Abstract
This study investigated sexual drive and satisfaction of Chinese gynecologic cancer survivors. It also examined the extent to which personal mastery, adaptive coping, and perceived spousal support would exert direct and/or indirect influences on sexual outcomes. The cancer survivor group included 134 Chinese women who had received treatment for gynecologic cancer, while the healthy control group included 105 Chinese women who did not have a known history or current diagnosis of cancer. Compared to healthy women, cancer survivors reported lower levels of sexual drive and sexual satisfaction. Among sexually active participants, cancer survivors relative to healthy women engaged in less masturbation, less kissing and caressing, and less sexual fantasy in the past month. Hierarchical multiple regression analyses showed that mastery and spousal support, but not adaptive coping, had a direct influence on sexual outcomes in cancer survivors. Contrary to moderation hypotheses, the three psychological factors did not interact with each other to influence sexual drive and satisfaction. Mediation analyses showed that spousal support fully mediated the influence of mastery on sexual satisfaction. Routine assessment of sexual functioning prior to and following treatment of gynecologic cancer is suggested. Sexual rehabilitation should also aim to enhance personal mastery and spousal support.
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Bergmark, K., Avall-Lundqvist, E., Dickman, P. W., Henningsohn, L., & Steineck, G. (1999). Vaginal changes and sexuality in women with a history of cervical cancer. New England Journal of Medicine, 340, 1382–1389.
Bodurka, D., & Sun, C. (2006). Sexual function after gynecologic cancer. Obstetrics and Gynecology Clinics of North America, 33, 621–630.
Carmack Taylor, C. L., Basen-Engquist, K., Shin, E. H., & Bodurka, D. (2004). Predictors of sexual functioning in ovarian cancer patients. Journal of Clinical Oncology, 22, 881–889.
Carver, C. S., Pozo, C., & Harris, S. D. (1993). How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. Journal of Personality and Social Psychology, 65, 375–390.
Champion, V., Williams, S., Miller, A., Reuille, K., Wagler-Ziner, K., Monahan, P., et al. (2007). Quality of life in long-term survivors of ovarian germ cell tumors: A gynecologic oncology group study. Gynecologic Oncology, 105, 687–694.
Cheng, P., & Tang, C. (1995). Coping and psychological distress of Chinese parents of children with Down syndrome. Mental Retardation, 33, 10–20.
Cohen, S., & Willis, T. A. (1985). Stress, social support and the buffering hypothesis. Psychological Bulletin, 98, 310–357.
Corney, R. H., Everett, H., Howells, A., & Crofter, M. E. (1992). Psychosocial adjustment following major gynecologic surgery for carcinoma of the cervix and vulva. Journal of Psychosomatic Research, 36, 561–568.
Cull, A., Cowie, V. J., Farquharson, D., Livingstone, J., Smart, G., & Elton, R. (1993). Early stage cervical cancer: Psychosocial and sexual outcomes of treatment. British Journal of Cancer, 68, 1216–1220.
Derogatis, L. R., & Melisaratos, N. (1979). The DSFI: A multidimensional measure of sexual functioning. Journal of Sex and Marital Therapy, 5, 244–281.
Frumovitz, M., Sun, C. C., Schover, L. R., Munsell, M. F., Jhingran, A., Wharton, J. T., et al. (2005). Quality of life and sexual functioning in cervical cancer survivors. Journal of Clinical Oncology, 30, 7428–7436.
Grumann, M., Robertson, R., Hacker, N. F., & Sommer, G. (2001). Sexual functioning in patients following radical hysterectomy for stage IB cancer of the cervix. International Journal of Gynecologic Cancer, 11, 372–380.
Hagedoorn, M., Kuijer, R., Buunk, B., deJong, G., Wobbes, T., & Sanderman, R. (2000). Marital satisfaction in patients with cancer: Does support form intimate partners benefit those who need it most? Health Psychology, 19, 274–282.
Helgeson, V. S., & Cohen, S. (1996). Social support and adjustment to cancer: Reconciling description, correlational, and interventional research. Health Psychology, 15, 135–148.
Jensen, P. T., Groenvold, M., Klee, M. C., Thranov, I., Petersen, M. A., & Machin, D. (2003). Early-stage cervical carcinoma, radical hysterectomy, and sexual function: A longitudinal study. Cancer, 100, 97–106.
Juraskova, I., Butow, P., Robertson, R., Sharpe, L., McLeod, C., & Hacker, N. (2003). Post-treatment sexual adjustment following cervical and endometrial cancer: A qualitative insight. Psycho-Oncology, 12, 267–279.
Kershaw, T., Northhouse, L., Kritpracha, C., Schafenacker, A., & Mood, D. (2004). Coping strategies and quality of life in women with advanced breast cancer and their family caregivers. Psychology & Health, 19, 139–155.
Krumm, S., & Lamberti, J. (1993). Changes in sexual behavior following radiation therapy for cervical cancer. Journal of Psychosomatic Obstetrics and Gynecology, 14, 381–390.
Kylstra, W. A., Leenhouts, G. H., Everaerd, W., Panneman, M., Hahn, D., Weijmar Schultz, W., et al. (1999). Sexual outcomes following treatment for early stage gynecologic cancer: A prospective multicenter study. International Journal of Gynecologic Cancer, 9, 387–395.
Lagana, L., McGarvey, E., Classen, C., & Koopman, C. (2001). Psychosexual dysfunction among gynecologic cancer survivors. Journal of Clinical Psychology in Medical Settings, 8, 73–84.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
Lepore, S. J. (2001). A social-cognitive processing model of emotional adjustment to cancer. In A. Baum & B. L. Andersen (Eds.), Psychosocial interventions for cancer (pp. 99–116). Washington, DC: American Psychological Association.
Luszczynska, A., Mohamed, N., & Schwarzer, R. (2005). Self-efficacy and social support predict benefit finding 12 months after cancer surgery: The mediating role of coping strategies. Psychology, Health, & Medicine, 10, 365–375.
Matthews, A. K., Aikens, J. E., Helmrich, S. P., Anderson, D. D., Herbst, A. L., & Waggoner, S. E. (1999). Sexual functioning and mood among long-term survivors of clear-cell adenocarcinoma of the vagina or cervix. Journal of Psychosocial Oncology, 17, 27–45.
Mishel, M. H., Padilla, G., Grant, M., & Sorenson, D. (1991). Uncertainty in illness theory: A replication of the mediating effects of mastery and coping. Nursing Research, 40, 236–240.
Pearlin, L., Menaghan, E., Lieberman, M., & Mullan, J. (1981). The stress process. Journal of Health and Social Behavior, 22, 337–356.
Preacher, K. J., & Hayes, A. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36, 717–731.
Schulz, U., & Schwarzer, R. (2004). Long term effects of spousal support on coping with cancer after surgery. Journal of Social and Clinical Psychology, 23, 716–732.
Schwarzer, R., & Knoll, N. (2007). Functional roles of social support within the stress and coping process: A theoretical and empirical overview. International Journal of Psychology, 42, 243–252.
Scott, J., Halford, K., & Ward, B. (2004). United we stand? The effects of a couple-coping intervention on adjustment to early stage breast or gynecologic cancer. Journal of Consulting and Clinical Psychology, 72, 1122–1135.
Sinclair, V. G., & Wallston, K. A. (2004). The development and psychometric evaluation of the Brief Resilience Coping Scale. Assessment, 11, 94–101.
So, H. W., & Cheung, F. (2005). Review of Chinese sex attitudes and applicability of sex therapy for Chinese with sexual dysfunction. Journal of Sex Research, 42, 93–101.
Tang, C. (2006). Positive and negative post-disaster psychological adjustment among adult survivors of the Southeast Asia earthquake-tsunami. Journal of Psychosomatic Research, 61, 699–705.
Tang, C. (2008). The influence of gender-related factors on HIV prevention among Chinese women with disrupted marital relationship. Sex Roles, 59, 119–126.
Tang, C., Lai, F., & Chung, T. (1997). Assessment of sexual functioning for Chinese college students. Archives of Sexual Behavior, 26, 79–90.
Tang, C., Siu, B. N., Lai, F., & Chung, T. (1996). Heterosexual Chinese women’s sexual adjustment after gynecologic cancer. Journal of Sex Research, 33, 189–195.
Weijmar Schultz, W., van de Wiel, H., & Bouma, J. (1991). Psychosexual functioning after treatment of cancer of the cervix: A comparative and longitudinal study. International Journal of Gynecological Cancer, 1, 37–46.
Wills, T. A. (1985). Supportive functions of interpersonal relationship. In S. Cohen & S. L. Syme (Eds.), Social support and health (pp. 61–82). Orlando, FL: Academic Press.
Yan, E., & Tang, C. (2003). The role of individual, interpersonal, and organizational factors in mitigating burnout among elderly Chinese volunteers. International Journal of Geriatric Psychiatry, 18, 795–802.
Yang, H. C., Brothers, B. M., & Andersen, B. L. (2008). Stress and quality of life in breast cancer recurrence: Moderation or mediation of coping? Annuals of Behavior Medicine, 35, 188–197.
Yip, S. K., Chan, A., Pang, S., Leung, P., Tang, C., Shek, D., et al. (2003). The impact of urodynamic stress incontinence and detrusor overactivity on marital relationship and sexual functioning. American Journal of Obstetrics and Gynecology, 188, 1244–1248.
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Tang, C.Sk., Lai, B.P.Y. & Chung, T.K.H. Influences of Mastery, Spousal Support, and Adaptive Coping on Sexual Drive and Satisfaction Among Chinese Gynecologic Cancer Survivors. Arch Sex Behav 39, 1191–1200 (2010). https://doi.org/10.1007/s10508-009-9528-0
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DOI: https://doi.org/10.1007/s10508-009-9528-0