Construction of an integrated sexual function questionnaire for women with breast cancer.

OBJECTIVE: With the increasing incidence of breast cancer in young women, its side effects have extended into the sexual lives of women. However, an appropriate tool to measure the sexual function is nonexistent. The aim of this study was to develop a suitable tool to measure sexual function in women with breast cancer. MATERIALS AND METHODS: After conducting literature reviews regarding the sexual function characteristics of women with breast cancer, this study designed a set of integrated sexual function questionnaires, which included pertinent information and three scales. The validity of the scales was examined under the guidance of three gender studies experts and two gynecologists who are also professors. Regarding the construct validity, researchers conducted exploratory factor analysis on the measurement results of 196 women with breast cancer. RESULTS: The integrated sexual function questionnaires included the following three scales: "Breasts' Role Self-Checklist," "Scales for Breasts' Role in the Foreplay," and "Female Sexual Function Scale for BCSs." The questionnaire tool consisted of the longitudinal time change, patients' and their partners' situation, information related to the recovery process, participants' perspective toward objectification of women's breasts, the role of breasts in foreplay during sexual activities, sexual desire, sexual satisfaction, sexual obstacle, and other self-evaluations. We first derived one factor from six questions in "Breasts' Role Self-Checklist" and named it as "The Importance of Breasts for Women." The other two factors were obtained from eight questions in "Scales for Breasts' Role in the Foreplay" and named as "Sexual Attraction to Breasts" and "Function of Breasts in Foreplay." In addition, three factors were derived from 16 questions in "Female Sexual Function Scale for BCSs" and named as "Sexual Desire," "Sexual Satisfaction," and "Sexual Obstacle." CONCLUSION: This study determined that these integrated scales for breast cancer survivors are suitable due to their content validity, construct validity, and high internal consistency reliability, with a Cronbach's alpha of higher than 0.9 for all the three scales.

Community resilience after disaster in Taiwan: a case study of Jialan Village with the strengths perspective.

This article examines community resilience in disaster recovery in Jialan Village, where many families lost their homes when Typhoon Morakot struck Taiwan in 2008. In-depth interviews were conducted with policymakers, social workers, resource coordinators, and leaders of the local aboriginal community. The main findings were (a) the village's recovery was due to the effective use and coordination of community resources; (b) partnership building between the public and private sectors was crucial in the community's recovery; and (c) the recovery was enhanced by values such as a strong sense of mutual help, good physical health, positive attitudes, and autonomy.

Psychological responses of women infected with cervical human papillomavirus: a qualitative study in Taiwan.

OBJECTIVE: To determine the psychological response of cervical human papillomavirus (HPV) infected women. MATERIALS AND METHODS: Twenty oncogenic or high-risk HPV infected cases were collected by purposive sampling, and a 2-hour in-depth interview was carried out with 20 women at a tertiary referring medical center. The interview content was analyzed using the qualitative method. Psychological responses included cognition, emotions, and behavior. RESULTS: Differences in psychological responses arose more from individual cognition and personality than from whether or not one was single or married. After learning of their infection, most patients searched the Internet for HPV information and for a reputable doctor. They cared about privacy in the outpatient clinic. Most patients had all kinds of negative feelings, principally involving fear, worry, and suspicion. The better a couple's relationship, the less these patients struggled to tell the truth (HPV infection). Patients often urged partners to check-up and advised friends for Pap smear tests. CONCLUSIONS: Most HPV infected women have many kinds of negative feelings. Psychological help for these women is necessary.

The effect of HPV infection on a couple's relationship: a qualitative study in Taiwan.

OBJECTIVE: The purpose of this study is to explore the effect of human papillomavirus (HPV) on the sexual lives of women and their partners. MATERIALS AND METHODS: Twenty oncogenic or high-risk HPV infected cases were collected via purposive sampling. At a tertiary medical center in Taipei, 20 women underwent a 2-hour in-depth interview. The content of each interview was analyzed qualitatively regarding (1) effect of HPV infection on a couple's relationship; (2) effect of HPV infection on sexual life; (3) partner support and social support; (4) myths about love and marriage; and (5) sexual myths. RESULTS: The better a couple's relationship, the less these patients struggled to confront the issue (HPV infection). Most patients urged partners to have check-ups and advised friends about Pap smear tests. Couple relationships were generally not affected by HPV infection, unlike their sexual lifestyles. Most patients fulfilled the traditional Chinese female role of maintaining the relationship. However, due to the physical and psychosocial discomfort of treatment and fear of infection, some had no desire for sex, while others lessened their sex frequency. Most patients received very little support from their partner, family, and friends. The relationship quality was affected by marital and sexual myths held by patients. CONCLUSION: Cervical HPV infection has a negative effect on women's sexual relationships. Thus, more attention from health care providers is required.

Vaginal laceration and hemorrhagic shock during consensual sexual intercourse.

Coital injury causing severe vaginal laceration is not uncommon during first coitus. However, hemorrhagic shock during consensual sexual intercourse is quite rare. In this report, there was one 30-year-old, 20-year-old one, and one 24 year-old women who suffered severe vaginal laceration and bleeding during the process of consensual coitarche. All subjects were transferred to the hospital in the condition of impending shock. We found that the lacerated sites were located at right posterior fornices in all cases. We postulate that these vulnerable sites of vaginal laceration may be due to the dextro-rotation characteristics of the uterus and the distensibility of the vagina in this area. The vaginal fornix can be extremely distended during sexual intercourse, making it vulnerable to laceration in this area. Besides, there was a disproportionate genital size in all three cases which may be a cause of vaginal laceration. It is critical that such patients receive a prompt diagnosis to provide efficient management. It needs only simple surgical skills to cure the injury if the vital signs are stable. However, those survivors may need further psychological consultation to prevent negative impact on their future sexual functioning.

Management and outcome of primary vaginismus.

Our objective was to access the success rate, and the factors affecting it, of treatment based on Masters and Johnson's sex therapy. For this prospective study, we enrolled 120 couples with unconsummated coitus due to vaginismus. We made a clinical diagnosis after taking a detailed history taking and conducting a clinical examination. Participants completed a questionnaire regarding characteristics of vaginismus after participating in a face-to-face interview. Both of these were done prior to treatment, after 3 months, and after 12 months. We provided sex therapy based on Masters and Johnson's method. Treatment results were then analyzed. After therapy, 93.3% of vaginismic women were successfully penetrated, and 83.3% had regular intercourse with orgasm. The abilities to reach orgasm and sexual desire were not different than that among normal women. There was a correlation between duration of unconsummation and success rate and also between severity of vaginismus, treatment sessions, and success rate. Because of our high success rate, we encourage vaginismic women and their partners to accept aggressive management.

Sexual functioning after vaginal hysterectomy or transvaginal sacrospinous uterine suspension for uterine prolapse: a comparison.

OBJECTIVE: To examine changes in sexuality after total vaginal hysterectomy (TVH) or transvaginal sacrospinous uterine suspension (SSUS)for uterine prolapse. STUDY DESIGN: One hundred fifty-eight women with moderate to severe uterine prolapse undergoing TVH (78) or SSUS (80) were included in a prospective study from January 2001 to June 2002. All women were <50 years old and sexually active within the last 6 months before surgical intervention. None had major medical disorders. Sexual functioning before and 6 months after surgery was examined via a face-to-face questionnaire. Sexual interest, sexual satisfaction, frequency of sexual intercourse and frequency of orgasm were measured using an analogue scale. RESULTS: Of women undergoing TVH, 5.1% had decreased sexual interest, and 21% had less frequent orgasms postoperatively. For women undergoing SSUS, 13% had decreased sexual interest, and 20% had less frequent orgasms postoperatively. Frequency of orgasm was the only parameter that changed significantly after surgery in the 2 groups. All women with less frequent orgasms said that they were afraid of wound disruption or disease recurrence and so refrained from vigorous or exciting sexual intercourse. About four-fifths of the women in both groups accepted or were satisfied with their sexuality after surgery. For women undergoing TVH, 2.6% had increased frequency of orgasm, and 5% had better overall sexual satisfaction postoperatively. For women undergoing SSUS, 10% had increased sexual satisfaction postoperatively. There was a 2.5% and 2.6% increase in postoperative sexual interest in the SSUS and TVH groups, respectively. The sexual functioning scores were not different before or after surgical intervention in either group. CONCLUSION: There is a decrease in thefrequency of orgasm after both TVH and SSUS. However, there is no significant difference in postoperative sexual functioning between women with and without preservation of the uterus in correcting uterine prolapse.