Cindy L. Carmack Taylor

Predictors of Sexual Functioning in Ovarian Cancer Patients

PURPOSE To characterize sexual functioning of ovarian cancer patients and identify factors predicting sexual activity, functioning or satisfaction, discomfort, and habit or frequency. PATIENTS AND METHODS Data were collected on 232 women with epithelial ovarian cancer, 47% of whom were receiving treatment. RESULTS Fifty percent of the patients had engaged in sexual activity in the past month. Of those who were sexually active, 47% reported no or little desire, 80% reported problems with vaginal dryness, and 62% reported pain or discomfort during penetration. Of those who were sexually inactive, reasons included no partner (44.1%), lack of interest (38.7%), physical problems making sex difficult (23.4%), and fatigue (10.8%). Partner factors also were identified, including physical problems (16.2%), lack of interest (15.3%), and fatigue (5.4%). A multivariate model was used to predict sexual activity and included demographic, medical, and psychosocial factors as predictors. Women who were married (P <.001), were younger than 56 years (P <.001), were not receiving active treatment (P <.01), had a longer time since original diagnosis (P =.104), and liked the appearance of their bodies (P =.004) were more likely to be sexually active. Univariate analyses indicated that demographic, medical, and psychosocial factors are significantly associated with sexual functioning or satisfaction, sexual discomfort, and sexual frequency or habit. CONCLUSION Sexual rehabilitation for ovarian cancer patients should address management of physical and psychologic symptoms and include the patients partner when appropriate.

Sexual dysfunction and spousal communication in couples coping with prostate cancer

Objective: To characterize the sexual function of both prostate cancer patients and their partners, and to examine whether associations between sexual dysfunction and psychosocial adjustment vary depending on spousal communication patterns.

Does couple identity mediate the stress experienced by caregiving spouses

For caregivers, the stress process is multifaceted, involving primary stressors, which stem directly from the needs of the patient, and secondary stressors, which relate to the subjective burden of caregiving. According to stress proliferation theories, both primary and secondary stressors can exacerbate caregiver distress. However, individuals vary considerably in their reactions to caregiving. This study explored whether seeing oneself as part of a couple and incorporating ones relationship into ones self-concept (couple identity) alleviates the negative effects of primary and secondary stressors on caregiver mental health. The sample comprised 92 healthy spouses who had been caregiving for a partner with a chronic physical illness for an average of 5.9 years. Results showed that couple identity partially mediated the effects of negative primary (i.e., relational deprivation and overload) and secondary (i.e., loss of self and captivity) role stressors, and fully mediated the effects of positive secondary role stressors (i.e., caregiver self-esteem and competence) on caregiver mental health. Viewing the relationship as an extension of oneself, or high levels of couple identity, may thus help to minimize the negative effects and maximize the positive effects of the caregiving experience on caregiver mental health.

Effects of treatment factors, comorbidities and health-related quality of life on self-efficacy for physical activity in cancer survivors

Objective: The physical and psychological benefits of exercise for cancer survivors are well documented. Researchers have examined self‐efficacy (SE) as a target for promoting exercise; however, the predictors of SE, including treatment factors and comorbidities, have not been examined extensively. The purpose of this cross‐sectional analysis was to examine how variables related to cancer and cancer treatment, comorbid health problems, health‐related quality of life (QOL), and depression relate to SE for physical activity in cancer survivors.

Mode effects in the center for epidemiologic studies depression (CES-D) scale: personal digital assistant vs. paper and pencil administration

As interest grows in creating computerized versions of established paper-and-pencil (P&P) questionnaires, it becomes increasingly important to explore whether changing the administration modes of questionnaires affects participants’ responses. This study investigated whether mode effects exist when administering the Center for Epidemiologic Studies Depression (CES-D) scale by a personal digital assistant (PDA) versus the classic P&P mode. The Differential Functioning of Items and Tests (DFIT) procedure identified mode effects on the overall test and individual items. A mixed-effects regression model summarized the mode effects in terms of CES-D scores, and identified interactions with covariates. When the P&P questionnaire was administered first, scores were higher on average (2.4–2.8 points) than those of the other administrations (PDA second, PDA first, and P&P second), and all 20 questionnaire items exhibited a statistically significant mode effect. Highly educated people and younger people demonstrated a smaller difference in scores between the two modes. The mode-by-order effect influenced the interpretation of CES-D scores, especially when screening for depression using the established cut-off scores. These results underscore the importance of evaluating the cross-mode equivalence of psychosocial instruments before administering them in non-established modes.