Sexuality after breast cancer: cultural specificities of Tunisian population.
BACKGROUND
Women's sexuality may be particularly affected after breast cancer. The objectives of this study were to evaluate the changes in sexual life after treatment of breast cancer in Tunisian women and to identify the influence of demographic and clinical factors on sexuality.


METHODS
We recruited 50 patients who were in remission for at least 3 months after initial treatment of breast cancer. Sexuality and body image were evaluated using the Arabic version of the specific scale of breast cancer QLQ-BR23. Screening for emotional disorders has been done with the Arabic version of HAD scale (Hospital anxiety and depression scale).


RESULTS
Patients had poor sexual functioning and sexual satisfaction and the mean scores were respectively 45.3% and 43.9%. Only menopausal status and sexual difficulties in the partner was significantly related to poorer sexual satisfaction (p respectively 0.018 and 0.014). According to the HAD scale, 42% of patients had anxiety and 44% had depression. The sexual satisfaction was statistically associated with the presence of anxiety symptoms (p=0.0003).


CONCLUSIONS
Results suggest that the psychological side and the sexual difficulties in partner are the most important factors that appear to be involved in sexual satisfaction of Tunisian women after breast cancer. So, those factors need to be taken into account in therapeutic process and psychological counseling to maintain and enhance patient's psychological well-being.
Psychiatry Department, Hedi Chaker Hospital, Sfax, Tunisia.
Mnif
M
Leila
Psychiatry Department, Hedi Chaker Hospital, Sfax, Tunisia.
Charfi
C
Nada
Gynecology Department, Hedi Chaker Hospital, Faculty of Medicine of Sfax, Tunisia.
Chaabene
C
Kais
Psychiatry Department, Hedi Chaker Hospital, Sfax, Tunisia.
Masmoudi
M
Jawaher
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D001828:Body Image; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003466:Cultural Characteristics; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D007802:Language; D008875:Middle Aged; D010549:Personal Satisfaction; D011569:Psychiatric Status Rating Scales; D012725:Sexual Behavior; D012747:Sexual Partners; D019529:Sexuality; D014416:Tunisia / Q000453:epidemiology
Breast cancer; anxiety; body image; culture; depression; quality life; satisfaction; sexual functioning