Pathways to Sexual Health After Breast Cancer: Actively Navigating Sexual Health Changes Through Flexibility and Growth

Abstract

Breast cancer is the most commonly diagnosed cancer for Canadian women and its treatments frequently have significant long-term effects on sexual health. These changes to sexual health are associated with distress and lower quality of life for a majority of women. However, a subset of women adapt and thrive in response to these sexual health changes. The aim of my dissertation was to examine two types of positive coping--sexual script flexibility and sexual growth--in response to sexual health changes after breast cancer and its treatments. First, I conducted two cross-sectional studies that examined the relationship between sexual script flexibility and sexual well-being at both the individual and dyadic level (Chapter 2). Results indicate that greater sexual script flexibility may be an adaptive response for women diagnosed with breast cancer and their partners. Specifically in Study One, I found that women diagnosed with breast cancer who reported greater sexual script flexibility also reported greater sexual satisfaction, and lower sexual distress. In Study Two, I used Actor-Partner Interdependence Modelling and found that both individual and partner levels of sexual script flexibility were associated with greater sexual satisfaction, however, only individual level of sexual script flexibility was associated with lower distress. These findings highlight the importance of considering dyadic influences. In Chapter 3, I describe the development and evaluation of a measure of sexual growth--the Sexual Growth after Changes Scale (SGCS)--across two studies. The four factors identified from the Exploratory Factor Analysis conducted with a sample of women diagnosed with breast cancer were: Relating to Partner, New Sexual Possibilities, Sexual Self-Confidence, and Priorities and Appreciation of Sexuality. These four factors align with domains of posttraumatic growth found in the broader literature (Tedeschi & Calhoun, 1996). Results from the psychometric evaluation of the SGCS in Study One and Two (Chapter 3) suggested acceptable model fit, and a stable factor solution. Overall, the results in Chapter 3 provide promising results for the SGCS as a measure of sexual growth.