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BMC Cancer
Published in: BMC Cancer 1/2015

Open Access 01-12-2015 | Study protocol

Internet-based cognitive behavioral therapy for sexual dysfunctions in women treated for breast cancer: design of a multicenter, randomized controlled trial

Authors: Susanna B Hummel, Jacques JDM van Lankveld, Hester SA Oldenburg, Daniela EE Hahn, Eva Broomans, Neil K Aaronson

Published in: BMC Cancer | Issue 1/2015

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Abstract

Background

Sexual dysfunction is a prevalent, long-term complication of breast cancer and its treatment and can be treated effectively with face-to-face sexual counselling. However, relatively few women actually opt for face-to-face sex therapy, with many women indicating that it is too confronting. Internet-based interventions might be a less threatening and more acceptable approach, because of the convenience, accessibility and privacy it provides. Recent studies have demonstrated the efficacy of internet-based programs for improving sexual functioning in the general population. The objective of the current study is to investigate the efficacy of an internet-based cognitive behavioral therapy (CBT) program in alleviating problems with sexuality and intimacy in women who have been treated for breast cancer.

Methods/design

In a multicenter, randomized controlled trial we are evaluating the efficacy of an internet-based CBT program in reducing problems with sexuality and intimacy in breast cancer survivors. Secondary outcomes include body image, marital functioning, psychological distress, menopausal symptoms, and health-related quality of life. We will recruit 160 breast cancer survivors (aged 18-65 years) with a formal DSM-IV diagnosis of sexual dysfunction from general and academic hospitals in the Netherlands. Women are randomized to either an intervention or waiting-list control group. Self-report questionnaires are completed by the intervention group at baseline (T0), ten weeks after start of therapy (T1), post-treatment (T2), 3 months post-treatment (T3), and 9 months post-treatment (T4). The control group completes questionnaires at T0, T1 and T2.

Discussion

There is a need for accessible and effective interventions for the treatment of sexual dysfunctions in breast cancer survivors. This study will provide evidence about the efficacy of an internet-based approach to delivering a CBT intervention targeted specifically at these sexual health issues. If proven to be effective, internet-based CBT for problems with sexuality and intimacy will be a welcome addition to the care offered to breast cancer survivors. Hopefully this therapy will lower the barrier to seeking help for these problems, resulting in improved quality of life after breast cancer.

Trial registration

The study is registered at ClinicalTrials.gov (NCT02091765).
Literature
1.
2.
Coleman MP, Forman D, Bryant H, Butler J, Rachet B, Maringe C, et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995-2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet. 2011;377(9760):127–38.PubMedPubMedCentralCrossRef
3.
Sadovsky R, Basson R, Krychman M, Morales AM, Schover L, Wang R, et al. Cancer and sexual problems. J Sex Med. 2010;7(1 Pt 2):349–73.PubMedCrossRef
4.
Fobair P, Stewart SL, Chang S, D’Onofrio C, Banks PJ, Bloom JR. Body image and sexual problems in young women with breast cancer. Psychooncology. 2006;15(7):579–94.PubMedCrossRef
5.
Kedde H, van de Wiel HB, Weijmar Schultz WC, Wijsen C. Sexual dysfunction in young women with breast cancer. Support Care Cancer. 2013;21(1):271–80.PubMedCrossRef
6.
Bloom JR, Stewart SL, Chang S, Banks PJ. Then and now: quality of life of young breast cancer survivors. Psychooncology. 2004;13(3):147–60.PubMedCrossRef
7.
Krychman ML, Pereira L, Carter J, Amsterdam A. Sexual oncology: sexual health issues in women with cancer. Oncology. 2006;71(1-2):18–25.PubMedCrossRef
8.
Broeckel JA, Thors CL, Jacobsen PB, Small M, Cox CE. Sexual functioning in long-term breast cancer survivors treated with adjuvant chemotherapy. Breast Cancer Res Treat. 2002;75(3):241–8.PubMedCrossRef
9.
Bredart A, Dolbeault S, Savignoni A, Besancenet C, This P, Giami A, et al. Prevalence and associated factors of sexual problems after early-stage breast cancer treatment: results of a French exploratory survey. Psychooncology. 2011;20(8):841–50.PubMedCrossRef
10.
Dorval M, Maunsell E, Deschênes L, Brisson J, Mâsse B. Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls. J Clin Oncol. 1998;16(2):487–94.PubMed
11.
Ganz PA, Greendale GA, Petersen L, Kahn B, Bower JE. Breast cancer in younger women: reproductive and late health effects of treatment. J Clin Oncol. 2003;21(22):4184–93.PubMedCrossRef
12.
Burwell SR, Case LD, Kaelin C, Avis NE. Sexual problems in younger women after breast cancer surgery. J Clin Oncol. 2006;24(18):2815–21.PubMedCrossRef
13.
Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE. Life after breast cancer: understanding women’s health-related quality of life and sexual functioning. J Clin Oncol. 1998;16(2):501–14.PubMed
14.
Ganz PA, Kwan L, Stanton AL, Krupnick JL, Rowland JH, Meyerowitz BE, et al. Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial. J Natl Cancer Inst. 2004;96(5):376–87.PubMedCrossRef
15.
Rosenberg SM, Tamimi RM, Gelber S, Ruddy KJ, Bober SL, Kereakoglow S, et al. Treatment-related amenorrhea and sexual functioning in young breast cancer survivors. Cancer. 2014;120(15):2264–71.PubMedPubMedCentralCrossRef
16.
Avis NE, Crawford S, Manuel J. Psychosocial problems among younger women with breast cancer. Psychooncology. 2004;13(5):295–308.PubMedCrossRef
17.
Alder J, Zanetti R, Wight E, Urech C, Fink N, Bitzer J. Sexual dysfunction after premenopausal stage I and II breast cancer: do androgens play a role? J Sex Med. 2008;5(8):1898–906.PubMedCrossRef
18.
Ganz PA, Desmond KA, Belin TR, Meyerowitz BE, Rowland JH. Predictors of sexual health in women after a breast cancer diagnosis. J Clin Oncol. 1999;17(8):2371–80.PubMed
19.
Ochsenkuhn R, Hermelink K, Clayton AH, von Schonfeldt V, Gallwas J, Ditsch N, et al. Menopausal status in breast cancer patients with past chemotherapy determines long-term hypoactive sexual desire disorder. J Sex Med. 2011;8(5):1486–94.PubMedCrossRef
20.
Cavalheiro JA, Bittelbrunn A, Menke CH, Biazus JV, Xavier NL, Cericatto R, et al. Sexual function and chemotherapy in postmenopausal women with breast cancer. BMC Womens Health. 2012;12:28.PubMedPubMedCentralCrossRef
21.
Baumgart J, Nilsson K, Evers AS, Kallak TK, Poromaa IS. Sexual dysfunction in women on adjuvant endocrine therapy after breast cancer. Menopause. 2013;20(2):162–8.PubMed
22.
Berglund G, Nystedt M, Bolund C, Sjoden PO, Rutquist LE. Effect of endocrine treatment on sexuality in premenopausal breast cancer patients: a prospective randomized study. J Clin Oncol. 2001;19(11):2788–96.PubMed
23.
24.
Frechette D, Paquet L, Verma S, Clemons M, Wheatley-Price P, Gertler S, et al. The impact of endocrine therapy on sexual dysfunction in postmenopausal women with early stage breast cancer: encouraging results from a prospective study. Breast Cancer Res Treat. 2013;141(1):111–7.PubMedCrossRef
25.
Buijs C, de Vries EG, Mourits MJ, Willemse PH. The influence of endocrine treatments for breast cancer on health-related quality of life. Cancer Treat Rev. 2008;34(7):640–55.PubMedCrossRef
26.
Schover LR, Baum GP, Fuson LA, Brewster A, Melhem-Bertrandt A. Sexual Problems During the First 2 Years of Adjuvant Treatment with Aromatase Inhibitors. J Sex Med. 2014;11(12):3102–11.PubMedPubMedCentralCrossRef
27.
Mok K, Juraskova I, Friedlander M. The impact of aromatase inhibitors on sexual functioning: current knowledge and future research directions. Breast (Edinburgh, Scotland). 2008;17(5):436–40.CrossRef
28.
Markopoulos C, Tsaroucha AK, Kouskos E, Mantas D, Antonopoulou Z, Karvelis S. Impact of breast cancer surgery on the self-esteem and sexual life of female patients. J Int Med Res. 2009;37(1):182–8.PubMedCrossRef
29.
Schover LR, Yetman RJ, Tuason LJ, Meisler E, Esselstyn CB, Hermann RE, et al. Partial mastectomy and breast reconstruction. A comparison of their effects on psychosocial adjustment, body image, and sexuality. Cancer. 1995;75(1):54–64.PubMedCrossRef
30.
Greendale GA, Petersen L, Zibecchi L, Ganz PA. Factors related to sexual function in postmenopausal women with a history of breast cancer. Menopause. 2001;8(2):111–9.PubMedCrossRef
31.
Aerts L, Christiaens MR, Enzlin P, Neven P, Amant F. Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: A prospective controlled study. Breast (Edinburgh, Scotland). 2014;23(5):629–36.CrossRef
32.
Rowland JH, Desmond KA, Meyerowitz BE, Belin TR, Wyatt GE, Ganz PA. Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. J Natl Cancer Inst. 2000;92(17):1422–9.PubMedCrossRef
33.
Gilbert E, Ussher JM, Perz J. Sexuality after breast cancer: a review. Maturitas. 2010;66(4):397–407.PubMedCrossRef
34.
Speer JJ, Hillenberg B, Sugrue DP, Blacker C, Kresge CL, Decker VB, et al. Study of sexual functioning determinants in breast cancer survivors. Breast J. 2005;11(6):440–7.PubMedCrossRef
35.
Baucom DH, Porter LS, Kirby JS, Gremore TM, Wiesenthal N, Aldridge W, et al. A couple-based intervention for female breast cancer. Psychooncology. 2009;18(3):276–83.PubMedCrossRef
36.
Hawkins Y, Ussher J, Gilbert E, Perz J, Sandoval M, Sundquist K. Changes in sexuality and intimacy after the diagnosis and treatment of cancer: the experience of partners in a sexual relationship with a person with cancer. Cancer Nurs. 2009;32(4):271–80.PubMedCrossRef
37.
Northouse LL, Templin T, Mood D, Oberst M. Couples’ adjustment to breast cancer and benign breast disease: a longitudinal analysis. Psychooncology. 1998;7(1):37–48.PubMedCrossRef
38.
Günzler C, Berner MM. Efficacy of Psychosocial Interventions in Men and Women With Sexual Dysfunctions—A Systematic Review of Controlled Clinical Trials. J Sex Med. 2012;9(12):3108–25.PubMedCrossRef
39.
Heiman JR, Meston CM. Empirically validated treatment for sexual dysfunction. Annu Rev Sex Res. 1997;8:148–94.PubMed
40.
ter Kuile MM, Both S, van Lankveld JJ. Cognitive behavioral therapy for sexual dysfunctions in women. Psychiatr Clin North Am. 2010;33(3):595–610.PubMedCrossRef
41.
van Lankveld JJDM, ter Kuile MM, Leusink P. Seksuele disfuncties: Diagnostiek en behandeling. Houten: Bohn Stafleu Van Loghum; 2010.
42.
Masters WH, Johnson VE. Human Sexual Inadequacy. Boston: Little, Brown; 1970.
43.
van Lankveld JJDM, Broomans E. Cognitieve therapie bij seksuele disfuncties. In: Bögels SM, van Oppen P, editors. Cognitieve therapie: theorie en praktijk. 2nd ed. Houten: Bohn Stafleu Van Loghum; 2011. p. 391–424.CrossRef
44.
Scott JL, Kayser K. A review of couple-based interventions for enhancing women’s sexual adjustment and body image after cancer. Cancer J. 2009;15(1):48–56.PubMedCrossRef
45.
Hucker A, McCabe MP. Incorporating Mindfulness and Chat Groups Into an Online Cognitive Behavioral Therapy for Mixed Female Sexual Problems. J Sex Res. 2014;17:1–13.
46.
Trudel G, Marchand A, Ravart M, Aubin S, Turgeon L, Fortier P. The effect of a cognitive-behavioral group treatment program on hypoactive sexual desire in women. Sex Relation Ther. 2001;16(2):145–64.CrossRef
47.
Hurlbert DF. A comparative study using orgasm consistency training in the treatment of women reporting hypoactive sexual desire. J Sex Marital Ther. 1993;19(1):41–55.PubMedCrossRef
48.
Spence SH. Group versus individual treatment of primary and secondary female orgasmic dysfunction. Behav Res Ther. 1985;23(5):539–48.PubMedCrossRef
49.
Morokoff PJ, LoPiccolo J. A comparative evaluation of minimal therapist contact and 15-session treatment for female orgasmic dysfunction. J Consult Clin Psychol. 1986;54(3):294–300.PubMedCrossRef
50.
Bergeron S, Binik YM, Khalife S, Pagidas K, Glazer HI, Meana M, et al. A randomized comparison of group cognitive–behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis. Pain. 2001;91(3):297–306.PubMedCrossRef
51.
Masheb RM, Kerns RD, Lozano C, Minkin MJ, Richman S. A randomized clinical trial for women with vulvodynia: Cognitive-behavioral therapy vs. supportive psychotherapy. Pain. 2009;141(1-2):31–40.PubMedCrossRef
52.
ter Kuile MM, Bulte I, Weijenborg PT, Beekman A, Melles R, Onghena P. Therapist-aided exposure for women with lifelong vaginismus: a replicated single-case design. J Consult Clin Psychol. 2009;77(1):149–59.PubMedCrossRef
53.
ter Kuile MM, Melles R, de Groot HE, Tuijnman-Raasveld CC, van Lankveld JJ. Therapist-aided exposure for women with lifelong vaginismus: a randomized waiting-list control trial of efficacy. J Consult Clin Psychol. 2013;81(6):1127–36.PubMedCrossRef
54.
Taylor S, Harley C, Ziegler L, Brown J, Velikova G. Interventions for sexual problems following treatment for breast cancer: a systematic review. Breast Cancer Res Treat. 2011;130(3):711–24.PubMedCrossRef
55.
Hill EK, Sandbo S, Abramsohn E, Makelarski J, Wroblewski K, Wenrich ER, et al. Assessing gynecologic and breast cancer survivors’ sexual health care needs. Cancer. 2011;117(12):2643–51.PubMedCrossRef
56.
Stead ML, Brown JM, Fallowfield L, Selby P. Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues. Br J Cancer. 2003;88(5):666–71.PubMedPubMedCentralCrossRef
57.
Ussher JM, Perz J, Gilbert E, Wong WK, Mason C, Hobbs K, et al. Talking about sex after cancer: a discourse analytic study of health care professional accounts of sexual communication with patients. Psychol Health. 2013;28(12):1370–90.PubMedCrossRef
58.
Flynn KE, Reese JB, Jeffery DD, Abernethy AP, Lin L, Shelby RA, et al. Patient experiences with communication about sex during and after treatment for cancer. Psychooncology. 2012;21(6):594–601.PubMedCrossRef
59.
Hordern AJ, Street AF. Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs. Med J Aust. 2007;186(5):224–7.PubMed
60.
Halley MC, May SG, Rendle KA, Frosch DL, Kurian AW. Beyond barriers: fundamental ‘disconnects’ underlying the treatment of breast cancer patients’ sexual health. Cult Health Sex. 2014;16(9):1169–80.PubMedCrossRef
61.
Ritterband LM, Gonder-Frederick LA, Cox DJ, Clifton AD, West RW, Borowitz SM. Internet interventions: In review, in use, and into the future. Prof Psychol: Res Pract. 2003;34(5):527–34.CrossRef
62.
Taylor CB, Luce KH. Computer- and Internet-Based Psychotherapy Interventions. Curr Dir Psychol Sci. 2003;12(1):18–22.CrossRef
63.
Emmelkamp PM. Technological innovations in clinical assessment and psychotherapy. Psychother Psychosom. 2005;74(6):336–43.PubMedCrossRef
64.
Barak A, Klein B, Proudfoot JG. Defining internet-supported therapeutic interventions. Ann Behav Med. 2009;38(1):4–17.PubMedCrossRef
65.
Hall P. Online psychosexual therapy: a summary of pilot study findings. Sex Relation Ther. 2004;19(2):167–78.CrossRef
66.
Cuijpers P, Marks IM, van Straten A, Cavanagh K, Gega L, Andersson G. Computer-aided psychotherapy for anxiety disorders: a meta-analytic review. Cogn Behav Ther. 2009;38(2):66–82.PubMedCrossRef
67.
Griffiths KM, Farrer L, Christensen H. The efficacy of internet interventions for depression and anxiety disorders: a review of randomised controlled trials. Med J Aust. 2010;192(11 Suppl):S4–11.PubMed
68.
Andersson G, Cuijpers P. Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cogn Behav Ther. 2009;38(4):196–205.PubMedCrossRef
69.
Johansson R, Andersson G. Internet-based psychological treatments for depression. Expert Rev Neurother. 2012;12(7):861–9. quiz 870.PubMedCrossRef
70.
Ritterband LM, Thorndike FP, Gonder-Frederick LA, Magee JC, Bailey ET, Saylor DK, et al. Efficacy of an Internet-based behavioral intervention for adults with insomnia. Arch Gen Psychiatry. 2009;66(7):692–8.PubMedPubMedCentralCrossRef
71.
Dolemeyer R, Tietjen A, Kersting A, Wagner B. Internet-based interventions for eating disorders in adults: a systematic review. BMC Psychiatry. 2013;13:207.PubMedPubMedCentralCrossRef
72.
Beintner I, Jacobi C, Taylor CB. Effects of an Internet-based prevention programme for eating disorders in the USA and Germany–a meta-analytic review. Eur Eat Disord Rev. 2012;20(1):1–8.PubMedCrossRef
73.
Knaevelsrud C, Maercker A. Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: a randomized controlled clinical trial. BMC Psychiatry. 2007;7:13.PubMedPubMedCentralCrossRef
74.
van Diest SL, van Lankveld JJ, Leusink PM, Slob AK, Gijs L. Sex therapy through the internet for men with sexual dysfunctions: a pilot study. J Sex Marital Ther. 2007;33(2):115–33.PubMedCrossRef
75.
van Lankveld JJ, Leusink P, van Diest S, Gijs L, Slob AK. Internet-based brief sex therapy for heterosexual men with sexual dysfunctions: a randomized controlled pilot trial. J Sex Med. 2009;6(8):2224–36.PubMedCrossRef
76.
Jones LM, McCabe MP. The effectiveness of an Internet-based psychological treatment program for female sexual dysfunction. J Sex Med. 2011;8(10):2781–92.PubMedCrossRef
77.
McCabe MP, Price E, Piterman L, Lording D. Evaluation of an internet-based psychological intervention for the treatment of erectile dysfunction. Int J Impot Res. 2008;20(3):324–30.PubMedCrossRef
78.
Schover L, Canada A, Yuan Y, Sui D, Neese L, Jenkins R, et al. A randomized trial of internet-based versus traditional sexual counseling for couples after localized prostate cancer treatment. Cancer. 2012;118(2):500–9.PubMedCrossRef
79.
Leusink PM, Aarts E. Treating erectile dysfunction through electronic consultation: a pilot study. J Sex Marital Ther. 2006;32(5):401–7.PubMedCrossRef
80.
Andersson E, Walen C, Hallberg J, Paxling B, Dahlin M, Almlov J, et al. A randomized controlled trial of guided Internet-delivered cognitive behavioral therapy for erectile dysfunction. J Sex Med. 2011;8(10):2800–9.PubMedCrossRef
81.
Schover LR, Yuan Y, Fellman BM, Odensky E, Lewis PE, Martinetti P. Efficacy trial of an Internet-based intervention for cancer-related female sexual dysfunction. J Natl Compr Canc Netw. 2013;11(11):1389–97.PubMedPubMedCentral
82.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: 4th, Text Revision edn; 2000.
83.
Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22–33. quiz 34-57.PubMed
84.
Arrindell WA, Boelens W, Lambert H. On the psychometric properties of the Maudsley Marital Questionnaire (MMQ): Evaluation of self-ratings in distressed and ‘normal’ volunteer couples based on the dutch version. Pers Individ Differences. 1983;4(3):293–306.CrossRef
85.
Rosen R, Riley A, Wagner G, Osterloh I, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49(6):822–30.PubMedCrossRef
86.
Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191–208.PubMedCrossRef
87.
Schaefer MT, Olson DH. Assessing Intimacy: The Pair Inventory. J Marital Fam Ther. 1981;7(1):47–60.CrossRef
88.
Thirlaway K, Fallowfield L, Cuzick J. The Sexual Activity Questionnaire: a measure of women’s sexual functioning. Qual Life Res. 1996;5(1):81–90.PubMedCrossRef
89.
Atkins L, Fallowfield LJ. Fallowfield’s Sexual Activity Questionnaire in women with without and at risk of cancer. Menopause Int. 2007;13(3):103–9.PubMed
90.
ter Kuile MM, Brauer M, Laan E. The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS): psychometric properties within a Dutch population. J Sex Marital Ther. 2006;32(4):289–304.PubMedCrossRef
91.
Derogatis L, Clayton A, Lewis-D’Agostino D, Wunderlich G, Fu Y. Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder. J Sex Med. 2008;5(2):357–64.PubMedCrossRef
92.
Sprangers MA, Groenvold M, Arraras JI, Franklin J, te Velde A, Muller M, et al. The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol. 1996;14(10):2756–68.PubMed
93.
Fallowfield LJ, Leaity SK, Howell A, Benson S, Cella D. Assessment of quality of life in women undergoing hormonal therapy for breast cancer: validation of an endocrine symptom subscale for the FACT-B. Breast Cancer Res Treat. 1999;55(2):189–99.PubMedCrossRef
94.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.PubMedCrossRef
95.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale: An updated literature review. J Psychosom Res. 2002;52(2):69–77.PubMedCrossRef
96.
Ware J, Sherbourne C. The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.PubMedCrossRef
97.
Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R, et al. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998;51(11):1055–68.PubMedCrossRef
98.
Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum; 1988.
99.
Derogatis LR, Rosen R, Leiblum S, Burnett A, Heiman J. The Female Sexual Distress Scale (FSDS): initial validation of a standardized scale for assessment of sexually related personal distress in women. J Sex Marital Ther. 2002;28(4):317–30.PubMedCrossRef
Metadata
Title
Internet-based cognitive behavioral therapy for sexual dysfunctions in women treated for breast cancer: design of a multicenter, randomized controlled trial
Authors
Susanna B Hummel
Jacques JDM van Lankveld
Hester SA Oldenburg
Daniela EE Hahn
Eva Broomans
Neil K Aaronson
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2015
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-015-1320-z

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