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Lu J, Chen XM, Xie KH. Effectiveness of nursing interventions on the sexual quality of life of patients with breast cancer: A systematic review and meta-analysis. PLoS One 2022; 17:e0277221. [PMID: 36327334 PMCID: PMC9632802 DOI: 10.1371/journal.pone.0277221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Although many studies have reported the effectiveness of nursing interventions on the sexual quality of life of patients with breast cancer, the results have not been synthesized. This study aims to assess the effectiveness of nursing interventions on the sexual quality of life of patients with breast cancer. REVIEW METHODS A comprehensive search was conducted in 11 databases from inception to October 7, 2021. Studies evaluating the effects of nursing interventions on sexual quality of life were included. Study selection, data extraction, and risk of bias assessment were performed by two independent reviewers. RESULTS This review pooled 38 studies with 3,664 participants. Meta-analysis results showed that nursing interventions significantly improved sexual quality of life, including sexual function (standardized mean difference [SMD] = 0.98, 95% confidence interval [CI] = [0.60-1.37], P < 0.001) and sexual satisfaction (SMD = 0.99, 95% CI = [0.41-1.57], P < 0.001). In addition, depression (SMD = -1.16, 95% CI = [-2.08--0.24], P = 0.01) and general quality of life (SMD = 0.20, 95% CI = [0.08-0.33], P = 0.002) were significantly improved, but body image (SMD = 0.17, 95% CI = [-0.08-0.41], P = 0.19) and anxiety (SMD = -0.45, 95% CI = [-0.93-0.02], P = 0.06) did not significantly improve. Subgroup analysis showed that nursing interventions had a stronger long-term effect on sexual function (SMD = 1.15, 95% CI = [0.51-1.80], P = P < 0.001) and was more effective in younger patients (SMD = 1.43, 95% CI = [0.63-2.23], P = P < 0.001). Nursing interventions showed a statistically significant short-term effect on sexual satisfaction (SMD = 1.32, 95% CI = [0.44-2.20], P = 0.003) and a significant effect in older patients (SMD = 1.27, 95% CI = [0.46-2.08], P = 0.002). CONCLUSIONS Nursing intervention may be an effective way to improve the sexual quality of life of patients with breast cancer. Nursing interventions had a stronger long-term effect on sexual function, and the group with the strongest effect is the younger patients. Nursing interventions showed a significant short-term effect on sexual satisfaction, and older patients had significant improvement in sexual satisfaction.
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Affiliation(s)
- Jia Lu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao Min Chen
- Nursing Department, Zhejiang Provincial People’s Hospital, Hangzhou, China
- * E-mail:
| | - Kai Hong Xie
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
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LeBaron V, Boukhechba M, Edwards J, Flickinger T, Ling D, Barnes LE. Exploring the use of wearable sensors and natural language processing technology to improve patient-clinician communication: Protocol for a feasibility study (Preprint). JMIR Res Protoc 2022; 11:e37975. [PMID: 35594139 PMCID: PMC9166632 DOI: 10.2196/37975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Virginia LeBaron
- School of Nursing, University of Virginia, Charlottesville, VA, United States
| | - Mehdi Boukhechba
- School of Engineering & Applied Science, University of Virginia, Charlottesville, VA, United States
| | - James Edwards
- School of Nursing, University of Virginia, Charlottesville, VA, United States
| | - Tabor Flickinger
- School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - David Ling
- School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Laura E Barnes
- School of Engineering & Applied Science, University of Virginia, Charlottesville, VA, United States
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van Beusekom M, Cameron J, Bedi C, Banks E, Harris R, Humphris G. Using Co-design With Breast Cancer Patients and Radiographers to Develop "KEW" Communication Skills Training. Front Psychol 2021; 12:629122. [PMID: 33692727 PMCID: PMC7937896 DOI: 10.3389/fpsyg.2021.629122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Abstract
Previous work (FORECAST) has shown that concerns of breast cancer patients after finishing radiotherapy are responsive to conversations with radiographers during the treatment period. This study seeks to further understand radiographer and patient experiences, determine shared priorities for improvement in clinical interaction and develop communication guidelines and training to help radiographers support patients. Methods: Using the principles of Experience-Based Co-Design, semi-structured interviews were held with N = 4 patients (videoed) and N = 4 radiographers, followed by feedback events (N = 7) to validate findings. Patients and radiographers exchanged experiences in a joint co-design session, agreed with shared priorities and generated ideas for further support. A survey was conducted for process evaluation. To scale up findings, UK-wide representatives from patient networks (N = 8) and radiographers and managerial staff (N = 16) provided consultative input utilizing an iterative, adaptive procedure. Results: Radiographers expressed a need for support with “difficult conversations,” especially those on Fear of Cancer Recurrence, and their appropriate management. Important pointers for reassuring communication were identified, including: being treated like a person, knowing what to expect, and space to ask questions. The co-design process was rated positively by both staff and patients. Thematic collation of findings and mapping these on literature evidence resulted in the “KEW” communication guidelines for radiographers: Know (Confidence; Expectations; Person), Encourage (Emotions; Space; Follow-up), Warmth (Start; Normalize; Ending). National stakeholder consultations validated and helped fine-tune the training model. The resulting training package, included: trigger videos (n = 6), a simulated patient scenario and interactive handouts on fears of cancer recurrence and the patient pathway. Conclusions: The co-design process captured good practice to help standardize quality in empathic communication in the radiotherapy service. The resulting KEW: Know, Encourage, Warmth guidelines, and training package are user-centered as well as evidence-based. Supplementing single-site co-design with national consultative feedback allows for the development of interventions that are relevant to the clinical practice, even in detail, and helps to generate appropriate buy-in for roll out on a wider scale after evaluation. Trial Registration:www.ClinicalTrials.gov ID: NCT03468881
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Affiliation(s)
- Mara van Beusekom
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Josie Cameron
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom
| | - Carolyn Bedi
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom
| | - Elspeth Banks
- National Cancer Research Institute, London, United Kingdom
| | - Rachel Harris
- Society and College of Radiographers, London, United Kingdom
| | - Gerry Humphris
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, United Kingdom
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Takayama T, Inoue Y, Yokota R, Hayakawa M, Yamaki C, Toh Y. New Approach for Collecting Cancer Patients' Views and Preferences Through Medical Staff. Patient Prefer Adherence 2021; 15:375-385. [PMID: 33633445 PMCID: PMC7901553 DOI: 10.2147/ppa.s292239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/21/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE It is crucial for health professionals to understand patients' and families' views and preferences (PVPs) to enhance their adherence to treatments and subsequent satisfaction. Regularly and consistently collecting comprehensive information on the needs and concerns of patients/families and utilizing the information is vital for improving clinical practice and the healthcare environment. As an initial approach, this study aimed to develop a new system for appropriately collecting PVPs regarding cancer from nationwide medical staff and consider the potential utilization of PVPs in clinical practice. METHODS Web-based anonymous surveys were conducted with medical staff in nationwide cancer care hospitals in Japan. The surveys queried the questions, values, desires, and experiences expressed by cancer patients or their families on five topics, namely two cancer sites (colorectal and esophageal cancers) and three symptoms and signs (lymphedema, urinary symptoms, and tingling/numbness/pain) within the past year. The PVPs were compared to the five topics and staff medical specialties, and those on tingling/numbness/pain were analyzed qualitatively. RESULTS Among the 904 medical staff who responded to this survey, the PVPs encountered by the staff differed according to the topic and staff medical specialty. Tingling/numbness/pain was the most frequently encountered symptom, and urinary symptoms were the least encountered. Only half or fewer of the medical staff had information available regarding urinary symptoms and tingling/numbness/pain. Further, qualitative content analysis of the expressed PVPs regarding tingling/numbness/pain raised clinical questions on this topic that led to the construction of a "Questions & Answers" section on a public website in Japan. CONCLUSION This study suggests that collecting PVPs through nationwide cancer-related medical staff might be an efficient way to understand the specific requirements of patients/families. It would also be possible to document PVP trends according to changes in the environments of patients/families by nationwide, consistent, and continuous PVP collection.
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Affiliation(s)
- Tomoko Takayama
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
- Correspondence: Tomoko Takayama Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045, JapanTel +81-3-3542-2511 Ex. 1621Fax +81-3-3547-8577 Email
| | - Yoji Inoue
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Rie Yokota
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masayo Hayakawa
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Chikako Yamaki
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Yasushi Toh
- National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
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Mooney K, Berry DL, Whisenant M, Sjoberg D. Improving Cancer Care Through the Patient Experience: How to Use Patient-Reported Outcomes in Clinical Practice. Am Soc Clin Oncol Educ Book 2017; 37:695-704. [PMID: 28561689 DOI: 10.1200/edbk_175418] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Poorly controlled symptoms are common and debilitating during cancer treatment and can affect functional status and quality of life, health care resource utilization, treatment adherence, and cancer survivorship. Historically, the patient experience, including symptoms during treatment, has not been tracked or documented in the patient health record. Measurement of patient-reported outcomes (PROs), including symptoms, is an essential component to cancer care focused on the illness impact to the patient and family. PROs can be useful at the individual level for monitoring and promoting symptom care both in the clinic and remotely and at the population level for aggregating population data for use in research and quality improvement initiatives. Implementation of PROs in cancer clinical care requires a carefully thought out process to overcome challenges related to integrating PROs into existing electronic health records and clinical work flow. Issues with implementing PRO collection may include making decisions about measurement tools, modes of delivery, frequency of measurement, and interpretation that are guided by a clarification of the purpose for collecting PROs. We focus on three aspects of PRO use: (1) improving care for individual patients, (2) analyzing aggregated data to improve care and outcomes overall, and (3) considerations in implementing PRO collection.
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Affiliation(s)
- Kathi Mooney
- From the University of Utah, Salt Lake City, UT; Hunstman Cancer Institute, Salt Lake City, UT; Harvard Medical School, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Donna L Berry
- From the University of Utah, Salt Lake City, UT; Hunstman Cancer Institute, Salt Lake City, UT; Harvard Medical School, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Meagan Whisenant
- From the University of Utah, Salt Lake City, UT; Hunstman Cancer Institute, Salt Lake City, UT; Harvard Medical School, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Daniel Sjoberg
- From the University of Utah, Salt Lake City, UT; Hunstman Cancer Institute, Salt Lake City, UT; Harvard Medical School, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY
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Berry DL, Nayak MM, Abrahm JL, Braun I, Rabin MS, Cooley ME. Clinician perspectives on symptom and quality of life experiences of patients during cancer therapies: Implications for eHealth. Psychooncology 2017; 26:1113-1119. [PMID: 28497471 DOI: 10.1002/pon.4455] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 03/03/2017] [Accepted: 05/05/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this study was to explore clinician experiences with cancer symptom and quality of life (SQL) management from diagnosis throughout therapy in the ambulatory setting, plus identify preferences for a future SQL decision support system. METHODS Eligible clinicians worked in ambulatory cancer care with responsibility for direct patient care. Focus groups were conducted to discuss symptom management throughout the treatment experience and features desired in a future decision support system. Each group was audio-recorded, transcribed, de-identified, and entered into NVivo 9 for analysis. Open and axial coding was completed, grouping common concepts into nodes; large constructs among the nodes were identified and main messages were synthesized. RESULTS A total of 118 clinicians were contacted by email resulting in a final sample of 51 attending 1 of 9 focus groups. Clinicians described a standard face-to-face approach to assessment of SQL, before and throughout therapy. Preparing patients for expected symptoms and approaches to management included paper-based patient education materials and referrals. Communicating with patients between visits was covered in detail, notably use of telephone and email. Future system features desired by the clinicians included an electronic, Web-based system with real-time, trended data, reasonable alerts, and tailored information for patients. CONCLUSIONS Cancer care specialists reported strategies to assess and manage cancer SQL in ambulatory care including patient-reported outcome measures, contact communication modes, face-to-face interviews, and paper-based patient education materials. Future system features desired by clinicians included an electronic, Web-based system with real-time, trended data, reasonable alerts, and tailored information for patients.
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Affiliation(s)
| | | | | | - Ilana Braun
- Dana-Farber Cancer Institute, Boston, MA, USA
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Rocque GB, Halilova KI, Varley AL, Williams CP, Taylor RA, Masom DG, Wright WJ, Partridge EE, Kvale EA. Feasibility of a Telehealth Educational Program on Self-Management of Pain and Fatigue in Adult Cancer Patients. J Pain Symptom Manage 2017; 53:1071-1078. [PMID: 28185891 PMCID: PMC8641243 DOI: 10.1016/j.jpainsymman.2016.12.345] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/12/2016] [Accepted: 12/29/2016] [Indexed: 02/08/2023]
Abstract
CONTEXT Pain and fatigue are common symptoms among cancer patients and often lead to substantial distress. Innovative self-management programs for pain and fatigue are needed. OBJECTIVES The primary objective was to assess the feasibility of a telehealth pain and fatigue self-management program among adult cancer patients. Secondary objectives included assessment of differences in patient characteristics, recruitment, and retention of patients based on two screening strategies: 1) navigator-collected, patient-reported pain or fatigue and 2) in-clinic, physician-identified pain or fatigue. METHODS This prospective, nonrandomized, pre-post evaluation assessed feasibility, which was defined as 50% of eligible patients choosing to participate and completing the intervention. Patient demographics and patient-reported outcomes (patient activation, distress, symptoms, and quality of life) were collected at baseline and study completion. Differences in baseline characteristics were compared between cohorts and for patients who did vs. did not graduate from the program. RESULTS The program did not meet feasibility requirements because of only 34% of eligible patients choosing to participate. However, 50% of patients starting the program graduated. Differences in baseline characteristics and retention rates were noted by recruitment strategy. At baseline, 27.3% of navigated patients were at the highest activation level compared with 7.1% in the physician-referred, non-navigated patients (P = 0.17); more than 15% of non-completers were at the lowest activation level compared with 9% of completers (P = 0.85). CONCLUSION Telehealth self-management program for pain and fatigue may be better accepted among selected segments of cancer patients. Larger scale studies are needed to assess the efficacy of this program in a more selective activated population.
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Affiliation(s)
- Gabrielle B Rocque
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA; Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
| | - Karina I Halilova
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Allyson L Varley
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Courtney P Williams
- Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Richard A Taylor
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | | | - Edward E Partridge
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Elizabeth A Kvale
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA; Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Sleath B, Sayner R, Vitko M, Carpenter DM, Blalock SJ, Muir KW, Giangiacomo AL, Hartnett ME, Robin AL. Glaucoma patient-provider communication about vision quality-of-life. PATIENT EDUCATION AND COUNSELING 2017; 100:703-709. [PMID: 27916461 PMCID: PMC5385288 DOI: 10.1016/j.pec.2016.11.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 11/18/2016] [Accepted: 11/21/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The purpose of this study was to: (a) describe the extent to which ophthalmologists and glaucoma patients discuss vision quality-of-life during office visits, and (b) examine the association between patient and ophthalmologist characteristics and provider-patient communication about vision quality-of-life. METHODS Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited at six ophthalmology clinics. Patients' visits were video-tape recorded and quality-of-life communication variables were coded. Generalized estimating equations were used to analyze the data. RESULTS Two hundred and seventy-nine patients participated. Specific glaucoma quality-of-life domains were discussed during only 13% of visits. Older patients were significantly more likely to discuss one or more vision quality-of-life domains than younger patients. African American patients were significantly less likely to make statements about their vision quality-of-life and providers were less likely to ask them one or more vision quality-of-life questions than non-African American patients. CONCLUSION Eye care providers and patients infrequently discussed the patient's vision quality-of-life during glaucoma visits. African American patients were less likely to communicate about vision quality-of-life than non-African American patients. PRACTICE IMPLICATIONS Eye care providers should make sure to discuss vision quality-of-life with glaucoma patients.
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Affiliation(s)
- Betsy Sleath
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB# 7573, Chapel Hill, NC 27599-7573, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, CB # 7590, Chapel Hill, NC 27599-7590, USA.
| | - Robyn Sayner
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB# 7573, Chapel Hill, NC 27599-7573, USA.
| | - Michelle Vitko
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB# 7573, Chapel Hill, NC 27599-7573, USA.
| | - Delesha M Carpenter
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB# 7573, Chapel Hill, NC 27599-7573, USA.
| | - Susan J Blalock
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB# 7573, Chapel Hill, NC 27599-7573, USA.
| | - Kelly W Muir
- Department of Ophthalmology, School of Medicine, Duke University and Durham VA Medical Center, Health Services Research and Development, 2351 Erwin Rd #3802, Durham, NC 27705, USA.
| | - Annette L Giangiacomo
- Ophthalmology, Emory University School of Medicine, 1365B Clifton Rd, Atlanta, GA 30322, USA.
| | - Mary Elizabeth Hartnett
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center University of Utah, 65 N Mario Capecchi, Salt Lake City, UT 84132, USA.
| | - Alan L Robin
- Ophthalmology and International Health, Johns Hopkins School of Medicine, 600 N Wolfe St, Baltimore, MD 21287, USA; Department of Ophthalmology, University of Maryland, 419 West Redwood St., Suite 420, Baltimore, MD 21201, USA; Department of Ophthalmology, University of Michigan, 1000 Wall St., Ann Arbor, MI 48105, USA.
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Dow J, Kennedy Sheldon L. Breast Cancer Survivors and Sexuality: A Review of the Literature Concerning Sexual Functioning, Assessment Tools, and Evidence-Based Interventions. Clin J Oncol Nurs 2015. [DOI: 10.1188/15.cjon.456-461] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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