Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial

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...

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Main Authors: Laura E.R. Schutte, MSc, Heleen C. Melissant, PhD, Femke Jansen, PhD, Birgit I. Lissenberg-Witte, PhD, C. René Leemans, MD, PhD, Mirjam A.G. Sprangers, PhD, Marije R. Vergeer, MD, Irma M. Verdonck-de Leeuw, PhD, Ellen T.M. Laan, PhD
Format: Article
Language:English
Published: Oxford University Press 2021-02-01
Series:Sexual Medicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2050116120301914
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author Laura E.R. Schutte, MSc
Heleen C. Melissant, PhD
Femke Jansen, PhD
Birgit I. Lissenberg-Witte, PhD
C. René Leemans, MD, PhD
Mirjam A.G. Sprangers, PhD
Marije R. Vergeer, MD
Irma M. Verdonck-de Leeuw, PhD
Ellen T.M. Laan, PhD
author_facet Laura E.R. Schutte, MSc
Heleen C. Melissant, PhD
Femke Jansen, PhD
Birgit I. Lissenberg-Witte, PhD
C. René Leemans, MD, PhD
Mirjam A.G. Sprangers, PhD
Marije R. Vergeer, MD
Irma M. Verdonck-de Leeuw, PhD
Ellen T.M. Laan, PhD
author_sort Laura E.R. Schutte, MSc
collection DOAJ
description 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.Schutte LER, Melissant HC, Jansen F, et al. Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial. Sex Med 2021;9:100304.
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spelling doaj.art-6b4e8979f90948d3ade1e2b1b7b13f2c2023-09-03T06:13:53ZengOxford University PressSexual Medicine2050-11612021-02-0191100304Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled TrialLaura E.R. Schutte, MSc0Heleen C. Melissant, PhD1Femke Jansen, PhD2Birgit I. Lissenberg-Witte, PhD3C. René Leemans, MD, PhD4Mirjam A.G. Sprangers, PhD5Marije R. Vergeer, MD6Irma M. Verdonck-de Leeuw, PhD7Ellen T.M. Laan, PhD8Department of Sexology and Psychosomatic Gynaecology, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsDepartment of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsDepartment of Epidemiology and Biostatistics, Amsterdam University Medical Centers, Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsDepartment of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsDepartment of Medical Psychology, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Radiation Oncology, Amsterdam University Medical Centers, Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsDepartment of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsDepartment of Sexology and Psychosomatic Gynaecology, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands; Corresponding Author: Ellen T. M. Laan, PhD, Department of Sexology and Psychosomatic Obstetrics and Gynaecology, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, 9 Meibergdreef, Suite H4-140, 1105 AZ, Amsterdam, The Netherlands. Tel: + 31 20 566 4354; Fax: (+31) 20 696 3489Introduction: 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.Schutte LER, Melissant HC, Jansen F, et al. Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial. Sex Med 2021;9:100304.http://www.sciencedirect.com/science/article/pii/S2050116120301914Head and neck cancerRCTStepped careQuality of lifeDistressSexuality
spellingShingle Laura E.R. Schutte, MSc
Heleen C. Melissant, PhD
Femke Jansen, PhD
Birgit I. Lissenberg-Witte, PhD
C. René Leemans, MD, PhD
Mirjam A.G. Sprangers, PhD
Marije R. Vergeer, MD
Irma M. Verdonck-de Leeuw, PhD
Ellen T.M. Laan, PhD
Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial
Sexual Medicine
Head and neck cancer
RCT
Stepped care
Quality of life
Distress
Sexuality
title Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial
title_full Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial
title_fullStr Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial
title_full_unstemmed Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial
title_short Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial
title_sort effect of stepped care on sexual interest and enjoyment in distressed patients with head and neck cancer a randomized controlled trial
topic Head and neck cancer
RCT
Stepped care
Quality of life
Distress
Sexuality
url http://www.sciencedirect.com/science/article/pii/S2050116120301914
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