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QUALITY OF LIFE AND SEXUAL FUNCTION OF JORDANIAN WOMEN DIAGNOSED WITH BREAST CANCER

QUALITY OF LIFE AND SEXUAL FUNCTION OF JORDANIAN WOMEN DIAGNOSED WITH BREAST CANCER. Dr. Diala Tawalbeh, RN, MSN, PhD. Breast cancer prevalence globally. Breast cancer is the most common cancer among women in the world today (Parkin et al., 2005).

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QUALITY OF LIFE AND SEXUAL FUNCTION OF JORDANIAN WOMEN DIAGNOSED WITH BREAST CANCER

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  1. QUALITY OF LIFE AND SEXUAL FUNCTION OF JORDANIAN WOMEN DIAGNOSED WITH BREAST CANCER Dr. Diala Tawalbeh, RN, MSN, PhD

  2. Breast cancer prevalence globally • Breast cancer is the most common cancer among women in the world today (Parkin et al., 2005). • The National Cancer Institute estimated that 13.4% of women born today will be diagnosed with breast cancer in their lifetime (National Cancer Institute, 2006).

  3. Breast cancer prevalence in Jordan • The Jordanian cancer registry (2006) ranked breast cancer first among cancers in women. • Breast cancer constituted 34.8% of all women cancers. In 2006, there were 749 breast cancer cases among Jordanian women accounting of 18.2% of all newly diagnosed cancer cases. • The median age at diagnosis of breast cancer in women was 51.

  4. Research purposes • There is growing evidence that women treated for breast cancer with surgery, chemotherapy, radiotherapy and hormonal therapy commonly experience disturbances in quality of life and sexual function related to changes in physical, psychological, and social functions. The purposes of this study were to: • describe the perceived QOL and sexual function of Jordanian breast cancer survivors • explore differences in sexual function and QOL related to selected sociodemographics and clinical variables, • examine the significance of selected scociodemographics and clinical variables in predicting QOL and sexual function, • and to describe the relationship between QOL and sexual function of breast cancer survivors

  5. Methodology • A descriptive cross-sectional design was used to collect data from 135 breast cancer survivors from two hospitals in Amman city. • A self administrated questionnaire consisting of Sociodemographics and Clinical Data Sheet (SCDS), Functional Assessment of Cancer Therapy-Breast (FACT-B), and the Female Sexual Function Index (FSFI) was used to collect data from 135 breast cancer survivors.

  6. Methodology • The sociodemographic data include age, education, income, employment status, husband support, fear of recurrence, participation in decision making, presence of relatives diagnosed with breast cancer, marriage length, and number of children. • Clinical data including type of treatment, years after treatment, body mass index (based on height and weight), hot flashes and comorbidity (measured by Charlson's Comorbidity Index (CCI)

  7. Results/ sociodemographic

  8. Results/ sociodemographic

  9. Results/ clinical data

  10. Results/ clinical data

  11. Results/ QOL of Jordanian survivors • Data analysis included computation of scores on overall QOL domains, and for each domain. • Functional Assessment of Cancer Therapy-Breast scores range from 33-133, with an average of 81.35 ± 20.28. • QOL was affected by chemotherapy, participation in decision making, vaginal dryness, perception of breast as a symbol of femininity and attractiveness.

  12. Results/ QOL of Jordanian survivors • Women who reported that their husband; supported them emotionally, accepted their diagnosis and its and accepted their body shape after treatment had achieved better FACT-B scores. • Women who discussed sexual issues with their husbands and received of sexual consultation had achieved better FACT-B scores. • QOL as was significantly and positively correlated with FSFI (r = 0.568, p < 0.01), education (r = 0.49, p < 0.01), and family income (r = 0.24, p < 0.01). • Quality of life was significantly and negatively correlated with age (r =-.38, p < 0.01), marriage length (r = -.26, P < 0.01), and comorbidity (r = -.26, p < 0.01).

  13. Results/ QOL of Jordanian survivors Stepwise regression analysis indicated that FSFI score, education, husband acceptance of disease, presence of relatives with breast cancer and fear of disease recurrence explained 49.5% of the variance in QOL (F = 25.244, d.f = 134, p < 0.000).

  14. Results/ FSFI of Jordanian survivors • 25.9% (n = 35) of women were not engaged in any sexual activity 4 weeks prior to the study, 80% (n =28) of the sexually not active women were older than 50 years. • The mean score of FSFI for the sexually active women was 20.67± 6.47, range from 7.2 to 33.

  15. Results/ FSFI of Jordanian survivors • The cutoff point of FSFI was 26.55. The percentage of women with sexual dysfunction was 75 % (n =101). • The analysis of the responses of all participants (n =135) showed that 70.3% (n = 95) of them reported decreased desire, and nearly half of them (45.9%) reported dissatisfaction with their overall sex life. • Analysis of the responses of sexually active participants (n = 100) showed that 55% (n = 55) of them reported decreased arousal, 45% (n = 45) reported; problems with lubrication, pain during vaginal penetration, and infrequently or never reaching orgasm

  16. T- test showed that FSFI of women with lumpectomy is significantly higher than that of women with mastectomy. • FSFI score was affected by chemotherapy, participation in decision making, vaginal dryness, perception of breast as a symbol of femininity and attractiveness. • Women who reported that their husband; supported them emotionally, accepted their diagnosis, and its treatment, and accepted their body shape after treatment had achieved better FSFI scores. • Women who discussed sexual relationships with their husbands and received sexual consultation achievedbetter FSFI

  17. Result showed that FSFI score was significantly and positively correlated with education (r = 0.31, p < 0.01), • but negatively correlated with age (r = -0.53, P < 0.01), years after treatment (r = -0.20, p < 0.05), marriage length (r = -0.38, p < 0.01) and comorbidity (r = -0.22, p < 0.01). • Stepwise regression analysis indicated that vaginal dryness, age, husband acceptance of treatment, chemotherapy, discussion of sexual relationship between couples, and the perceived perception of the importance of breast can explained 66.6% of the variance in sexual function.

  18. Conclusion • Sexual dysfunction is a highly prevalent and neglected problem among breast cancer survivors. • The study has many implications for practice, education and research. • Health care providers need to play a more visible and instrumental role in continuously assessing and improving quality of life and sexual function of women diagnosed with breast cancer.

  19. Thank you

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