精巣腫瘍や治療が精巣腫瘍サバイバーのセクシュアリティに与える影響

Impact of Testicular Cancer and Treatment on the Sexuality of Testicular Cancer Survivors

要　旨

　目的：本研究の目的は，精巣腫瘍やその治療により，精巣腫瘍サバイバーのセクシュアリティにどのような影響があるかを明らかにすることである．

　方法：研究デザインは質的記述的研究で，精巣腫瘍の治療後に外来通院する精巣腫瘍サバイバーへ半構造化インタビューを実施した．

　結果：対象者は，精巣腫瘍サバイバー11名（平均年齢39.8歳）であった．内容分析の結果，精巣腫瘍の治療がセクシュアリティに与える影響として，大カテゴリー【ボディイメージの変化や仕事ができなくなることで男らしさを失うと思う】【治療を経験していくなかで，治療前の男らしさが変化しないことに気づく】【造精機能や治療後に生まれた子どもの発育が気がかり】【性欲の状態での生活の変化はない】【性欲と意欲の減退で，生活全般がうまくいかない】【男らしい振る舞いをとらえなおす】が抽出された．

　考察および結論：対象者は，性欲や意欲の減退にともないパートナーとの関係や仕事への影響，治療による精子の機能への影響を経験していた．これらの影響は，治療前にイメージすることが難しく，個人差があり，治療後に初めて自覚することから，対処が難しい状況に置かれていた．看護師は，精巣腫瘍サバイバーが対処を必要とした時に情報を得られるように支援を行うことが必要である．また，男性としての自己認知のとらえなおしに対する看護支援の必要性も示唆された．

　Purpose: To clarify how testicular cancer and its treatment affects the sexuality of testicular cancer survivors'

　Method: Participants were survivors with a diagnosis of testicular cancer who were visiting an outpatient clinic post completion of treatment. Semi-structured interviews were conducted for the qualitative and descriptive study. The interviews were recorded, and the contents were analyzed.

　Results: The study participants included 11 testicular cancer survivors (mean age: 39.8 years). The results of content analysis were classified into six main categories in terms of the impact of testicular cancer treatment on sexuality. The categories included “I think I will lose masculinity due to changes in body image and inability to work”, “As I go through the treatment, I found that my masculinity didn't change”, “Concerns about spermatogenic function and the growth of my child who was born after my treatment”, “There's no life-change by status of libido”, “Entire life goes wrong by libido and motivation”, and “Reframe one's masculinity”.

　Discussion: Participants experienced unpredictable changes in sexuality after discharge from the hospital, such as a diminished libido and motivation. Changes in sexuality only became apparent post completion of the treatment, and patients experienced difficulty dealing with problems concerning their sexuality. Therefore, it is necessary to provide testicular cancer survivors with resources concerning potential sexuality issues and the potential means for coping with such issues. Furthermore, it was also suggested that nursing support should be provided for reframe one's masculinity.