Journal List > Asian Oncol Nurs > v.18(1) > 1095308

Nam, Lee, Kim, and Lee: Factors Affecting Body Image and Sexual Life for the Colorectal Cancer Patients with Stoma

초록

Purpose

The purpose of this study was to describe factors affecting body image and sexual life for colorectal cancer patients with stoma.

Methods

A cross-sectional descriptive correlational study was applied to 102 ostomates from June to November in 2015 using self-report questionnaires: the Body image scale (BIS), and the Derogatis interview for sexual functioning self report (DISF-SR).

Results

The influencing factors for body image were ‘need for preoperative sexual education and sexual counseling’ (β=-.29, p=.003), and clinical stage II of colorectal cancer (β=-.26, p=.006). The influencing factor for sexual life was educational level (college education or higher) (β=.21, p=.02).

Conclusion

The results of this study showed that colorectal cancer patients with stoma had a negative body image. The sexual counseling and education for ostomates should be approached by considering gender characteristics.

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Table 1.
General Characteristics of Participants (N =102)
Variables Categories Total (n=102)
Male (n=70)
Female (n=32)
n (%) or M ± SD n (%) or M ± SD n (%) or M ± SD
Age groups <59 44 (43.1) 27 (38.6) 17 (53.1)
  60~69 36 (35.3) 27 (38.6) 9 (28.1)
  ≥70 22 (21.6) 16 (22.9) 6 (18.8)
Religion No 47 (46.1) 37 (52.9) 10 (31.3)
Education Yes <Middle school 55 (53.9)35 (34.3) 33 (47.1)24 (34.3) 22 (68.8)11 (34.4)
  High school 36 (35.3) 22 (31.4) 14 (43.8)
  ≥ College 31 (30.4) 24 (34.3) 7 (21.9)
Occupation No 57 (55.9) 37 (52.9) 20 (62.5)
  Yes (Including leave of absence) 55 (44.1) 33 (47.1) 12 (37.5)
Monthly household <100 38 (37.3) 24 (34.3) 14 (43.8)
income (10,000 won) 100~199 18 (17.6) 11 (15.7) 7 (21.9)
  200~299 24 (23.5) 19 (27.1) 5 (15.6)
  ≥300 22 (21.6) 16 (22.9) 6 (18.7)
Marriage duration (year)   33.96 ± 11.83 34.06 ± 11.16 33.71 ± 13.58
Ostomy care Patient self 70 (68.7) 47 (67.1) 23 (71.9)
  Spouse 24 (23.5) 19 (27.1) 5 (15.6)
  Others 8 (7.8) 4 (5.7) 4 (12.5)
ECOG 0 84 (82.4) 56 (80.0) 28 (87.5)
  1 16 (15.7) 13 (18.6) 3 (9.4)
  2 2 (2.0) 1 (1.4) 1 (3.1)
Time since surgery   57.29 ± 71.44 61.54 ± 9.60 33.96 ± 11.83
(month) <6 29 (28.4) 14 (20.0) 15 (46.9)
  6~35 29 (28.4) 23 (32.9) 6 (18.8)
  ≥36 44 (43.2) 33 (47.1) 11 (34.3)
Type of stoma Ileostomy 40 (39.2) 27 (38.6) 13 (40.6)
  Transverse colostomy 5 (4.9) 4 (5.7) 1 (3.1)
  Sigmoid colostomy 57 (55.9) 39 (55.7) 18 (56.3)
Method of surgery APR 47 (46.1) 31 (44.3) 16 (50.0)
  LAR 32 (31.4) 23 (32.9) 9 (28.1)
  Hartmann's procedure 12 (11.8) 9 (12.9) 3 (9.4)
  Total colectomy 11 (10.8) 7 (10.0) 4 (12.5)
Stage I 6 (5.9) 4 (5.7) 2 (6.3)
  II 47 (46.1) 38 (54.3) 9 (28.1)
  III 42 (41.2) 24 (34.3) 18 (56.3)
  IV 7 (6.9) 4 (5.7) 3 (9.4)
Chemotherapy No 18 (17.6) 14 (20.0) 4 (12.5)
  Yes 84 (82.4) 56 (80.0) 28 (87.5)
Radiation therapy No 48 (47.1) 31 (44.3) 17 (53.1)
  Yes 54 (52.9) 39 (55.7) 15 (46.9)

ECOG= Eastern cooperative oncology group.

Table 2.
Sexual Life Characteristics of Part Variables (N =102)
Varible Categories Total (n=102)
Male (n=70)
Female (n=32)
n (%) n (%) n (%)
Postoperative resumption of No 47 (46.1) 34 (48.6) 13 (40.6)
sexual intercourse Yes 55 (53.9) 36 (51.4) 19 (59.4)
Postoperative frequency of No change 15 (14.7) 11 (16.2) 4 (12.5)
sexual intercourse Decrease 87 (85.3) 59 (83.8) 28 (87.5)
Response of sexual life change Concern 53 (51.9) 39 (55.1) 14 (41.9)
  No concern 49 (48.1) 31 (44.9) 18 (58.1)
Sexuality education and counseling Yes Pre-operation 2 (1.9) 2 (18.2) 0 (0.0)
  Post-operation 8 (7.8) 6 (54.5) 2 (66.7)
  Pre and post-operation 4 (3.9) 3 (27.3) 1 (33.3)
  No 88 (86.4) 59 (83.8) 29 (90.6)
Comments on sexual education Unnecessary 22 (21.8) 11 (15.7) 11 (35.5)
and counseling for ostomates Before surgery 22 (21.8) 18 (25.7) 4 (12.9)
  After surgery 20 (19.8) 16 (22.9) 4 (12.9)
  After discharge 35 (33.7) 23 (32.9) 12 (35.5)
  Others 3 (2.9) 2 (2.9) 1 (3.2)
Desired health care provider for sexuality Physician 34 (33.3) 29 (41.4) 5 (15.6)
  Nurse 10 (9.9) 1 (1.4) 9 (28.2)
  Professional counselor 34 (33.3) 23 (32.9) 11 (34.4)
  Others 24 (23.5) 17 (24.3) 7 (21.8)
Table 3.
Score of Body Image and Sexual Life of Participants (N =102)
Variables Range Male (n=70)
Female (n=32)
t (p)
M ± SD M ± SD
Body image total score 0~30 13.49 ± 7.22 15.75 ± 7.97 -1.42 (.158)
 The treatment has left your body whole 0~3 1.71 ± 0.84 1.66 ± 0.90 -1.42 (.158)
 Less sexually attractive 0~3 1.61 ± 1.00 1.66 ± 1.00 -0.20 (.844)
 Less feminine/masculine 0~3 1.59 ± 1.04 1.56 ± 1.08 0.10 (.918)
 Less physically attractive Difficult to look at yourself naked 0~30~3 1.46 ± 0.99 1.43 ± 1.03 1.84 ± 0.85 1.53 ± 1.05 -2.03 (.046)-0.47 (.643)
 Dissatisfied with appearance 0~3 1.31 ± 1.00 1.78 ± 0.91 -2.25 (.027)
 Self-conscious about appearance 0~3 1.20 ± 0.98 1.50 ± 1.02 -1.40 (.164)
 Dissatisfied with body 0~3 1.13 ± 0.96 1.56 ± 0.84 -2.20 (.030)
 Dissatisfied with appearance of scar 0~3 1.06 ± 0.98 1.44 ± 0.95 -1.84 (.068)
 Avoid people 0~3 1.00 ± 1.09 1.22 ± 1.07 -0.95 (.347)
Sexual life total score 20~75 24.00 ± 8.56 21.69 ± 6.08 1.56 (.123)
 Sexual cognition/fantasy 25~72 34.13 ± 8.56 28.41 ± 6.65 3.67 (<.001)
 Sexual arousal 20~75 32.09 ± 16.41 22.44 ± 5.97 4.33 (<.001)
 Sexual behavior/experiences 20~75 28.20 ± 9.09 24.97 ± 7.61 1.75 (.083)
 Orgasm 20~68 25.27 ± 9.33 28.91 ± 6.79 -1.98 (.051)
 Drive/relationship 20~75 25.54 ± 8.95 24.09 ± 6.78 0.82 (.417)
Table 4.
Correlations among Body Image and Sexual Life (N =102)
Variable   Body image
Sexual life
Sexual cognition/ fantasy Sexual arousal Sexual behavior/ experiences Orgasm
r (p) r (p) r (p) r (p) r (p)
Sexual life Sexual cognition/fantasy -.06 (.564)        
  Sexual arousal -.22 (.027) .57 (<.001)      
  Sexual behavior/experiences -.12 (.234) .39 (<.001) .66 (<.001)    
  Orgasm -.25 (.011) .25 (.010) .63 (<.001) .68 (<.001)  
  Drive/relationship -.23 (.018) .37 (<.001) .59 (<.001) .68 (<.001) .75 (<.001)
Table 5.
Influencing Factor of Body Image and Sexual Life (N =102)
Variables Factor B SE β t p VIF
Body image (Constant) 17.10 0.96   17.81 <.001  
  Preoperative sexual education -5.18 1.69 -.29 -3.07 .003 1.04
  Stage II -3.88 1.39 -.26 -2.79 .006 1.04
      R2=.175, Adj. R2=.159, F=10.53, p<.001  
Sexual life (Constant) 20.13 3.19   6.30 <.001  
  ≥ College 3.78 1.90 .21 1.99 .02 1.00
      R2=.032, Adj. R2=.298, F=3.73, p<.001  

Adj. R2= Adjusted R2.

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