Factors Associated With Quality of Sexual Life in Allogeneic Stem Cell Transplantation Survivors and Partners

Sunday, 22 July 2018

Chun-Man Chen1
Ming-Chung Kuo1
Hsueh-Erh Liu, PhD, RN2
(1)Division of Hematology-Oncology, Chang Gung Memorial Hospital, Taiwan, ROC, Tao Yuan, Taiwan
(2)School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan

Purpose: As survival rates for allogeneic hematopoietic stem cell transplantation (HSCT) improved in the past two decades, issues for long-term complications became more attractive, including sexual function in the survivors. Although sexual problems also occurred in a proportion of normal population, the quality of sexual life in survivor with their partners after allogeneic HSCT had seldom been studied in Asian countries. The major purposes of this descriptive and correlational study were to investigate the quality of sexual life and predictive factors for allogeneic HSCT survivors and their constant sexual partners.

Methods: We recruited 110 patients and 57 constant sexual partners from the outpatient department of medical center in northern Taiwan. Structured questionnaires such as demographic and medical-related questions, Symptom Distress Scale, Female sexual function Index (FSFI; sexual dysfunction was defined as FSFI score < 26 points), intimate relationship, and importance of sexual life were selected for analysis. The statistical analysis was carried out by software SPSS 17.0 for Windows (SPSS Inc., Chicago, USA) and methods included: descriptive statistics, t-test, independent one–way ANOVA test, Scheffe’s Post Hoc, paired-t test, Pearson Correlation analysis and multiple -regression analysis.

Results: The mean follow-up duration after allogeneic HSCT was 83.5 ± 66.7 months. The mean time after marriage was 18.5±10.5 years. The mean score of quality of sexual life in patients was 36.99 ± 23.68. Several factors contributed to poor quality of sexual life for patients who received allogeneic HSCT including female gender, consciously economic status, unmarried status, single, live alone without family, pre-transplant chemotherapy, acute graft versus host disease of oral mucosa, and increased number and severity of symptoms distress. The mean score of quality of sexual life in their partners was 56.45 ± 15.6. Several factors contributed to poor quality of sexual life for the patient’s constant sexual partner including chronic medical disease and dissatisfied emotional state before transplantation. Multiple regression analysis showed the important factors to predict the quality of sexual life were partner availability (p<0.001), symptom distress (p<0.001) and cohabit with partner (p<0.05). We found a multiple regression model for quality of sexual life: 28.42+ 32.767 (partner availability)-1.064 (number of symptom distress) + 7.888 x (cohabit with partner or not). The number of each additional symptom distress resulted in one point drop of sexual quality of life. We also observed the interrelationship between patients and their constant sexual partners. Better intimate relationship with partners resulted in a better quality of sexual life in patients (r = 0.34; p <0.01), whereas, better partner’s sexual function also resulted in a better quality of sexual life in patients (r = 0.76; p <0.01).

Conclusion: Our study demonstrates the quality of sexual life in allogeneic HSCT survivors was worse than their partners. We also found the associated factors of the sexual quality in patients and their partners were different, however, they interacted on each other. We expect that our study will explore the parameters that influence the quality of sexual life in survivors of allogeneic HSCT in Taiwan and help to improve the sexual quality in these patients and their partners.