkar sexualitet, Rädsla för negativ förändring och Lust och njutning, en tudelad upplevelse. Slutsats: Kvinnor upplevde negativa förändringar i sin sexualitet som följd av cancerbehandlingen. Vaginalsmärta som följd av behandlingen var den vanligaste komplikationen. Rädslan hade både fysiska- och psykiska orsaker till exempel att cancern skulle leda till återfall, spridning av cancern samt att bli lämnad av sin partner. Kvinnor upplevde en avsaknad av lust och njutning i samband med sexuell aktivitet. Att tillfredsställa sin partner var något som kvinnorna strävade efter trots minskad eller avsaknad av sexuell lust. Information från hälso- och sjukvården om sexualitet var något som kvinnorna saknade. Klinisktillämpbarhet: Examensarbetes resultat kan användas för att öka barnmorskor och övrig hälso- och sjukvårdspersonals förståelse för kvinnors sexualitet efter gynekologisk cancer och efterföljande behandling. Examensarbetet kan inspirera vårdgivarna att våga diskutera och informera om sexualitet för kvinnor som drabbats av gynekologisk cancer för att undvika att kvinnor ska uppleva skam och skuld eller leva sitt sexuella liv i ovisshet. / Background: Every year, 1.3 million women in the world are diagnosed with gynecological cancer. Gynecological cancer includes corpus-, cervix- and ovarian cancer. The prognosis and survival rates are good when treating the cancer. Treatments used for gynecological cancer may include surgery, radiation, and chemotherapy. Most women are sexually active throughout their lives, and the sexuality can be experienced and expressed both physically and psychologically. Aim: The purpose of the thesis was to explore women's experiences of sexuality after going through treatment for gynecological cancer. Method: Meta ethnography was used as the method of analysis in this qualitative meta synthesis. PubMed and CINAHL were the databases used for data collection. The articles were quality assessed according to the Joanna Briggs checklist. The result of the meta synthesis is a result of 12 scientific articles. Results: Three main themes were identified: Changes in sexuality, Lack of knowledge impede sexuality and being a woman, an experience of guilt and coercion. Main theme Changed Sexuality was followed by three sub-themes: complications after cancer treatment affect sexuality, Fear of negative change and Lust and Pleasure, an ambiguous experience. Conclusion: Women experienced negative changes in sexuality because of cancer treatment. Vaginal pain because of treatment was the most extensive change. The fear unfolded from different physical and psychological perspectives. The fear could express itself through the cancer's recurrence, spread and being left by their partner. The women´s experienced a lack of desire and pleasure in connection with the sexual activity. Satisfying their partner was something that the women´s strived for despite reduced or absent sexual desire. Information from the healthcare system about sexuality was something that the women were missing. Clinical applicability: The results of the thesis can be used to increase midwives' and other healthcare personnel's understanding of women's sexuality after going through gynecological cancer treatment. The thesis can inspire the midwives to dare to discuss and inform about sexuality for the women affected by gynecological cancer, to avoid the women experiencing shame and guilt or living their sexual life in uncertainty.

Bakgrund: Varje år insjuknar cirka 3000 kvinnor i gynekologisk cancer i Sverige, vilket innebär cancer i de kvinnliga könsorganen. Behandling mot gynekologisk cancer medför olika fysiska biverkningar. Sexuell hälsa är individuell och påverkas av faktorer som könsroller, njutning, könsidentitet och erotik. Sexuell lust, upphetsning och orgasm är delar av den sexuella hälsan. Sjuksköterskans roll innefattar personcentrerad vård med ett holistiskt perspektiv, där alla aspekter av patientens behov ingår, vilket innefattar den sexuella hälsan. Syfte: Syftet var att belysa upplevelsen av sexuell hälsa hos kvinnor som behandlats för gynekologisk cancer. Metod: Litteraturöversikten baserades på 11 kvalitativa artiklar som inhämtades från databaserna CINAHL Complete, Nursing and Allied health database och PubMed. Artiklarna som valdes att ingå i litteraturöversikten granskades i syfte att tematisera likheter och skillnader. Detta mynnade ut i litteraturöversiktens resultat. Resultat: Resultatet sammanställdes till fyra huvudteman som benämndes; Upplevelsen av ett förändrat sexuellt liv, En förändrad syn på sig själv, Förhållanden och En ny syn på sexuell hälsa. Under Upplevelsen av ett förändrat sexuellt liv identifierades två underteman; Den sexuella lusten och Den sexuella akten. Under En förändrad syn på sig själv identifierades Kvinnlighetens betydelse för kvinnan och Kroppsuppfattning som två underteman. Diskussion: En diskussion har förts kring metoden som användes i litteraturöversikten. Callista Roys adaptionsmodell, tidigare forskning och egna reflektioner har diskuterats i relation till litteraturöversiktens resultat för att stödja samt utöka förståelsen för resultatet. / Background: In Sweden approximately 3000 women fall ill in gynecological cancer each year. Gynecological cancer occurs in women’s genitals. Treatment for gynecological cancer can have different side effects. Sexual health is unique for each individual and is influenced by gender roles, identity, pleasure and erotism. Sexual desire, arousal and orgasm are segments of sexual health. The nurse’s role includes person centered care with a holistic perspective. All aspects of the patient’s needs should be included; therefore, sexual health should not be excluded.  Aim: The aim was to illustrate the experience of sexual health in women who have been treated for gynecological cancer. Method: The literature review was based on 11 qualitative studies collected from CINAHL Complete, Nursing and Allied health database and PubMed. The articles were reviewed in order to find similarities and differences. Results: The results were categorized into four main themes; The experience of a changed sexual life, An altered view on oneself, Relationship and A new view on sexual health. Within The experience of a changed sexual life two subthemes were identified; The sexual desire and The sexual act. Further on, two subthemes were identified in An altered view on oneself; The meaning of womanhood for women and Body image. Discussion: The chosen method for the literature review was discussed. To create understanding and support for the results Callista Roys adaptation model, previous research and our own thoughts were used to discuss the findings of the literature review.

Women treated for a gynecological cancer report longstanding post-treatment difficulties for which they rarely seek or receive help. Few intervention studies have successfully improved global sexual health within this population. Research in this domain is challenging due to inconsistent measurements of sexuality, low response rates and high attrition rates. The overarching study objectives were: (a) To contribute to the advancement of research on supportive care needs (including sexual health needs), desire for help, and predictors of needs; and, (b) To inform the development of services for gynecological cancer survivors. In Study 1, a qualitative interview study explored the experiences of 15 gynecological cancer survivors. Interviews were conducted and analysed based on the Interpretive Description approach . In Study 2 (for which results were analyzed in two parts), a descriptive, cross-sectional needs assessment was conducted to measure supportive care needs, desire for help, sexual health and vaginal changes, and service format preferences in 113 patients. In Part 1 of Study 2, descriptive and regression analyses explored patient needs, desire for help and potential predictors of these variables. In Part 2, a descriptive analysis explored sexual health needs and vaginal changes, desire for help with sexual health needs, and their associations with sociodemographic and medical variables. Qualitative results from Study 1 suggested that psychological, emotional and relational aspects of sexuality were as important to the participants as physiological sexual response. In the needs assessment, the strongest predictors of greater unmet needs and increased readiness for help were younger age and shorter time since treatment. Moderate to high sexual and social needs were equally prevalent in women recently treated and those treated several years prior to the study, suggesting that sexual and social needs may remain unaddressed over time. Further, many women who reported a need did not desire help, demonstrating the subjectivity of needs and distress, as well as the potential presence of barriers to seeking help. Both studies revealed a common finding, where sexual health needs were a product of the discordance between participants’ current sexual experiences and their perceptions of ideal sexual health. Overall, the two studies indicate that a significant subgroup of patients experience unmet needs in cancer survivorship, most of which are non-physical; also, while some needs were higher following treatment, unmet social and sexual health needs show little relationship with time since treatment. Ambivalence about receiving help with unmet needs is related to beliefs about the role of the health care team in meeting non-physical needs, as well as other perceived barriers. Patient’s perceived sexual health needs and barriers to receiving help should be evaluated within a comprehensive framework of needs and discussed one-on-one. Future research should explore the added predictive value of other groups of medical and psychological variables.

Women treated for a gynecological cancer report longstanding post-treatment difficulties for which they rarely seek or receive help. Few intervention studies have successfully improved global sexual health within this population. Research in this domain is challenging due to inconsistent measurements of sexuality, low response rates and high attrition rates. The overarching study objectives were: (a) To contribute to the advancement of research on supportive care needs (including sexual health needs), desire for help, and predictors of needs; and, (b) To inform the development of services for gynecological cancer survivors. In Study 1, a qualitative interview study explored the experiences of 15 gynecological cancer survivors. Interviews were conducted and analysed based on the Interpretive Description approach . In Study 2 (for which results were analyzed in two parts), a descriptive, cross-sectional needs assessment was conducted to measure supportive care needs, desire for help, sexual health and vaginal changes, and service format preferences in 113 patients. In Part 1 of Study 2, descriptive and regression analyses explored patient needs, desire for help and potential predictors of these variables. In Part 2, a descriptive analysis explored sexual health needs and vaginal changes, desire for help with sexual health needs, and their associations with sociodemographic and medical variables. Qualitative results from Study 1 suggested that psychological, emotional and relational aspects of sexuality were as important to the participants as physiological sexual response. In the needs assessment, the strongest predictors of greater unmet needs and increased readiness for help were younger age and shorter time since treatment. Moderate to high sexual and social needs were equally prevalent in women recently treated and those treated several years prior to the study, suggesting that sexual and social needs may remain unaddressed over time. Further, many women who reported a need did not desire help, demonstrating the subjectivity of needs and distress, as well as the potential presence of barriers to seeking help. Both studies revealed a common finding, where sexual health needs were a product of the discordance between participants’ current sexual experiences and their perceptions of ideal sexual health. Overall, the two studies indicate that a significant subgroup of patients experience unmet needs in cancer survivorship, most of which are non-physical; also, while some needs were higher following treatment, unmet social and sexual health needs show little relationship with time since treatment. Ambivalence about receiving help with unmet needs is related to beliefs about the role of the health care team in meeting non-physical needs, as well as other perceived barriers. Patient’s perceived sexual health needs and barriers to receiving help should be evaluated within a comprehensive framework of needs and discussed one-on-one. Future research should explore the added predictive value of other groups of medical and psychological variables.

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No. of bitstreams: 2 Tese - Tereza Raquel de Melo Alcântara-Silva.pdf: 3175551 bytes, checksum: 574347502e52a9058a69b0b0001f8cbe (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2012-04-05 / To study the influence of music therapy in reduction of Fatigue related to cancer in patients with breast’s or gynecology’s cancer, during the radiotherapy treatment. METHODS: This is a randomized controled study (Control Group - CG e Musictherapy Group - MTG) wich values fatigue, life’s quality, anxienty, depression by using evaluative instruments Functional Assessment of Cancer Therapy: Fatigue (FACT-F), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) in three differents moments (during first week of radiotherapy, in the intermediate phase’s week and during the last week of radiotherapy) for patients of bouth groups. Women allocated in MTG, in addition to the scales described above, answered the Music therapy Questionary (MQ), and the Subjective Impression of the Subject’s Questionary in last meeting. Music Therapy sessions were individual and lasted an average of 40 minutes. Music therapeutic techniques used were Musical Audition (MA) and Therapeutic Musical Audition (TMA). RESULTS: 164 women were randomized and 116 women with middle age of 52,9 (CG) and 51,85 years (MTG) were included in the analysis. MTG’s patients had on average 10 music therapy sessions, totalizing 509 assistences during the search. In the analysis between groups, Functional Assesment of Cancer Therapy: Fatigue (FACIT-F) demonstrated significance related to Trial Outcome Index (TOI) (p=0,011), Functional Assesment of Cancer Therapy – Geral (FACT-G) FACT-G (p=0,001) FACIT-F FACT-F(p=0,005) areas to the MGT compared to CG. In comparisson made inside the same group results pointed a significant worsening for women. The GMT showed a significant in TOI, FACT-G and FACIT – F (p<0,001) areas in fatigue scale. Music Therapy Questionary showed that 59,3% of the pacients didn’t know what music therapy was, and 53,7% thought that Music Therapy was a relaxing activity. In the end of the process, based on ISS, 98,1% of the women afirmated that Music Therapy made difference in their lives, 96,2% reported a positive perception of music therapy, 75,5% noticed less fatigue and 84,9% reported less stress. CONCLUSION: Individual Music therapy is effective in treatment of Fatigue Related to Cancer during the radiotherapy, to depression and to improve quality of life. / Estudar a influência da musicoterapia na redução da fadiga relacionada ao câncer em mulheres com câncer de mama ou ginecológico durante o tratamento radioterápico. MÉTODOS: Trata-se de um estudo randomizado controlado (Grupo Controle - GC e Grupo de Musicoterapia - GMT) de avaliação da fadiga e fatores corelacionados (qualidade de vida, ansiedade, depressão) em mulheres submetidas à radioterapia através dos instrumentos avaliativos Functional Assessment of Cancer Therapy: Fatigue (FACT-F), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) em três momentos distintos (durante a primeira semana de radioterapia, na semana da fase intermediária e durante a última semana de radioterapia) para as participantes dos dois grupos. As sessões de musicoterapia foram individuais, com duração, em média, de 40 minutos. As técnicas musicoterapêuticas utilizadas foram audição musical (AM) e audição musical terapêutica (AMT). RESULTADOS: Foram randomizadas 164 mulheres (82 GC e 82 GMT) e incluídas na análise 116 mulheres com média de idade de 52,9 anos (GC) e 51,85 anos (GMT). As participantes do GMT tiveram em média 10 sessões de musicoterapia, totalizando 509 atendimentos ao longo da pesquisa. Os resultados da FACT-F mostraram maior significância quanto aos domínios Trial Outcome Index (TOI) (p=0,011), Functional Assesment of Cancer Therapy – Geral (FACT-G0 (p=0,005) e Functional Assesment of Cancer Therapy - Fatigue (FACT-F) (p=0,001) para o GMT em relação ao GC. O Questionário Musicoterapêutico mostrou que 59,3% nada sabiam a respeito da Musicoterapia e para 53,7% ela se constituia em uma atividade de relaxamento. Ao final do processo, por meio do questionário Impressão Subjetiva do Sujeito obteve-se que 98,1% afirmaram que a Musicoterapia fez diferença em sua vida; 96,2% relataram percepção positiva da musicoterapia; 75,5% perceberam melhora quanto à fadiga e 84,9% relataram redução do estresse. CONCLUSÃO: A musicoterapia individual é efetiva para a redução da fadiga relacionada ao câncer e dos sintomas depressivos, assim como para a melhora da qualidade de vida de mulheres com câncer de mama ou ginecológico, submetidas à radioterapia.

Bakgrund Gynekologisk cancer drabbar många kvinnor globalt och är ett samlingsnamn för äggstockscancer, vulvacancer, livmoderhalscancer och livmodercancer. Vanliga behandlingsmetoder inkluderar strålbehandling, cellgiftsbehandling (cytostatika) och kirurgi. Dessa behandlingsmetoder kan leda till påtagliga biverkningar som kan påverka den sexuella funktionen. Sexualitet utgör en viktig del av människans välbefinnande och har betydelse för övergripande hälsa. Det är dock viktigt att notera att upplevelsen av sexualitet är subjektiv och variationer kan förekomma bland individer. Rätten till sexuell och reproduktiv hälsa är universell, och hälso- och sjukvården bör sträva efter att tillgodose och främja denna rättighet genom att tillhandahålla information och resurser på ett personcentrerat sätt. Syfte Syftet var att beskriva upplevelser av sexuell hälsa vid gynekologisk cancer. Metod ​​En allmän litteraturöversikt som undersökt vetenskapliga originalartiklar från databaserna Cinahl Complete och PubMed. För att hitta dessa artiklar användes Mesh-termer och Cinahl Subject Headings och sökord relaterade till sexuell hälsa och gynekologisk cancer. Sökningen resulterade i elva utvalda artiklar som användes till resultatet. Resultat Denna litteraturöversikt fann att gynekologisk cancer och dess behandling negativt påverkar kvinnors sexualitet genom fysiska och känslomässiga förändringar, inklusive minskad sexlust och påverkan på relationer. Bristande informationsutbyte och stöd från sjukvårdspersonal ökar osäkerhet och lidande. Denna litteraturöversikt identifierade fyra teman relaterade till kvinnor som diagnostiseras och behandlas för gynekologisk cancer: sexuell funktion, kroppsbild och kvinnlig identitet, relationstillfredsställelse och kontakt med vården. Slutsats ​​Kvinnors sexualitet påverkades i olika grad av en gynekologisk cancerdiagnos och medföljande behandling. Det framkom dock att dessa upplevelser skiljde sig från person till person vilket förtydligar vikten av ett personcentrerat och holistiskt perspektiv i mötet med dessa personer. Ytterligare forskning krävs för att vidare undersöka kulturella skillnader, åldersskillnader och upplevelser hos dessa kvinnor. / Background Gynecological cancer affects many women worldwide and encompasses ovarian cancer, vulvar cancer, cervical cancer, and uterine cancer. Common treatment methods include radiation therapy, chemotherapy (cytostatics), and surgical interventions. These treatment modalities may entail challenging side effects that can impact sexual functioning. Sexuality is a crucial aspect of human life and influences overall health. However, sexuality is subjective, and cultural differences in the experience of sexuality may exist. Everyone has the right to sexual and reproductive health, and it is essential for healthcare to meet and promote these needs through, among other things, personalized information and resources.​ Aim The aim was to describe experiences of sexual when effected with gynecological cancer​. Method A general literature review that examined scientific original articles from the Cinahl Complete and PubMed databases. To find these articles, Mesh terms and Cinahl Subject Headings, as well as keywords related to sexual health and gynecological cancer, were used. These resulted in eleven selected articles. Results This literature review found that gynecological cancer and its treatment negatively impact women's sexuality through physical and emotional changes, including decreased libido and effects on relationships. Insufficient information exchange and support from healthcare professionals increase insecurity and suffering. This literature review identified four themes related to women diagnosed and treated for gynecological cancer: sexual function, body image and female identity, relationship satisfaction, and healthcare communication. Conclusions Women's sexuality was variably affected by a diagnosis of gynecological cancer and its accompanying treatments. However, it became evident that these experiences differed among individuals, underscoring the significance of a person-centered and holistic perspective when engaging with these individuals. Further research is warranted to explore cultural variations, age-related differences, and the unique experiences of these women.​

Bakgrund: År 2020 rapporteras det globalt 604 000 nya fall av livmoderhalscancer. I 90% av fallen skedde dessa i låg- eller medelinkomstländer. Den vanligaste orsaken till livmoderhalscancer är infektion med HPV-virus som är en sexuellt överförbar infektion. Behandlingen vid livmoderhalscancer är kirurgi, cytostatika, strålbehandling och kombinerad behandling med cytostatika och strålning. En god hälsa är en grundläggande mänsklig rättighet och en fundamental del av människans generella hälsa är sexuell hälsa. Syftet: Syftet var att belysa kvinnors upplevelse av sexuell hälsa vid diagnostiserad livmoderhalscancer. Metod: Studien är en kvalitativ litteraturöversikt med induktivt förhållningssätt där 14 artiklar har analyserats enligt analys av Friberg i fem steg. Resultat: Huvudkategorierna som framträdde var sexuellt lidande med underkategorierna sexuell hälsa relaterat till fysiska besvär och sexuell hälsa relaterat till psykiska besvär. Andra huvudkategorin är sexuellt välbefinnande med underkategorierna sexuellt intresse och stöd av vården. Slutsats: Livmoderhalscancern påverkade välbefinnandet och sexuella hälsan för kvinnor på ett negativt sätt. Resultatet visade att kvinnors självkänsla och kroppsbild förändrades med livmoderhalscancern och behandlingen och att fysiska symtom gjorde att kvinnorna upplevde en förändrad sexualitet. I de fall där kvinnorna upplevde en förbättrad sexuell hälsa och kunde återgå till ett fungerande sexliv hade partnern ett stöttande förhållningssätt och sjukvården hade försett dem med information och kunskap. / Background: In 2020, 604 000 new cases of cervical cancer were reported globally. 90% of these cases took place in low- or middle-income countries. The most common cause of cervical cancer is infection with the HPV virus, which is a sexually transmitted infection. The treatment for cervical cancer is surgery, cytostatics, radiotherapy as well as combined treatment with cytostatics and radiation. Satisfactory health is a basic human right and a fundamental part of a person's general health is their sexual health. Aim: The aim was to describe women’s experience of sexual health when diagnosed with cervical cancer. Method: The study is a qualitative literature review with an inductive approach where 14 articles have been analyzed according to analysis by Friberg in five steps. Result: The main categories that emerged were sexual suffering with the subcategories sexual health related to physical problems and sexual health related to psychological problems and the main category sexual well-being with the subcategories sexual interest and support from caregivers. Conclusion: Cervical cancer affected quality of life and sexual health of women in a negative way. The results showed that women's self-esteem and body image changed with cervical cancer and treatment and that physical symptoms caused the women to experience a changed sexuality. In cases where women experienced improved sexual health and were able to return to a functioning sex life, their partners had a supportive approach and health care had provided them with information and knowledge.

In der klinischen Diagnostik gewinnt die Untersuchung des Ernährungszustandes zunehmend an Bedeutung. Denn die Güte des Ernährungszustandes hat einen Einfluss auf die Mortalität und Morbidität der Patienten. Zur groben Evaluierung des Ernährungszustandes dient der Body Mass Index (BMI). Eine differenzierte Beurteilung des Ernährungszustandes wird durch die Analyse der Körperzusammensetzung erreicht. Die phasensensitive bioelektrische Impedanzanalyse (BIA) ist eine schnelle, preisgünstige und nicht-invasive Methode zur Messung der Körperzusammensetzung. Insbesondere der Phasenwinkel, der ein direkter Messparameter der BIA ist, gibt einen schnellen Überblick über den Ernährungszustand der Patienten. Er spiegelt das Verhältnis von Extrazellulärmasse zu Körperzellmasse wieder, welches in vielen Studien als Indikator zur frühzeitigen Erfassung einer beginnenden Mangelernährung validiert wurde. Bei der Applikation einer Chemotherapie ist es von großer Bedeutung, dass die vorgesehene Dosis und Dosisintensität der Therapie eingehalten wird. Insbesondere unerwünschte Nebenwirkungen sind häufig für Dosisreduktionen und Verschiebungen der Chemotherapie verantwortlich. In einer prospektiven Studie wurde bei 40 Frauen, die sich aufgrund eines gynäkologischen Malignoms einer Chemotherapie unterzogen haben, die Körperzusammensetzung mit der BIA vor jedem Chemotherapiezyklus gemessen. Diese Studie zeigt, dass durch die Messung der Körperzusammensetzung ein Risikokollektiv, welches für Nebenwirkungen der Therapie anfällig ist, ermittelt werden kann. Der Body Mass Index (BMI) erwies sich als unzureichender Parameter zur Beschreibung des Ernährungszustandes der Patientinnen. Insbesondere muss mit einer erhöhten Rate von Nebenwirkungen der Chemotherapie bei einem verminderten Phasenwinkel, welcher einen reduzierten Ernährungszustand widerspiegelt, gerechnet werden. / In clinical diagnostics the nutritional status is becoming more and more of interest. The nutritional status is closely connected with morbidity and mortality. It is usually evaluated by the body mass index (BMI). An exact estimation of nutritional status can be given by the measurement of body composition. The bioelectrical impedance analysis (BIA) allows a quick and non-invasive measurement of the body composition for each patient. A main point of interest is the phase angle, which is measured directly. It gives a prompt view on the nutritional status. There is a relation between the phase angle and the ECM/BCM-Ratio, a sensitive marker for early signs of malnutrition which was validated in many studies. For patients receiving chemotherapy (CT) it is especially important that the application of the therapy is administered in the right dose and dose intensity. Adverse events often lead to a dose reduction or delay of CT administration. In a prospective clinical study we measured consecutively 40 women receiving chemotherapy for a gynaecological malignancy. BIA was performed before each course of CT. The study demonstrates that an evaluation of the nutritional status can be used to predict the risk for adverse events in patients under chemotherapy. The BMI showed not to be a reliable parameter to estimate the nutritional status. A decreased phase angle which is a parameter for a reduced nutritional status showes that a higher rate of side effects in chemotherapy can be expected .

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La santé sexuelle des femmes touchées par un cancer gynécologique peut être affectée par la maladie et ses traitements. Même si l’infirmière est une professionnelle de choix pour aborder la discussion sur ce sujet, de nombreuses études constatent que la communication est minimale en raison d’un manque de formation et de connaissances en santé sexuelle. Peu d’interventions éducatives sont répertoriées pour améliorer la communication des infirmières intervenant auprès de cette clientèle. Cette étude avait pour but de tester et de documenter la faisabilité, l’expérience d’apprentissage et les retombées d’une simulation en ligne réalisée avec une patiente partenaire pour améliorer la communication des infirmières en santé sexuelle chez la clientèle gynéco-oncologique. Une étude de faisabilité utilisant une approche qualitative a été réalisée auprès de 11 infirmières œuvrant avec la clientèle oncologique. Une analyse thématique itérative a été effectuée. Les résultats indiquent que l’activité de simulation en ligne est faisable selon plusieurs indicateurs (p. ex., contexte, ressources). L’expérience d’apprentissage a été décrite comme offrant des interactions réalistes avec une patiente partenaire et encourageant un apprentissage actif et sécuritaire malgré une structure pédagogique pouvant entraver la collaboration en groupe. Les résultats suggèrent que cette intervention pourrait avoir plusieurs retombées positives entre autres sur l’amélioration des connaissances et des habiletés de communication en santé sexuelle oncologique. Cette étude a permis de proposer une intervention éducative novatrice pour améliorer la communication infirmière en matière de santé sexuelle gynéco-oncologique. Différentes recommandations énoncées soulignent l’importance de poursuivre le développement des connaissances et de la formation infirmière en santé sexuelle gynéco-oncologique. / Nursing communication with the gynecological cancer clientele about their sexual health threatened by cancer and its treatments is suboptimal due to the lack of training and knowledge in this field. Few educational interventions exist to improve communication about sexual health among nurses working in Canadian cancer care settings. The aim of this study was to test and to document the feasibility, the learning experience and the effects of an online simulation with a patient-partner to improve nursing communication on sexual health with gynecological cancer clientele. A feasibility study using a qualitative approach was conducted with 11 nurses working with cancer patients. An iterative thematic analysis was performed. The results suggest that the online simulation activity is feasible according to several indicators (e.g., context, resources). The learning experience has been perceived as providing realistic nursing interactions with a patient-partner and encouraging active and safe learning despite an educational structure that may hinder group collaboration. The results indicate that this intervention could have several positive effects, including improving knowledge and communication skills about sexual health in cancer. In sum, this study has proposed an innovative educational intervention to improve nursing communication on sexual health after gynecological cancer. Many recommendations have been elaborated and emphasize the importance of continuing professional development and nursing training in sexual health with cancer patients.