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Weijmar Schultz, Willibrordus Canisius Maria University of Groningen Sexual functioning after gynaecological cancer treatment Wiel, Henricus Balthazar Maria van de; Weijmar Schultz, Willibrordus Canisius Maria IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 1991 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Wiel, H. B. M. V. D., & Weijmar Schultz, W. C. M. (1991). Sexual functioning after gynaecological cancer treatment. s.n. Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license. More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne- amendment. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 06-10-2021 SEXUAL FUNCTIONING AFTER GYNAECOLOGICAL CANCER TREATMENT Stellingen behorend bij het proefschrift van Harry B.M. van de Wiel SEXUAL FUNCTIONING AFTER GYNAECOLOGICAL CANCER TREATMENT 1. Confrontatie met gynaecologische kanker leidt doorgaans tot een toename van ambivalente gevoelens ten aanzien van seksualiteit en slechts zelden tot seksuele emancipatie. (dit proefschrift) 2. Hoe groter de crisis voor het individu, des te minder individueel het zich gedraagt. (dit proefschrift) 3. Een radicale hysterectomie kan om psychologische redenen de seksuele respons verstoren. (dit proefschrift) 4. In psychologisch opzicht krijgt niet alleen het individu kanker maar het hele gezin. 5. Door de hiërarchisch geneste opbouw van gedrag, blijft het steeds de vraag wat men onder "welzijn", i.c. seksuele satisfactie,dient te verstaan. 6. De onenigheid op het punt van de methode betekent eigenlijk dat men het nergens minder over eens is dan over de manier om het eens te worden. (De Boer: Tussen filosofie en profetie, 1987) 7. Een probleem op de polikliniek Psychosomatische Gynaecologie is dat mensen zich niet willen laten helpen. 8. Gesponsord seksuologisch onderzoek vormt een link tussen het bedrijven van de liefde en de liefde van het bedrijf. 9. Aan ieder thuis zit een luchtje, behalve bij ons. (Floortje, 8 jaar) 10. De natuurwetenschappen hebben laten zien dat reductie tot productie kan leiden; de natuur zelf demonstreert nu dat productie tot reductie kan leiden. 11. Voor wie kan klappen met één hand, is empirisch onderzoek overbodig. 12. Ook van dingen zonder handen kun je een klap krijgen. (Anne, 6 jaar) 13. Het verwerven van assertiviteit loopt van waardig, via vaardig naar aardig. 14. Carrière maken is een sterk overschatte vorm van vermijding. 15. De lage status van "opvoeders" heeft niet zozeer te maken met de afwezigheid van de daarvoor benodigde vaardigheden als wel met de onzichtbaarheid daarvan. 16. Bij de bakker doe je "broodschappen". (Pim, jaar) 4 17. Uit het nieuwe Rite-report blijkt dat 34% van de mannen een orgasme simuleren. (Van Kootcn en De Bic, Bescheurkalender) 18. Het therapeutische rollenspel kan gezien worden als een inhaalactie voor diegenen voor wie het leven nimmer een spel was dat op rolletjes liep. 19. Racewagens ogen sneller naarmate ze langzamer rijden. 20. Worilber man nicht sprechen kann, muss man einen Psychologen zu Rate ziehen. 21. Bij multidisciplinaire samenwerking is het noodzakelijk contact-tics om te zetten in con-tactics. (H.B.M. van de Wiel, C.M.J. Boon & W.C.M. Weijmar Schultz, Gedragstherapie, 1991) 22. Dat mensen op hun werk de krant lezen geeft aan dat er iets goed mis is in deze wereld. 23. Minnen heeft plussen. Stellingen behorend bij het proefschrift van Willibrord C.M. Weijmar Schultz SEXUAL FUNCTIONING AFTER GYNAECOLOGICAL CANCER TREATMENT 1. Het is onterecht om bij de voorlichting aan gynaecologische kankerpatiënten seksualiteit buiten beschouwingte laten. (dit proefschrift) 2. De motivatie voor seksueel kontakt na de behandeling van gynaecologisch kanker is belangrijker dan welke fysieke belemmering ook. (dit proefschrift) 3. Een radicale hysterectomie kan om fysiologische redenen de seksuele respons verstoren. (dit proefschrift) 4. De perceptie van genitale symptomen gedurende seksuele opwinding is geen goede graadmeter voor de tevredenheid over het seksueel funktioneren. (dit proefschrift) 5. Het herstel van het seksueel functioneren na oncologisch gynaecologische behandeling is meer een kwestie van woorden dan van daden. (dit proefschrift) 6. "Als je meer over de vrouw wilt weten moet je je eigen ervaringen nagaan of de dichters raadplegen ......". (Freud, 1933) 7. Een probleem op de polikliniek psychosomatische gynaecologie is dat mensen zich zo graag willen laten behandelen. 8. "Any treatment that bas the power to help bas also the power to hurt". (Le Shan, 1990) 9. Een meersporenbeleid, waarbij aandacht wordt besteed aan de interaktie tussen psychoseksuele, relationele en somatische aspekten komt in de gynaecologische praktijk niet zelden als mosterd na de maaltijd. 10. Het grote aantal patiënten met onbegrepen buikklachten is een teken aan de wand. 11. Een geknipt perineum bij een ongecompliceerde eerste bevalling is een verknipt perineum. (W.C.M. Weijmar Schultz, H.B.M. van de Wiel, R. Heidemann, J.G. Aamoudse & H.I. Huisjes, l 1990, Joumal of PsychosomaticObstctrics and Gynaccology, Il, pp. 119-127) 12. Kortere wachtlijsten voor IVF kan leiden tot het ongewenst vroeg uitvoeren van IVF. 13. Bij iedere operatie hoort een bijsluiter. 14. De uitval van deelnemers aan een gerandomiseerd onderzoek verloopt niet gerandomiseerd. 15. Het best bewaarde geheim van Nederland: Groningen. (Humphrcy, 1986) 16. Promoveren is meer een kwestie van avonduren dan van avonturen. 17. Veranderen is voor anderen. 18. De rijken rest eten, de armen eten resten. 19. Er zijn mensen die zitten in ieder circuit, behalve het huiselijke. 20. Kennis is macht, kennissen is meer macht. RIJKSUNIVERSITEIT GRONINGEN SEXUAL FUNCTIONING AFTER GYNAECOLOGICAL CANCER TREATMENT PROEFSCHRIFT ter verkrijging van het doctoraat in de Geneeskunde aan de Rijksuniversiteit Groningen op gezag van de Rector Magnificus Dr. L.J. Engels in het openbaar te verdedigen op woensdag 27 februari1991 des namiddags te 3.00 uur precies door HENRICUS BALTHAZAR MARIA VAN DE WIEL geboren op 26 juni 1955 te 's-Hertogenbosch & des namiddags te 4.00 uur precies door WILLIBRORDUS CANISIUS MARIA WEIJMAR SCHULTZ geboren op 30 januari 1948 te Rijssen 1991 m Promotor: Prof.Or. J. Janssens Referent: Dr. J. Bouma Promotiecommissie: Prof.Or. J.G. van Dijk Prof.Or. E.V. van Hall Prof.Or. E.C. Klip The study was supportedby grants from The Dutch Cancer Society (KWF-GUKC 83-1) and The Maurits and Anna de Koek Foundation The printing of this thesis was supported by grants from Schering Nederland B.V., ConvaTec Nederland B.V., Sandoz B.V. and AHMAS Groningen. COLOPHON: Correction of English Judith Abma-Hill Correction of typescript : Anneke Meijer Illustrations Martin van den Berg Photography: Jacob Pleiter Type-setting: COMPUTEKST grafische tekstverwerking, Groningen Printing: DijkhuizenVan Zanten bv, Groningen Cover design Douwe Buiter Preface This dissertation is the result of a close cooperationbetween a gynaecologist and a psy­ chologist. A bi-disciplinary approach requires the combination of two different scienti­ ficdisciplines, each withits own methodological and ideological background. Although two types of readerswere aimed at, physicians and psychologists, we were unable to avoid that the accessibility of some parts of the study may be limited. This goes for physicians as well as psychologists. Because the dissertation is based upon a number of articles, published over the last few years, there may besome overlap in the text. At the officialpart of the PhD ceremony the chapters 2.1-2.4.4 / 3.3-3.3.4 / 5 / 6.3 / 6.5 / 6.6 / 6.8 and 6.9 will be defended primarily by Harry van de Wiel. The chapters 2.5- 2.5.7 / 3.1 - 3.2.5.4 / 4 / 6.1 / 6.2 / 6.4 and 6.7 will be defendedprimarily by Willibrord Weijmar Schultz.Tuis division is not valid forthe chapters 1, 6.10 and 7. V We suffered years from iliis book,now il's your turn. Vl A WORD OF TIIANKS: THANKS! A specialword of thanks goes to prof. dr. P. E. Boeke,to whom we would like to refer as one of the promotors of this book. VII CONTENTS Preface V A word of thanks VII Nederlandse samenvatting XIII PARTI: SURVEY OF OPINION S, THEORIES AN D RESULTS OF 1 PREVIOUS STUDIES CHAP'IER1 3 INTRODUCTION AND AIM OF THE STIJDY 1.1 3 1.2 Psychosocial oncology Sexual functioning after gynaecological cancer treatment; 4 1.2.1 relevance and research questions 4 1.2.2 Relevance 5 Research quesLions CHAP'IER2 A CONCEPTUALIZATION OF SEXUAL FUNCTIONING; 9 2.1 SOCIAL,PSYCHOLOGICAL AND SOMATIC ASPECTS 9 2.2 Introduction; views on human sexuality 10 2.3 Scripting theory 10 2.4 Sexual scripts 11 2.4.1 Sexual behaviour 12 2.4.2 Cognitive factors
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