Repair of the Threatened Feminine Identity

Experience of Women With Cervical Cancer Undergoing Fertility Preservation Surgery

Hiroko Komatsu, PhD, RN; Kaori Yagasaki, MSN, RN; Rie Shoda, RN; Younghui Chung, RN; Takashi Iwata, PhD, MD; Juri Sugiyama, MD; Takuma Fujii, PhD, MD


Cancer Nurs. 2014;37(1):75-82. 

In This Article

Implications for Practice

Although most of the present participants' concerns are often based on misconceptions and misunderstandings,[10] the women expressed concerns about postoperative complications, the baby's health, fertility treatment, and fears of cancer recurrence in particular, all of which can affect their reproductive plans. Some of the patients in this study believed, even before being sexually active after surgery, that a surgical scar in the vagina and cervical stenosis would affect their sexual activity. They related these potential complications to their sexual activities and to the fear of cancer recurrence after the surgery. These concerns based on a misconception discouraged the women from being sexually active. Nurses need to talk about sexual function concerns and provide education on disease process and adverse effects of treatment. One of the participants who reported not being sexually active because of recurrence concerns was referred to a fertility specialist, underwent ART, and became a mother. Nurses need to assess patient needs, refer those who need counseling to a relevant specialist, and provide emotional support throughout the continuum of care.

The beliefs of nurses are reflected in their attitudes toward patients, and patients are sensitive to the nurses' intentions.[28] Understanding the identity transformation process helps nurses assist the patient's decision making as the ultimate patient advocate, taking into account the patient's belief and priorities. To achieve the patient's goal, it is necessary to establish an oncofertility care system in which the patient choice is respected through the cancer, reproductive, and perinatal/neonatal care process. Healthcare delivery is increasingly fragmented and complex due to technological advances. The patient's wish may change according to the situation. It is important for nurses to navigate cancer patients through the healthcare system and to coordinate care between all clinical teams to link the patient to service.