Orientadores: Cássio Luis Zannettini Riccetto, Simone Botelho Pereira / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-20T03:58:07Z (GMT). No. of bitstreams: 1 Lanza_AnaHelenaBarbosa_M.pdf: 1640627 bytes, checksum: c135a5857fcde47208c0a3c7f837045b (MD5) Previous issue date: 2011 / Resumo: Objetivo. Avaliar o efeito de um programa supervisionado de cinesioterapia sobre a contratilidade do assoalho pélvico, e sua eventual correlação com a função orgásmica feminina. Sujeito e Métodos. Para este estudo clínico, prospectivo, randomizado, controlado e cego, foram inclusas 20 mulheres, com média de idade de 26,6 ± 6,1 anos, com queixa de falta de orgasmo durante a atividade sexual, as quais foram divididas aleatoriamente em dois grupos. Grupo 1 (G1): 10 mulheres; avaliadas quanto à função orgásmica e quanto à contratilidade muscular do assoalho pélvico; realizaram um protocolo de exercícios cinesioterapêuticos (12 sessões individuais, com duração de 30 minutos, duas vezes por semana), focado no fortalecimento muscular pélvico; e reavaliada quanto à função orgásmica e quanto à contratilidade muscular; Grupo 2 (G2): 10 mulheres; avaliadas quanto à função orgásmica e quanto à contratilidade muscular do assoalho pélvico; não realizaram o protocolo de exercícios cinesioterapêuticos; foram reavaliadas quanto à função orgásmica e quanto à contratilidade muscular simultaneamente às mulheres do G1, sendo denominado G2-Controle. Após uma semana, esse grupo realizou o mesmo protocolo de exercícios cinesioterapêuticos, foi reavaliado quanto à função orgásmica e quanto à contratilidade muscular, sendo denominado G2-Tratado. A função orgásmica foi avaliada por meio do domínio orgasmo do questionário validado para língua portuguesa Female Sexual Function Index (FSFI), e por meio do cálculo do Coeficiente de Capacidade Orgásmica (CCO). As avaliações da contratilidade muscular do assoalho pélvico foram realizadas por segundo pesquisador, o qual não tinha conhecimento do programa de tratamento, através de palpação digital (PD) e de eletromiografia de superficie (EMGs - com sensor intravaginal), enquanto que, o programa de exercícios cinesioterapêuticos foi elaborado e supervisionado por pesquisador, o qual não participou das avaliações da contratilidade muscular do assoalho pélvico. O questionário International Consultation on Incontinence Questionnaire Short-Form, validado para a língua portuguesa, foi aplicado na avaliação inicial, no intuito de verificar a coexistência da incontinência urinária. Para análise estatística foram utilizados o Teste t de Student, o Teste de Correlação de Pearson, e o Teste Regressão Linear Simples, com nível de significância de 5%. Resultados. Em contraste com o grupo controle (G2-Controle), os grupos que realizaram o programa de exercícios cinesioterapêuticos proposto (G1 e G2-Tratado) apresentaram aumento significativo na contratilidade do assoalho pélvico, tanto a avaliada pela PD (p<0,001), quanto a mensurada pela EMGs (p<0,001), e este aumento de contratilidade se correlacionou de forma significativa com a melhora no escore do domínio orgasmo do FSFI (p<0,001), e no escore do Coeficiente de Capacidade Orgásmica (p=0,001). Conclusão. O programa de exercícios cinesioterapêuticos proposto promoveu aumento na contratilidade do assoalho pélvico, com concomitante melhora da função orgásmica, indicando que essa abordagem terapêutica possa ser adjuvante no tratamento da disfunção orgásmica feminina / Abstract: Objective. Evaluate the effect of a protocol supervised of the kinesiotherapy on the contractility of the pelvic floor, and its possible correlation with female orgasmic function. Subjects and methods. For this clinical, prospective, randomized, controlled, blind study, were included 20 women, mean age 26.6 ± 6.1 years, complaining of lack of orgasm during sexual activity, which were randomly divided into two groups. Group 1 (G1): 10 women, evaluated for orgasmic function and on the contractility of the pelvic floor, made a kinesiotherapy protocol (12 sessions, lasting 30 minutes, twice a week), focused on muscle strengthening, and reassessed as the orgasmic function and the contractility of the pelvic floor; Group 2 (G2): 10 women, evaluated for orgasmic function and on the contractility of the pelvic floor, did not realize the kinesiotherapy protocol, were reassessed on the orgasmic function and on the contractility of the pelvic floor while the women in the G1, and called G2- Control. After one week, this group received the same kinesiotherapy protocol, was reassessed as the orgasmic function and on the contractility of the pelvic floor, and called G2- Treaty. Orgasmic function was assessed using the orgasm domain of the validated questionnaire to portuguese Female Sexual Function Index (FSFI), and by calculating the Coefficient of Orgasmic Capacity (COC). The assessments of the pelvic floor muscle contractility were performed by the second researcher, which was not aware of the treatment program, by digital palpation (DP) and surface electromyography (sEMG - with intravaginal sensor), while kinesiotherapy program was drafted and supervised by a researcher no involved in the assessments of contractility of the pelvic floor. The International Consultation on Incontinence Questionnaire, validated for the portuguese language was used in the initial assessment, in order to verify the coexistence of urinary incontinence. Statistical analysis was performed using the Student t Test, the Pearson Correlation Test, and the Simple Linear Regression Test, with a significance level of 5%. Results. In contrast to the control group xvi (G2-control), groups that performed kinesiotherapy (G1 and G2-Treaty) showed a significant increase in contractility of the pelvic floor, assessed by PD (p <0,001), and measured by EMG (p <0.001), and this increase in contractility was positively correlated with the improvement in the orgasm domain score of the FSFI (p <0,001), and the score of the Coefficient Orgasmic Capacity (p = 0,001). Conclusion. The kinesiotherapy exercises program promoted increase in contractility of the pelvic floor, with concomitant improvement in orgasmic function, indicating that this therapeutic approach could be an adjunct in the treatment of female orgasmic dysfunction / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências da Cirurgia

Prostate cancer, the leading cause of cancer in men, has positive survival rates and constitutes a challenge to men with its side effects. Studies have addressed the bivaritate relationships between prostate cancer treatment side effects masculinity, partner relationship, and quality of life (QOL). However, few studies have highlighted the relationships among prostate cancer treatment side effects (i.e., sexual dysfunction, urinary incontinence), masculinity, and relationship with the partner together on QOL in men. Most studies were conducted with predominately Caucasian sample of men. Miami is a unique multiethnic setting that hosts Cuban, Columbian, Venezuelan, Haitian, other Latin American and Caribbean communities that were not represented in previous literature. The purpose of this study was to examine relative contributions of age, ethnicity, sexual dysfunction, urinary incontinence, masculinity, and perception of the relationship with the partner on the quality of life in men diagnosed with prostate cancer. Data were collected using self administered questionnaires measuring demographic variables, sexual and urinary functioning (UCLA PCI), masculinity (CMNI), partner relationship (DAS), and QOL (SF-36). A total of 117 partnered heterosexual men diagnosed with prostate cancer were recruited from four urology clinics in Miami, Florida. Men were 67.47 (SD = 8.42) years old and identified themselves to be of Hispanic origin (54.3 %, n = 63). Findings demonstrated that there was a significant moderate negative relationship between urinary and sexual functioning of men. There was a significant strong negative association between men’s perceived relationship with partner and masculinity. There was a weak negative relationship between the partner relationship and QOL. Hierarchal multiple regression showed that the partner relationship (β = -.25, t (91) = -2.28, p = .03) significantly contributed overall to QOL. These findings highlight the importance of the relationship satisfaction in the QOL of men with prostate cancer. Nursing interventions to enhance QOL for these men should consider strengthening the relationship and involving the female partner as an active participant.

Title: Sexual Dysfunction and Pelvic Floor Dysfunction in Patients with Systemic Rheumatic Diseases Objectives: To assess sexual functions, quality of life and pelvic floor function in female patients with Systemic Sclerosis (SSc) and Idiopathic Inflammatory Myopathies (IIM) compared to age-/sex-matched healthy controls (HC). Methods: In total, 41 women with SSc (mean age: 50.9, disease duration: 5.8 years), who fulfilled the ACR/EULAR 2013 classification criteria for SSc, 41 healthy controls (mean age: 50.9) without rheumatic diseases, 22 women with IIM [mean age: 55.1, disease duration: 7.9 years, dermatomyositis (DM, 8)/ polymyositis (PM, 10)/ necrotizing myopathy (IMNM, 3)/ inclusion body myositis (IBM, 1)], who fulfilled the Bohan/Peter 1975 diagnostic criteria for DM/PM, and 22 healthy controls (mean age: 55.1 years) filled in 12 well-established and validated questionnaires assessing sexual function/quality of life, pelvic floor function, fatigue, physical activity and depression. Results: Compared to HC, patients with SSc and IIM had significantly higher prevalence and greater severity of sexual dysfunction (FSFI, BISF-W: in all subscales as well as total scores), dysfunction of pelvic floor (PISQ-12), and worse sexual quality of life (SQoL-F). Worse scores in SSc patients were associated...

Introduction: Burnout syndrome is a topical issue in the world and in the Czech Republic, not only in the healt sector. The diploma thesis is focused on finding the conection between burnout syndrome and sexuality of general nurses in emergency care. I chose the topic for my diploma thesis because it is close to me and I work in emergency care myself. In addition, the topic is not very well explored, and the research data will contribute to an international study examining the imapct od burnout syndrome on human health. This study in the Czech Republic is under the guidance of PhDr. Šárky Dynákové, Ph.D. and doc. PhDr. Jana Kožnara, CSc. Methodology: Data collection for research was conducted using two anonymous questionnaires. The first questionnaire focused on burnout syndrome using the Czech version of the Shirom-Melamed scale (Shirom, Melamed, 2006 In Ptáček, 2013). The second questionnaire examined the sexual function of a woman according to Mellan in Kratochvíl, S. (1999). The research sample consisted of general nurses working in emergency care at a teaching hospital. Results: The impact of burnout syndrome has been demonstrated by research in sexual desire (H1), self-assessment as a sexual partner (H2), and mood before sexual intercourse (H4). The results show that the area that achieved...

Introduction to the issue: This paper examines the impact of burnout syndrome, which is common among caring professionals, on the sexuality of male paramedics. The term "burnout" was coined in the US 25 years ago. Burnout is defined as a mental state resulting from constant and long-term exposure to stress, especially in relation to psychosocial work factors (Melamed and Shirom, 2006). The effect of burnout syndrome on sexuality is a topic that has received very little attention. That is why I decided to cooperate with PhDr. Šárka Dynáková, Ph.D. and doc. PhDr. Jan Kožnar, CSc, who are working on an international study in the Czech Republic on the effects of burnout syndrome on human health. Methodology: For the theoretical part of this diploma thesis, use was made of monographs and databases. For the practical part, quantitative data was collected using standardized questionnaires distributed among male paramedics. The first questionnaire focused on burnout syndrome using a validated questionnaire for the Czech Republic, one that applies the Shirom-Melamed scale from 2006 (Ptáček, 2013). An extended Kroměříž version of the Sexual Functions of Men questionnaire was used for collecting the data on sexuality (Kratochvíl, 1999). After establishing five working hypotheses (H), the relationship between...

Bakgrund: Kvinnor som genomgår bröstcancerbehandling kan erhålla strålbehandling, cytostatika, endokrin behandling och/eller total eller delvis borttagande av bröst. Sjukdomen och behandlingen kan innebära stor påverkan på kvinnors hälsa och livssituation och ge stora effekter på sexuell funktion och sexuell hälsa.  Syfte: Syftet med studien var att beskriva kvinnors erfarenheter av sexualitet efter genomgången bröstcancerbehandling. Metod: En litteraturstudie med systematisk ansats genomfördes. Sökningar i databaserna PubMed, CINAHL och PsycINFO genererade resultat ur vilket kvalitativa studier inkluderades. Innehållsanalys användes för att analysera studierna, flertalet koder återkom som kondenserades till kategorier som vidare kondenserades till teman. Resultat: Resultatet baserades på åtta kvalitativa och mixed-method studier som undersökte kvinnors sexualitet relaterat till bröstcancerbehandling. Dataanalysen sammanställdes slutligen i fyra teman; fysiska förändringar som påverkar sexualiteten,emotionella konsekvenser, sociala konsekvenser av den förändrade sexualiteten och stöd och coping. Slutsats: Många kvinnor upplever en förändrad kroppsbild och sexuell dysfunktion som ger påverkan på livsstil och partnerrelation. Både negativa och positiva konsekvenser förekommer och vid partnerrelation är kvaliteten av denna avgörande för kvinnans välmående. Kvinnorna erfar också bristande kunskap och stöttning från vården, vilken är beroende av kunskap och kompetens inom ämnet.

Few studies focus on sexual dysfunction among young women diagnosed with breast cancer. The aim of this study was to examine prevalence of sexual dysfunction over time among this group and to identify factors associated with sexual dysfunction. The specific research questions were 1) How does sexual function in young women with breast cancer change from 1.5 years to 3 years after diagnosis? 2) What factors are associated with sexual dysfunction in young women 3 years after receiving a breast cancer diagnosis? This study investigated several biopsychosocial factors such as current cancer treatment, sexual self-efficacy (SSE), body image, emotional distress, having children and relationship status and their associations with sexual dysfunction. Sexual dysfunction was assessed with the scale PROMIS® SexFS. Participants consisted of 260 women, who responded to a survey 1,5 respectively 3 years after being diagnosed with breast cancer at age 18-39. Dependent t-test and McNemar tests wereconducted to identify differences in sexual function over time. Multiple logistic regression analysis was conducted to identify factors associated with sexual dysfunction. Results showed that sexual dysfunction remained a common problem 3 years after diagnosis. Sexual dysfunction was more common among women who did not have children, was currently undergoing treatment, reported lower SSE, and more depressive symptoms. Future research should focus on developing interventions to improve SSE in order to improve sexual function for breast cancer survivors. Clinical implications include following up sexual function through dialogue with patients and offering medical aid and treatment. / Få studier fokuserar på sexuell dysfunktion bland unga kvinnor som diagnostiserats med bröstcancer. Syftet med denna studie var att undersöka prevalensen av sexuell dysfunktion över tid hos denna grupp och identifiera faktorer associerade med sexuell dysfunktion. De specifika forskningsfrågorna var 1) Hur förändras sexuell funktion hos unga kvinnor med bröstcancer från 1,5 år till 3 år efter diagnos? 2) Vilka faktorer är associerade med sexuell dysfunktion hos unga kvinnor 3 år efter att de erhållit en bröstcancerdiagnos? Den här studien undersökte flera biopsykosociala faktorer såsom nuvarande cancerbehandling, sexuell self-efficacy (SSE), kroppsuppfattning, ångest, depression, att ha barn samt relationsstatus och deras samband med sexuell dysfunktion. Sexuell dysfunktion undersöktes med skalan PROMIS® SexFS. Deltagarna bestod av 260 kvinnor, som svarade på en enkät 1,5 respektive 3 år efter att de fått diagnosen bröstcancer i ung vuxen ålder (18-39 år). Beroende t-test och McNemar-tester genomfördes för att identifiera skillnader i sexuell funktion över tid. Multipel logistisk regressionsanalys utfördes för att identifiera faktorer associerade med sexuell dysfunktion. Resultaten visade att sexuell dysfunktion var ett fortsatt vanligt problem 3 år efter cancerdiagnosen. Sexuell dysfunktion var vanligare bland kvinnor som inte hade barn, som hade en pågående cancerbehandling, som rapporterade lägre SSE och hade mer depressiva symtom. Framtida forskning bör fokusera på att utveckla interventioner för att förbättra sexuellfunktion genom att höja SSE för bröstcancer-överlevare. Kliniska implikationer inkluderar att följa upp sexuell funktion genom dialog med patienter, samt att erbjuda medicinsk hjälp och behandling.

Theoretical part Currently accepted new conceptualization of women's sexual dysfunction is based on the model found in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-IV) and International Classification of Diseases (ICD). These classifications are extended and combined interpersonal, contextual, personalpsychological and biological factors. Recent DSM- IV definitions have focused on absence of sexual fantasies and sexual desireprior to sexual activity and arousal, even though the frequencyof this type of desire is known to vary greatly among women without sexual complaints. DSM-IV definitions also focus on genital swelling and lubrication, entities known to correlate poorly with subjective sexual arousal and pleasure. The structure of the new classification is based on the four categories of DSM-IV: disorders of desire, arousal, orgasm and pain. However these categories are newly assigned to the subjective dimension of satisfaction, stress and the presence of disorders during other sexual activities besides intercourse. The dimension lifetime vs. acquired, generalized vs. situational were added, as well as the etiology is taking into account. For clinical work it is important that these changes highlight the significance and importance of psychological, situational...

Background Relational intimacy is hypothesized to underlie the association between female sexual functioning and various sexual outcomes, and married women and women with sexual dysfunction have been generally absent from prior studies investigating these associations, thus restricting generalizability. Aim To investigate whether relational intimacy mediates sexual outcomes (sexual satisfaction, coital frequency, and sexual distress) in a sample of married women with and without impaired sexual functioning presenting in clinical settings. Methods Using a cross-sectional design, 64 heterosexual married women with (n = 44) and without (n = 20) impaired sexual functioning completed a battery of validated measurements assessing relational intimacy, sexual dysfunction, sexual frequency, satisfaction, and distress. Intimacy measurements were combined using latent factor scores before analysis. Bias-corrected mediation models of the indirect effect were used to test mediation effects. Moderated mediation models examined whether indirect effects were influenced by age and marital duration. Outcomes Patients completed the Female Sexual Function Index, the Couple's Satisfaction Index, the Sexual Satisfaction Scale for Women, the Inclusion of the Other in the Self Scale, and the Miller Social Intimacy Test. Results Mediation models showed that impaired sexual functioning is associated with all sexual outcomes directly and indirectly through relational intimacy. Results were predominantly independent of age and marital duration. Clinical Implications Findings have important treatment implications for modifying interventions to focus on enhancing relational intimacy to improve the sexual functioning of women with impaired sexual functioning. Strengths and Limitations The importance of the role relational intimacy plays in broad sexual outcomes of women with impaired sexual functioning is supported in clinically referred and married women. Latent factor scores to improve estimation of study constructs and the use of contemporary mediation analysis also are strengths. The cross-sectional design precludes any causal conclusions and it is unknown whether the results generalize to male partners, partners within other relationship structures, and non-heterosexual couples. Conclusion Greater relational intimacy mitigates the adverse impact of impaired sexual functioning on sexual behavior and satisfaction in women. Witherow MP, Chandraiah S, Seals SR, et al. Relational Intimacy Mediates Sexual Outcomes Associated With Impaired Sexual Function: Examination in a Clinical Sample. J Sex Med 2017;14:843–851.

6 Abstract Background: Obesity and associated comorbidities increase the probability of sexual disorders. We aimed to assess sexual satisfaction in obese women before and after bariatric surgery using the validated Female Sexual Function Index (FSFI) and also to assess sexual satisfaction in obese women in comparison with women of normal weight. We also compared the frequency of female sexual dysfunction (FSD) of the participants. Methods: 60 obese women 5.99 completed the questionnaire on sexual satisfaction (FSFI) before a bariatric procedure (laparoscopic adjustable gastric banding, 22 women; gastric plication, 33 women; and biliopancreatic diversion, 5 women), 6 months and 12 months after the procedure, i.e. after a significant weight reduction (final BMI of . The control group consisted of 60 women of normal weight (mean BMI of 22.2 1.9 domains, with higher scores indicating better sexual function. The FSFI total score (range 2- dicating FSD. Results: Baseline sexual function in the preoperative obese female was significantly lower than in the control group of women of normal weight (p < 0.01) in each domain. Average postoperative FSFI scores increased from preoperative levels in all domains, but significant improvement occurred only in the domain for desire (p < 0.01). The results at 6 and 12 months...