Representations of Vaginal Symptoms in Cervical Cancer Survivors

Jennifer M. Tornatta MSN, RN; Janet S. Carpenter PhD, RN; Jeanne Schilder, MD; Higinia R. Cardenes, MD, PhD

Disclosures

Cancer Nurs. 2009;32(5):378-384. 

In This Article

Results

Sample Description

The sample consisted of 26 women posttreatment for cervical cancer whose mean (SD) age was 52.4 (11.1) years and had a mean (SD) of 11.7 (2.0) years of education. Most were white (77%), partnered or married (47%), and sexually active (39%). The average length of their current relationship was 22 years (SD, 15.9 years). Most were diagnosed with stage I or II disease (72%) and were postmenopausal at diagnosis (60%). Women had received both chemotherapy and radiation (84%), chemotherapy only (12%), or surgery only (4%). The mean (SD) time since complete remission was 15.2 (10.8) months.

Symptom Representations

Table 1 shows severity ratings (means and SDs) for all symptoms and the percentage of participants rating each symptom as severe (ie, rating between 7 and 10 on the 10-point scale). On average, women perceived vaginal symptoms as mild to moderate; however, approximately one-third of ratings of 11 different symptoms were severe. The 4 symptoms rated as most severe included vagina feels narrow or tight, decrease in sexual desire, vagina feels short or smaller, and feel less feminine and/or desirable. In addition, 6 women named an "other" symptom; 5 reported bone, back, or vaginal pain and 1 reported facial hair growth. Mean (SD) severity for these other symptoms was 9.33 (1.63), with 83% rating the painful symptoms as severe.

Table 2 shows the frequency of symptoms rated as first, second, and third most bothersome. The top 3 most bothersome symptoms included painful intercourse (23%), decrease in sexual desire (15%), and vaginal dryness (12%).

Women were nearly evenly divided on beliefs about whether the treatment (52%) or the cancer (48%) caused their most bothersome symptom. A similar pattern was seen for the second most bothersome symptom-50% endorsed treatment as the cause, 46% endorsed cancer as the cause. For the third most bothersome symptom, 69% believed that treatment and 33% reported that cancer was the cause.

Table 3 shows descriptive statistics for symptom representations. Scores on the representation subscales indicate that women's most noticed symptoms were perceived as moderately severe, emotionally distressing, likely to last a long time, having negative consequences on their lives, and uncontrollable.

Quality of Life

Table 4 shows descriptive statistics for quality of life. Overall, the quality of life for cervical cancer survivors was below comparison data, with the exception of social well-being. This difference between our sample and the comparison data can be considered clinically significant.

Relationships between Representations and Quality of Life

Table 5 shows the relationships between symptom representations and FACT-G quality of life. The emotional and consequence representations for symptom 1 were significantly related to each quality-of-life dimension and total scores. This pattern was similar for symptoms 2 and 3.

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