Background: Breast and Gynecological cancers are a major public health problem. Smoking is associated with several chronic diseases including cancer. Other lifestyles of public health predispose many people to dyslipidemia, hypertension and obesity; risk factors for metabolic syndrome, and are associated with cancer. Objectives: The purpose of this study is to find if those who smoke, and have the metabolic syndrome, are more likely to have breast or gynecological cancers, and to find the distribution by education, having health insurance, race/ethnicity and socio-economic status. Methods: A case-control study of females aged 20 years and above who participated in the United States National Health and Nutrition Examination Survey (NHANES) 2001-2010. Results: Females who have smoked more than hundred cigarettes in life and still smoke; a) have a 42 percent less chance of having a breast cancer diagnosis (OR 0.58; 95% CI 0.36 – 0.93, p-value 0.025), and b) are 2.67 times as likely to report a cervical cancer diagnosis as females who have smoked less than hundred cigarettes in life (OR 2.67; 95% CI 1.72 – 4.13, p-value Conclusion: Smoking and metabolic syndrome are very important indicators of reproductive health and needs further study. Smoking cessation interventions should be an integral part of cervical cancer prevention programs especially targeted at younger females and females who live below the federal poverty level.

Bakgrund: Gynekologisk cancer är ett utbrett spektrum av cancersjukdomar bland kvinnor och behandlingarna har betydelse för upplevelsen av den sexuella hälsan. Den sexuella hälsan är viktig för människans totala upplevelse av hälsa. Om den sexuella hälsan upplevs otillfredsställande kan ett lidande uppstå. Syfte: Syftet är att beskriva kvinnors upplevelse av sexuell hälsa vid gynekologisk cancer. Metod: En litteraturöversikt över tolv kvalitativa artiklar har genomförts. Resultat: Resultatet visade upplevda barriärer för sexuell hälsa vid gynekologisk cancer. Barriärerna presenteras i tre huvudkategorier: Den sexuella kroppen, Sexuella hinder och Sexuella relationer. Slutsats: Kvinnor med gynekologisk cancer upplever huvudsakligen flera barriärer för sexuell hälsa. Upplevelsen av dessa sexuella barriärer kan leda till en otillfredsställande sexuell hälsa vilket vidare kan orsaka ett lidande. Genom kunskap om upplevelsen av sexuell hälsa vid gynekologisk cancer kan sjukvården erbjuda vård som omfattar flera aspekter av sjukdomen och därmed minska risken för lidande. Klinisk betydelse: Denna litteraturstudie kan bidra med kunskap om kvinnors upplevda sexuella hälsa vid gynekologisk cancer. Sjukvården har en viktig roll att uppfylla med hänsyn till kvinnors upplevelse av bristande information. Utbildning och diskussion kring sexuell hälsa på sjuksköterskeutbildningen skapar förutsättningar för att samtal om sexuella hälsa ska bli ett självklart inslag i vården. / Background: Gynecological cancer is an expanded spectrum of cancer diseases among women and the treatments have importance for the experience of sexual health. Sexual health is important for the total experience of health. If the sexual health is perceived unsatisfactory, a suffering can arise. Aim: The aim is to describe women’s experience of sexual health within gynecological cancer. Method: A literature review of twelve qualitative articles was performed. Results: The analysis resulted in experienced barriers for sexual health within gynecological cancer. The barriers are presented in three main categories: The sexual body, Sexual obstacles and Sexual relations. Conclusion: Women with gynecological cancer mainly experience several barriers for sexual health. The barriers can lead to an unsatisfied sexual health which can cause a suffering. By knowledge about the experience of sexual health within gynecological cancer, the health care can provide care including several aspects of the disease and thereby decrease the risk for suffering. Clinical significance: This study can contribute knowledge about women’s perceived sexual health within gynecological cancer. Health care providers have an important role to fulfill regarding women’s experience of lack of information. Education and discussion about sexual health in the nursing education creates conditions for conversations about sexual health to become an obvious part of the health care. / <p>Röda Korsets sjuksköterskeförening stipendium juni 2015</p>

Background: Breast and Gynecological cancers are a major public health problem. Smoking is associated with several chronic diseases including cancer. Other lifestyles of public health predispose many people to dyslipidemia, hypertension and obesity; risk factors for metabolic syndrome, and are associated with cancer. Objectives: The purpose of this study is to find if those who smoke, and have the metabolic syndrome, are more likely to have breast or gynecological cancers, and to find the distribution by education, having health insurance, race/ethnicity and socio-economic status. Methods: A case-control study of females aged 20 years and above who participated in the United States National Health and Nutrition Examination Survey (NHANES) 2001-2010. Results: Females who have smoked more than hundred cigarettes in life and still smoke; a) have a 42 percent less chance of having a breast cancer diagnosis (OR 0.58; 95% CI 0.36 – 0.93, p-value 0.025), and b) are 2.67 times as likely to report a cervical cancer diagnosis as females who have smoked less than hundred cigarettes in life (OR 2.67; 95% CI 1.72 – 4.13, p-value Conclusion: Smoking and metabolic syndrome are very important indicators of reproductive health and needs further study. Smoking cessation interventions should be an integral part of cervical cancer prevention programs especially targeted at younger females and females who live below the federal poverty level.

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.

Submitted by Biblioteca da Faculdade de Farmácia (bff@ndc.uff.br) on 2017-04-03T17:52:51Z No. of bitstreams: 1 Araujo, Fernanda Miranda de [Dissertação, 2011].pdf: 1770084 bytes, checksum: 02dc9fe25e679414ba90c97935473f41 (MD5) / Made available in DSpace on 2017-04-03T17:52:51Z (GMT). No. of bitstreams: 1 Araujo, Fernanda Miranda de [Dissertação, 2011].pdf: 1770084 bytes, checksum: 02dc9fe25e679414ba90c97935473f41 (MD5) / Objetivo. Descrever a prevalência de resistência a ciprofloxacino e analisar as variáveis potencialmente associadas a esta resistência em amostras de Escherichia coli isoladas de pacientes com câncer ginecológico e infecção do trato urinário (ITU). Métodos. Trata-se de uma série de casos de pacientes com ITU por E. coli assistidas no Hospital do Câncer II do Instituto Nacional do Câncer (INCA/HCII) de março de 2009 a fevereiro de 2010. Os casos foram detectados através de vigilância microbiológica no laboratório de bacteriologia clínica do INCA/HCII. As análises microbiológicas foram realizadas conforme recomendado pelo Clinical and Laboratory Standards Institute (CLSI). Os dados clínicos e epidemiológicos foram coletados através de revisão de prontuários. Para a avaliação das variáveis potencialmente associadas à resistência a ciprofloxacino foi feita análise multivariada por regressão logística. Resultados. Entre os 275 casos de ITU por E. coli em pacientes com câncer ginecológico incluídas no estudo, a prevalência de resistência das amostras a ciprofloxacino foi 31%. A prevalência de resistência das amostras a outros antimicrobianos como cefazolina, ceftazidima, fosfomicina, gentamicina e nitrofurantoína aumentou significativamente (p≤0,05) ao longo do período. Não foi detectada resistência a amicacina e carbapenemas. Duas amostras foram produtoras de b-lactamases de espectro ampliado (ESBL). As variáveis independentemente associadas à resistência a ciprofloxacino entre as amostras de E. coli foram: presença de nefrostomia (OR: 4,83; IC95%: 1,15-20,23; p: 0,031), internação (OR: 4,00; IC95%: 1,35-11,85; p: 0,012) e uso de fluoroquinolona (OR: 3,02; IC95%: 1,28-7,91; p: 0,015) nos 3 meses anteriores ao episódio de ITU. Conclusão. A resistência ao ciprofloxacino foi elevada. Os fatores de risco para esta resistência foram aqueles relacionados à manipulação de vias urinárias, sugerindo a possibilidade de transmissão cruzada de amostras resistentes a ciprofloxacino, e o uso prévio de fluoroquinolonas / Objective. To describe the prevalence of resistance to ciprofloxacin and analyze variables potentially associated with this resistance in samples of Escherichia coli isolated from patients with gynecological cancer and urinary tract infection (UTI). Methods. A case-series was conducted between March 2009 and February 2010 at the Cancer Hospital II part of the National Cancer Institute (INCA/HCII) with patients aged over 18 years with gynecological cancer presenting UTI caused by E. coli. Cases were detected through microbiological surveillance in the laboratory of clinical bacteriology in INCA/HCII. Microbiological analyses were performed as recommended by Clinical and Laboratory Standards Institute (CLSI). Clinical and epidemiological data were collected through charts review. For the evaluation of variables potentially associated with resistance to ciprofloxacin the multivariate analysis were performed by logistic regression. Results. Among 275 cases of UTI caused by E. coli in patients with gynecological cancer included in the study, the prevalence of samples resistant to ciprofloxacin was 31%. The prevalence of samples resistant to other antimicrobials such as cefazolin, ceftazidima, fosfomycin, gentamicin and nitrofurantoína increased significantly (p≤0,05) during the period. It was not detected resistance to amikacin and carbapenems. Two samples were producers of extended spectrum b-lactamase (ESBL). The variables independently associated with resistance to ciprofloxacin between samples of E. coli were: undergone nephrostomy (OR: 4.83; IC95%: 1.15-20.23; p: 0.031), hospitalization (OR: 4.00; IC95%: 1.35-11.85; p: 0.012) and use of fluoroquinolone (OR: 3.02; IC95%: 1.28- 7.91; p: 0.015) in the 3 months preceding the episode of UTI. Conclusion. Resistance to ciprofloxacin was high. Risk factors for this resistance were those related to urinary tract manipulation suggesting the possibility of cross transmission of samples resistant to ciprofloxacin, and previous use of fluoroquinolones

Anderson, P & Sinclair, F. Omvårdnad vid gynekologisk cancer. En litteraturstudie. Examensarbete i omvårdnad 15 högskolepoäng. Malmö universitet: Fakulteten för hälsa och samhälle, Institutionen för vårdvetenskap, 2019.Bakgrund: Årligen insjuknar cirka 3000 kvinnor i gynekologiska cancersjukdomar i Sverige. Detta omfattar maligna sjukdomar i ovarier, uterus, endometriet, cervix, och äggledare. Kvinnor i alla åldrar och livsfaser insjuknar i sjukdomar som på olika sätt och beroende på vilken livssituation kvinnan befinner sig i, påverkar henne. Sjukdomarna har olika prognos, symtom och behandling och medför således olika behov av omvårdnad. Syfte: Syftet med litteraturstudien var att sammanställa kvinnors erfarenheter av omvårdnad vid gynekologisk cancer. Metod: Litteraturstudier genomfördes med sökningar i databaserna PubMed, Cinahl och PsycINFO, 13 kvalitativa artiklar valdes ut och sammanställdes i resultatet genom innehållsanalys där texterna lästes upprepade gånger, meningsbärande och återkommande delar valdes ut, tolkades och sammanställdes i gemensamma teman. Resultat: Ett huvudtema identifierades under analysens gång; Att bli sedd. Detta konkretiserades i tre teman; Kommunikation, Tillgänglighet och Tillit med totalt fem subteman. Konklusion: Gynekologisk cancer berör de kvinnor som insjuknar på olika sätt, bland annat beroende på vilken livsfas de befinner sig i. Kvinnor som insjuknar i gynekologisk cancersjukdom har en önskan om att ses som en individ och har olika behov av stöd och omvårdnad. Att bli sedd var ett genomgående tema som framkom i litteraturstudierna. Personcentrerad omvårdnad bör vara ett ledord i omvårdnad av gynekologiska cancersjukdomar.Nyckelord: gynekologisk cancer, omvårdnad, personcentrerad vård, sjuksköterska, upplevelser / Anderson, P & Sinclair, F. Nursing care during treatment for gynecological cancer. Degree project in nursing 15 Credits. Malmö University: Faculty of Health and Society, Department of Care Science, 2019.Background: Each year approximately 3000 women in Sweden is diagnosed with gynecological cancer. This includes malignant diseases of the ovaries, uterus, endometrium, cervix and the fallopian tubes. Women of all ages and in all phases of life are afflicted differently, depending upon the phase of life she is in and when the cancer is detected. Gynecological cancers have different prognoses, symptoms and treatments. Aim: The aim of this literature review was to compile women´s perceptions and experiences of nursing care during gynecological cancer. Method: A literature review was conducted using the databases PubMed, Cinahl and PsycINFO, 13 qualitative studies were chosen and analyzed through content analysis. Meaningful parts of the articles were extracted and interpreted. Parts with similar messages were then compiled into themes. Findings: One main theme was identified through the analysis; To be seen. Three themes were then further identified during the analysis; Communication, Accessibility and Trust. Five sub-themes were additionaly included in the results. Conclusion: Gynecological cancer affects women in different ways depending on the phase of life and age they are in. Women are afflicted differently and want to be seen as individuals. To be seen was a recurring theme in the literature review. Person-centred care should be considered a leading word in nursing care for gynecological cancer.Key words: Experiences, gynecological cancer, nurse, nursing care, person-centred care

Bakgrund: I Sverige drabbas cirka 3000 kvinnor varje år av gynekologisk cancer. Cancer i kvinnans reproduktionsorgan innefattar cancer i äggstockarna, livmodern, livmoderhalsen, vulva och vaginan. Vanligtvis behandlas dessa cancerformer med cytostatika, strålbehandling, kirurgi eller hormonbehandling. Kvinnorna behandlas med kombinerade eller enskilda behandlingsformer beroende på cancerns form och stadium. Syfte: Syftet med denna studie var att beskriva kvinnors erfarenheter av gynekologisk cancer efter avslutad behandling. Metod: En beskrivande litteraturstudie innehållande 15 artiklar med både kvantitativa och kvalitativa ansatser samt mixed-methods. Dessa artiklar har sökts fram i databasen Medline via PubMed. Huvudresultat: Kvinnorna hade både negativa och i sällsynta fall även positiva erfarenheter efter en gynekologisk cancerbehandling. Oavsett om det var positiva eller negativa erfarenheter orsakade de förändringar i kvinnornas liv. Dessa förändringar innebar psykiska, fysiska och sociala konsekvenser som kvinnorna fick leva med under en längre tid. Slutsats: Även om kvinnornas erfarenheter var individuella upplevde många kvinnor liknande konsekvenser efter behandlingen mot gynekologisk cancer. Kvinnorna påverkades psykiskt, fysiskt och socialt vilket ledde till förändringar i deras liv. Sjuksköterskan hade en central roll i kvinnans möte med vården och sjuksköterskan bör eftersträva bästa möjliga omvårdnad för den unika kvinnan. / Background: About 3000 women are affected by gynecological cancer in Sweden every year. Cancer in female genitals includes cancer of the ovaries, uterus, cervix, vagina and vulva. These cancers are usually treated with chemotherapy, radiation, surgery or hormone treatment. The women are treated with combined or individual treatments depending on the type and stage of the cancer. Aim: The aim of this study was to describe women's experiences of gynecological cancer after the treatment was concluded. Methods: This study is a descriptive literature study containing 15 articles with both quantitative and qualitative approaches and mixed-methods. These articles have been searched in the database Medline through PubMed. Results: The women experienced both negative and in rare cases also positive experiences after a gynecological cancer treatment. Whether it was positive or negative experiences it caused changes in women’s lives. These changes entailed psychological, physical and social consequences that the women had to live with for a long time. Conclusion: Although the women’s experiences were individual, many women experienced similar consequences after treatment for gynecological cancer. The women were affected menatally, physically and socially which led to changes in their lives. The nurse had a central role in the women's encounter with the care and the nurses should strive for the best possible care for the unique woman.

Introduktion: I Sverige insjuknar ungefär 3 000 kvinnor i gynekologisk cancer varje år, symptom samt behandlingen ger upphov till många olika biverkningar. Att diagnostiseras med cancer kan skapa varierande reaktioner och upplevas på olika sätt.  Syfte: Syftet var att undersöka hur kvinnor upplever att det är att leva med gynekologisk cancer samt deras upplevelse av stöd från vården.  Metod: En litteraturstudie med en deskriptiv kvalitativ design och en induktiv ansats för att granska vetenskapliga artiklar. Det sammanställda resultatet utgjordes av tio kvalitativa artiklar, hämtade från databaserna Cinahl, PubMed och Psycinfo.  Resultat: I resultatet kunde fyra huvudteman fastställas; Upplevelser av förändrad kroppsuppfattning, upplevelser av förändrade relationer, upplevelser av emotionell omställning och stöd från vården. Cancersjukdomen kunde medföra både psykiskt och fysiskt lidande för kvinnorna, som till exempel förändrad självmedvetenhet och fertilitet. Informationen som kvinnorna fick av vårdpersonalen upplevdes ofta som bristfällig och flera önskade mer stöd och kunskap om sin sjukdom.  Slutsats: Många fysiska och psykiska upplevelser uppstår i samband med att en kvinna blir diagnostiserad med gynekologisk cancer. Stöd från närstående och sjukvården ansågs som viktiga komponenter i kvinnornas tillfrisknande. Bristande information skapade svårigheter för bearbetningsprocessen. För att vården ska bli personcentrerad och omvårdnadsprocessen ska kunna utformas efter patientens behov är det av vikt att som sjuksköterska ha kunskap om hur kvinnor upplever livet med cancer. / Introduction: Around 3000 women are diagnosed with gynecological cancer in Sweden every year, with symptoms and treatments causing many different side effects. Being diagnosed with cancer can create varying reactions which can be experienced in different ways.  Aim: The aim was to investigate how women experience living with gynecological cancer and their experience of the support from the health care provider.  Method: A literature review with a descriptive qualitative design and an inductive approach to review scientific articles. The compiled result consisted of ten qualitative articles, retrieved from the databases Cinahl, PubMed and Psycinfo.  Results: Four main themes were identified; Experiences of changed body perception, Experiences of changed relationships, Experiences of emotional adjustment and Experience of the support from the health care provider. The cancer diagnosis could cause both mental and physical suffering for the women, such as transformed self-awareness and fertility. The information the women received from the health worker was often perceived as deficient and a considerable number of them wanted more support and knowledge about their illness.  Conclusion: Several physical and mental experiences appear in connection with a woman being diagnosed with gynecological cancer. Support from relatives and the health care provider were considered important components in the women ́s recovery. Lack of information created difficulties for the processing experience. In order for the health care to be person-centered and to enable the nursing process to be designed after the patient's needs, it is important as a nurse to have knowledge of how women experience life with cancer.

BAKGRUND: Gynekologisk cancer och dess behandling påverkar hela kvinnan. Den sexuella hälsan påverkar både reproduktion och det sexuella umgänget. Lidandets alla tre former har en stor betydelse och kan skapa existentiella frågor. Stödet från anhöriga men även vårdpersonal har en stor betydelse för kvinnans hantering av sjukdomen. SYFTE: Att beskriva kvinnors upplevelser av hur den sexuella hälsan påverkas av gynekologisk cancer. METOD: Litteraturöversikt baserad på 14 artiklar med kvalitativ och kvantitativ ansats. RESULTAT: Ur analysen identifierades två huvudteman: en förändrad kropp, behov av support för ökat välbefinnande, med vardera två underteman. DISKUSSION: Sjuksköterskor ska erbjuda och vara öppna för samtal om sexuell hälsa, inte bara för de yngre med reproduktiva aspekter. Det professionella och sociala stödet kan både ge positiva och negativa aspekter. Ett stort lidande skapas för kvinnan som har och får diagnosen gynekologisk cancer, vilket skapar stora utmaningar där sjuksköterskan ska lindra lidandet i största mån. KONKLUSION: Kvinnor upplever stor minskad sexuell hälsa och minskad livskvalité. Samtalet om sexuell hälsa är svårt att ta upp med vårdpersonal. Socialt stöd har en betydande roll i kvinnans livskvalité. / BACKGROUND: Gynaecological cancer and its treatment affect the whole woman. Sexual health affects both reproduction and sexual intimacy. All three forms of suffering have great importance and can create existential questions. Support from relatives and healthcare professionals is essential for women to manage their disease. AIM: To describe women's experiences of how sexual health is affected by gynaecological cancer. METHOD: A literature review where qualitative and quantitative articles have been analyzed. RESULT: The analysis identified two main themes, a changed body, the need for support for increased well-being, with two sub-themes each. DISCUSSION: Nurses should offer and be open to conversations about sexual health, not just for the younger ones with reproductive aspects. Professional and social support can provide both positive and negative aspects. Grand suffering is created for the woman who has and is diagnosed with gynaecological cancer, which creates significant challenges where the nurse must alleviate the suffering to the greatest extent. CONCLUSION: Women experience significantly reduced sexual health and reduced quality of life. The conversation about sexual health is challenging to discuss with healthcare professionals. Social support plays a significant role in a woman's quality of life.

Syftet med uppsatsen är att belysa barnmorskors och sjuksköterskors erfarenheter av och förhållningssätt till att förmedla sexologisk information till kvinnor som drabbats av gynekologisk cancer. Vårdpersonal överlag upplever en stor utmaning i att förmedla sexuell information till människor som drabbats av cancer och tidigare forskningsresultat visar att många patienter aldrig får någon sexologisk information överhuvudtaget (Sheppard & Ely, 2008, Hughes, 2009 och Rasmusson et al, 2012). En kvalitativ metod med explorativ ansats valdes i form av semistrukturerade intervjuer för att den skapar en fördjupad förståelse för vad barnmorskor och sjuksköterskor själva tycker och har för erfarenhet av att prata om sexualitet med denna patientgrupp. Fem barnmorskor och fyra sjuksköterskor alla med minst ett års erfarenhet av att vårda kvinnor som drabbats av gynekologisk cancer deltog i studien. Under analysprocessen återkom ständigt betydelsen av kompetens och den gick att identifiera på tre nivåer; den individuella nivån, den organisatoriska nivån samt på den normativa nivån. När valda teoretiska perspektiv lades på de deskriptiva teman framträdde; individuell kompetens som förutsättning, organisatoriskt utrymme – individuellt eller kollektivt ansvar, patienters kön och ålder – betydelse för hur och av vem frågan tas upp och föreställningar om sjukdomsdiagnos och sexualitet. I studien framkom att intervjupersonerna uppfattar att sexualitet ska inkluderas i den holistiska omvårdnaden men möjligheten till sexologisk information för de cancerdrabbade kvinnorna påverkas av vårdpersonalens eget förhållningssätt till ämnet. En konsekvens av begränsat organisatoriska utrymmet är att den individuella kompetensen får liten betydelse. Hög ålder i kombination med sjukdom osynliggör sexualiteten. Vårdpersonal upplever svårigheter att prata om sexualitet i relation till sjukdom. Genom att synliggöra svårigheter på olika nivåer ges möjlighet till förändringar i att förmedla sexologisk information inom vården. / The aim of this paper is to highlight midwives and nurses' experiences and attitudes to discussing sexological information to women affected by gynecological cancer. In general, healthcare professionals find it a great challenge to convey sexual information to people affected by cancer. Previous research shows that many patients never receive any information of a sexual nature at all (Sheppard & Ely, 2008; Hughes, 2009 and Rasmusson et al, 2012). A qualitative method with an exploratory approach was chosen in the form of semi-structured interviews to gain a deeper understanding of what midwives and nurses themselves think and what they experience when talking about sexuality with their patients. Five midwives and four nurses, all with at least one year of experience caring for women affected by gynecological cancer participated in the study. During the analysis process the importance of competences arose frequently and three levels were identified; the individual level, the organisational level and the normative level. When the chosen theoretical perspective was applied to the descriptive themes emerged; individuals competences and knowledge, organisational environment - whether there is an individual or collective responsibility, the patient’s sex and age, how and by whom the question of sexuality is raised and beliefs about illness and sexuality. The study revealed that healthcare professionals see a need for sexuality to be included as part of the holistic nursing care process, but the possibility of sexological information for the affected women is affected by the nursing staff's own attitude to the subject. One consequence of limited organisational environments is that the individual competency may be of little importance. Both old age and illness can contribute to making sexuality invisible. Health professionals find it problematic to consider sexuality in relation to illness. By exposing these difficulties at various levels give us the opportunity to changes in the process of conveying sexological information as part of a comprehensive health care process.