The scope of application of sexual dysfunction intervention in cervical cancer patients and nursing inspira-tion

doi:10.3761/j.issn.0254-1769.2025.07.020

Abstract

Abstract:

Objective To review the application of sexual dysfunction intervention in cervical cancer patients，and refine the intervention elements，so as to provide ideas and methods for the development of personalized intervention measures. Methods Guided by the 2021 updated methodological guidelines for scoping reviews from the Joanna Briggs Institute in Australia，CINAHL，PubMed，Web of Science，Embase，Cochrane Library，CNKI，Wanfang and VIP databases were systematically searched from inception to February 29，2024，and the included literature were analyzed and summarized. Results A total of 17 studies were included，involving 9 randomized controlled trials，7 quasi-experimental studies and 1 pilot study. The theoretical basis of the intervention includes PLISSIT model，BETTER model，FOCUS program，PERMA flourish theory，empowerment theory，the trans-theoretical model and narrative therapy. The intervention content involves 4 themes：sexual problem disclosing，sexual science education，sexual physiological rehabilitation and sexual psychological rehabilitation. The main forms are offline and online independent or combined intervention. The outcomes include sexual health function，social function，psychological status and self-management. Conclusion Sexual dysfunction interventions have a positive impact on cervical cancer patients. Future research should develop sexual dysfunction interventions with more comprehensive content，richer forms and more accurate evaluation based on the in-depth understanding of the theoretical connotation，and play the role of nurse-led multidisciplinary teams to maintain the long-term sexual and reproductive health of cervical cancer patients.

Key words: Cervical Cancer, Sexual Dysfunction, Intervention, Scoping Review, Oncology Nursing

摘要：

目的对性功能障碍干预在宫颈癌患者中的应用进行范围综述，提炼干预要素，为制订个性化的干预措施提供参考。方法以2021年澳大利亚乔安娜布里格斯研究所更新的范围综述方法学指南为指导，系统检索CINAHL、PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方数据库和维普数据库，检索时限为建库至2024年2月29日，对纳入文献进行分析、总结。结果共纳入17篇文献，包括9篇随机对照试验、7篇类实验研究和1篇预实验。干预的理论依据包括PLISSIT模式、BETTER模型、FOCUS计划、PERMA心盛理论、赋能理论、跨理论模型和叙事疗法；干预内容涉及性问题表露、性科学宣教、性生理康复和性心理康复4个主题；干预形式包括线下和线上独立或相结合的方式进行；评价指标包括性健康功能、社会功能、心理状态及自我管理。结论性功能障碍干预对宫颈癌患者有积极影响。未来研究应在深入理解理论内涵的基础上，探索内容更全面、形式更丰富、评价更精准的干预模式，发挥以护士为主导的多学科团队的作用，长期维护宫颈癌患者的性与生殖健康。

关键词: 宫颈癌, 性功能障碍, 干预, 范围综述, 肿瘤护理

ZHOU Nan, ZHI Shihan, WANG Meng, ZHANG Hui, ZHANG Lihong, LUO Maoyu, HE Ying, GU Wei. The scope of application of sexual dysfunction intervention in cervical cancer patients and nursing inspira-tion[J]. Chinese Journal of Nursing, 2025, 60(7): 890-897.

周楠, 智诗涵, 王萌, 张惠, 张丽红, 罗茂语, 何瑛, 顾炜. 性功能障碍干预在宫颈癌患者中应用的范围综述及护理启示[J]. 中华护理杂志, 2025, 60(7): 890-897.

Figures/Tables 1

References 40

[1]	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality world-wide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3):229-263.
[2]	Zheng RS, Chen R, Han BF, et al. Cancer incidence and morta-lity in China,2022[J]. Chin J Oncol, 2024, 46(3):221-231. DOI PMID
[3]	Mishra N, Singh N, Sachdeva M, et al. Sexual dysfunction in cervical cancer survivors:a scoping review[J]. Womens Health Rep, 2021, 2(1):594-607.
[4]	吴志勇, 李燕云, 徐丛剑. 子宫颈癌患者治疗后的性生活管理[J]. 中国实用妇科与产科杂志, 2024, 40(1):38-41.
	Wu ZY, Li YY, Xu CJ. Management of sexual life of patients with cervical cancer after treatment[J]. Chin J Pract Gynecol Obstet, 2024, 40(1):38-41.
[5]	邢孔燕, 王茹, 王敏, 等. 我国宫颈癌患者性功能障碍患病率的Meta分析[J]. 中国性科学, 2023, 32(5):91-96.
	Xing KY, Wang R, Wang M, et al. Meta analysis of the prevalence of sexual dysfunction in patients with cervical cancer in China[J]. Chin J Hum Sex, 2023, 32(5):91-96.
[6]	Zhang YQ, Sun SG, Ding JX, et al. The effect of different surgi-cal methods on female and male sexual activity and marital quality in patients with early-stage cervical cancer[J]. Sex Med, 2020, 8(2):307-314.
[7]	郑楹楹, 吕宏英, 陈正飞, 等. 宫颈癌根治术后患者康复期症状体验及心理感受的质性研究[J]. 中华护理杂志, 2020, 55(4):569-573. DOI URL
	Zheng YY, Lü HY, Chen ZF, et al. Symptoms and psychological experience of cervical cancer patients after radical hysterec-tomy:a qualitative research[J]. Chin J Nurs, 2020, 55(4):569-573.
[8]	孙艳霞, 李莹, 刘明月, 等. 宫颈癌患者性健康护理培训方案的构建[J]. 中华护理杂志, 2022, 57(9):1054-1060. DOI URL
	Sun YX, Li Y, Liu MY, et al. Construction of sexual health care training program for cervical cancer patients[J]. Chin J Nurs, 2022, 57(9):1054-1060. DOI URL
[9]	王喜益, 叶志弘, 汤磊雯. 范围综述在护理领域的应用进展[J]. 中华护理杂志, 2019, 54(8):1259-1263. DOI URL
	Wang XY, Ye ZH, Tang LW. An integrative review of scoping review applied in nursing literature[J]. Chin J Nurs, 2019, 54(8):1259-1263.
[10]	Peters MDJ, Marnie C, Tricco AC, et al. Updated methodologi-cal guidance for the conduct of scoping reviews[J]. JBI Evid Implement, 2021, 19(1):3-10. DOI PMID
[11]	Lockwood C, dos Santos KB, Pap R. Practical guidance for know-ledge synthesis:scoping review methods[J]. Asian Nurs Res, 2019, 13(5):287-294. DOI PMID
[12]	乔杰, 徐丛剑, 李雪兰. 女性生殖系统与疾病[M]. 2版. 北京: 人民卫生出版社, 2021.
	Qiao J, Xu CJ, Li XL. Female reproductive system and disor-ders[M]. 2nd ed. Beijing: People’s Medical Publishing House, 2021.
[13]	Araya-Castro P, Sacomori C, Diaz-Guerrero P, et al. Vaginal dilator and pelvic floor exercises for vaginal stenosis,sexual health and quality of life among cervical cancer patients treated with radiation:clinical report[J]. J Sex Marital Ther, 2020, 46(6):513-527. DOI PMID
[14]	戴云云, 谢颖, 陈阳广, 等. PLISSIT干预模式改善宫颈癌病人性生活质量和性功能的效果分析[J]. 护理研究, 2019, 33(15):2586-2589.
	Dai YY, Xie Y, Chen YG, et al. Effect of PLISSIT interven-tion model on improving quality of sexual life and sexual function of cervical cancer patients[J]. Chin Nurs Res, 2019, 33(15):2586-2589.
[15]	Salim HM, Abdelmonem MM, ElSayed AM. Nursing counseling utilizing BETTER model on sexuality,marital satisfaction and quality of life among cervical cancer women[J]. Egypt Nurs J, 2023, 20(1):57-67.
[16]	Li J, Huang JL, Zhang J, et al. A home-based,nurse-led health program for postoperative patients with early-stage cervical cancer:a randomized controlled trial[J]. Eur J Oncol Nurs, 2016, 21:174-180.
[17]	胡熠慧, 高金凤. FOCUS夫妻干预对宫颈癌患者及其配偶心理弹性、性生活质量的影响[J]. 国际护理学杂志, 2023, 42(7):1223-1227.
	Hu YH, Gao JF. Effect of FOCUS couples intervention on psychological resilience and quality of sexual life of patients with cervical cancer and their spouses[J]. Int J Nurs, 2023, 42(7):1223-1227.
[18]	Shi Y, Cai J, Wu ZM, et al. Effects of a nurse-led positive psy-chology intervention on sexual function,depression and sub-jective well-being in postoperative patients with early-stage cervical cancer:a randomized controlled trial[J]. Int J Nurs Stud, 2020, 111:103768.
[19]	Du J, Tian YL, Dan X, et al. The effect of empowerment edu-cation-based nursing intervention on the postoperative sexual function and depression state of cervical cancer patients of reproductive age[J]. Int J Clin Exp Med, 2020, 13(6):4052-4061.
[20]	Tung TH, Chen HW, Chou HH, et al. Does a one-session se-xual health education program improve sexual confidence in patients with cervical cancer? A transtheoretical model-based clinical study[J]. Arch Gynecol Obstet, 2024, 309(1):249-258.
[21]	纵波, 王芹, 王凌云. 叙事心理疗法联合盆底肌训练在早期宫颈癌术后性功能障碍患者中的应用[J]. 中国性科学, 2023, 32(8):52-56.
	Zong B, Wang Q, Wang LY. Application of narrative psycho-therapy combined with pelvic floor muscle training in patients with sexual dysfunction after early cervical cancer surgery[J]. Chin J Hum Sex, 2023, 32(8):52-56.
[22]	Afiyanti Y, Rachmawati IN, Milanti A. Evaluating sexual nursing care intervention for reducing sexual dysfunction in Indone-sian cervical cancer survivors[J]. Asia Pac J Oncol Nurs, 2016, 3(3):266-271.
[23]	Hassan HE, Ali R, Salam SAE, et al. Impact of an educational program on sexual dysfunction associated with cervical cancer[J]. J Cancer Res, 2021, 9:22-31.
[24]	Bİlge Ç, Aslan E. The effect of post-operative sexual counse-ling carried out with PLISSIT model on sexual function and sexual satisfaction in gynecologic cancers[J]. Clin Exp Health Sci, 2023, 13(3):623-629.
[25]	Bakker RM, Mens JW, de Groot HE, et al. A nurse-led sexual rehabilitation intervention after radiotherapy for gynecological cancer[J]. Support Care Cancer, 2017, 25(3):729-737. DOI PMID
[26]	Åkeflo L, Dunberger G, Elmerstig E, et al. Sexual health and wellbeing among female pelvic cancer survivors following individualized interventions in a nurse-led clinic[J]. Support Care Cancer, 2022, 30(11):8981-8996. DOI PMID
[27]	Yang EJ, Lim JY, Rah UW, et al. Effect of a pelvic floor muscle training program on gynecologic cancer survivors with pelvic floor dysfunction:a randomized controlled trial[J]. Gyne-col Oncol, 2012, 125(3):705-711.
[28]	Li JY, D’Addario J, Tymon-Rosario J, et al. Benefits of a mul-tidisciplinary women’s sexual health clinic in the management of sexual and menopausal symptoms after pelvic radiotherapy[J]. Am J Clin Oncol, 2021, 44(4):143-149.
[29]	Aktaş D, Terzioğlu F. Effect of home care service on the se-xual satisfaction of patients with gynecologic cancer[J]. Sex Di-sabil, 2015, 33(2):243-252.
[30]	Annon JS. The PLISSIT model:a proposed conceptual scheme for the behavioral treatment of sexual problems[J]. J Sex Educ Ther, 1976, 2(1):1-15.
[31]	Mick J, Hughes M, Cohen MZ. Using the BETTER model to assess sexuality[J]. Clin J Oncol Nurs, 2004, 8(1):84-86. PMID
[32]	Northouse LL, Walker J, Schafenacker A, et al. A family-based program of care for women with recurrent breast cancer and their family members[J]. Oncol Nurs Forum, 2002, 29(10):1411-1419. PMID
[33]	Seligman M. Flourish:a visionary new understanding of happi-ness and well-being[J]. Choice Rev Online, 2011, 48(12):48-7217.
[34]	Anderson RM, Funnell MM, Aikens JE, et al. Evaluating the efficacy of an empowerment-based self-management consultant intervention:results of a two-year randomized controlled trial[J]. Ther Patient Educ, 2009, 1(1):3-11. DOI PMID
[35]	Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking:toward an integrative model of change[J]. J Consult Clin Psychol, 1983, 51(3):390-395. DOI PMID
[36]	White MJ, Epston D. Narrative means to therapeutic ends[M]. Berlin, Springer 1990.
[37]	Shalamzari KH, Asgharipour N, Jamali J, et al. Comparing the effect of sexual counseling based on BETTER and PLISSIT models on sexual assertiveness in women with breast cancer after mastectomy[J]. J Educ Health Promot, 2024, 13:55. DOI PMID
[38]	Karimi F, Babazadeh R, Roudsari RL, et al. Comparing the effe-ctiveness of sexual counseling based on PLISSIT and BETTER models on sexual self-disclosure in women with sexual problems after childbirth:a randomized trial[J]. Iran J Nurs Midwifery Res, 2021, 26(1):68-74.
[39]	石艳, 蔡均, 吴治敏, 等. 宫颈癌患者根治术后两性关系体验的质性研究[J]. 中华护理杂志, 2019, 54(12):1825-1830. DOI URL
	Shi Y, Cai J, Wu ZM, et al. Experience of sexual relationship of postoperative patients with cervical cancer:a qualitative study[J]. Chin J Nurs, 2019, 54(12):1825-1830.
[40]	Tramacere F, Lancellotta V, Casà C, et al. Assessment of se-xual dysfunction in cervical cancer patients after different treatment modality:a systematic review[J]. Medicina, 2022, 58(9):1223.