Keywords

Depression, Gynecological cancer, Quality of life, Sexual function

Authors

1. Bai, Jinbing PhD, MSN, RN
2. Belcher, Sarah M. PhD, RN, OCN
3. Meador, Rebecca MS
4. Daniel, Gaea PhD, RN
5. Shelton, Joseph MD
6. Patel, Pretesh MD
7. Dolan, Mary MD
8. Arluck, Jessica MD
9. Khanna, Namita MD
10. Horowitz, Ira MD
11. Liu, Tian PhD
12. Watkins Bruner, Deborah PhD, RN, FAAN

Abstract

Background: Although higher incidence and mortality of gynecological cancer (GynCa) are documented in black compared with white women, few studies have documented quality of life (QOL) or healthy control comparisons.

Objective: This study compared depression, sexual function, and QOL between patients with GynCa and race-matched healthy controls.

Methods: Patients with GynCa and healthy controls completed the Patient Health Questionnaire-9, Female Sexual Function Index, and Functional Assessment of Cancer Therapy-General measures at baseline; GynCa patients were assessed again at 6 months post-radiation therapy (RT).

Results: Analyses included 84 participants (51% white, 49% black), including 28 GynCa patients and 56 controls with similar marital status. Compared with healthy controls, patients were younger, had a higher body mass index, and had more depression (P = .01); 82% of the patients and 71% of the healthy controls met criteria for sexual dysfunction at baseline (P = .29). Patients pre-RT had greater sexual dysfunction and lower QOL (P = .001) than controls did; patients at 6-month post-RT showed improved sexual function scores compared with pre-RT, with similar results to controls. White GynCa patients reported less sexual desire (P = .02), more pain (P = .05), and lower total Female Sexual Function Index scores (P = .01) than did black GynCa patients. Both black and white GynCa patients reported lower total QOL than their race-matched controls did (P = .07 and P = .002).

Conclusions: Women with GynCa reported more depression and lower QOL than did healthy controls pre-RT. Among GynCa patients, white women had more sexual dysfunction than black women did.

Implications for Practice: The differences in sexual dysfunction between white and black women with GynCa suggest developing guidelines directing routine sexual assessment and rehabilitation in women treated for GynCa.