Family And Sexual Functioning Among Women Diagnosed With Cervical Cancer In Urban Ghana: A Mixed-Methods Study

Abstract

Background: 8 , Peter Agyei-Baffour 6 , Thomas Okpoti Konney 7 , and , Cervical cancer significantly impacts sexual and family functioning, yet limited evidence exists on addressing these issues in sub-Saharan Africa. Objectives: This study examined the prevalence and associations of sexual and family function among women diagnosed with cervical cancer in Kumasi-Ghana. Design: A concurrent mixed-methods study design. Methods: This study was conducted at the Komfo Anokye Teaching Hospital from 2020-2021. The quantitative component employed a cross-sectional design using 181 women with histologically confirmed cervical cancer. Sexual functioning was assessed using the Female Sexual Function Index, while family functioning was evaluated using the APGAR Family Functioning Scale. Systematic sampling was used for participant selection. Associations between predictors were examined using Firth penalized logistic regression. Analysis tool was STATA version 16.0. The qualitative component utilized purposive sampling to recruit 15 participants for in-depth interviews. Thematic analysis was performed for qualitative data using NVIVO software version 14. Results: Participants had a mean age of 57.5 years (SD=12.85). Almost all (96.1%) women with cervical cancer had sexual dysfunction, despite majority (93.4%) reporting a frequent sexual desire as a relational dimension rather than an indicator of preserved sexual health. Family dysfunction was prevalent, with 65.7% classified as severely dysfunctional families. The study revealed that women with 8–13 children had significantly lower odds of family functioning (AOR = 0.12, 95% CI: 0.01–0.59, p = 0.006). Qualitative findings revealed that, despite higher family dysfunction, meaningful support from spouses and children provided substantial practical and emotional support even as extended family involvement remained limited. Conclusion: Sexual and family functioning challenges are highly prevalent among Ghanaian women with cervical cancer despite a maintained sexual desire and support from nuclear family. Integration of culturally-appropriate, holistic sexual health counselling and family-centered interventions into routine cervical cancer care is essential for survivorship support in resource-limited settings.