Sexual health in vulvar cancer survivors

Uvod: Spolnost je univerzalna izkušnja in je eden izmed glavnih vidikov človeškega življenja. Karcinom vulve je redek ginekološki rak, ki se večinoma pojavlja pri ženskah v poznem fertilnem obdobju ter pri starostnicah in lahko vpliva na fizični, psihični in socialni vidik življenja ženske. Medicinska sestra igra pomembno vlogo pri oskrbi pacientk s karcinomom vulve. Namen: Namen diplomskega dela je preučiti povezanost karcinoma vulve s fizičnim vidikom spolnosti, s psihosocialnim vidikom partnerskega odnosa, s samopodobo in s samozavestjo žensk ter preučiti priložnosti in ovire v obravnavi spolnega zdravja žensk s karcinomom vulve z vidika zdravstvene nege. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo s sistematičnim pregledom literature. Literaturo smo iskali od februarja 2016 do januarja 2017. Literatura je bila iskana v angleškem in slovenskem jeziku s ključnimi besedami sexual function AND vulval cancer/spolna funkcija IN karcinom vulve, change in sexual function AND vulvectomy/spremembe v spolni funkciji IN vulvektomija, gynecological cancer AND nursing care/ginekološki rak IN zdravstvena nega, gynecological cancer AND sexual function/ginekološki rak IN spolna funkcija, sexual health AND vulvar cancer/spolno zdravje IN rak vulve, vulvar cancer/rak vulve, vulvar cancer AND quality of life/rak vulve IN kakovost življenja, v podatkovnih bazah CINAHL, Medline (PubMed),ScienceDirect in COBIB.SI. V analizo smo vključili 20 člankov. Članki so bili ovrednoteni po štiristopenjski lestvici glede na moč dokazov. Rezultati: Spolna aktivnost se pri pacientkah s karcinomom vulve po zdravljenju spremeni. Srečujejo se lahko s težavami, kot so spremenjeno zunanje spolovilo, bolečina, občutek omrtvičenosti, ki posledično vplivajo na partnerske odnose ter na samopodobo in samozavest žensk. Medicinska sestra ima pomembno vlogo pri obravnavi pacientk in nudenju podpore. Kljub temu da medicinske sestre sprejemajo skrb za spolno zdravje kot svojo odgovornost, le malokrat razpravljajo o tem. Razprava in sklep: Fizični vidik spolnosti, psihosocialni vidik partnerske zveze in pa vidik samopodobe in samozavesti so močno povezani med seboj. Ženske po operativnem posegu doživijo veliko spremembo, na katero se morajo privaditi, kar lahko vodi v spremembe v partnerski zvezi, ki se predvsem navezujejo na spolnost ter na samopodobo in samozavest žensk. Zdravstvena nega predstavlja pomemben del multidisciplinarnega pristopa pri obravnavi pacientk in njihovih partnerjev. Še vedno se premalo govori o spolnih težavah. Že v času izobraževanja bi morali poudarjati pomen spolnega zdravja in spodbujati uporabo znanja v praksi, ker bomo le tako lahko zagotovili celovito in kakovostno zdravstveno nego.Introduction: Sexuality is a universal experience and one of the most important aspects of human life. Vulvar cancer is a rare form of gynecological cancer that affects mostly women in their late fertile period and older women. And can affects physical, psychological and social aspect of patient\u27s life. Nurse plays an important role in taking care of patients with vulvar cancer. Purpose: The purpose of this diploma thesis is to study the connection between vulvar cancer and physical aspect of sexuality, psychosocial aspect of relationships with spouse, affects on self-esteem and confidence and opportunities and obstacles in addressing the sexual health of women with vulvar cancer in terms of nursing care. Methods: We used descriptive method of work with systematic review of literature. We searched for literature from February 2016 until January 2017. We searched for literature in English and Slovene language, with keywords: sexual function AND vulval cance, change in sexual function AND vulvectomy, gynecological cancer AND nursing care, gynecological cancer AND sexual function, sexual health AND vulvar cancer, vulvar cancer, vulvar cancer AND quality of life in databases: CINAHL, Medline (PubMed), ScienceDirect and COBIB.SI. We analised 20 articles. The articles were evaluated on a four-level scale based on the power of evidence. Results: Sexual function in patients with vulvar cancer changes after treatment. They may encounter problems such as changed external genitalia, pain, feeling of numbness, which consequently affect partner relationships and self-esteem and confidence of women. The nurse plays an important role in dealing with patients and providing support. Although nurses accept sexual health as their responsibility, they discuss the subject with patients very rarely. Discussion and conclusion: The physical aspect of sexuality, the psychosocial aspect of the relationship with the partner, and the aspect of self-esteem and confidence are strongly linked to one another. After a surgery, women experience a major change, which they need to get used to, which can lead to changes in relationship with partner, which are mainly related to sexuality, and the self-esteem and confidence of women. Health care is an important part of the multidisciplinary approach in dealing with patients and their partners. There is still not enough talk about sexual problems. During the course of education, we should emphasize the importance of sexual health and promote the use of knowledge in practice, because only in this way can we ensure comprehensive and high-quality health car