Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial. Issue 1 (15th January 2021)

• Record Type: Journal Article
• Authors: Schutte, Laura E.R.; Melissant, Heleen C.; Jansen, Femke; Lissenberg-Witte, Birgit I.; Leemans, C. René; Sprangers, Mirjam A.G.; Vergeer, Marije R.; Verdonck-de Leeuw, Irma M.; Laan, Ellen T.M.
• Is Part Of: Sexual medicine. Volume 9:Issue 1(2021)
• Page Start: 100304
• Page End: 100304
• Publication Date: 2021-01-15
• Subjects: Head and neck cancer -- RCT -- Stepped care -- Quality of life -- Distress -- Sexuality; Sexual disorders -- Periodicals; Sexual health -- Periodicals; 616.69005
• DOI: 10.1016/j.esxm.2020.100304
• Languages: English
• ISSNs: 2050-1161

Abstract

Abstract: Introduction: A recent randomized controlled trial (RCT) in patients with head and neck cancer (HNC) with psychological distress showed that a stepped care (SC) program targeting psychological distress compared with care as usual (CAU), is (cost)effective in reducing psychological distress. Aim: The aim of the present study was to investigate whether SC can coalleviate problems with sexual interest and enjoyment. A secondary aim was to investigate whether the presence of an unmet sexual health need and having a psychiatric disorder (depression or anxiety) at baseline moderated any effect of SC on these sexual variables until 1-year follow-up. Methods: HNC survivors ( N = 134), randomized to SC or CAU, were assessed regarding their sexual interest and enjoyment before and after the intervention and at 3, 6, 9, and 12 months follow-up. Linear mixed models were used to evaluate differences in the course of sexual interest and enjoyment between SC and CAU. Main Outcome Measure: The "sexuality" symptom subscale, part of the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire, Head and Neck Cancer–specific module. Results: Of all patients, 76.1% had an unmet sexual need at baseline, 24.6% had a psychiatric disorder (anxiety or depression). SC did not reduce problems with sexual interest and enjoyment at any of the follow-up measurements compared with CAU ( P = .85). This was neither moderated by an unmet sexual health need at baseline ( P = .64) nor by the presence of a psychiatric disorder at baseline ( P = .59). Conclusion: A substantial number of patients with HNC have unmet sexual health needs. SC targeting psychological distress does not reduce problems with sexuality in these patients. Interventions specifically targeting sexuality are recommended.