Quality Of Sexual Relationship Research Articles

Psychological interventions for the sexual sequelae of cancer: A review of the literature

Despite the frequency of sexual side effects of cancer, treatment outcome studies focus almost exclusively on pharmacologic agents, most of which are completely ineffective for women. We conducted a systematic review of the literature on psychological interventions for sexual difficulties following cancer. We searched eight research databases using the terms "sexual dysfunction," "cancer," and "psychological therapy" for empirical studies (not case illustrations). Three independent raters evaluated studies using a modified version of the Oxford Centre for Evidence-Based Medicine System to rate the level of evidence for every retrieved study. We identified 27 papers ranging in level of evidence from 1b (randomized controlled trial) to 4 (expert committee report or clinical experience). Youth showed positive outcomes on sexual knowledge, body image, and sexual functioning, and treatments administered by paraprofessionals were equally effective. Thematic counseling, addressing mental health, social functioning, and sexual functioning, significantly improved quality of sexual relationships, independent partner presence, whereas other studies revealed more pronounced benefits if the partner participated. Despite the importance of talking to a cancer care provider about sexual difficulties, interventions designed to empower patients to do so were ineffective. Treatments addressing sex education were more effective if they also addressed motivation and self-efficacy. Only three treatment outcome studies focused on ethnic minority (African-American or Hispanic) sexual concerns and one focused on sexual minority (Lesbian) issues. There was moderate support for the effectiveness and feasibility of psychological interventions targeting sexual dysfunction following cancer but attrition rates are high, placebo response is notable, and there are often barriers impeding survivors from seeking out psychological interventions for sexual concerns. Despite the prevalence of sexual difficulties following cancer treatment, psychological interventions are a viable, but not often sought after option to help improve sexual functioning, intimacy, and quality of life for cancer survivors and their partners.

The Quality of Young People’s Heterosexual Relationships: A Longitudinal Analysis of Characteristics Shaping Subjective Experience

Research on young people's sexual relationships often overlooks subjective experiences and enjoyment. Perceived quality of sexual relationships may be related to gender, background characteristics, circumstances of first intercourse and subsequent sexual history. Longitudinal data from 13-16-year-olds who participated in randomized trials of school sex education in either Scotland (N=5,356) or England (N=6,269) were used to examine young people's subjective experiences of heterosexual relationships. Logistic regression models tested for associations between selected variables and pressure and regret at first intercourse, pressure and enjoyment at most recent intercourse, and three measures of relationship quality. Of the 42% of youth who reported having had sex by follow-up, most assessed their first and most recent sexual relationships positively. Greater proportions of females than of males felt pressure at first sexual intercourse (19% vs. 10%), regretted their first time (38% vs. 20%) and did not enjoy their most recent sex (12% vs. 5%). Younger age at first sex was an important correlate of partner pressure and regret at first intercourse (odds ratios, 2.0 each, for those 13 or younger vs. 15-16-year-olds). Negative experiences were associated with less control (e.g., feeling pressure, being drunk or stoned, and not planning sex) and with less intimacy (e.g., sex with a casual partner and less frequent sex). Background social characteristics had limited influence compared with circumstances of first intercourse and subsequent sexual history. Most young people evaluated their early sexual experiences positively. The quality of relationships was enhanced by better communication and greater physical intimacy. For a vulnerable minority, however, early sexual experiences were negative. They could be protected by delaying first intercourse, restricting sexual activity to established relationships and learning skills to improve control in sexual encounters.

The relationship between hysterectomy and sexual life according to the latest research

Hysterectomy is one of the most frequent surgical interventions. Both specialists and lay people are interested in the following question: what kind of late psychosexual consequences does hysterectomy have? In the past years many publications showed a new aspect of the effects of hysterectomy on sexual life. The results of these prospective, randomized studies show that the late psychosexual changes do not primarily depend on the surgical method (vaginal, abdominal total or subtotal hysterectomy). The most significant predictive factor is the quality of sexual relationship before the operation. In the light of the evidence of the latest research, women can be reassured about the fact that hysterectomy, performed due to a benign disease, usually ameliorates the function of the organs in the small pelvis, i.e. positive change in sexual life can be expected. On the basis of the observations, this statement is valid for 2 years after the intervention. To analyze the effects after this period, further long-term studies are required. In this literature review the authors present the most significant study results published in the recent past.

Depression, anxiety, hostility and hysterectomy

Sixty-five women (aged 32 – 54 yrs) were assessed at 2 months before to 8 months after total abdominal hysterectomy on four separate occasions. Beck's Depression Inventory (BDI), Taylor's Manifest Anxiety Scale (TMAS), the Buss-Durkee Hostility Inventory (BDHI), Measurement of Masculinity-Femininity (MF), Likert scales and semantic differentials for psychological, somatic and sexual factors varied as assessment tools. High-dysphoric and low-dysphoric women were compared with regard to hysterectomy outcomes. Married nulliparae suffered from enhanced depression post-surgery. Pre-surgery anxiety, back pain and lack of dyspareunia contributed to post-surgery anxiety. Pre-surgery anxiety was related to life crises. Pre- and post-surgery hostility occurred in conjunction with poor sexual gratification. Post-hysterectomy health improved, but quality of sexual relationship was impaired. Partner support and knowledge counteracted hysterectomy aftermath. Post-hysterectomy symptoms constituted a continuum to pre-surgery signs of depression, anxiety or hostility.

Symptômes dépressifs pendant la grossesse : prévalence et facteurs de risque

To study the prevalence of depression during pregnancy and its associated risk factors in Lebanese women. A prospective randomized study was conducted on a sample of 79 women consulting the gynecology outpatient department of Hotel-Dieu de France in Beirut, Lebanon who completed the Beck depression inventory as well as a 45 multiple choice questionnaire covering known risk factors implicated in depression during pregnancy. The 79 women of our sample were mostly over 20 years old, had a high educational level, and were almost all in the second or third trimesters of pregnancy. The prevalence of depression was 13.9%, without a significant difference between the different trimesters. Risk factors implicated were: personal or familial history of depression (OR = 8.1 and 4.9 respectively), a history of anti-depressive medication (OR = 12.4) and oral contraceptives (OR = 4.9), mood disorders associated with menstruation (OR = 8), major financial problems (OR = 10.5), medical complications associated with pregnancy (OR = 6.9), unwanted pregnancy (OR = 6.4), lack of support from the husband (OR=10.4), and poor quality of sexual relationship (OR = 13.3). Our results were comparable to those in the literature. Depression during pregnancy is a common problem in Lebanon, which should be treated and diagnosed early.

Dual taboos: sexuality and women with severe mental illness in South Africa. Perceptions of mental health care providers.

The AIDS epidemic in South Africa is among the fastest growing in the world. While much of the population is at risk for infection, marginalized groups such as women with severe mental illness (SMI) are often neglected in prevention efforts. A qualitative study of mental health care providers' perceptions of HIV risk and sexuality among women with SMI was conducted in four provinces of South Africa. Semistructured qualitative interviews explored providers' views on the impact of mental illness on sexuality and reproductive health for women with SMI. Providers described their perceptions of the role of psychiatric symptoms in sexual behavior, the kinds of sexual behavior engaged in, and the quality of sexual relationships for women with SMI. Providers prioritized family planning and prevention of pregnancy for women with SMI over HIV prevention. The findings suggest that mental health care providers' ambivalence about sexual expression in women with SMI may be a barrier to complete care as well as effective HIV prevention for this population.

Impact of migraine on the family.

The extensive literature on pain and the family contains little on migraine and the family. A national sample of migraine sufferers, interviewed by telephone, was questioned on how they perceived migraine affected their family life. Sixty percent believed that their families were significantly affected. Most stated that their families were understanding. but a considerable number reported that family members took a negative attitude. This was particularly so with younger children deprived of parental care during migraine attacks. Spousal relationships also suffered. Frequency and quality of sexual relationships were affected; and in a small number of cases divorce was the outcome. The significance of these findings in migraine management is discussed.

Early childhood exposure to parental nudity and scenes of parental sexuality ("primal scenes"): an 18-year longitudinal study of outcome.

As part of the UCLA Family Lifestyles Project (FLS), 200 male and female children participated in an 18-year longitudinal outcome study of early childhood exposure to parental nudity and scenes of parental sexuality ("primal scenes"). At age 17-18, participants were assessed for levels of self-acceptance; relations with peers, parents, and other adults; antisocial and criminal behavior; substance use; suicidal ideation; quality of sexual relationships; and problems associated with sexual relations. No harmful "main effect" correlates of the predictor variables were found. A significant crossover Sex of Participant X Primal Scenes interaction was found such that boys exposed to primal scenes before age 6 had reduced risk of STD transmission or having impregnated someone in adolescence. In contrast, girls exposed to primal scenes before age 6 had increased risk of STD transmission or having become pregnant. A number of main effect trends in the data (nonsignificant at p < 0.05, following the Bonferonni correction) linked exposure to nudity and exposure to primal scenes with beneficial outcomes. However, a number of these findings were mediated by sex of participant interactions showing that the effects were attenuated or absent for girls. All effects were independent of family stability, pathology, or child-rearing ideology; sex of participant; SES; and beliefs and attitudes toward sexuality. Limitations of the data and of long-term regression studies in general are discussed, and the sex of participant interactions are interpreted speculatively. It is suggested that pervasive beliefs in the harmfulness of the predictor variables are exaggerated.