Top

BMC Women's Health

Published in:

01-12-2021 | Breast Cancer | Research article

Qualitative exploration of sexual life among breast cancer survivors at reproductive age

Authors: Maryam Maleki, Abbas Mardani, Mansour Ghafourifard, Mojtaba Vaismoradi

Published in: BMC Women's Health | Issue 1/2021

Abstract

Background

Our understanding of the experiences of women at reproductive age regarding sexual life and issues they may face after starting the treatment of breast cancer is limited. Therefore, this qualitative study aimed to explore sexual life and its related issues among breast cancer survivors at reproductive age in Iran.

Methods

A qualitative research was conducted. Participants were 21 breast cancer survivors who were under 51 years of age that were chosen using purposeful sampling. In-depth semi-structured interviews were carried out for data collection and the content analysis method was used for data analysis.

Results

The data analysis led to the development of main theme of ‘unfulfilled sexual life’. Also, four subthemes were: ‘undesirable sexual function’, ‘context-based beliefs’, ‘unmet information and supportive needs’, and ‘emotional crisis’.

Conclusions

Our research findings inform healthcare providers about the experiences of breast cancer survivors and related changes in their sexual and marriage life at reproductive age. Nurses and other healthcare providers in the multidisciplinary team should proactively identify health-related problems and design appropriate caring strategies to mitigate sexual and marriage issues among breast cancer survivors. Also, the establishment of sexual health counseling units for breast cancer survivors can help this vulnerable group of women with the improvement of their long-term sexual satisfaction.

Available only for authorised users

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. https://doi.org/10.3322/caac.21492.CrossRefPubMed

World Health Organization, Cancer: Cancer Country Profiles 2020, Available from the URL: https://www.who.int/cancer/country-profiles/IRN_2020.pdf?ua=1. Accessed 7 Feb 2021.

Rivera-Franco MM, Leon-Rodriguez E. Delays in breast cancer detection and treatment in developing countries. Breast Cancer (Auckl). 2018;12:1178223417752677. https://doi.org/10.1177/1178223417752677.CrossRef

Harandy TF, Ghofranipour F, Montazeri A, Anoosheh M, Mohammadi E, Ahmadi F, et al. Health-related quality of life in Iranian breast cancer survivors: a qualitative study. Appl Res Qual Life. 2010;5(2):121–32. https://doi.org/10.1007/s11482-010-9097-3.CrossRef

Fouladi N, Pourfarzi F, Dolattorkpour N, Alimohammadi S, Mehrara E. Sexual life after mastectomy in breast cancer survivors: a qualitative study. Psychooncology. 2018;27(2):434–41. https://doi.org/10.1002/pon.4479.CrossRefPubMed

Ussher JM, Perz J, Gilbert E. Information needs associated with changes to sexual well-being after breast cancer. J Adv Nurs. 2013;69(2):327–37. https://doi.org/10.1111/j.1365-2648.2012.06010.x.CrossRefPubMed

Boswell EN, Dizon DS. Breast cancer and sexual function. Transl Androl Urol. 2015;4(2):160–8.PubMedPubMedCentral

Davies CC, Brockopp D, Moe K, Wheeler P, Abner J, Lengerich A. Exploring the lived experience of women immediately following mastectomy: a phenomenological study. Cancer Nurs. 2017;40(5):361–8. https://doi.org/10.1097/NCC.0000000000000413.CrossRefPubMed

Nasiri A, Taleghani F, Irajpour A. Men’s sexual issues after breast cancer in their wives: a qualitative study. Cancer Nurs. 2012;35(3):236–44. https://doi.org/10.1097/NCC.0b013e31822d48e5.CrossRefPubMed

10.

Ghizzani A, Bruni S, Luisi S. The sex life of women surviving breast cancer. Gynecol Endocrinol. 2018;34(10):821–5. https://doi.org/10.1080/09513590.2018.1467401.CrossRefPubMed

11.

Manne S, Badr H. Intimacy and relationship processes in couples’ psychosocial adaptation to cancer. Cancer. 2008;112(S11):2541–55. https://doi.org/10.1002/cncr.23450.CrossRefPubMed

12.

Brédart 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. https://doi.org/10.1002/pon.1789.CrossRefPubMed

13.

Milbury K, Badr H. Sexual problems, communication patterns, and depressive symptoms in couples coping with metastatic breast cancer. Psychooncology. 2013;22(4):814–22. https://doi.org/10.1002/pon.3079.CrossRefPubMed

14.

Yeung NC, Zhang Y, Ji L, Lu G, Lu Q. Correlates of sexual quality of life among husbands of Chinese breast cancer survivors. Eur J Oncol Nurs. 2019;40:63–70. https://doi.org/10.1016/j.ejon.2019.03.007.CrossRefPubMed

15.

Chang YC, Chang SR, Chiu SC. Sexual problems of patients with breast cancer after treatment: a systematic review. Cancer Nurs. 2019;42(5):418–25. https://doi.org/10.1097/NCC.0000000000000592.CrossRefPubMed

16.

Maasoumi R, Taket A, Zarei F. How Iranian women conceptualize the role of cultural norms in their sexual lives. Sex Cult. 2018;22(4):1376–90. https://doi.org/10.1007/s12119-018-9531-5.CrossRef

17.

Merghati-Khoei E, Ghorashi Z, Yousefi A, Smith TG. How do Iranian women from Rafsanjan conceptualize their sexual behaviors? Sex Cult. 2014;18(3):592–607. https://doi.org/10.1007/s12119-013-9212-3.CrossRef

18.

Faghani S, Ghaffari F. Effects of sexual rehabilitation using the PLISSIT model on quality of sexual life and sexual functioning in post-mastectomy breast cancer survivors. Asian Pac J Cancer Prev. 2016;17(11):4845. https://doi.org/10.22034/APJCP.2016.17.11.4845

19.

Maasoumi R, Lamyian M, Khalajabadi FF, Montazeri A. Women’s perception of sexual socialization in Iran: a qualitative study. J Qual Res Health Sci. 2013;2(3):221–33.

20.

Rostamkhani F, Jafari F, Ozgoli G, Shakeri M. Addressing the sexual problems of Iranian women in a primary health care setting: a quasi-experimental study. Iran J Nurs Midwifery Res. 2015;20(1):139–46.PubMedPubMedCentral

21.

Wang F, Chen F, Huo X, Xu R, Wu L, Wang J, et al. A neglected issue on sexual well-being following breast cancer diagnosis and treatment among Chinese women. PLoS ONE. 2013;8(9):e74473. https://doi.org/10.1371/journal.pone.0074473.CrossRefPubMedPubMedCentral

22.

Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15(3):398–405. https://doi.org/10.1111/nhs.12048.CrossRefPubMed

23.

Holloway I, Galvin K. Qualitative research in nursing and healthcare. New York: Wiley; 2016.

24.

Mohammad K, Hashemi SMS, Farahani FKA. Age at natural menopause in Iran. Maturitas. 2004;49(4):321–6. https://doi.org/10.1016/j.maturitas.2004.02.006.CrossRefPubMed

25.

Saei Ghare Naz M, Sayehmiri F, Kiani F, Ozgoli G. A systematic review and meta-analysis on the average age of menopause among iranian women. Evid Based Care. 2019;8(4):26–34.

26.

O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89(9):1245–51. https://doi.org/10.1097/ACM.0000000000000388.CrossRefPubMed

27.

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12. https://doi.org/10.1016/j.nedt.2003.10.001.CrossRefPubMed

28.

Vaismoradi M, Snelgrove S. Theme in qualitative content analysis and thematic analysis. Forum Qual Soc Res. 2019;20(3):23. https://doi.org/10.17169/fqs-20.3.3376.

29.

Thomas E, Magilvy JK. Qualitative rigor or research validity in qualitative research. J Spec Pediatr Nurs. 2011;16(2):151–5. https://doi.org/10.1111/j.1744-6155.2011.00283.x.CrossRefPubMed

30.

Öztürk D, Akyolcu N. Assessing sexual function and dysfunction in Turkish women undergoing surgical breast cancer treatment. Jpn J Nurs Sci. 2016;13(2):220–8. https://doi.org/10.1111/jjns.12106.CrossRefPubMed

31.

Cairo Notari S, Favez N, Notari L, Panes-Ruedin B, Antonini T, Delaloye JF. Women’s experiences of sexual functioning in the early weeks of breast cancer treatment. Eur J Cancer Care (Engl). 2018;27(1):e12607. https://doi.org/10.1111/ecc.12607.CrossRef

32.

Emilee G, Ussher JM, Perz J. Sexuality after breast cancer: a review. Maturitas. 2010;66(4):397–407. https://doi.org/10.1016/j.maturitas.2010.03.027.CrossRefPubMed

33.

Leila M, Nada C, Kais C, Jaweher M. Sexuality after breast cancer: cultural specificities of Tunisian population. Pan Afr Med J. 2016;25(1):17. https://doi.org/https://doi.org/10.11604/pamj.2016.25.17.10399

34.

Boquiren VM, Esplen MJ, Wong J, Toner B, Warner E, Malik N. Sexual functioning in breast cancer survivors experiencing body image disturbance. Psychooncology. 2016;25(1):66–76. https://doi.org/10.1002/pon.3819.CrossRefPubMed

35.

Olasehinde O, Arije O, Wuraola FO, Samson M, Olajide O, Alabi T, et al. Life without a breast: Exploring the experiences of young Nigerian women after mastectomy for breast cancer. J Glob Oncol. 2019;5:1–6. https://doi.org/10.1200/JGO.18.00248.CrossRefPubMed

36.

Alhusban RY. Changed body image as perceived by Jordanian women undergoing breast cancer treatment. Asian Pac J Cancer Prev. 2019;20(3):767–773. https://doi.org/https://doi.org/10.31557/APJCP.2019.20.3.767

37.

Rezaei M, Elyasi F, Janbabai G, Moosazadeh M, Hamzehgardeshi Z. Factors influencing body image in women with breast cancer: a comprehensive literature review. Iran Red Crescent Med J. 2016;18(10):e39465. https://doi.org/10.5812/ircmj.39465.CrossRefPubMedPubMedCentral

38.

ALmegewly W, Gould D, Anstey S. Hidden voices: an interpretative phenomenological analysis of the experience of surviving breast cancer in Saudi Arabia. J Res Nurs. 2019;24(1–2):122–132. https://doi.org/https://doi.org/10.1177/1744987118809482

39.

Torres E, Dixon C, Richman AR. Understanding the breast cancer experience of survivors: a qualitative study of African American women in rural eastern North Carolina. J Cancer Educ. 2016;31(1):198–206. https://doi.org/10.1007/s13187-015-0833-0.CrossRefPubMed

40.

Hammoudeh W, Hogan D, Giacaman R. From a death sentence to a disrupted life: Palestinian women’s experiences and coping with breast cancer. Qual Health Res. 2017;27(4):487–96. https://doi.org/10.1177/1049732316628833.CrossRefPubMed

41.

Jassim GA, Whitford DL. Understanding the experiences and quality of life issues of Bahraini women with breast cancer. Soc Sci Med. 2014;107:189–95. https://doi.org/10.1016/j.socscimed.2014.01.031.CrossRefPubMed

42.

Klungrit S, Thanasilp S, Jitpanya C. Supportive care needs: An aspect of Thai women with breast cancer undergoing chemotherapy. Eur J Oncol Nurs. 2019;41:82–7. https://doi.org/10.1016/j.ejon.2019.05.008.CrossRefPubMed

43.

Den Ouden ME, Pelgrum-Keurhorst MN, Uitdehaag MJ, De Vocht HM. Intimacy and sexuality in women with breast cancer: professional guidance needed. Breast Cancer. 2019;26(3):326–32. https://doi.org/10.1007/s12282-018-0927-8.CrossRef

44.

Bartula I, Sherman KA. Screening for sexual dysfunction in women diagnosed with breast cancer: systematic review and recommendations. Breast Cancer Res Treat. 2013;141(2):173–85. https://doi.org/10.1007/s10549-013-2685-9.CrossRefPubMedPubMedCentral

45.

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. https://doi.org/10.1002/cncr.25832.CrossRefPubMed

46.

Begovic-Juhant A, Chmielewski A, Iwuagwu S, Chapman LA. Impact of body image on depression and quality of life among women with breast cancer. J Psychosoc Oncol. 2012;30(4):446–60. https://doi.org/10.1080/07347332.2012.684856.CrossRefPubMed

47.

Cordero MJA, Villar NM, Sánchez MN, Pimentel-Ramírez ML, García-Rillo A, Valverde EG. Breast cancer and body image as a prognostic factor of depression: a case study in México City. Nutr Hosp. 2015;31(1):371–9.

48.

Koçan S, Gürsoy A. Body image of women with breast cancer after mastectomy: a qualitative research. J Breast Health. 2016;12(4):145. https://doi.org/10.5152/tjbh.2016.2913.CrossRefPubMedPubMedCentral

49.

McClelland SI. Gender and sexual labor near the end of life: Advanced breast cancer and femininity norms. Womens Reprod Health (Phila). 2017;4(1):29–45. https://doi.org/10.1080/23293691.2017.1276367.CrossRef

Title: Qualitative exploration of sexual life among breast cancer survivors at reproductive age
Authors: Maryam Maleki
Abbas Mardani
Mansour Ghafourifard
Mojtaba Vaismoradi
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Breast Cancer
Breast Cancer
Published in: BMC Women's Health / Issue 1/2021
Electronic ISSN: 1472-6874
DOI: https://doi.org/10.1186/s12905-021-01212-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Qualitative exploration of sexual life among breast cancer survivors at reproductive age

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Prevalence of premature ovarian insufficiency and its determinants in Iranian populations: Tehran lipid and glucose study

Experiences of family violence and parental unavailability in childhood in relation to parental socioeconomic position and psychological problems: a cohort study of young Swedish women 1990–2013

Economic empowerment and intimate partner violence: a secondary data analysis of the cross-sectional Demographic Health Surveys in Sub-Saharan Africa

The factors associated with the quality of life among postmenopausal women

Factors associated with delay in seeking treatment among women with pelvic organ prolapse at selected general and referral hospitals of Southern Ethiopia, 2020

Relationship between vitamin D receptor gene polymorphisms (BsmI, TaqI, ApaI, and FokI) and calcium intake on bone mass in young Japanese women