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Please use this identifier to cite or link to this item: http://ir.lib.stu.edu.tw:80/ir/handle/310903100/1376

Title: 乳癌治療對女性患者性功能及親密關係之影響
The Impact of Breast Cancer Treatment on Female Sexual Functions and Intimate Relationship
Authors: 黃浿綺
Huang, Pey-Chi
Contributors: 阮芳賦;簡上淇
Ruan, Fang-Fu;Chien, Shang-Chi
人類性學研究所
Keywords: 乳癌治療;性功能;親密關係
breast cancer treatment;sexual functions;intimate relationship
Date: 2009
Issue Date: 2011-05-26 10:25:18 (UTC+8)
Publisher: 高雄市:[樹德科技大學人類性學研究所]
Abstract: 本研究欲了解乳癌治療對女性患者之性功能及親密關係之影響,以台灣南部某醫學中心乳房外科,年齡在20-60歲,並於術後接受治療半年以上門診回診的乳癌婦女病患為調查對象。藉由個人基本屬性資料量表、女性性功能簡略索引問卷及親密關係問卷來測量術前、術後乳癌女性患者之性功能及其親密關係的差異與影響。本研究設計先以問卷填寫,再依自訂的訪談大綱作半結構式開放問答並作成記錄以為佐證。
本研究的有效問卷共計103份,以SPSS 15.0 軟體進行資料處理的工具,資料分析方法包括描述性統計(眾數、百分比、平均值、標準差)、獨立樣本t檢定,雙因子變異數分析(two-way ANOVA)、多元迴歸分析(multiple regression analysis)、皮爾森相關分析(pearson correlation)、結構方程模式(structural equation modeling, SEM)等。
研究結果顯示: (1).受試者的平均年齡為48.98歲,高中(職)、信佛教、家庭經濟平均月收入以介於2-5萬的中低收入者居多;半數以上體重超過BMI標準值(n=65, 63.11%)、已停經者(n=76, 73.79%)、並與伴侶同住。受試者距離手術後時間以1-5年內者最多(n=72, 69.89%),手術方式以接受全切除(改良型乳房根除術者)(n=61, 59.22%)與術後接受化學藥物治療者(n=67, 65.05%) 的比率最高。(2).有關性功能的描述統計分析:「性慾望」以「完全沒有」的比率最高(術後43.69%);「性激發」以「因撫摸或前戲而性激發的頻率」最高(標準差為1.39%);「性高潮」以「因接吻達到性高潮的頻率」最高(標準差為1.37%);整體言之的「性滿意度」術後較術前為差。(3).手術前、後的比較:覺得性功能比手術前差者(n=58,56.31%),覺得術前、術後一樣者(n=43, 41.75%),覺得術後較術前為佳者(n=2,1.94%); 術後治療受試者以「害怕疾病復發」為性親密關係中最大的心理障礙。有六成以上的受試者(n=64,62.14%)對於性方面的問題,都以「不去理會」方式處理。(4).與伴侶的親密關係:有超過半數以上覺得術前、術後沒有改變者(n=63,61.17%),覺得術後較術前者(n=23, 22.33%),覺得術後較術前佳者(n=17,16.50%)。
歸結言之,乳癌治療對女性患者之性功能:術後較術前為差。親密關係:術後與術前沒有改變。乳癌治療方式(是否化療)對性功能及親密關係:無化療者比化療者性經驗較多、性慾望較高、較易達性高潮且較有性親密關係。開刀方式(乳房全切或部份切除)對性功能及親密關係無顯著影響。性功能與親密關係有顯在之關聯性。研究結果發現: 一、「性慾低下」是乳癌治療中女性患者性功能最大的障礙。二、「身體親密」為喚醒女性乳癌患者性覺醒值得重視的因素。三、「自慰」的樂趣與滿足可增進女性乳癌患者與伴侶之間的感情親密。
This is a single-centered study, focusing on outpatients during their follow-ups in a breast surgery clinic in southern Taiwan. By enrolling female patients with breast cancer of age between 20 and 60, this study aims at investigating the impact of breast cancer treatment on sexual functions and intimacy with their sexual partners. The enrollment criteria include female patients who had received surgical treatment of breast cancer for over six months. Study parameters consisted of basic demographic characteristics, data from questionnaires on female sexual functions and intimacy with sexual partners as well as information obtained by interviewing the study subjects.
There were totally 103 valid questionnaires collected. Statistical analyses were undertaken using SPSS software (version 15.0). Analytical methods included t-test, two-way ANOVA, multiple regression analysis, pearson correlation and structural equation modeling (SEM).
Demographic analysis showed that (1). the mean age of the patients was 48.98. The majority graduated from high schools with Buddhism as their religious beliefs. Financially, the income of the study subjects was about average or below with a monthly salary between NT $20,000 to 50,000. Over 50% of the patients were menopausal (n=76, 73.79%) with an elevated BMI (n = 65, 63.11 %) and stayed with their partners. The majority of patients had received modified radical mastectomy (n = 61, 59.22 %) with postoperative chemotherapy (n = 67, 65.05 %). Most patients had received operative treatment within 5 years. Postoperative “loss of sexual desire” was the most common breast cancer therapy-related sexual dysfunction reported (43.69%). The most common “turn-on” parameter was “caressing or foreplay-elicited” (SD = 1.39 %). Achievement of “orgasm” through kissing was most common (SD = 1.37%). There was an overall decline in sexual satisfaction postoperatively compared with the preoperative level.
The majority of patients reported a deterioration in sexual function postoperatively compared to the pre-operative levels (n=58, 56.31%), whereas less than half of all patients (n=43, 41.75%) claimed no difference between their pre- and post-operative perception. Only two patients (1.94%) reported an improved sexual function after operation as compared with the pre-operative levels. The main psychological barrier to intimate sexual relationship was “fear for disease recurrence”. “Ignoring” was the most common behavior adapted by the study subjects (n=64, 62.14%),
Regarding the impact of breast cancer treatment on the intimate relationship with their partners, over half of the patients reported no difference between their pre-operative and postoperative levels (n = 63, 61.17%). On the other hand, part of the patient population perceived a deterioration in the relationship (n = 23, 22.33%), whereas the rest claimed an improvement after therapy (n = 17, 16.5%). The attitude toward sexual activities with their partners was generally passive and negative in the study population under breast cancer treatment. The results of the present study showed that physical intimacy on an affectionate basis was still anticipated. An analysis of the factors affecting the establishment of an intimate relationship revealed that “sexual life being respected by the partner”, “active hand-holding by the partner and the sense of being pampered”, and “consideration during sexual activities“ significantly contributed to the degree of intimacy. Multiple regression analysis demonstrated that “frequency of orgasm through masturbation alone” and “frequency of stimulation through body contact and foreplay” were two significant factors associated with emotional intimacy.
In summary, Breast cancer treatment on sexual function of female patients: postoperative worse than preoperative. Intimate relationships: patients with pre-operative has not changed. Breast cancer treatment (whether or not chemotherapy) on sexual function and intimacy: no chemotherapy than chemotherapy were more sexual experience, sexual desire higher, easier to reach orgasm and sexual intimacy than that. Operation mode (modified radical mastectomy or lumpectomy) of no significant impact on sexual function. Intimate relationships between sexual function and have significant relevance. The results of the current study showed that: (1). The major factor contributing to sexual dysfunction in breast cancer patients under treatment was “decreased sexual desire”; (2).“Physical intimacy” significantly aroused the awareness of sexual needs in the study subjects; (3). The pleasure and satisfaction from masturbation significantly enhanced emotional intimacy of the study patients with their partners.
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