OBJECTIVE: This systematic literature review aimed to explore the effects of head and neck cancer (HNC) on relationship intimacy in adults and identify the current support available to patients with HNC and their partners in relation to relationship intimacy.
METHODS: Seven databases (CINAHL, Pubmed, Scopus, Web of Science, SocINDEX, PsycARTICLES, Psychology, and Behavioural Science Collection) were searched using grouped terms \"head and neck cancer and intimacy\" and \"head and neck cancer and support.\" Studies written in English to assess adult patients with HNC and its effects on relationship intimacy and studies assessing the use of intimacy-specific support tools/methods were included. The review protocol was registered in June 2022 with PROSPERO ID: CRD42022329614.
RESULTS: Thirty publications were included within the review. Six topics emerged: relationships, communication, sexual interest, barriers, couples-based communication intervention strategies, and assessment tools. While there were positive dyadic changes observed, many patients reported negative experiences relating to changes in relationship roles, sexual issues, and poor communication with partners and health care professionals that affected intimacy. There were 5 interventions identified; of those, the results varied, with some improvements noted in psychological well-being but not necessarily sexual interest and enjoyment.
CONCLUSIONS: HNC profoundly affects relationship intimacy. However, both patients and health care professionals find it challenging to discuss these issues, often leaving it an unmet need. Appropriate training and development for health care professionals that facilitate communication between clinician and patient are necessary to support conversations on intimacy needs.
CONCLUSIONS: There exists a need for patients to receive support in relation to intimacy following diagnosis and treatment, and the evidence suggests that this may be more effective post-treatment and from health care professionals who are appropriately trained. Couples\' communication interventions may prove useful, but further research is required on the efficacy of combining both psychological and sexual support together.

Patients with anal squamous cell carcinoma (SCC) are treated with sphincter-preserving radiation therapy and concurrent chemotherapy, achieving excellent oncologic outcomes. Patients, however, may experience treatment-related morbidity including sexual dysfunction. The objective of this systematic review was to review the literature on sexual dysfunction in female patients treated for anal cancer and to identify knowledge gaps.
This systematic review was registered in PROSPERO prior to initiation. Databases searched included MEDLINE, Embase, PubMed, Cochrane, and Google Scholar. There were no restrictions on the study time period. Studies were limited to English. All study designs were included except review articles, letters to the editor, and case reports with less than ten patients.
In total, 1801 studies were retrieved and 19 met the inclusion criteria, including: 13 cross-sectional surveys, 3 prospective studies, 1 longitudinal intervention study, 1 retrospective chart review, 1 case control study. Sexual function was assessed using the female sexual functioning index (FSFI), EORTC-QLQ-CR30 and -CR38; response rates were low (<50 % in most studies). Sexual dysfunction was reported by up to 85 % of women; the most common symptoms being dyspareunia (17-65 %), vaginal dryness (22-88 %), and loss of libido (38-95 %). Gastrointestinal issues, such as bowel problems, and body image concerns additionally affected sexual function and quality of life.
Sexual dysfunction is a common issue affecting most female patients treated for anal cancer and there is a paucity of evidence on the management of this important survivorship issue. There is additionally a lack of ethnic, economic, and educational diversity and there are no studies addressing the unique needs of LGBTQ individuals - future studies should make a concerted effort to include a diverse patient population.

Research on sex in later life has been concerned with documenting that older people continue to have sex and establishing the links between good health and sexual activity. Although sexual avoidance is common in clinical and nonclinical populations of older adults, little attention has been given to the motives for sexual avoidance. To address gaps in the literature on sexual avoidance, the present study explored the self-reported reasons for, and correlates of, sexual avoidance in older partnered individuals with probability samples of 60-75-year-olds in four European countries (Norway, Denmark, Belgium, and Portugal). Results revealed significant differences between men and women in sexual avoidance, with women reporting more avoidance than men. The main reasons reported for avoiding sex were sexual difficulties, health problems, partner\'s sexual difficulties, and lack of sexual interest. Among men, significant predictors of sexual avoidance were age, relationship intimacy (the only relational predictor), physical health, and own and partner\'s sexual problems. In women, significant predictors of sexual avoidance were age, relationship duration, relationship satisfaction, relationship intimacy, physical and mental health, and own and partner\'s sexual problems. Thus, in men, health-related factors were more important predictors of sexual avoidance than relationship factors. In women, relationship factors were as important as health-related factors. These findings provide insight into an under-researched area. They also have important implications for health care and could inform the development of tailored sexual health interventions in older adults.

Objectives: This study analysed the association between demographic, psychological and relationship factors and resource loss in pregnant women. Methods: Quantitative descriptive correlational study. Depressive mood, social support, relationship intimacy and resource loss were assessed in a sample of 200 pregnant women recruited from public primary-care clinics. Results: Hierarchical regression showed that being younger, having lower yearly income, and having stronger depressive mood, little relationship intimacy and little satisfaction with social support were the main factors associated with resource loss. Depressive mood accounted for most resource loss after controlling for demographic risk factors. The models show the combined influence of demographic, psychological and relationship factors in shaping resource loss. Conclusions and implications: Depressive mood was a major risk factor for resource loss among pregnant women, whereas social support and relationship intimacy had a protective role. The results highlight the importance of screening for depressive mood and level of resources during routine prenatal care, in order to identify pregnant women at risk of depression. The findings point to interventions that foster patient\'s emotions to help them protect resources.

Recent studies show that sexual approach (SA) motives, i.e., having sex to achieve a positive state such as sexual pleasure, are associated with higher sexual and relationship satisfaction. However, mechanisms linking SA motives to these outcomes are poorly understood, and the important distinction between SA motives that are self-directed (e.g., self-gratification) and other-directed (e.g., pleasing one\'s partner) has received little empirical attention, particularly in the everyday context of couples\' sexuality. The present study focused, at an event level, on the associations between self-directed and other-directed SA motives, and sexual satisfaction and perceived partner responsiveness (PPR, an aspect of relationship intimacy). We also examined the mediating role of the couple\'s sexual behavior in these associations. Data were collected over a month-long daily diary study involving 35 newlywed heterosexual couples and analyzed using the Actor-Partner Interdependence Model. Results showed that men and women\'s self-directed SA motives were associated with their own higher sexual satisfaction and, in men, with their female partners\' sexual satisfaction as well. For both men and women, these associations were mediated by sexual behavior: Self-directed SA motives were associated with more genitally focused sexual behavior (e.g., vaginal intercourse, oral sex), in turn associated with higher sexual satisfaction. For men, other-directed SA motives were associated with their own greater PPR and with that of their female partners. For women, self-directed SA motives were associated with their own greater PPR and with that of their male partners. Sexual behavior did not mediate associations with PPR. Theoretically, these findings support dyadic models of sexual satisfaction and intimacy and indicate that self-directed SA motives may be more important to sexual satisfaction than other-directed motives. Clinically, they support sex therapy approaches that integrate both partners and suggest that sexual motives and behavior may be relevant targets for intervention.

Background: Assessment and treatment of emotional distress during pregnancy show that worries during pregnancy and interpersonal relationships with partners are the important factors determining psychological health.Aims: The present study aimed to investigate the impact of worries during pregnancy, relationship intimacy, and marital satisfaction on anxiety, depression, and stress symptoms in pregnant women, as well as to analyse the mediating effect of relationship intimacy between marital satisfaction and emotional distress.Method: During their second and third trimester of pregnancy, 200 Portuguese women were recruited during childbirth preparation consultations and completed the Cambridge Worry Scale (CWS), the Personal Assessment of Intimacy in Relationships Scale (PAIR), the Marital Life Areas Satisfaction Evaluation Scale (MLASES), and the Depression, Anxiety, and Stress Scale (DASS-21).Results: Hierarchical multiple regression analyses showed that being unemployed or on sick leave, being younger, having a history of miscarriage, having more worries during pregnancy, and declaring low-relationship intimacy were the main predictors of emotional distress. Relationship intimacy mediated the relation of marital satisfaction to anxiety and depression symptoms.Conclusions: This study highlights the importance of the worries during pregnancy and relationship intimacy in shaping pregnant women\'s emotional distress, and identifies both as targets of intervention.

This paper explores barriers to consistent condom use among female sex workers in Jamaica in a qualitative study using grounded theory. Multiple perspectives were sought through 44 in-depth interviews conducted with female sex workers, clients, the partners of sex workers and facilitators of sex work. Poverty and lack of education or skills, severely limited support systems as well as childhood abuse served to push the majority of participants into sex work and created vulnerability to HIV and other STIs. Despite these constraints, women found ways to exercise agency, ensure condom use, adopt protective measures and gain economic advantage in various aspects of the Jamaican sex trade. Perceived relationship intimacy between sex workers and their clients and/or their main partners emerged as the main factor contributing to reduced risk perception and inconsistent condom use. Relationship intimacy, with associated trust and affirmation of self, is the most important factor influencing sexual decision-making with respect to lapse in condom use among female sex workers in Jamaica. Study findings provide important insights that can enhance individual psychosocial, interpersonal and community-based interventions as well as inform environmental, structural and policy interventions to reduce risk and vulnerability among female sex workers.

Historically, women\'s sexual desire has been deemed socially problematic. The growing popularity of the concept of hypersexuality-which lists high sexual desire among its core components-poses a risk of re-pathologizing female sexual desire. Data from a 2014 online survey of 2,599 Croatian women aged 18-60 years was used to examine whether high sexual desire is detrimental to women\'s relationship and sexual well-being. Based on the highest scores on an indicator of sexual desire, 178 women were classified in the high sexual desire (HSD) group; women who scored higher than one standard deviation above the Hypersexual Disorder Screening Inventory mean were categorized in the hypersexuality (HYP) group (n = 239). Fifty-seven women met the classification criteria for both groups (HYP&HSD). Compared to other groups, the HSD was the most sexually active group. Compared to controls, the HYP and HYP&HSD groups-but not the HSD group-reported significantly more negative consequences associated with their sexuality. Compared to the HYP group, women with HSD reported better sexual function, higher sexual satisfaction, and lower odds of negative behavioral consequences. The findings suggest that, at least among women, hypersexuality should not be conflated with high sexual desire and frequent sexual activity.