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Sexuality in the aftermath of breast and prostate cancer: Gendered experiences
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Sexuality is a sensitive topic in health care and is often interpreted through a natural scientific lens as just corresponding to sexual dysfunction and fertility problems. The purpose of this thesis was to describe sexuality and its outcomes in two cancer populations. Women with breast cancer and men with prostate cancer in all stages were invited to participate. In this thesis, these two populations are restricted to age groups between 45 and 65 years, since there are reasons to believe that younger people are more vulnerable to sexuality changes. Lifeworld, gender, and sexuality are three concepts of importance in this thesis and they are used from the viewpoint of nursing care.

Phenomenological interviews (I, III) and focus group interviews (II, IV) were carried out with a total number of 46 informants. The EPP-method (Empirical Phenomenological Psychological) was used (I, III) in order to grasp the lived experience, and qualitative content analysis was used to analyse the seven focus groups (II, IV).

The lifeworld experiences of those women and men were comparable. The changes brought by the cancer and its treatment were a threat to their very existence, their existential base of knowledge had gone and alienation occurred (I, III). For the women, this was illustrated through the metaphor of a bird which is pinioned and unable to fly anymore. For the men it was expressed in the essential meaning “to lose the elixir of life”. Both women and men suffered, sexuality changed from one day to another and they handled it individually. Changed body appearance, and feeling old and unattractive were, for the women, the dominating features, whilst for the men changed desire and erection problems were their main concerns. The findings from the group discussions (II, IV) elucidate the gendered differences in these two contexts. The aim of the women was to look healthy and attractive and for the men the ability to have an erection was important. Neither of these two groups of people was able to meet their aims. On the other hand, being diagnosed with a life-threatening disease they were not in a position to claim preserved sexuality. This opens up existential questions that need to be confirmed in health care. To succeed in this, a change of perspective is required in health care. It should be possible to use human science to the same extent as natural science in health care.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2011. , 71 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1263
Keyword [en]
Breast cancer, prostate cancer sexuality, gender, lifeworld, psycho social oncology
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-72339ISBN: 978-91-7393-064-2 (print)OAI: oai:DiVA.org:liu-72339DiVA: diva2:459214
Public defence
2011-12-16, Berzeliussalen, Universitetssjukhuset, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2011-11-25 Created: 2011-11-25 Last updated: 2013-09-12Bibliographically approved
List of papers
1. Sexual identity following breast cancer treatments in premenopausal women
Open this publication in new window or tab >>Sexual identity following breast cancer treatments in premenopausal women
2008 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 3, 185-192 p.Article in journal (Refereed) Published
Abstract [en]

The phenomenon in focus for this study was the sexual identity preserved in premenopausal women due to breast cancer treatments. During the last decade the methods of breast cancer treatments have become more aggressive and many women have had to undergo surgery, radiation, and chemotherapy, as well as three to five years of hormone therapy. All these forms of treatment can have negative side effects on their sexual capability. The purpose of this study was to describe the meaning structure and the constituents of sexual identity in the lifeworld of premenopausal women. Six informants who had become menopausal following cancer treatment were interviewed about their experiences related to their sexual identity. Their ages varied between 38 and 48 years. The empirical phenomenological psychological (EPP) method was used. The meaning structure of the phenomenon could be symbolized using the metaphor of a bird which is pinioned and unable to fly. The women perceived their sexual identity as being inhibited in different ways. They felt odd and marginalized as women, and it was only within a support group that they felt completely confirmed. A future challenge for the health care professionals would be to care for their patients on the basis of their lifeworld experiences.

Keyword
Breast cancer, lived experience, premenopausal, sexuality identity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-42803 (URN)10.1080/17482620802130399 (DOI)68903 (Local ID)68903 (Archive number)68903 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2014-04-10Bibliographically approved
2. To feel like an outsider: focus group discussions regarding the influence on sexuality caused by breast cancer treatment
Open this publication in new window or tab >>To feel like an outsider: focus group discussions regarding the influence on sexuality caused by breast cancer treatment
2011 (English)In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 20, no 6, 728-737 p.Article in journal (Refereed) Published
Abstract [en]

The aftermath of breast cancer treatment, especially the sexual side effects, appears to be a neglected issue in developed society. The purpose of this study was to explore how middle-aged women treated for a breast cancer experienced their sexual identity connected to the community norms and values in the society as a whole. Three focus group interviews were conducted, with a total of 12 women. The discussions were analysed using qualitative content analysis. The main theme to feel like an outsider symbolises the womens situation after breast cancer treatment. They experienced their body in a wholly new unfamiliar way, which affected their sexuality in a deep and profound way. This feeling affected their female roles and overshadowed earlier experiences in life. All their female roles were suddenly vague and this was expressed in various ways across each of the four subthemes: to feel different, the unruly body, eroticism is not what it used to be and re-evaluating. From a nursing perspective, there appears to be a definite challenge to identify the womens own unique sexual needs in the rehabilitation transition and to use the skills from all team professionals to improve sexual health in this context.

Place, publisher, year, edition, pages
Blackwell, 2011
Keyword
breast cancer, femininity, qualitative content analysis, sexuality
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-71684 (URN)10.1111/j.1365-2354.2011.01239.x (DOI)000296271300005 ()
Note
Funding agencies|Skaraborg Institute for Research and Development||Research and Development Unit at Skaraborgs Hospital||Faculty of Health Sciences, Linkoping University||Available from: 2011-10-31 Created: 2011-10-31 Last updated: 2017-12-08
3. Losing the Elixir of Life: Sexuality in the Context of Prostate Cancer Narratives
Open this publication in new window or tab >>Losing the Elixir of Life: Sexuality in the Context of Prostate Cancer Narratives
2012 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 22, no 9, 1184-1194 p.Article in journal (Refereed) Published
Abstract [en]

In this phenomenological paper we explored how men diagnosed with prostate cancer experienced their sexuality from a lifeworld perspective. One essential meaning was identified: “having the elixir of life stolen”. This essential meaning had four constituents: “something that no longer exists”, “the threat to manhood”, “intimacy” and “staged manhood”. The lifeworld for these men comprised the dynamic interaction between being deprived of their “life’s elixir” and their ability to have and experience intimacy. The men were preoccupied with embodied experiences unfamiliar to them. They mourned the loss of sexuality in connection with their new life situation which threatened their identity. Their female partner was a great support, and with her the man could picture himself and at best renegotiate his sexuality. In the future, cancer care should be organized so as to enable all aspects of sexuality to be acknowledged and discussed.

Place, publisher, year, edition, pages
Sage Publications, 2012
Keyword
Qualitative analysis, lived experience, sexuality, men’s health
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-72337 (URN)10.1177/1049732312449208 (DOI)000307334500003 ()
Available from: 2011-11-25 Created: 2011-11-25 Last updated: 2017-12-08Bibliographically approved
4. Talking About Sexuality: Desire, Virility, and Intimacy in the Context of Prostate Cancer Associations
Open this publication in new window or tab >>Talking About Sexuality: Desire, Virility, and Intimacy in the Context of Prostate Cancer Associations
2008 (English)Manuscript (preprint) (Other academic)
Abstract [en]

The number of middle-aged men with a diagnosis of prostate cancer has increased in recent decades. The aim of this study was therefore to explore how some of these middle-aged men experienced and talked about their sexuality. Four focus group discussions were performed in the context of associations for prostate cancer. Using qualitative content analysis, it was identified how the diagnosis was a threat to their male identity; the men‟s vulnerability as a group in society was made explicit. Their sexuality was diminished by their illness experiences, which was also connected with silence and sorrow. Their contact with health care services was precarious and as patients they often played a passive role when or if discussing issues of sexuality. The possibility of voluntarily joining a cancer association was probably highly beneficial for these men. During the sessions, several men expressed the opinion that it is always great to talk.

Keyword
Sexuality, prostate cancer, masculinity, qualitative content analysis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-72338 (URN)
Available from: 2011-11-25 Created: 2011-11-25 Last updated: 2013-09-12Bibliographically approved

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