| Objective:(1) To investigate the sexual function of cervical cancer survivors who have been completed their treatments between3months and36months previously.(2) To explore the associated factors on sexual function of cervical cancer survivors.(3) To establish the path analysis model of those associated factors on sexual function of cervical cancer survivors, in order to provide scientific, efficient measurements to improve the sexual function of cervical cancer survivors.Methods:A cross-sectional study design was used in this paper.202cervical cancer survivors were investigated by sociodemographic-disease questionnaire, Female Sexual Function Index (FSFI), Lock-Wollance Marital Adjustment Scale, Short Form of Beck Depression Inventory. Analyses were performed using SPSS statistical software(Version13.0; SPSS, Chicago) and AMOS7.0. Statistic methods included statistic description, t-test, analysis of variance, correlation analysis, multiple linear regression and path analysis.Results:(1) The total mean score of sexual function of202cervical cancer survivors was12.87±11.03,80.2%of them were suffering from sexual dysfunction.100of202cervical cancer survivors reported have no sexual life in the last4weeks, and the main reason was afraid of sexual life will cause cancer recurrence.(2) One-way ANOVA results showed that college and higher educational level(P<0.05), white collar (P<0.05)cervical cancer survivors whose six circles of sexual function were better than others; there were significant differences in the total FSFI score (H=7.45, P=0.024) and sexual satisfaction score(H=6.33, P=0.042) among clinical stage groups; There were significant differences in the score of FSFI circles and the total score of FSFI among treatment groups(P<0.01), as long as survivors once had radiotherapy, whose sexual function were worse than those who only had surgery or had surgery combination with chemotherapy; There were significant differences in the score of FSFI circles and the total score of FSFI among different surgical type groups(P<0.001), removing uterus and ovarian had an adverse effect on survivors’sexual function; There were no significant differences in the score of FSFI circles and the total score of FSFI except on sexual satisfaction score (P=0.049) between survivors who received or not receive sex knowledge guidance from the medical staff, but those who once received sex knowledge guidance from the medical staff had higher scores of sexual function than those who did not. Those survivors who were suffering from insomnia had lower scores of FSFI circles and the total score of FSFI(P<0.01); The more complications, the lower scores of FSFI circles and the total score of FSFI(P<0.05).(3) Logistic stepwise regression analysis showed: age(OR=2.614), marital satisfaction(OR=0.305), radiotherapy(OR= 3.986), vaginal atrophy(OR＝7.119) were included into the regression equation(X2=37.878, P=0.000) in which the total score of FSFI was dependent variable. Marital satisfaction was protective factor; Age, radiotherapy, vaginal atrophy were risk factors.(4) According to the result of path analysis, the path ways included age to sexual function(β=-0.28, P=0.000), medical insurance to depression(β=-0.25, P=0.000), radiotherapy to sexual function(β=-0.24, P=0.000), complications to depression(β=0.29, P＝0.000), radiotherapy to depression(β=0.13, P=0.041), depression to marital satisfaction(β=-0.41, P=0.000), marital satisfaction to sexual function(β=0.24, P=0.000). Age had a direct adverse effect on sexual function(the effects=-0.276), marital satisfaction had a direct positive effect on sexual function(the effects=0.237), depression had an indirect adverse effect on sexual function by the mediation of marital satisfaction(the total effects=-0.097), medical insurance had an indirect positive effect on sexual function by the mediation of depress and marital satisfaction(the total effects=0.024), radiotherapy not only had a direct adverse effect on sexual function, but also had an indirection adverse effect on sexual function by the mediation of depression and marital satisfaction(the direct effects=-0.244, the indirect effects=-0.013,the total effects=-0.257), complications had an indirect adverse effect on sexual function by the mediation of depression and marital satisfaction(the effects=-0.028). Conclusions:(1) The sexual function of cervical cancer survivors had been declined.(2) Logistic stepwise regression analysis showed the associated factors were:Age, radiotherapy, vaginal atrophy and marital satisfaction.(3) Path analysis showed age、marital satisfaction had a direct effect on cervical cancer survivors’sexual function, depression、complications medical insurance had an indirect effect on sexual function, Radiotherapy not only had a direct but also an indirect effect on sexual function of cervical cancer survivors. |
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