Indications for sexology consultation in women after surgical treatment due to breast cancer

Introduction and objectives. Surgical treatment due to brest cancer have an impact on women sexuality. There is a need for research about effective indications for sexology consultation in women after such treatment. The aim of this study is to determine the indications for sexology consultation in women after surgical treatment for breast cancer. Materials and method. We tested 42 women patients diagnosed with breast cancer who had undergone mastectomy 3 months before the study. 3 months after the surgery the women were surveyed using the Polish version of FSFI assessing sexual functioning in women. The result of PL-FSFI were compared with the control group. Results. It was found that the mean score of PL-FSFI in the study group 3 months after the surgery was 13.33 points (score range: 1.2–31.7; median 8.3 points) with a statistically significant difference in terms of areas: desire, arousal, lubrication and orgasm in favour of the control group. The total score of PL-FSFI was significantly lower in women after mastectomy than in women after breast-conserving surgery. It has been shown that sexually active women in whom the surgery concerned the right breast (on the side of the dominant hand) scored lower on the scale “sexual functioning” of QLQ-BR-23 than women with surgery of the left breast, with this difference being statistically significant. There was a statistically significant correlation between the baseline performance status on the Zubrod scale and the scales: desire, lubrication and satisfaction of PL-FSFI. Living in a small town proved to be statistically significant for predicting a lower risk of sexual dysfunction among the surveyed women. Conclusions. The women who underwent surgery due to breast cancer had a higher risk of sexual dysfunction compared to the general population. Higher risk of sexual dysfunction especially concerns women after mastectomy, those who underwent breast surgery on the side of the dominant hand, and those with a worse preoperative overall level of functioning of ≥ 1 point on the Zubrod scale. A lower risk of disorders was observed in women living in smaller towns. The above factors indicate the advisability for sexology consultation in women with breast cancer

Emotional Burden and Perceived Social Support in Male Partners of Women with Cancer

Background: The aim of this study was to describe the correlations between the psychosocial burden on male caregivers and their perception of social support, as well as distress, anxiety, and depression among their partners in the first six months after a cancer diagnosis. Methods: A cross-sectional, longitudinal and observational study was conducted on a group of 61 couples, with the use of Zarit Burden Interview (ZBI), Caregiver Burden Scale (CBS), Berlín Social Support Scales (BSSS), Hospital Anxiety and Depression Scale (HADS) and Distress Thermometer (DT). Statistical analysis was performed using Statistica v.13. Results: A strong positive correlation between the ZBI and CBS, as well as between support-seeking and the emotional involvement of male partners, was documented. The negative correlation between the lack of instrumental support and a much greater burden on caregivers, in emotional, social, and family life was documented. The level of distress, anxiety, and depression, as well as family problems reported by female patients, were positively correlated with the male caregiver′s burden. A demographic analysis showed significant relationships between the number of offspring and the negative health indicators of patients and their partners. Implications: The obtained results encourage deeper reflection on the need to improve the availability of instrumental support for male caregivers and support for families with an oncological ill parent in caring for minor children, and to maintain the social activity of the caregiver

Evaluation of quality of life in women with breast cancer, with particular emphasis on sexual satisfaction, future perspectives and body image, depending on the method of surgery

Introduction. Both because of the large number of women undergoing surgery and a high cure rates, psychological rehabilitation of the consequences of breast cancer and side effects of their treatment is a major challenge of modern psycho-oncology. Aim. The study analyzed the quality of life in women with breast cancer, with particular emphasis on indicators of sexual satisfaction, future perspectives and body image, depending on the method of surgery. Method. The study included 42 women aged 35–70 years, 3 months after surgery due to early breast cancer, treated with adjuvant chemotherapy. The following research tools were used in the study: two EORTC questionnaires: QLQ-C30, BR23, and sexual function questionnaire: PL-FSFI. Results. There was no significant difference in the overall quality of life, depending on the type of surgery. The greatest local complaints were reported by patients after breast conserving surgery (BCT) with axillary lymphadenectomy. A higher level of cognitive functioning but a greater severity of systemic side effects was found in women undergoing mastectomy compared to BCT-patients. Women who underwent surgery of the right breast reported increased problems in sexual functioning (p = 0.034). Multiple regression analysis showed a positive correlation of the emotional functioning variable with the assessment of future perspectives (p = 0.01) and body image (p = 0.007). Conclusions. The type of surgical technique does not affect the overall quality of life and sexual satisfaction. Problems with memory and attention do not correlate directly with the side effects, and as such require an independent diagnostics. Women undergoing treatment of the dominant-side breast should be the candidates for sexology consultation. There is a risk of disturbances in the body image and in the assessment of future perspectives in patients with emotional disorders observed within 3 months after surgery

The relationship between surgical treatment (mastectomy vs. breast conserving treatment) and body acceptance, manifesting femininity and experiencing an intimate relation with a partner in breast cancer patients

Aim. The aim of the study was to verify the following hypotheses: (1) Do women who have undergone surgical treatment for breast cancer differ from healthy women in the way they experience their body (body self)?; (2) Does the surgical technique (mastectomy vs. breast conserving treatment) differentiate the group in terms of experiencing their body after the surgery?; (3) Do demographic variables, BMI, breast size and the evaluation of the scar differentiate the group in terms of experiencing their body self after the surgery? Method. In order to gain some insight into how women experience their body after breast surgery, the Body Self Questionnaire designed in 2005 by Beata Mirucka was used. The analysis included data from 50 women who completed surveys. This data were compared to the control group. Data were analyzed using IBM SPSS Statistics package, version 24, with a one-way analysis of variance (ANOVA). Results. Statistically significant differences were obtained between the entire group of women after breast surgery (mastectomy and BCT, jointly) and the control group of healthy women in three aspects of the Body Self Questionnaire: body acceptance, manifesting femininity and experiencing an intimate relation with a partner. Conclusions. Surgical treatment of breast cancer is significantly associated with the way patients experience their body, which is expressed in three dimensions of the body self in treated women

Attitude towards pharmacotherapy in the course of psychotherapy : pilot study of women-psychotherapists in urban medical and psychotherapeutic centre

Wstęp: Nastawienia psychoterapeutów do stosowania leków psychotropowych w trakcie trwania psychoterapii, rzadko były dotychczas badane. Mogą one mieć znaczenie dla postaw i zachowań pacjentów wobec przyjmowanych przez nich leków. Może to wynikać zarówno z jawnych, jak i niejawnych komunikatów ze strony psychoterapeutów co do przyjmowania leków, a także założeń danej modalności psychoterapii. Z tego powodu nastawienia psychoterapeutów do leczenia psychofarmakologicznego powinny stać się przedmiotem świadomej refleksji. Materiał i metody: Opracowano kwestionariusz wypełniany on-line dotyczący liczby pacjentów przyjmujących leki w trakcie psychoterapii oraz nastawień psychoterapeutów do prowadzenia psychofarmakoterapii w trakcie psychoterapii. Badanie przeprowadzono w dużym ośrodku psychiatryczno-psychoterapeutycznym w Warszawie. Wyniki: Uzyskano odpowiedzi 36 psychoterapeutów, wyłącznie kobiet. Leki w trakcie psychoterapii przyjmowało jednocześnie 55,5% pacjentów, w tym 68,5% osób w trakcie terapii poznawczo behawioralnej i 47,5% osób w trakcie psychoterapii psychoanalitycznych i psychodynamicznych. Nazwy leków psychotropowych przyjmowanych przez pacjentów znało ponad 61% terapeutów. Terapeuci sami inicjowali rozmowę na ten temat leków w 52,8% przypadków lub w 36% podejmowali temat, jeśli zainicjował go pacjent. Wprowadzanie farmakoterapii w leczeniu zaburzeń niepsychotycznych za wskazane uznało 97% osób. Psychoterapeuci uważali także, że przyjmowanie przez pacjenta ma znaczenie dla procesu terapii, i może zarówno przeszkadzać jak i pomagać w jej prowadzeniu. Zdaniem osób badanych stosowanie leków jest przeważnie korzystne dla pacjenta (66% odpowiedzi twierdzących), jednak zdaniem 33% badanych możliwe są różne warianty, może być ono korzystne lub niekorzystne dla osób leczonych. Wnioski: Potrzebne są dalsze badania nad nastawieniami psychoterapeutów do leczenia psychofarmakologicznego w zmieniającej się rzeczywistości klinicznej i społecznej.Introduction: Attitudes of psychotherapist toward psychopharmacotherapy in the course of psychotherapy rarely was the subject of systematic research. Nevertheless they can have important impact on patients’ attitudes to medication and ultimately on adherence to pharmacotherapy. Psychotherapists attitudes can be expressed directly or indirectly and may by connected to psychotherapeutic modality and its theoretical assumptions. Those attitudes should be consciously reflected. Material and methods: Special questionnaire available on line was designed for the purpose of this study and mailed to psychotherapists in one urban psychiatric and psychotherapeutic centre. Results: Data were obtained from 36 psychotherapists, only women. In the course of psychotherapy 55.5% of patients was simultaneously on medication, 68,%% in the course of cognitive-behavioral therapy and 47.5% in the course of psychodynamic or psychoanalytic psychotherapy. Drug names were known to 61% of therapists. In 52.8% conversation abut medication was initiated by psychotherapist and in 36% was sustained if it was initiated by the patient. According to 97% of psychotherapists medication is indicated in some cases of non-psychotic disorders. Psychopharmacotherapy was considered as important for the psychotherapy, not neutral and both with positive and negative effects 33% of opinions. According to 66% of responders it is mostly helpful. Conclusions: More systematic researches of psychotherapists attitudes to psychopharmacotherapy are needed in the ever-changing clinical and socio-economic conditions

Autotelic vs. instrumental motivation of doctors and their medical specialty choice in relation to sense of coherence

Aim. Analysis and comparison of two types of motivation (autotelic and non-autotelic) which are behind the choice of medical specialisation by doctors in relation to their sense of coherence. Method. Questionnaire method was used in the study. The study included a group of 86 graduates of the Faculty of Medicine of the Jagiellonian University, who have completed postgraduate internships at the Department of Haematology and Oncology, Department of Gynaecology of the Jagiellonian University and the L. Rydygier hospital in Krakow in 2010–2012. Statistical analyses were performed using the IBM SPSS Statistics 21. The level of significance was alpha = 0.05. Results. It has been shown that doctors are more frequently characterised by the autotelic type of motivation. It has also been proven that there is a relationship between the male sex of the surveyed doctors and their autotelic type of motivation. Moreover, it has been demonstrated that there is a correlation between the comprehensibility component of the sense of coherence and the male sex. It has been also demonstrated that there is a correlation between meaningfulness component of the sense of coherence and the choice of surgical specialisation Conclusions. Autotelic motivation prevails when choosing a medical specialty and this tendency is more noticeable in men than in women. The meaningfulness component of SoC plays a regulatory role in making career decisions related to the greater physical and mental pressure put on doctors. The observed differences in the types of motivation and the size of the components of the sense of coherence in groups of surveyed doctors – men and women – encourage further observations of these relationships on a larger population

Caregiver Burden Domains and Their Relationship with Anxiety and Depression in the First Six Months of Cancer Diagnosis

Cancer caregiving is associated with burden and a poor psychological state. However, there is no previous information about the predictive utility of specific burden domains on anxiety and depression in the first six months after a partner’s cancer diagnosis. In a longitudinal study, 67 caregivers completed the Zarit Burden Interview (ZBI) and Hospital Anxiety and Depression Scale (HADS) at T1 (45–60 days after diagnosis) and T2 (180–200 days after diagnosis). Most of the caregivers were female (65.7%, mean age = 51.63, SD = 13.25), while patients were mostly male (56.7%). The TRIPOD checklist was applied. ZBI scores were moderate and HADS anxiety reached significant values. There were no differences in ZBI and HADS between T1 and T2. The relationship between burden, anxiety, and depression were more consistent at T2, while emotional burden at T1 were related and predicted anxiety and depression at T2. Some burden domains were related and predicted anxiety in caregivers in the first six months after partner cancer diagnosis. This information could be useful to prevent the onset of these symptoms in the first six months after diagnosis

Temperature-dependent polymorphism of N-(4-fluorophenyl)-1,5-dimethyl-1H-imidazole-4-carboxamide 3-oxide: experimental and theoretical studies on intermolecular interactions in the crystal state

X-ray analysis of N-(4-fluorophenyl)-1,5-dimethyl-1H-imidazole-4-carboxamide 3-oxide reveals the temperature-dependent polymorphism associated with the crystallographic symmetry conversion. The observed crystal structure transformation corresponds to a symmetry reduction from I41 /a (I) to P43 (II) space groups. The phase transition mainly concerns the subtle but clearly noticeable reorganization of molecules in the crystal space, with the structure of individual molecules left almost unchanged. The Hirshfeld surface analysis shows that various intermolecular contacts play an important role in the crystal packing, revealing graphically the differences in spatial arrangements of the molecules in both polymorphs. The N-oxide oxygen atom acts as a formally negatively charged hydrogen bonding acceptor in intramolecular hydrogen bond of N–H…O− type. The combined crystallographic and theoretical DFT methods demonstrate that the observed intramolecular N-oxide N–H…O hydrogen bond should be classified as a very strong charge-assisted and closed-shell non-covalent interaction