Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Originalia

Auswirkungen einer psychoonkologischen Intervention für Paare auf die Sexualität bei einer Brustkrebserkrankung der Frau

Published Online:January 11, 2011https://doi.org/10.1026/0943-8149/a000037

Abstract

Zusammenfassung. Die psychosozialen Auswirkungen einer Brustkrebsdiagnose und -behandlung auf die betroffenen Frauen und auch ihre Partner beinhalten neben emotionalen Schwierigkeiten auch sexuelle und partnerschaftliche Probleme. Diese randomisiert-kontrollierte Studie untersucht die Wirksamkeit einer kurzen partnerschaftlichen Intervention (Seite an Seite) bei Paaren, bei denen die Frau an Brustkrebs erkrankt ist, auf die sexuelle Funktionsfähigkeit des Paares über einen Zeitraum von 1.5 Jahren nach Diagnosestellung. Sexualität wird dabei auf mehreren Ebenen erfasst: Sexuelle Gedanken, sexuelle Erregung, sexuelle Erfahrung, Orgasmus und sexuelles Verlangen. An der Studie nahmen 72 Paare teil, von denen 38 ein partnerschaftliches Unterstützungstraining erhielten und 34 die Kontrollgruppe bildeten. Die Ergebnisse zeigen, dass Männer in den Bereichen sexuelle Erregung (signifikante Zunahme der Häufigkeit des Erlebens sexueller Erregung) und sexuelles Verlangen (stärkeres Interesse an Sexualität sowie höhere Zufriedenheit mit der Beziehung zur Partnerin und der eigenen sexuellen Funktionsfähigkeit) von der Intervention profitieren. In Bezug auf sexuelle Erfahrungen zeigte die Intervention sowohl bei den Patientinnen als auch bei ihren Partnern eine signifikante Zunahme der Häufigkeit sexueller Aktivitäten, die auch nach 6 Monaten noch stabil blieb. Trotz andauernder medizinischer Behandlung (Chemo-, Strahlen- bzw. Hormontherapie) findet sich eine Zunahme sexueller Aktivitäten bei Paaren in der Seite an Seite Intervention. Obwohl die sexuelle Funktionsfähigkeit ein wichtiger Aspekt der Lebensqualität ist, erhält das Thema Sexualität im klinischen Kontext nur wenig Aufmerksamkeit. Die Ergebnisse zeigen jedoch, dass der offene und routinemäßige Umgang mit dem Thema Sexualität ein wichtiger Aspekt psychoonkologischer Angebote sein sollte.


Effects of a psychosocial intervention for couples on sexuality when the woman has breast cancer

Abstract. The diagnosis and medical treatment of cancer is a stressful life-event that poses formidable and enduring challenges, not only to the patient but also to her partner. Besides psychological symptoms, breast cancer often leads to problems regarding sexual functioning and relationships. The present randomized controlled study investigates the efficacy of a relationship enhancement program (Side by Side) with regard to sexual functioning. Sexual functioning was measured on five domains: sexual cognition/fantasy, sexual arousal, sexual behavior/experience, orgasm, sexual drive/relationship. Seventy-two couples where the woman was diagnosed with breast cancer were randomly assigned to either a relationship enhancement program (n = 38) or to a couples’ control program (n = 34). The results suggest that males receiving the active couples’ skills program experienced more sexual arousal and sexual drive (increased interest in sexuality and higher relationship satisfaction and satisfaction with sexual functioning) compared to males in the control condition. In addition, males and females in the Side by Side condition showed more sexual behavior than did couples in the control condition; this remained stable over 6 months. Although sexual functioning has high impact on quality of life, sexual well-being after breast cancer has received little clinical attention. The results suggest that an open discussion of sexual issues should be important in psycho-oncology.

Literatur

  • Alferi, S. M. , Carver, C. S. , Antoni, M. H. , Weiss, S. & Duran, R. E. (2001). An exploratory study of social support, distress, and life disruption among low-income hispanic women under treatment for early stage breast cancer. Health Psychology, 20, 41–46. First citation in articleCrossref, Google Scholar

  • Andersen, B. (1985). Sexual functioning morbidity among cancer survivors: Current status and future research directions. Cancer, 55, 1835–1842. First citation in articleCrossref, Google Scholar

  • Andersen, B. , Anderson, B. , deProsse, C. (1989). Controlled prospective longitudinal study of women with cancer: I. Sexual functioning outcomes. Journal of Consulting and Clinical Psychology, 57, 683–691. First citation in articleCrossref, Google Scholar

  • Andersen, B. , Golden-Kreutz, D. (2000). Sexual self-concept for the women with cancer. In L. Baider, C. L. Cooper, A. Kaplan De Nour, (Eds.), Cancer and the family (2nd ed., pp. 312–334). Chichester: Wiley. First citation in articleGoogle Scholar

  • Andersen, B. L. (1993). Predicting sexual and psychologic morbidity and improving the quality of life for women with gynecologic cancer. Cancer, 71 (Supplement), 1678–1690. First citation in articleGoogle Scholar

  • Andersen, B. L. , Carpenter, K. M. , Yang, H. C. & Shapiro, C. L. (2007). Sexual well-being among partnered women with breast cancer recurrence. Journal of Clinical Oncology, 25, 3151–3157. First citation in articleCrossref, Google Scholar

  • Andersen, B. L. , Jochimsen, P. R. (1985). Sexual functioning among breast cancer, gynecologic cancer, and healthy women. Journal of Consulting and Clinical Psychology, 53, 25–32. First citation in articleCrossref, Google Scholar

  • Anllo, L. M. (2000). Sexual life after breast cancer. Journal of Sex & Marital Therapy, 26, 241–248. First citation in articleCrossref, Google Scholar

  • Avis, N. E. , Crawford, S. , Manuel, J. (2005). Quality of life among younger women with breast cancer. Journal of Clinical Oncology, 23, 3322–3330. First citation in articleCrossref, Google Scholar

  • Baucom, D. H. , Porter, L. S. , Kirby, J. S. , Gremore, T. M. , Wiesenthal, N. , Aldridge, W. et al. (2009). A couple-based intervention for female breast cancer. Psycho-Oncology, 18, 276–283. First citation in articleCrossref, Google Scholar

  • Ben-Zur, H. , Gilbar, O. , Lev, S. (2001). Coping with breast cancer: Patient, spouse, and dyad models. Psychosomatic Medicine, 63, 32–39. First citation in articleCrossref, Google Scholar

  • Berglund, G. , Nystedt, M. , Bolund, C. , Sjoden, P. O. , Rutquist, L. E. (2001). Effect of endocrine treatment on sexuality in premenopausal breast cancer patients: A prospective randomized study. Journal of Clinical Oncology, 19, 2788–2796. First citation in articleCrossref, Google Scholar

  • Bloom, J. R. , Stewart, S. L. , Chang, S. , Banks, P. J. (2004). Then and now: Quality of life of young breast cancer survivors. Psycho-Oncology, 13, 147–160. First citation in articleCrossref, Google Scholar

  • Burwell, S. R. , Case, L. D. , Kaelin, C. , Avis, N. E. (2006). Sexual problems in younger women after breast cancer surgery. Journal of Clinical Oncology, 24, 2815–2821. First citation in articleCrossref, Google Scholar

  • Cain, V. S. , Johannes, C. B. , Avis, N. E. , Mohr, B. , Schocken, M. , Skurnick, J. et al. (2003). Sexual functioning and practices in a multi-ethnic study of midlife women: Baseline results from SWAN. Journal of Sex Research, 40, 266–276. First citation in articleCrossref, Google Scholar

  • Christensen, D. N. (1983). Postmastectomy couple counseling: An outcome study of a structured treatment protocol. Journal of Sex & Marital Therapy, 9, 266–275. First citation in articleCrossref, Google Scholar

  • Derogatis, L. R. (1996). Derogatis Interview for Sexual Functioning (DISF/DISF-SR). Preliminary scoring procedures & administration manual. Baltimore, MD: Clinical Psychometric Research. First citation in articleGoogle Scholar

  • Ditz, S. (2007). Beratung zu sexuellen Problemen bei Patientinnen mit Mammakarzinom Gynäkologe, 40, 303–316. First citation in articleCrossref, Google Scholar

  • Dizon, D. S. (2009). Quality of life after breast cancer: Survivorship and sexuality. Breast Journal, 15, 500–504. First citation in articleCrossref, Google Scholar

  • Dorval, M. , Maunsell, E. , Deschenes, L. , Brisson, J. & Masse, B. (1998). Long-term quality of life after breast cancer: Comparision of 8-year survivors with population controls. Journal of Clinical Oncology, 16, 487–494. First citation in articleCrossref, Google Scholar

  • Fang, C. Y. , Manne, S. L. , Pape, S. J. (2001). Functional impairment, marital quality and patient psychological distress as predictors of psychological distress among cancer patient’s spouses. Health Psychology, 20, 452–457. First citation in articleCrossref, Google Scholar

  • Fobair, P. , Spiegel, D. (2009). Concerns about sexuality after breast cancer. Cancer Journal, 15, 19–26. First citation in articleCrossref, Google Scholar

  • Fobair, P. , Stewart, S. , Chang, S. , D’Onofrio, C. , Banks, P. , Bloom, J. (2006). Body image and sexual problems in young women with breast cancer. Psycho-Oncology, 15, 579–594. First citation in articleCrossref, Google Scholar

  • Ganz, P. A. , Coscarelli, A. , Fred, C. , Kahn, B. , Polinsky, M. L. & Petersen, L. (1996). Breast cancer survivors: Psychosocial concerns and quality of life. Breast Cancer Research and Treatment, 38, 183–199. First citation in articleCrossref, Google Scholar

  • Ganz, P. A. , Rowland, J. H. , Desmond, K. , Meyerowitz, B. E. , Wyatt, G. E. (1998). Life after breast cancer: Understanding women’s health-related quality of life and sexual functioning. Journal of Clinical Oncology, 16, 501–514. First citation in articleCrossref, Google Scholar

  • Ghizzani, A. , Pirtoli, L. , Bellezza, A. & Velicogna, F. (1995). The evaluation of some factors influencing the sexual life of women affected by breast cancer. Journal of Sex and Marital Therapy, 21, 57–63. First citation in articleCrossref, Google Scholar

  • Graham, J. W. (2009). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60, 549–576. First citation in articleCrossref, Google Scholar

  • Haagedorn, M. , Sanderman, R. , Bolks, H. N. , Tuinstra, J. & Coyne, J. (2008). Distress in couples coping with cancer: A meta-analysis and critical review of role and gender effects. Psychological Bulletin, 134, 1–30. First citation in articleCrossref, Google Scholar

  • Heinrichs, N. , Zimmermann, T. (2008). Bewältigung einer gynäkologischen Krebserkrankung in der Partnerschaft. Ein psychoonkologisches Behandlungsprogramm für Paare. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Heinrichs, N. , Zimmermann, T. , Herschbach, P. , Huber, B. & Baucom, D. H. (under review). Cancer distress reduction with a couple relationship enhancement program: A randomized controlled trial. Annals of Behavioral Medicine. Manuscript submitted for publication. First citation in articleGoogle Scholar

  • Henson, H. K. (2002). Breast cancer and sexuality. Sexuality and Disability, 20, 261–275. First citation in articleCrossref, Google Scholar

  • Herbenick, D. , Reece, M. , Hollub, A. , Satinsky, S. & Dodges, B. (2008). Young female breast cancer survivors: Their sexual function and interest in sexual enhancement products and services. Cancer Nursing, 3, 417–425. First citation in articleCrossref, Google Scholar

  • Hinnen, C. , Hagedoorn, M. , Ranchor, A. V. & Sanderman, R. (2008). Relationship satisfaction in women: A longitudinal case-control study about the role of breast cancer, personal assertiveness, and partners’ relationship-focused coping. British Journal of Health Psychology, 13, 737–754. First citation in articleCrossref, Google Scholar

  • Holmberg, S. K. , Scott, L. L. , Alexy, W. , Fife, B. L. (2001). Relationship issues of women with breast cancer. Cancer Nursing, 24, 53–60. First citation in articleCrossref, Google Scholar

  • Hughes, M. K. (2000). Sexuality and the cancer survivor: A silent coexistence. Cancer Nursing, 23, 477–482. First citation in articleCrossref, Google Scholar

  • Kalaitzi, C. , Papadopoulos, V. P. , Michas, K. , Vlasis, K. , Skandalakis, P. & Filippou, D. (2007). Combined brief psychosexual intervention after mastectomy: Effects on sexuality, body image, and psychological well-being. Journal of Surgical Oncology, 96, 235–240. First citation in articleCrossref, Google Scholar

  • Kaplan, H. S. (1992). A neglected issue: The sexual side effects of current treatments for breast cancer. Journal of Sex and Marital Therapy, 18, 3–19. First citation in articleCrossref, Google Scholar

  • Katz, A. (2005). The sounds of silence: Sexuality information for cancer patients. Journal of Clinical Oncology, 23, 238–241. First citation in articleCrossref, Google Scholar

  • Kayser, K. , Scott, J. L. (2008). Helping couples cope with women’s cancers. New York: Springer. First citation in articleGoogle Scholar

  • Knoll, N. , Burkert, S. , Kramer, J. , Roigas, J. , Gralla, O. (2009). Relationship satisfaction and erectile functions in men receiving laparoscopic radical prostatectomy: Effects of provision and receipt of spousal social support. Journal of Sexual Medicine, 6, 1438–1450. First citation in articleCrossref, Google Scholar

  • Krychman, M. L. (2006). Sexual rehabilitation medicine in a female oncology setting. Gynecologic Oncology, 101, 380–384. First citation in articleCrossref, Google Scholar

  • Kuijer, R. G. , Buunk, B. P. , De Jong, G. M. , Ybema, J. F. & Sanderman, R. (2004). Effects of a brief intervention program for patiens with cancer and their partners on feelings of inequity, relationship quality and psychological distress. Psycho-Oncology, 13, 321–334. First citation in articleCrossref, Google Scholar

  • Lichtman, R. R. , Taylor, S. E. , Wood, J. V. (1987). Social support and marital adjustment after breast cancer. Journal of Psychosocial Oncology, 5, 47–74. First citation in articleCrossref, Google Scholar

  • Manne, S. , Ostroff, J. , Sherman, M. , Heyman, R. E. , Ross, S. , Fox, K. (2004). Couples’ support-related communication, psychological distress, and relationship satisfaction among women with early stage breast cancer. Journal of Consulting and Clinical Psychology, 72, 660–670. First citation in articleCrossref, Google Scholar

  • Manne, S. , Winkel, G. , Grana, G. , Ross, S. , Ostroff, J. , Fox, K. et al. (2005). Couple-focused group intervention for women with early stage breast cancer. Journal of Consulting and Clinical Psychology, 73, 634–646. First citation in articleCrossref, Google Scholar

  • Manne, S. L. , Dougherty, J. , Veach, S. , Kless, R. (1999). Hiding worries from one’s spouse: Protective buffering among cancer patients and their spouses. Cancer Research, Therapy, and Control, 8, 175–188. First citation in articleGoogle Scholar

  • Manne, S. L. , Taylor, K. L. , Dougherty, J. , Kemeny, N. (1997). Supportive and negative responses in the partner relationships: Their association with psychological adjustment among individuals with cancer. Journal of Behavioral Medicine, 20, 101–125. First citation in articleCrossref, Google Scholar

  • Masters, W. H. , Johnson, V. E. (1970). Human sexual inadequacy. Boston, MA: Little, Brown. First citation in articleGoogle Scholar

  • Michael, R. , Gagnon, J. , Laumann, E. & Kolata, G. (1994). Sex in America. Boston: Little, Brown. First citation in articleGoogle Scholar

  • Neises, M. (2002). Sexuality and sexual dysfunction in gynecological psychooncology. Onkologie, 25, 571–574. First citation in articleCrossref, Google Scholar

  • Northouse, L. L. , Swain, M. A. (1998). Couples’ adjustment to breast cancer and benign breast disease: A longitudinal analysis. Psycho-Oncology, 7, 37–48. First citation in articleCrossref, Google Scholar

  • Robert-Koch-Institut (2008). Krebs in Deutschland 2003–2004. Häufigkeiten und Trends (6. überarb. Aufl.). Berlin: Robert Koch-Institut. First citation in articleGoogle Scholar

  • Schain, W. S. , d’Angelo, T. , Dunn, M. E. , Lichter, A. S. & Pierce, L. J. (1994). Mastectomy versus conservative surgery and radiation therapy. Cancer, 73, 1221–1228. First citation in articleCrossref, Google Scholar

  • Schmid-Büchi, S. , Halfens, R. J. G. , Dassen, T. , van den Borne, B. (2009). Psychosocial problems and needs of posttreatment patients with breast cancer and their relatives. European Journal of Oncology Nursing. doi:10.1016/j.ejon. 2009.11.001. First citation in articleGoogle Scholar

  • Schwarzer, R. (1996). Psychologie des Gesundheitsverhaltens (2., überarb. Aufl.). Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Scott, J. L. , Halford, W. K. , Ward, B. (2004). United we stand? The effects of a couple-coping intervention on adjustment to breast or gynaecological cancer. Journal of Consulting and Clinical Psychology, 72, 1122–1135. First citation in articleCrossref, Google Scholar

  • Scott, J. L. , Kayser, K. (2009). A review of couples based interventions for enhancing women’s sexual adjustment and body image after cancer. The Cancer Journal, 15, 48–56. First citation in articleCrossref, Google Scholar

  • Segraves, R. T. , Segraves, K. B. (1995). Human sexuality and aging. Journal of Sex Education and Therapy, 21, 88–102. First citation in articleCrossref, Google Scholar

  • Stead, M. L. (2001). Communications about sexual problems and sexual concerns in ovarian cancer: qualitative study. British Medical Journal, 323, 836–837. First citation in articleCrossref, Google Scholar

  • Sydow, K. (2001). Sexuelle Probleme im höheren Lebensalter – die weibliche Perspektive. In H. Berberich, E. Brähler, (Hrsg.), Sexualität und Partnerschaft in der zweiten Lebenshälfte (S. 87–103). Gießen: Psychosozial-Verlag. First citation in articleGoogle Scholar

  • Tan, G. , Waldman, K. , Bostick, R. (2002). Psychosocial issues, sexuality, and cancer. Sexuality and Disability, 20, 297–318. First citation in articleCrossref, Google Scholar

  • Thors, C. L. , Broeckel, J. A. , Jacobsen, P. B. (2001). Sexual functioning in breast cancer survivors. Cancer Control, 8, 442–448. First citation in articleCrossref, Google Scholar

  • Wellisch, D. K. , Jamison, K. R. , Pasnaus, R. O. (1978). Psychosocial aspects of mastectomy: II. The man’s perspective. American Journal of Psychiatry, 135, 543–546. First citation in articleCrossref, Google Scholar

  • Wimberly, S. , Carver, C. , Laurenceau, J. P. , Harris, S. , Antoni, M. (2005). Perceived partner reactions to diagnosis and treatment of breast cancer: Impact on psychosocial and psychosexual adjustment. Journal of Consulting and Clinical Psychology, 73, 300–311. First citation in articleCrossref, Google Scholar

  • Yi, J. C. , Syrjala, K. L. (2009). Sexuality after hematopoietic stem celle transplantation. Cancer Journal, 15, 57–64. First citation in articleCrossref, Google Scholar

  • Yurek, D. , Farrar, W. , Andersen, B. L. (2000). Breast cancer surgery: Comparing surgical groups and determining individual differences in postoperative sexuality and body change stress. Journal of Consulting and Clinical Psychology, 68, 697–709. First citation in articleCrossref, Google Scholar

  • Zimmermann, T. , Heinrichs, N. (2008). „Seite an Seite” eine gynäkologische Krebserkrankung in der Partnerschaft gemeinsam bewältigen – Ein Ratgeber für Paare. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Zimmermann, T. , Heinrichs, N. , Baucom, D. H. (2007). ”Does one size fit all?” Moderators in psychosocial interventions for breast cancer patients. A meta-analysis. Annals of Behavioral Medicine, 34, 225–239. First citation in articleCrossref, Google Scholar

  • Zimmermann, T. , Scott, J. L. , Heinrichs, N. (2009). Individual and dyadic predictors of body image in women with breast cancer. Psychooncology, 19, 1061–1068. First citation in articleCrossref, Google Scholar