Determinants of Sexual Function among Female Patients with Gynaecological Cancers at Kenyatta National Hospital, Nairobi City County, Kenya
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Background: Gynaecological cancer impacts approximately three million women globally. The problem is much intense in resource limited countries. Sexual health is attracting great focus as a key aspect of gynecological malignancy management and a component of Quality of Life. We have paucity of information in regards to the magnitude of sexual dysfunction among survivors with gynaecological cancers in Kenya. Therefore, investigating sexual function among survivors with gynaecological cancer is an important area of inquiry. Broad objective: To assess the determinants of sexual function among female patients with gynecological cancers at Kenyatta National Hospital. Methodology: Descriptive correlational study design was utilized where by 108 Female patients diagnosed with gynaecological cancers on treatment and regular follow up were consecutively recruited by simple random sampling. The study was conducted at Kenyatta National Hospital Cancer Treatment Centre. The main variables were socio-demographic, assessed with the socio-demographic questionnaire, clinical characteristics, extracted from medical records, psychological, assessed with the Body Image Scale (BIS), social, assessed with the Multidimensional Scale of perceived Social Support (MSPSS) and cultural, and assessed with the Sexual Dysfunction Beliefs Questionnaire. Sexual function was evaluated by female sexual function index. SPSS Version 25.0 was used in analysis .Chi square test, Pearson’s 𝑟 assessed correlations and logistic Regression were done to identify the predictors of sexual function. Results: Mean total score of Female Sexual Function Index scores was 10.0. Eighty-five (85%) of respondents had sexual dysfunction. Age (p=0.004), Employment status (p=0.002), cervical cancer (p =0.016), endometrial cancer (p=0.018), cancer staging 4 (p = 0.008) and social support (p =0.037) were significant predictors of sexual dysfunction. Age (p =0.001), education level (p =0.002), employment status (p<0.0001) and lifestyle adaptation (p =0.047) were significantly associated with sexual function. Respondents who had cancer of the cervix were 7 times more likely to have sexual dysfunction Conclusion and recommendations: These results signify that Sexual dysfunction is a disturbing and under managed problem among gynecological malignancy survivors. Assessment of sexual function using Female Sexual Function Index scores has yielded important information that predicted outcome of patients with gynecological cancers. Health professionals can contribute great impact on the Quality of Life of gynecologic malignancy survivors by focusing on sexual health issues. Therapeutic intervention at multidisciplinary level should incorporate sexual rehabilitative strategies in all oncology settings in order to provide relevant supportive care in addressing physical and psychosocial needs of patients with gynecological cancers across survivorship continuum of care and broadening sexual health training within the medical curriculum for all health professionals.