卵巢癌婦女治療後的身體意象與性生活

Abstract

【研究背景】 卵巢癌發生率高、年紀輕，隨著醫療進步病患存活率持續上升，其長期生活的品質越顯重要。身體意象是維持身體完整性的重要感知，性生活亦是維持伴侶關係中重要的議題，兩者皆會影響婦女生活品質。目前為止，在台灣的文化脈絡之下，卵巢癌婦女的身體意象和性生活，幾乎尚未被充分地揭露。 【研究目的】 描述治療後卵巢癌婦女對身體的感受與反應，探討與性生活相關的經驗感受。 【研究方法】 本研究設計採質性研究法，在臺灣北部某醫學中心婦科門診立意取樣14位曾經歷手術並完成化學治療的卵巢癌婦女，進行面對面深入訪談。訪談內容採現象學研究法進行分析。 【研究結果】 分析結果主要分成卵巢癌婦女治療後的身體意象以及性生活二部分。其中身體意象主要有四大主題：手術及化學治療導致外觀改變的感受、體型體重改變的反應、生殖器官切除的感受與反應，以及生育功能的喪失與保留。治療後的性生活包含治療對性功能及性生活有負面影響或沒有影響、與伴侶性需求有差異、性生活不協調的憂慮與解決方式、性生活以外的伴侶關係。 【結論】 本研究提供了卵巢癌婦女在治療後對自己身體外觀、內生殖器與生殖功能的看法；也揭露其性生活的狀態與感受。醫護人員在提供照護時除瞭解病患的身體狀況外，也應協助婦女面對身體改變，進而有所調適，並盡可能主動提出性生活相關的資訊，以提升卵巢癌病患治療後恢復伴侶生活的品質。

【Background】 As the number of cancer survivors has been raised in Taiwan recent years, long-term quality of life is more important than before. Body image and sexual life were considered as the factors of quality of life in women nowadays. Women with ovarian cancer might face dramatic changes of body and sexual life after surgery and chemotherapy. Few studies have discovered perception of body image and sexual life among women with ovarian cancer in Taiwan. 【Aim】 This study explored the experience and perception of body image and sexual life in women with ovarian cancer after surgery and chemotherapy. 【Method】 This qualitative study was conducted with purposive sampling at a medical center in northern Taiwan. Fourteen women with ovarian cancer after treatment participated in this study. Data were collected by individual, open-ended interview and analyzed using a phenomenological approach. 【Result】 According to the interviews, four themes of body image among women with ovarian cancer were identified: feelings toward the change of appearance after surgery and chemotherapy, reactions to the change of weight and body shape, responses to genital organs excision and sensations of loss/maintain of fertility. Sexual life experiences were also identified with four themes: negative/no impact to sexual function, sexual desire gap in partnership, worries and solutions to the changed sexual life, and partnership beyond sexual intercourse. 【Conclusion】 Most women with ovarian cancer faced crises of change in body image and sexual life. Healthcare providers should provide individual information proactively to help women with ovarian cancer to face their changed body and possible sexual life problems.