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Talking about sexual health during survivorship: understanding what shapes breast cancer survivors’ willingness to communicate with providers

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Abstract

Purpose

Breast cancer survivor (BCS)–provider communication about sexual health (SH) is often absent or inadequate. Patients report wanting providers to broach the topic, but providers cite barriers to initiating discussions. While the health care community works to address barriers, it is unrealistic to rely solely on provider initiation of SH conversations. This research investigates willingness to communicate about sexual health (WTCSH) to better understand what may interfere with survivors’ ability to self-advocate and receive care for these concerns.

Methods

(N = 305) BCSs completed online surveys. Hierarchical multiple regression determined the relationship between Sexual Quality of Life—Female (SQOL—F), which measures psychological and social dimensions of SH and WTCSH. Interviews were then conducted with forty BCSs. The constant comparative method was used to thematically analyze the transcripts.

Results

The mean SQOL score was 53.4 out of 100. No statistically significant differences in SQOL or WTCSH were found by age or survivorship length. The positive relationship between WTCSH and SQOL was significant, F (6,266) = 4.92, p < .000, adj. R2 = .080). Five themes illustrated factors that shape WTCSH: (1) comfort discussing SH; (2) perception of demographic similarity/discordance; (3) patient-centered communication; (4) belief that SH is (un)treatable, and (5) ability to access timely/coordinated care.

Conclusions

Findings establish the significance of SH concerns and provide an in-depth understanding of intrapersonal, interpersonal, and organizational issues informing WTCSH.

Implications for Cancer Survivors

Age and gender dynamics, perceptions of provider SQOL messaging, and futility influence survivor openness. Addressing these areas may encourage disclosure among women who would otherwise continue to suffer in silence.

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Acknowledgments

The authors would like to thank the women who participated in this study.

Author information

Authors and Affiliations

  1. Department of Communication, Wake Forest University, Winston-Salem, NC, USA

    Mollie Rose Canzona

  2. Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Mollie Rose Canzona

  3. Comprehensive Cancer Center of WFU, Winston-Salem, NC, USA

    Mollie Rose Canzona

  4. Department of Advertising, UF Health Cancer Center, UF Health Center for Arts in Medicine, University of Florida, Gainesville, FL, USA

    Carla L. Fisher

  5. Department of Communication, George Mason University, Fairfax, VA, USA

    Kevin B. Wright

  6. Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Christy J. W. Ledford

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  1. Mollie Rose Canzona
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  2. Carla L. Fisher
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  4. Christy J. W. Ledford
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Correspondence to Mollie Rose Canzona.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Canzona, M.R., Fisher, C.L., Wright, K.B. et al. Talking about sexual health during survivorship: understanding what shapes breast cancer survivors’ willingness to communicate with providers. J Cancer Surviv 13, 932–942 (2019). https://doi.org/10.1007/s11764-019-00809-2

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  • DOI: https://doi.org/10.1007/s11764-019-00809-2

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