Sexual dysfunction is highly prevalent in gynaecological cancer patients. Most of the time, sexual dysfunction in gynaecological cancer is underdiagnosed as there is overlapping of symptoms with other psychological morbidities, interplaying of multiple risks, patients’ reluctance to complain or incompetence of health care provider to assess. Determining the risk factors of sexual dysfunction in cancer patients enables us to pay more attention to those who are vulnerable and to device strategies for early detection, prevention and treatment of sexual dysfunction in them. The main aim of the study was to determine the prevalence of sexual dysfunction and its risk factors in gynaecological cancer patients in Hospital Sultanah Bahiyah, Alor Star, Malaysia. Sexual function of eighty-three gynaecological cancer patients who were married were assessed with self-rated MVFSFI (Malay version Female Sexual Function Index). Self-rated WHOQOL-BREF (World Health Organization- Quality of Life- 26) which assessed the domains of quality of life was used while MINI (Mini International Neuropsychiatry Interview) was used for diagnosis of major depressive disorder. The prevalence of sexual dysfunction among the married gynaecological cancer patients was 65% (54/83). Sexual dysfunction was significantly associated with low education level (OR 3.055, CI 1.009-9.250), shorter duration of cancer (OR 0.966, CI 0.966- 0.998), ongoing chemotherapy (OR 3.045, CI 1.149-8.067), pain perception (OR 3.230, CI 1.257-8.303), absence of sexual intercourse for more than one month (OR 1.862) and three domains of quality of life such as physical health, psychological health and social relationship (OR 0.942, CI 0.908-0.978; OR 0.955, CI 0.916-0.995; OR 0.933, CI 0.894-0.973, respectively). However, sexual dysfunction was not associated with major depressive disorder (χ2² = 1.224, p = 0.268). The prevalence of sexual dysfunction in gynaecological cancer patients was comparable to other studies of similar population. Since, the risk factors of sexual dysfunction in gynaecological cancer patients are multidimensional, the process of assessment and management need to be holistic and patient-oriented.
The Prevalence and Risk Factors of Sexual Dysfunction in Gynaecological Cancer Patients
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Abstrak
Disfungsi seksual di kalangan pesakit kanser ginekologi adalah prevalens. Pada kebanyakan situasi, disfungsi seksual di kalangan penderita kanser ginekologi adalah di bawah paras pengenalpastian di mana terdapat pelbagai faktor morbiditi psikologi, faktor berpelbagaian yang berinteraktif berserta kengganan pesakit menceritakan masalah mereka kepada doktor perawat. Menentukan faktor berisiko disfungsi seksual di kalangan pesakit akan membuka ruang untuk kita memberi lebih perhatian kepada golongan yang memerlukan perhatian serta membolehkan satu strategi untuk mengenalpasti disfungsi seksual di peringkat awal, agar usaha pencegahan dan rawatan boleh dilaksanakan. Kajian ini bertujuan untuk menentukan prevalens dan faktor berisiko disfungsi seksual di kalangan pesakit kanser ginekologi di Hospital Sultanah Bahiyah, Alor Star. Fungsi seksual dikalangan 83 penderita kanser ginekologi yang berkahwin dinilai dengan skala swa-penilaian MVFSFI (Malay version Female Sexual Function Index). Skala swa-penilaian WHOQOL-BREF (World Health Organization-Quality of Life-26) yang digunakan untuk menilai domain kualiti kehidupan sementara MINI (Mini International Neuropsychiatry Interview) pula untuk menilai masalah psikiatri di kalangan pesakit. Kadar prevalens disfungsi seksual di kalangan pesakit kanser ginekologi ialah 65% (54/83). Disfungsi seksual berkait secara signifikan dengan tahap pendidikan yang rendah (kadar odds, OR: 3.055; sela keyakinan, CI 1.009-9.250), tempoh penderitaan kanser yang pendek (OR 0.966, CI 0.966- 0.998), rawatan kemoterapi yang berterusan (OR 3.045, CI 1.149-8.067), persepsi tentang kesakitan (OR 3.230, CI 1.257-8.303), kurangnya perhubungan seks (OR 1.862) dan tiga domain kualiti kehidupan termasuk kesihatan fizikal, psikologi dan perhubungan sosial (masing-masing OR 0.942, CI 0.908-0.978; OR 0.955, CI 0.916-0.995; OR 0.933, CI 0.894-0.973). Walaubagaimana pun, disfungsi seksual tidak berkait dengan kemurungan yang dialami oleh penderita kanser ginekologi (χ2 = 1.224, p = 0.268). Kesimpulannya, prevalens disfungsi seksual di kalanganpenghidap kanser ginekologi adalah tinggi, sama seperti kajian-kajian lain yang telah dijalankan. Memandangkan prevalens disfungsi seksual adalah berpelbagaian dimensi, justeru proses penilaian dan perawatan seharusnya mendukung konsep holistik serta berorientasikan pesakit.
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