Quality of sexual life and associated factors: a cross-sectional survey of Chinese breast cancer patients.

PURPOSE: This study aimed to explore Chinese breast cancer patients' quality of sexual life (QSL) and factors associated with QSL. METHODS: The questionnaires in this cross-sectional study include the general information questionnaire, cognition and assessment of sexual health questionnaire, Self-acceptance Questionnaire (SAQ), Medical Coping Modes Questionnaire (MCMQ), and Quality of Sexual Life Questionnaire (QSLQ); 201 breast cancer patients were required to complete the questionnaires assessing characteristic information, cognition and assessment of sexual health, QSL, self-acceptance, and coping style. Finally, hierarchical regression was used to analyze the factors associated with QSL in Chinese breast cancer patients. RESULTS: The mean age (at the time of the survey) of the breast cancer patients was 48.31±9.15. The mean score of the QSLQ (range 28-140) was 75.14±16.57. Hierarchical regression analysis showed that the associated factors of breast cancer patients' QSL included age (at the time of the survey), education level, type of surgery, cognition and assessment of sexual health, self-acceptance, and avoidance and acceptance-resignation coping styles, that independent variables explained 60.4% of the variance. CONCLUSION: The QSL among Chinese breast cancer patients needs to be improved. Our findings indicated that breast cancer patients with older age, lower education level, or modified radical mastectomy have poor QSL. Breast cancer patients learn correct information about sexual health, enhance self-acceptance, and reduce acceptance-resignation, and avoidance coping could be intervention strategies to improve their QSL.

The relationship of marital adjustment and posttraumatic growth in female breast cancer patients and their husbands.

Posttraumatic growth (PTG) is very important for breast cancer couples to cope with cancer. Individual marital adjustment can affect PTG, however, it is still unknown that the effect of marital adjustment on one's own and their spouses' PTG in breast cancer couples. To investigate the status of PTG and marital adjustment and explore the relation between PTG and marital adjustment in breast cancer patient-husband dyads. General data, marital adjustment and PTG scores of breast cancer patients (N = 206) and their husbands (N = 206) were collected through a general information questionnaire, the Post-traumatic Growth Inventory (PTGI) and Marital Adjustment Test (MAT). T-tests and structural equation models were applied to explore the relations between marital adjustment and PTG among breast cancer patients and their husbands. The PTG among breast cancer patients was significantly higher than among their husbands (P < 0.05); the score of patients' marital adjustment was 96.18 ± 22.08, and that of their husbands was 96.22 ± 22.27. The participants' marital adjustment had a positive predictive effect on their own PTG (P < 0.05), and patients' marital adjustment also had a positive predictive effect on their husbands' PTG (P < 0.05). Breast cancer patients experienced more PTG than their husbands; patients' PTG was promoted by their own marital adjustment, while husbands' PTG was promoted by both their own and the patient's marital adjustment. In order to improve breast cancer patients' and their husbands' PTG, it is essential to promote their marital adjustment.

The effects of dyadic coping and marital satisfaction on posttraumatic growth among breast cancer couples.

OBJECTIVES: To examine the dyadic relationships of dyadic coping, marital satisfaction, and posttraumatic growth and to confirm the mediating effect of marital satisfaction between dyadic coping and posttraumatic growth among breast cancer patients and their spouses. METHODS: A total of 206 pairs of female breast cancer patients and their spouses from one tertiary hospital in Guangzhou, China, from August 2018 to July 2019 were invited to complete the demographics and disease-related information questionnaire, the Posttraumatic Growth Inventory, the Marital Adjustment Scale, and the Dyadic Coping Inventory. RESULTS: Patients' and spouses' positive/negative dyadic coping exerted actor effects and partner effects on marital satisfaction, while their marital satisfaction and positive dyadic coping only exerted actor effects on posttraumatic growth. In addition, the mediating effects of marital satisfaction on the impact of dyadic coping on posttraumatic growth were confirmed in both patients and spouses. CONCLUSION: Our findings provide a new perspective on the relationships between dyadic coping, marital satisfaction, and posttraumatic growth at the individual and dyadic levels. Promoting positive dyadic coping and decreasing negative dyadic coping among breast cancer patients and spouses can improve their marital satisfaction and posttraumatic growth.

The role of space in obstructing clinical sexual health education: A qualitative study on breast cancer patients' perspectives on barriers to expressing sexual concerns.

OBJECTIVE: Breast cancer patients report hoping to receive professional medical advice on sexual health and sexuality, but only few of them actively seek help from medical professionals. This study aims to gain clear understanding about barriers to patients' sexual health education seeking from the patient perspective. METHODS: A qualitative study using in-depth interviews was conducted in an urban hospital in Guangdong Province. China. 20 female breast cancer patients were selected and interviewed. The interview was recorded and transcribed verbatim. Content analysis was used for the data analysis. RESULTS: Four main barriers participants experienced to expressing sexual health education need to medical personnel included: (1) Avoiding discussion of sexuality due to the inappropriate space. (2) Avoiding sexual activity due to the disease treatment. (3) Avoiding sexual activity due to the body related distress. (4) Sexuality as a metaphor. CONCLUSIONS: It is found that breast cancer patients' expression about sexuality was constrained by the hospital, disease, body space and the cultural logic behind the three spaces. Clinical staff should provide an appropriate space for discussing sexual concerns, increase sexual health knowledge, comprehensively evaluate patients' condition and develop a culturally adaptable sexual health education.

The dissimilarity between myocardial infarction patients' and spouses' illness perception and its relation to patients' lifestyle.

AIM AND OBJECTIVES: To examine the dissimilarity between Chinese myocardial infarction (MI) patients' and spouses' illness perceptions (IPs), and to explore the relationship between patients' IP, differences in couples' IP and patients' lifestyle after discharge. BACKGROUND: An individual's IP is affected and moderated by several factors, including the social context. One of the most influential members of the social network of patients is the spouse. DESIGN: Cross-sectional design. METHODS: From April 2016-April 2017, 111 MI patients and their spouses were recruited. Before discharge from hospital, revised Illness Perception Questionnaire was administered to MI patients and their spouses separately. Two months after discharge, patients' lifestyle was assessed using Health Promoting Lifestyle Profile II. The manuscript was organised according to STROBE guidelines. RESULTS: Spouses were more likely to believe that the illness would last for a long time, and patients perceived MI as being more controllable than their spouses did. The patient-spouse dissimilarity in the perception of consequences was negatively correlated with both nutrition and stress control behaviours. Patients in couples with more dissimilar perception of environmental factors as a cause were more likely to choose a healthy diet, while patients in couples with more dissimilar perceived treatment control were more able to control stress. CONCLUSION: There are both similarities and dissimilarities between MI patients' and spouses' IP, and these dissimilarities contributed the majority of the explained variance in patients' lifestyle after discharge. RELEVANCE TO CLINICAL PRACTICE: We should consider both couples when examining how a patient copes with a chronic illness.

The Relationship Between Benefit Finding and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease: The Mediating Effects of Self-Management.

Objective: To explore the relationships among benefit finding (BF), self-management, and quality of life (QOL) among patients with COPD. Methods: A total of 205 patients with COPD were selected via a convenient sampling method. BF refers to the ability to find meaning or benefit from difficult situations. The Benefit Finding Scale (BFS), self-management scale, and 36-item Short-Form Health Survey (MOS SF-36) were used to investigate BF, self-management and QOL (including a physical component summary (PCS) and a psychological component summary (MCS)). Structural equation modeling was used to examine the relationships among BF, self-management and QOL in patients with COPD and to analyze the effects of BF and self-management on QOL. Results: The total QOL score of patients with COPD was 61.38±21.15, and the PCS and MCS scores were 57.67±23.60 and 65.09±21.24, respectively. BF and self-management had positive predictive effects on both the PCS (ßBF = 0.519, PBF = 0.012; ßself-management = 0.473, Pself-management = 0.012) and MCS (ßBF = 0.425, PBF = 0.013; ßself-management = 0.535, Pself-management = 0.016) of patients with COPD, and self-management mediated the relationships of BF with the PCS (ß = 0.144, P = 0.008) and MCS (ß = 0.162, P = 0.007). Conclusion: The QOL of patients with COPD needs to be improved, especially in terms of physical aspects. Helping COPD patients obtain better BF not only helps them improve their PCS and MCS directly but also indirectly through enhancing self-management to improve their PCS and MCS.

Adaptation and psychometric testing of the Chinese version of the Revised Illness Perception Questionnaire for cervical cancer patients.

PURPOSE: Illness perception is an important factor that influences psychological distress, coping behaviors, and illness outcomes, and this factor is often assessed by the Revised Illness Perception Questionnaire (IPQ-R). Data regarding illness perception among cervical cancer patients are limited, especially in China. The study aimed to adapt and psychometrically test the Chinese version of the IPQ-R for Cervical Cancer (CIPQ-R-CC). METHODS: This was a methodological study. Before the survey, the identity and causal subscales (originally 14 and 18 items, respectively) were adapted. Data were collected from 220 cervical cancer patients (N = 220) from June 2018 to February 2019. Psychometric properties were assessed using explanatory factor analysis, confirmatory factor analysis, Pearson correlation coefficients, one-way analysis of variance, t-tests and Cronbach's alpha coefficients. RESULTS: Eight identity items and twenty-six causal items were included in the CIPQ-R-CC, which showed acceptable content validity (I-CVI = 0.78-1.00, S-CVI = 0.97-0.99). A five-factor solution was obtained from the cause subscale by explanatory factor analysis, and these factors explained 60.19% of the total variance. For Part III of the CIPQ-R-CC, after deleting nine items and respecifying five error covariances, the proposed seven-factor model was confirmed. There were low to moderate correlations between the latent factors (r＜0.52). Known-group validity was demonstrated in some groups with different demographic characteristics. The Cronbach's alpha coefficients were also acceptable (0.60-0.88). CONCLUSION: The CIPQ-R-CC is a reliable and valid tool for assessing illness perception among Chinese cervical cancer patients. Future studies are needed to verify its factor structure and to confirm its theoretical connotation.