Rebecca Skog: Internet-delivered interventions for sexual and reproductive health following cancer: The Fex-Can Young Adult project

Abstract

This thesis is embedded within the Fex-Can Young Adult research project and consists of five papers. The overall aim was to develop and evaluate internet-delivered interventions targeting sexual problems and fertility-related distress following a cancer diagnosis, with the ultimate goal of improving the quality of survivorship among individuals diagnosed with cancer during young adulthood (18-39 years).

Paper I reported findings from a randomized controlled trial evaluating the efficacy of the Fex-Can Sex program in alleviating sexual dysfunction 1.5 years following a cancer diagnosis during young adulthood. No significant effects of the program were demonstrated, and participant activity in the intervention was limited. 

Paper II explored interactive activity and the content of discussions forum posts within the Fex-Can Sex and Fex-Can fertility programs. A limited proportion of participants met criteria for high level activity. Four themes were constructed through thematic analysis of the discussion forum posts: Fertility fears, Perceptions of the changed body, Missing out on life, and Importance of support and information. 

Paper III presented the internal pilot trial and randomized controlled trial of the Fex-Can 2.0 intervention, which was designed to alleviate sexual problems and fertility-related distress among individuals diagnosed with cancer during young adulthood. 

Paper IV presented the collaboration between patient research partners and researchers in the refinement and further development of the Fex-Can intervention. Using qualitative content analysis for analysis of multimodal data (impact log information, field notes, individual interviews), three main categories were constructed: Collaborative working process, Group atmosphere and Concrete impact. 

Paper V investigated changes in perceptions of the body during the first five years following a cancer diagnosis in young adulthood. Over half of female and one-fourth of male participants reported body image disturbance at 1.5 years post-diagnosis, with significant improvements in body image observed over time among males and among females diagnosed with breast cancer or lymphoma. 

The work presented in this thesis contributes to existing research by providing insight into the sexual and reproductive health of young adults diagnosed with cancer, and by informing future research aimed at refining and evaluating internet-delivered interventions.