Associations Between Sexual Script Flexibility and Sexual Outcomes: An Investigation Among Breast Cancer Survivor Couples.

Abstract

Objectives: Breast cancer (BC) survivors often experience sexual concerns affecting their intimate relationships. Sexual script flexibility (SSF) refers to the ability to adapt one's sexual scripts in response to sexual problems and may have implications for sexual adjustment. We studied SSF and its links to sexual self-efficacy and sexual satisfaction in BC survivor couples.

Methods: One hundred-twenty female post-treatment BC survivors reporting sexual concerns and their spouses (98% male) participating in a couples' sexual health intervention trial completed baseline surveys assessing SSF, sexual self-efficacy, and sexual satisfaction. Analyses included paired t-tests comparing survivors and spouses on SSF, ANOVA's to assess effects of couple-level SSF on sexual self-efficacy and satisfaction, and Actor-Partner Interdependence (APIM) models using multilevel modeling with generalized least squares analysis to assess effects of survivors' and spouses' SSF on their own and their spouses' sexual self-efficacy and satisfaction.

Results: Survivors reported lower SSF and sexual self-efficacy than spouses (p's ≤ 0.001). Couples where both members reported above median SSF (23% of couples) were distinguished by greater sexual self-efficacy and sexual satisfaction. APIM results indicated that (1) the greater survivors' and spouses' own SSF, the greater their own sexual self-efficacy (p < 0.01); (2) the greater survivors' SSF, the greater their own sexual satisfaction (p < 0.001); and (3) the greater survivors' SSF, the greater their partners' sexual satisfaction (p < 0.05).

Conclusions: Greater sexual script flexibility may benefit BC survivor couples coping with sexual concerns. Future studies should examine whether intervention-related changes in SSF lead to better sexual outcomes, with survivors' flexibility an especially promising target.