Over Kanseri Tanısı Alan Bir Olguda Cinsel Sağlığın Değerlendirilmesi

Yıl 2018, Cilt: 1 Sayı: 1, 77 - 85, 13.08.2018

Semra Tuncay , Zehra Can Sena Kaplan , Sevil Şahin

Öz

Amaç:
Günümüzde kanser dünya genelinde ölümlerin en önemli ikinci nedeni olup,
küresel olarak yaklaşık altı ölümden biri kanserlere bağlı olarak ortaya
çıkmaktadır. Kadınlarda kanserden kaynaklanan ölümlerde, jinekolojik kanserler,
meme kanserinden sonra ilk sırada yer almaktadır. Jinekolojik kanserlerde
cerrahi, radyoterapi ve kemoterapi gibi tedavilere bağlı olarak ortaya çıkan
sorunlar, kadının fiziksel, psikolojik ve cinsel sağlığını olumsuz yönde
etkilemektedir. Bunun yanı sıra jinekolojik kanserlerin tedavisinde uygulanan
cerrahi girişimlerden sonra kadınlar; kendilerini cinsel eş olarak çekici
bulmamakta ve doğurganlıklarını kaybettikleri için kadınlıklarını da
kaybettiklerini düşünmektedirler. Bu bakımdan, jinekolojik kanser deneyimi
yaşayan kadınların ve eşlerinin cinsel danışmanlık konusunda profesyonel
desteğe ihtiyacı artmaktadır. Bu çalışmada, jinekolojik kanser sürecinde olan
olgularda cinsel sağlığın değerlendirilmesi ve uygun yaklaşımın geliştirilmesi
ve hemşirelik hizmetlerine katkı sağlaması amaçlanmıştır.

Yöntem:
Çalışmada over kanseri tanısı alan bir olguda, yazılı onam alındıktan sonra;
sağlığın cinsel alanı değerlendirilmiş olup, bu kapsamda hemşirelik
yaklaşımları tartışılmıştır.

Bulgular:
Over kanseri tanısı alan bu olguda; kanser ve tedavisinin beden imajı, cinsiyet
rolü, cinsel fonksiyonlar ve üreme yeteneği olmak üzere cinsel sağlığın dört
temel alanının etkilendiği tespit edilmiştir.

Sonuç:
Jinekolojik kanser tanısı alan her hastada beden imajı, cinsiyet rolü, cinsel
fonksiyonlar ve üreme yeteneği olmak üzere cinsel sağlığın dört temel alanının
değerlendirilmesi, sorun alanlarına göre danışmanlık verilerek, ihtiyaçlarına
göre yönlendirilmeleri önem taşımaktadır.

Anahtar Kelimeler

cinsel sağlık, hemşirelik, jinekolojik kanserler

Assessment Of Sexual Health in A Case Diagnosed with Ovarian Cancer

Öz

Aim: In today’s world, cancer is the second most important
cause of death worldwide, and one of six deaths is caused by cancer on the
global scale. With regards to the mortality rate for woman with cancer,
gynecologic cancers are the first right after the breast cancer. The
complications arising out of such treatment procedures of gynecologic cancers
like radiotherapy and chemotherapy, lead to negative impacts on the physical,
psychological and sexual health of women. Besides, women do not find themselves
attractive as a sexual partner, while also thinking to have lost their
femininity for losing fertility potential, following the surgical interventions
applied in the treatment processes of gynecologic cancers. In this regard, the
need for a professional support in sexual counselling starts to increase in
women suffering from gynecologic cancer and their partners. In this study, it
is aimed at carrying out an assessment on the sexual health of cases diagnosed
with gynecologic cancer, developing a proper approach, as well as providing
contribution to the nursing services.

Method: In the study, the sexual health of the case, who was
diagnosed with ovarian cancer, was subjected to an assessment, while discussing
the nursing approaches within this scope, after receiving the respective
written confirmation.

Results: In this case, who was diagnosed with ovarian cancer,
it was established that four main areas of sexual health, as the body image,
gender role, sexual functions and fertility, were affected by cancer and its
treatment process.

Conclusion: It is of great
importance to carry out an assessment on four main areas of sexual health as
the body image, gender role, sexual functions and fertility for every patient,
who is diagnosed with gynecologic cancer, as well as providing consultancy
services based on the problems, while directing them as per their needs.

Anahtar Kelimeler

Gynecological cancers, sexual health, nursing

Kaynakça

• KAYNAKLAR 1. Keskin G, Gümüş BA. Turkish hysterectomy and mastectomy patients - depression, body ımage, sexual problems and spouse relationships. Asian Pacific J Cancer Prev 2011; 12: 425-432.
• 2. Gilbert E, Ussher JM, Perz J. Sexuality after gynaecological cancer: A review of the material, intrapsychic, and discursive aspects of treatment on women’s sexual-wellbeing. Maturitas 2011;70 (1): 42– 57.
• 3. World Health Organization: WHO ,Cancer;(28.06.2018)Erişim Adresi: http://www.who.int/news-room/fact-sheets/detail/cancer/
• 4. American Cancer Society Cancer facts & figures; 2018 (28.06.2018). Erişim Adresi: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2018/cancer-facts-and-figures-2018.pdf
• 5. TÜİK. “Ölüm Nedeni İstatistikleri, 2016”. Erişim Adresi: http://www.tuik.gov.tr/PreHaberBultenleri.do?id=24572, Erişim Tarihi: 29.06.2018
• 6. TÜİK Basın Odası Haberleri; (28.06.2018) Erişim Adresi: http://www.tuik.gov.tr/basinOdasi/haberler/2017_24_20170504.pdf
• 7. T.C. Sağlık Bakanlığı. Türkiye Halk Sağlığı Kurumu. Kanser Daire Başkanlığı. Türkiye Kanser İstatistikleri;(28.06.2018.);Erişim Adresi: https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/istatistik/2014RAPOR._uzuuun.pdf
• 8. Reis N. Jinekolojik Kanser ve Tedavilerinin Kadın Cinsel Sağlığına Etkileri. Cumhuriyet Üniversitesi Hemşirelik Yüksek Okulu Dergisi 2003;7(2): 35-41.
• 9. Parton, C. M., Ussher, J. M., & Perz, J. (2016). Women’s construction of embodiment and the abject sexual body after cancer.Qualitative Health Research, 26(4), 490-503.
• 10. Gershenson, D. M., Miller, A. M., Champion, V. L., Monahan, P. O., Zhao, Q., Cella, D., & Williams, S. D. (2007). Reproductive and sexual function after platinum-based chemotherapy in long-term ovarian germ cell tumor survivors: a Gynecologic Oncology Group Study. Journal of Clinical Oncology, 25(19), 2792-2797.
• 11. Bober, S. L., Recklitis, C. J., Michaud, A. L., & Wright, A. A. (2018). Improvement in sexual function after ovarian cancer: Effects of sexual therapy and rehabilitation after treatment for ovarian cancer. Cancer, 124(1), 176-182.
• 12. Ratner ES, Foran KA, Schwartz PE, Minkin MJ. Sexuality and intimacy afte r gynecological cancer. Maturitas 2010; 66(1): 23-26.
• 13. Cleary V, Hegarty J. Understanding sexuality in women with gynaecological cancer. Eur J Oncol Nurs 2011;15:38-45.
• 14. Pınar G, Kaplan S, Akalın A, Abay H, Ayhan A, Ayhan Y. Evaluation of sexual dysfunction and affecting factors in Turkish women with gynecological cancer, Sex. Disabil., 2016:34:49-62.
• 15. S Catt, L Fallowfield, V Jenkins, C Langridge, A Cox. The informational roles and psychological health of members of 10 oncology multidisciplinary teams in the UK, Br J Cancer. 2005 Nov 14; 93(10): 1092–1097.
• 16. Pearce G, Ntoumani TC, Duda JL, McKenna J. Changing bodies: Experiences of women who have undergone a surgically ınduced menopause. Qualitative Health Research 2014;24(6):738–48.
• 17. Hubayter Z, Simon JA. Testiosterone therapy for sexual dysfunction in postmenopausal women. Climacteric. 2008;11(3):181-91.
• 18. Green MS, Naumann W, Elliot M, Hall JB, Higgins R, Grigsby J. sexual dysfunction following vulvectomy. Gynecol Oncol. 2000 Nisan, 77 (1): 73-7.
• 19. Candy, B., Jones, L., Vickerstaff, V., Tookman, A., & King, M. (2016). Interventions for sexual dysfunction following treatments for cancer in women. The Cochrane Library.
• 20. Bilge Ç, Kaydırak M, Aslan E. Jinekolojik kanserin cinsel yaşam üzerindeki etkileri. Sdü Sağlık Bilimleri Enstitüsü Dergisi / Cilt 7 Sayı 3 / 2016.
• 21. Reis N, Beji NK, Coskun A. Quality of life and sexual functioning in gynecological cancer patients: Results from quantitative and qualitative data. European Journal of Oncology Nursing, (2010); 14: 137-146.
• 22. Burns M, Costello J, Ryan-Woolley B, Davıdson. Sassessing the impact of late treatment effects in cervical cancer: an exploratory study of women’s sexuality. European Journal of Cancer Care, . (2007); 16: 364-372.
• 23. Sacerdoti RC, Laganà L, Koopman C. Altered sexuality and body image after gynecological cancer treatment: how can psychologists help?. Professional Psychology: Research and Practice, 2010; 41(6), 533.
• 24. Teo I, Cheung YB, Lim TYK, Namuduri RP, Long V, Tewani K. The relationship between symptom prevalence, body image, and quality of life in Asian gynecologic cancer patients. Psycho‐oncology, 2018; 27(1), 69-74.
• 25. Bergmark K, Åvall-Lundqvist E, Dickman P. W, Henningsohn L, Steineck G. Vaginal changes and sexuality in women with a history of cervical cancer. New England Journal of Medicine, 2018; 340(18), 1383-1389.
• 26. Butler L, Banfreld V, Sveinson T. Conceptualizing sexual health in cancer care/commentaries/authors’response. Western Journal of Nursing Research, 1998; 20(6): 683-705.
• 27. Marangoz Ç. Jinekolojik Kanserlerde Cinsel Yaşam ve Etkileyen Faktörlerin Belirlenmesi. Ankara 2014.
• 28. Donovan KA, Talıaferro LA, Alvarez EM, Jacobsen PB, Roetzheım RG, Wenham RM. Sexual health in women treated for cervical cancer: Characteristics and correlates. Gynecologic Oncology, 2007; 104: 428-434.
• 29. Lo ST, Kok WM. Sexuality of Chinese women around menopause. Maturitas 2013;74(2):190–5.
• 30. Pıeterse QD, Maas CP, Ter Kuıle MM, Lowık M, Van Eıjkeren, MA, Trımbos JBMZ, Kenter GG. An observational longitudinal study to evaluate miction, defecation and sexual function after radical hysterectomy with pelvic lymphadenectomy for early-stage cervical cancer. Int J Gynecol Cancer, 2006; 16: 1119-1129.
• 31. Maiorino MI, Chiodini P, Bellastella G, Giugliano D, Esposito K. Sexual dysfunction in women with cancer: A systematic review with meta-analysis of studies using the Female Sexual Function Index. 2016.
• 32. ZA Alicikus, IB Gorken, RC Sen, S Kentli, M Kinay, H Alanyali, O Harmancioglu. Psychosexual and body image aspects of quality of life in Turkish breast cancer patients: a comparison of breast conserving treatment and mastectomy. Tumori 2009; 95, 212–218.
• 33. American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 5th edn. (American Psychiatric Association, Arlington, 2013.
• 34. Sacerdoti RC, Laganà L, Koopman C. Altered sexuality and body image after gynecological cancer treatment: how can psychologists help?. Professional Psychology: Research and Practice, 2010;. 41(6), 533.
• 35. Schover LR. Sexuality and fertility after cancer. American Society of Hematology,2005; 523- 527.
• 36. World Health Organızatıon ,Defining sexual health, (30. 05. 2018) Erişim adresi : http://www.who.int/reproductivehealth/topics/sexual_health/sh_definitions/en/, 37. Olesen, ML, Duun-Henriksen AK, Hansson H, Ottesen B, Andersen KK, Zoffmann V. A person-centered intervention targeting the psychosocial needs of gynecological cancer survivors: a randomized clinical trial. Journal of Cancer Survivorship, 2016; 10(5), 832-841.
• 38. Leach CR, Weaver KE, Aziz NM, Alfano CM, Bellizzi KM, Kent EE, Rowland JH. The complex health profile of long-term cancer survivors: prevalence and predictors of comorbid conditions. Journal of Cancer Survivorship, 2015; 9(2), 239-251
• 39. Portman DJ, Gass ML. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North American Menopause Society. Maturitas, 2014; 79(3), 349-354.
• 40. Archer S, Buxton S, Sheffield D. The effect of creative psychological interventions on psychological outcomes for adult cancer patients: a systematic review of randomised controlled trials. Psycho‐Oncology, 2015; 24(1), 1-10.
• 41. Green MS, Naumann W, Elliot M, Hall JB, Higgins R, Grigsby J. Sexual Dysfunction Following Vulvectomy. Gynecol Oncol. 2000; 77 (1): 73-7.
• 42. 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 Nursing. 2009; 32(4):271-280.
• 43. World Health Organızatıon ,Sexual health, (30. 06. 2018). Erişim adresi: http://www.who.int/topics/sexual_health/en/
• 44. Kucuk, N., Mecdi Kaydirak, M., Aydin Bilge, C., & Hotun Sahin, N. (2018). Evaluation of the effect of obesity on self-respect and sexuality in women. Anadolu psıkıyatrı dergısı-anatolıan journal of psychıatry, 19(2), 126-134.