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Massae AF, Mgopa LR, Bonilla ZE, Mohammed I, Rosser BRS, Mushy SE, Ross MW, Mwakawanga DL, Mkonyi E, Lukumay GG, Wadley J, Mkoka DA, Trent M. Addressing sexual health concerns in Tanzania: perceived barriers among healthcare professionals and students in the "training for health professionals" study. CULTURE, HEALTH & SEXUALITY 2024; 26:1217-1231. [PMID: 38284804 PMCID: PMC11284245 DOI: 10.1080/13691058.2024.2306227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 01/12/2024] [Indexed: 01/30/2024]
Abstract
Little is known about the factors that may prevent healthcare professionals as key stakeholders from exploring sexual health issues in Tanzania. This study examined healthcare professionals' perspectives on the barriers to addressing sexual health concerns in practice. In June 2019, we conducted an exploratory qualitative study involving 18 focus group discussions among healthcare professionals (n = 60) and students (n = 61) in the health professions (midwifery, nursing, medicine) in Dar es Salaam, Tanzania. Study participants and design were purposively selected and stratified. We used a focus group discussion guide in Kiswahili. Data were transcribed in Kiswahili and translated into English. A thematic analysis approach was used for data analysis. Two themes were developed: (1) differences between health care professional and patient socio-demographic characteristics; (2) health care system and patients' backgrounds, such as communication barriers, lack of confidentiality and privacy within health facilities, type of clinical presentation and complaint, patient behaviours, and their clinical background. Several key barriers prevented sexual health communication between healthcare professionals and patients, affecting the quality of sexual health service delivery. Additional sexual health clinical training is warranted for health professions students and professionals to optimise sexual health care delivery in a culturally conservative country like Tanzania.
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Affiliation(s)
- Agnes F. Massae
- School of Nursing, Muhimbili University of Health and Allied Sciences Dar es Salaam, Tanzania
| | - Lucy R. Mgopa
- School of Nursing, Muhimbili University of Health and Allied Sciences Dar es Salaam, Tanzania
| | - Zobeida E. Bonilla
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Inari Mohammed
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - B. R. Simon Rosser
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Stella E. Mushy
- School of Nursing, Muhimbili University of Health and Allied Sciences Dar es Salaam, Tanzania
| | - Michael W. Ross
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Dorkasi L. Mwakawanga
- School of Nursing, Muhimbili University of Health and Allied Sciences Dar es Salaam, Tanzania
| | - Ever Mkonyi
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Gift G. Lukumay
- School of Nursing, Muhimbili University of Health and Allied Sciences Dar es Salaam, Tanzania
| | - James Wadley
- Counseling and Human Services Department, Lincoln University, Baltimore Pike, Philadelphia, PA, USA
| | - Dickson A. Mkoka
- School of Nursing, Muhimbili University of Health and Allied Sciences Dar es Salaam, Tanzania
| | - Maria Trent
- Schools of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, MD, USA
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Lefebvre S, Cousin L, Bourmaleau J, Rohé S, Devictor J, Martin P, Jovic L. Nursing practices on sexual health for people with neurological disorders: A narrative review. J Clin Nurs 2024. [PMID: 38970146 DOI: 10.1111/jocn.17318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 05/17/2024] [Accepted: 06/03/2024] [Indexed: 07/07/2024]
Abstract
AIMS To identify and describe nursing practices on the sexual health of people with neurological disorders. DESIGN Narrative review. METHODS Data were extracted from 1 January 2002, to 20 May 2021. Inclusion criteria were nursing practices, sexual health and people with neurological disorders. The main outcome measures were: context of nursing practice implementation (assumptions, knowledge, strategies and skills), facilitators of and barriers to addressing and treating the sexual health of people with neurological disorders, and benefits of nursing practices in sexual health. PRISMA reporting guidelines were used. DATA SOURCES PubMed, Embase, ScienceDirect and CINAHL. RESULTS In total, 926 articles were identified and nine were included. The involvement of nurses was recommended in most studies. Assumptions about the impact of neurology on sexuality and nurse's role in sexual healthcare, biopsychosocial knowledge, and skills (ethical, interpersonal, and technical) were highlighted. We found that the modes of knowledge proposed by Carper were mobilized in an unequal way. Sexual difficulties were the key focus and eroticization concerns were not addressed in any of the articles. CONCLUSION Several studies advocate nursing intervention; however, few accurately present, detail and evaluate sexual health nursing practices of patients with neurological pathologies. Literature describes practices structured around disorders rather than the potentials, fails to address the brake of eroticism and provides little information on the results of interventions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Developing teaching programs on sexual health in nursing programs may be necessary if nurses are to support a diverse range of patients in an inclusive and positive manner. These programs should highlight the domain-specific knowledge that is mobilized. IMPACT Sexual health is a fundamental human right. Alterations in the nervous system have shown to affect sexual health, however, it is not often discussed among patients with neurological disorders, who are rarely provided with sexual health counselling. Our findings may impact healthcare professionals engaged in care with these patients. REPORTING METHOD PRISMA. No patient or public contribution.
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Affiliation(s)
- Sandrine Lefebvre
- Universite Paris Cite, INSERM, Paris, France
- Care Management, Sorbonne Universite Faculte de Medecine Campus Pitie-Salpetriere, Paris, France
| | - Lorraine Cousin
- APHP, L'unité de recherche clinique en économie de la santé (URC-Eco), Paris, France
- University of Paris, Patient-Reported Outcomes Unit (PROQOL), Paris, France
- Aix-Marseille University, Sciences Economiques & Sociales de la Santé and Traitement de l'Information Médicale (SESSTIM), Marseille, France
| | - Julie Bourmaleau
- Neurology Department, Sorbonne Universite Faculte de Medecine Campus Pitie-Salpetriere, Paris, France
| | - Séverine Rohé
- Anesthesia Service, Centre Hospitalier Sud Seine et Marne, Fontainebleau, France
| | - Julie Devictor
- Universite Paris Cite, INSERM, Paris, France
- Department of Hepatology, Beaujon Hospital, Clichy, France
| | - Philippe Martin
- Universite Paris Cite, INSERM, Paris, France
- Sexual and Reproductive Health and Rights Department, National Institute of Demographic Studies, Paris, France
- Paris-Saclay University, INSERM, Villejuif, France
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Aldiwan A, McParland J, Leeuwerik T, Stoneham S, Williamson M, Christie D. An interpretative phenomenological analysis of the psychosexual identity development in adolescent and young adult survivors of testicular cancer. Clin Child Psychol Psychiatry 2024:13591045241259920. [PMID: 38865494 DOI: 10.1177/13591045241259920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
BACKGROUND Qualitative research has explored how some testicular cancer survivors (TCS) experience the psychological impacts of diagnosis and treatment. More research into the impacts of testicular cancer (TC) on adolescent and young adults (AYA) is needed due to the critical period of identity development. The present study aimed to explore how AYA with TC appraise and make sense of their experience and to develop a greater understanding of psychosexual identity development in AYA TCS. METHOD Eight AYA TCS were interviewed. The results were analysed using Interpretative Phenomenological Analysis. The questions explored the experiences relating to diagnosis and treatment, how it affected their psychosexual identity development (e.g., sexual relationships and self-image) and the meanings attached to the experiences. ANALYSIS Four Group Experiential Themes were developed from the data; 'Dealing with the shock', 'Fear and weight of responsibility', 'those closest to me' and 'sense of change'. DISCUSSION The AYA TCS experiences may result in adoption of traditional masculine traits (e.g., stoicism) or abandonment of traditionally masculine traits (E.g. violence and aggression). AYA TCS also described feelings of insecurity when compared to other men. Psychology input could help manage stoicism and feelings of inferiority when compared to men with two testicles.
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Affiliation(s)
- Abdullah Aldiwan
- Salomons Institute for Applied Psychology, Canterbury Christ Church University Salomons Institute for Applied Psychology, Tunbridge Wells, UK
| | - James McParland
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Tamara Leeuwerik
- Salomons Institute for Applied Psychology, Canterbury Christ Church University Salomons Institute for Applied Psychology, Tunbridge Wells, UK
| | - Sara Stoneham
- University College London Hospitals NHS Foundation Trust, London, UK
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Gradellini C, Mecugni D, Castagnaro E, Frade F, da Luz Ferreira Barros M, Palma S, Bocos-Reglero MJ, Gomez-Cantarino S. Educating to sexuality care: the nurse educator's experience in a multicenter study. Front Psychol 2023; 14:1206323. [PMID: 37554130 PMCID: PMC10406512 DOI: 10.3389/fpsyg.2023.1206323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/26/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Sexuality is an issue inherent in the lives of all human beings. Education for Sexuality takes place informally, through relationships with the environment, with the family as a model, and formally, as a pedagogical practice in Teaching. Education for sexuality is recognized as an instrument of social transformation that leads to changes in behaviors and norms related to sexuality. OBJECTIVES Knowing the perception of nursing professors about sexuality education in professional training, recognizing attitudes of these professors in relation to sexual education and identifying barriers in education for sexuality. METHODS Exploratory and descriptive study, using qualitative methodology. Data collection was carried out from semi-structured interviews and thematic analysis. RESULTS The interviewees consider sexuality education to be very important, being taught in the nursing course, addressing different themes. In general, they reported feeling comfortable teaching these topics. The identified barriers to the level of education students are in, students' knowledge and reactions to the topic, religious and cultural issues, and the time available to talk about the topic and professional aspects. CONCLUSION Sexuality is a fundamental theme in nursing education and needs to be further explored to overcome the barriers associated with its approach.
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Affiliation(s)
- Cinzia Gradellini
- Reggio Emilia Nursing Course, University of Modena and Reggio Emilia, Modena, Italy
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Daniela Mecugni
- Reggio Emilia Nursing Course, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Fátima Frade
- Departamento de Enfermagem da Criança e do Jovem, Escola Superior de Enfermagem de Lisboa, Lisboa, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal
- Centre for Public Administration and Public Policies, Institute of Social and Political Sciences, Universidade de Lisboa, Lisbon, Portugal
| | - Maria da Luz Ferreira Barros
- Department of Nursing, University of Évora, Évora, Portugal
- Comprehensive Health Research Center (CHRC), Évora, Portugal
| | - Sara Palma
- School of Health, Polytechnic of Santarém, Santarém, Portugal
| | | | - Sagrario Gomez-Cantarino
- Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
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Lefebvre S, Houot M, Delgadillo D, Cantal Dupart MD, Varin D, Papeix C, Sevin M, Bourmaleau J, Laigle‐Donadey F, Jovic L. Validation of the French version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 Tools which help nurse for assessing the effect of perceived multiple sclerosis symptoms on sexual activity and satisfaction. Nurs Open 2022; 10:570-578. [PMID: 36054641 PMCID: PMC9834499 DOI: 10.1002/nop2.1323] [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: 05/09/2021] [Revised: 11/30/2021] [Accepted: 07/29/2022] [Indexed: 01/16/2023] Open
Abstract
AIM To validate a French version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 which examines patients' perception of the effect of multiple sclerosis symptoms on their sexual activity. METHODS After completing a translation/re-translation process to ensure linguistic and content validity, the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 French (MSISQ-15Fr) was completed by patients with multiple sclerosis. The validity of the construction, reliability, stability and reproducibility of the translation was evaluated. EXPLANATORY MIXED OBSERVATIONAL STUDY Validation of a French assessment tool for sexual disorders (borrowed theoretical framework): the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 (MSISQ 15) RESULTS: The normed χ2 was 1.21, the root mean square error of approximation was 0.046 [0.00; 0.07], the comparative fit index was 0.974, and the standardized root mean square was 0.065. The calculated Cronbach's coefficients indicated strong internal coherence, and the intraclass correlation coefficient was satisfactory at 0.9. Translations of the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 (MSISQ-15) have already been validated in five languages. This French version is valid, stable and reproducible. It provides French-speaking nurses an accessible and appropriate tool that will enable them to play an active role in the sexual health strategy recommended by the World Health Organization.
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Affiliation(s)
- Sandrine Lefebvre
- University of Paris Cité, ECEVE UMR 1123, InsermParisFrance,AP‐HPSorbonne University, GHU Pitié‐SalpêtrièreParisFrance
| | - Marion Houot
- AP‐HPSorbonne University, GHU Pitié‐SalpêtrièreParisFrance
| | - Daniel Delgadillo
- APHPSorbonne University, GHU Pitié SalpêtrièreDepartment 2‐MazarinParisFrance
| | | | | | - Caroline Papeix
- APHPSorbonne University, GHU Pitié SalpêtrièreDepartment of neurologyParisFrance
| | | | - Julie Bourmaleau
- APHPSorbonne University, GHU Pitié SalpêtrièreDepartment of neurologyParisFrance,EHESPParisFrance
| | | | - Ljiljana Jovic
- University of Paris Cité, ECEVE UMR 1123, InsermParisFrance,ARS Ile‐de‐FranceParisFrance
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Mkonyi E, Mwakawanga DL, Rosser BRS, Bonilla ZE, Lukumay GG, Mohammed I, Mushy SE, Mgopa LR, Ross MW, Massae AF, Trent M, Wadley J. The management of childhood sexual abuse by midwifery, nursing and medical providers in Tanzania. CHILD ABUSE & NEGLECT 2021; 121:105268. [PMID: 34416472 PMCID: PMC8513504 DOI: 10.1016/j.chiabu.2021.105268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 07/28/2021] [Accepted: 08/08/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Child sexual abuse (CSA) is a significant public health problem affecting one billion children aged 2 to 17 globally. The prevalence of CSA in Tanzania is one of the highest; however, how health care providers manage CSA cases has not been studied. OBJECTIVES This study investigated how medical, nursing, and midwifery professionals in Tanzania handle cases of CSA and identified the factors that facilitate or impede the provision of quality care to CSA victims. METHODS Participants were 60 experienced healthcare professionals and 61 health students working in Dar es Salaam, Tanzania. We conducted 18 focus groups stratified by profession (midwifery, nursing, or medicine) and experience (practitioners versus students). RESULTS Three main themes emerged. First, child abuse management involved using a multi-disciplinary approach, including proper history taking, physical assessment, treatment, and referral. Second, factors that enhanced disclosure of CSA included building rapport, privacy, and confidentiality. Third, factors that impeded care included fear of harm to the child if the abuse was reported, abuse reporting being perceived as a "waste of time" for providers, loss of evidence from the victim, family resistance, poverty, corruption and cultural dynamics. CONCLUSIONS Midwives, nurses and doctors were all experienced in and reported similar challenges in addressing CSA. At a structural level, the ratio of providers to patients in health facilities inhibits quality care. These findings have implications for strengthening CSA policy/guidelines and clinical practice in Tanzania. Mandated CSA training is necessary for midwifery, nursing, and medical students as well as in continuing education courses for more experienced providers.
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Affiliation(s)
- Ever Mkonyi
- University of Minnesota, Minneapolis, MN, USA
| | | | | | | | | | | | - Stella E Mushy
- Muhimbili University of Health and Allied Sciences Dar es Salaam, Tanzania
| | - Lucy R Mgopa
- Muhimbili University of Health and Allied Sciences Dar es Salaam, Tanzania
| | | | - Agnes F Massae
- Muhimbili University of Health and Allied Sciences Dar es Salaam, Tanzania
| | - Maria Trent
- Johns Hopkins University, Baltimore, MD, USA
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Oncology Nurses' Perspectives and Practices Toward the Delivery of Cancer Survivorship Care in Hong Kong. Cancer Nurs 2021; 44:295-304. [PMID: 32132367 DOI: 10.1097/ncc.0000000000000791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite tremendous progress in understanding the unmet needs of cancer survivors, our understanding of oncology nurses' perspectives and practices in the delivery of survivorship care is inadequate. OBJECTIVES The aims of this study were to assess oncology nurses' perceptions about their responsibility and frequency of delivery of survivorship care to cancer patients and to examine the factors influencing such care. METHODS A cross-sectional survey was administered to 81 nurses working in the oncology unit of hospitals in Hong Kong. Participants completed an investigator-developed questionnaire designed to assess oncology nurses' perceptions of responsibility, practices, and barriers regarding the provision of survivorship care for cancer patients. RESULTS Results revealed discrepancies between oncology nurses' perceptions of responsibility and practices, with high levels of perceptions of various survivorship care as their responsibility but low levels in delivery of such care. Despite that discussing and managing pain was agreed by most oncology nurses as their responsibility (95.1%), 34.6% of them have never managed survivors' pain. Besides, 33.3% of nurses have never discussed and managed survivors' sexuality issues. Lack of time (79.0%), inadequate educational resources for family members (59.3%), and lack of knowledge and skills (54.4%) were major factors that impeded survivorship care provision. CONCLUSIONS This study provides further evidence for inadequacies of oncology nurses in delivering survivorship care and their perceived barriers. Further studies are required to enhance our understanding of the strategies for improving the quality of cancer survivorship care. IMPLICATIONS FOR PRACTICE Results underscore the need to develop educational resources and enhance training in survivorship care for oncology nurses.
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Kim HW, Kim YH, Kang SY, Lee EJ, Lee JL, Kim Y. Gender Differences in Sexual Information Needs and Relating Factors in Cancer Patients: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3752. [PMID: 33916815 PMCID: PMC8038313 DOI: 10.3390/ijerph18073752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to identify the sexual information requirements and related factors according to gender to improve sexual health in cancer patients. In this cross-sectional study, a total of 687 cancer patients from a single cancer center in Korea completed a self-reported questionnaire. Multiple logistic regression analysis was used to compare the sexual information requirements and related factors among cancer patients. The results showed that male cancer patients had higher demands for sexual information than female cancer patients (t = 27.11, p < 0.001). Men appeared to have a greater need than women in the need for sexual information (t = 30.41, p < 0.001) and professional sexual intervention (t = 21.97, p < 0.001). Regarding sexual information needs, income (OR: 0.43, 95% CI: 0.25 to 0.73) was a significant factor in men. In women, age (OR: 0.51, 95% CI: 0.31 to 0.86), alcohol consumption (OR: 1.88, 95% CI: 1.12-3.16), and chemotherapy (OR: 1.87, 95% CI: 1.12-3.12) were significant factors. Significant differences in the overall sexual information needs and related factors were observed between male and female cancer patients. Therefore, a strategy needs to be established to improve the sexual health of cancer patients considering gender differences.
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Affiliation(s)
- Hae Won Kim
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, Department of Nursing, The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul 03080, Korea;
| | - Yeon Hee Kim
- Department of Clinical Nursing, University of Ulsan, Ulsan 44610, Korea;
| | - Saem Yi Kang
- College of Nursing, Seoul National University, Seoul 03080, Korea;
| | - Eun Ju Lee
- Department of Nursing, Inha University, Incheon 22212, Korea;
| | - Jung Lim Lee
- Department of Nursing, Daejeon University, Daejeon 34519, Korea;
| | - Youngji Kim
- Department of Nursing, College of Nursing and Health, Kongju National University, Gongju-si 32588, Korea
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Mbalè E, D'Hondt L, Vastrade C, Coppieters Y. [Perceptions and attitudes of nurses on emotional and sexual lives of cancer patients]. Bull Cancer 2020; 107:1233-1240. [PMID: 33069338 DOI: 10.1016/j.bulcan.2020.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/28/2020] [Accepted: 06/21/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Despite the frequency of sexual issues during cancer care, the majority of nurses do not bring up the topic with their patients. The purpose of this study is to encourage nurses in oncology and hematology units on how to better participate in the assessment of the well-being of cancer patients as part of their sexual health. METHODS Using an interview guide, we conducted a qualitative study by interviewing twenty nurses working in the Oncology and Hematology Units of four Belgian hospitals. The twenty semi-structured interviews were transcribed, and we performed a content analysis of the data collected. RESULTS Sexuality is still a taboo topic, sexual dysfunction is undervalued, nurses lack knowledge on the topic which create many barriers to sexual health assessment. Obstacles are intrinsic or extrinsic towards nurses: prejudices, embarrassment, lack of evaluation tools, lack of support, resources, the environment is not always adequate. This is linked to the lack of knowledge of side effects of treatments, the lack of know-how, well-being and reflexivity. The assessment of sexual health is however part of their role. Nurses would like to have tools and better education to address the various shortcoming on how to address sexual health. CONCLUSION Nurses must acknowledge the existence of sexual health issues in cancer patients by rectifying their perceptions of sexuality, improving their knowledge and management of care, by addressing the issue of sexual health early enough.
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Affiliation(s)
- Eugénie Mbalè
- Centre de recherches politiques et systèmes de santé, École de Santé Publique, Université libre de Bruxelles (ULB), route de Lennik 808, 1070 Bruxelles, Belgique.
| | - Lionel D'Hondt
- CHU UCL Namur (site Godinne), service d'oncologie, rue G.-Thérasse 1, 5530 Yvoir, Belgique
| | - Christelle Vastrade
- CHU UCL Namur (site Godinne), Département infirmier, rue G.-Thérasse 1, 5530 Yvoir, Belgique
| | - Yves Coppieters
- Centre de recherches politiques et systèmes de santé, École de Santé Publique, Université libre de Bruxelles (ULB), route de Lennik 808, 1070 Bruxelles, Belgique
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McGrath M, Low MA, Power E, McCluskey A, Lever S. Addressing Sexuality Among People Living With Chronic Disease and Disability: A Systematic Mixed Methods Review of Knowledge, Attitudes, and Practices of Health Care Professionals. Arch Phys Med Rehabil 2020; 102:999-1010. [PMID: 33045226 DOI: 10.1016/j.apmr.2020.09.379] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To systematically review health care professionals' practices and attitudes toward addressing sexuality with people who are living with chronic disease and disability. DATA SOURCES Scopus, PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health, Allied and Complementary Medicine Database, and MEDLINE were searched to August 2020 for English language publications. Reference lists of relevant publications were also searched. STUDY SELECTION Eligible studies reported on knowledge, attitudes, and behaviors of health care professionals about addressing sexuality in the context of chronic disease and disability. The search yielded 2492 records; 187 full texts were assessed for eligibility and 114 documents were included (103 unique studies). Study quality was rated using the Mixed Methods Appraisal Tool. DATA EXTRACTION Characteristics of included studies were recorded independently by 2 authors. Differences were resolved through discussion or by a third author. DATA SYNTHESIS A sequential, exploratory mixed studies approach was used for synthesis. Pooled analysis showed that 14.2% (95% CI, 10.6-18.9 [I2=94.8%, P<.001]) of health professionals report routinely asking questions or providing information about sexuality. Professionals reported limited confidence, competence, and/or comfort when initiating conversations about sexuality or responding to patient questions. Sexual rehabilitation typically focused on the effect of disease, disability, and medication on sexual function. Broader dimensions of sexuality were rarely addressed. CONCLUSION Despite recognizing the value of sexuality to health and well-being, most health professionals regardless of clinical context fail to routinely include assessment of sexuality in their practice. Professionals have limited knowledge and confidence when addressing sexuality and experience significant discomfort when raising this topic with people living with chronic disease and disability. Multicomponent implementation programs are needed to improve health professionals' knowledge, competence, and comfort when addressing sexuality for people living with chronic disease and disability.
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Affiliation(s)
- Margaret McGrath
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Michelle Anne Low
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Emma Power
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Annie McCluskey
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; The StrokeEd Collaboration, Sydney, Australia
| | - Sandra Lever
- Graythwaite Rehabilitation Centre, Ryde Hospital, Sydney, Australia; Susan Wakil School of Nursing and Midwifery (Sydney Nursing School), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Tsai LY, Liou CF, Huang LH, Huang CY. Correlation Between Needs Satisfaction and Behavioral Intentions of Sexual Health Care. J Contin Educ Nurs 2020; 51:457-464. [PMID: 32976614 DOI: 10.3928/00220124-20200914-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 05/04/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study aimed to evaluate correlations between female nurses' needs satisfaction and behavioral intentions for providing sexual health care and to assess moderating effects of learning needs on that correlation. METHOD A total of 300 female RNs were enrolled. Two validated instruments were used to collect information on participants' learning needs, needs satisfaction, and behavioral intentions for providing sexual health care. RESULTS Adjusted multivariable regression analysis revealed significant moderating effects of medium and low learning needs on correlations between needs satisfaction and behavioral intentions (medium learning needs: β = 0.282, 95% CI = 0.075, 0.490; p = .008; low learning needs: β = 0.293, 95% CI = 0.033, 0.553; p = .027), while no moderating effect was observed in those with high learning needs. CONCLUSION Needs satisfaction was significantly correlated with behavioral intentions of sexual health care in medium and low learning needs groups. [J Contin Educ Nurs. 2020;51(10):457-464.].
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Eid K, Christensen S, Hoff J, Drake D, Yadav K, Burtson P, Kuriakose M, Patton H, Nyamathi A. Sexual Health Education: Knowledge Level of Oncology Nurses and Barriers to Discussing Concerns With Patients. Clin J Oncol Nurs 2020; 24:E50-E56. [DOI: 10.1188/20.cjon.e50-e56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Winterling J, Lampic C, Wettergren L. Fex-Talk: a Short Educational Intervention Intended to Enhance Nurses' Readiness to Discuss Fertility and Sexuality with Cancer Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:538-544. [PMID: 30825079 PMCID: PMC7245594 DOI: 10.1007/s13187-019-01493-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Sexual and reproductive health is known to generally be insufficiently addressed by health care personnel working in cancer care. We hence developed a short educational intervention, Fex-Talk, to overcome the barriers to communicate about sexuality and fertility. The present study sought to evaluate the Fex-Talk intervention, which aims to enhance nurses' readiness to discuss fertility and sexuality issues with cancer patients. The educational intervention involves a single session with an optional follow-up session, and it includes different components in accordance with Kolb's experiential learning cycle. The evaluation was based on participants' oral and written feedback regarding the content and organization of the intervention, as well as on teachers' field notes from five educational events involving nurses who work with cancer patients (n = 140). The data were analyzed using a thematic approach. Four themes were identified, namely increased awareness, need for knowledge, challenging discomfort, and dealing with external obstacles. The intervention increased participants' awareness of patients' need to discuss sexuality and fertility and of their own need for additional knowledge. The role-play exercise was said to challenge personal discomfort, although the participants still felt it helped to boost their courage to, in the future, engage in such conversations. Several external obstacles to initiate a conversation about sexuality or fertility were identified, and possible strategies for overcoming them were discussed. In conclusion, the Fex-Talk intervention was experienced positively by the participating nurses. The results indicate that the intervention increased nurses' understanding of patients' needs related to sex and fertility and overcome barriers to initiate discussions about sex and fertility with patients.
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Affiliation(s)
- Jeanette Winterling
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 23 300, SE-141 83, Huddinge, Sweden.
- Patient Area of Hematology, Karolinska University Hospital, Stockholm, Sweden.
| | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Lena Wettergren
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Kerr D, Ostaszkiewicz J, Dunning T, Martin P. The effectiveness of training interventions on nurses' communication skills: A systematic review. NURSE EDUCATION TODAY 2020; 89:104405. [PMID: 32244125 DOI: 10.1016/j.nedt.2020.104405] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 02/03/2020] [Accepted: 03/15/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The objective of this systematic review was to identify, critically appraise and synthesise evidence for the effectiveness of communication skills training interventions in nursing practice. DESIGN A systematic review of literature. DATA SOURCES Randomised controlled trials published in English from 1998 to 2018, identified in five computerised databases (Medline, Cinahl, Embase, Psychinfo and Cochrane Database). Studies were included if they reported an educational intervention to enhance nurses' communication with patients and contained an objective measure of communication skills and/or patient outcome measures. REVIEW METHODS The Preferred reporting Items for Systematic reviews and Meta-Analyses guided the review. Data were extracted regarding study design and effectiveness on nurses' communication skills. Trial quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The heterogeneity of the included studies prohibited meta-analysis. RESULTS Of the 7811 papers identified, seven trials met the eligibility criteria. The quality was modest. Training programs varied significantly in duration, structure, location and use of outcome measurement tools. Five trials focused on communication with cancer patients using simulated patients. All trials found at least one statistically significant improvement for nurses' communication skills. CONCLUSIONS Educational interventions to enhance nurses' capacity to communicate with patients show promise. The paper reports the first systematic review of randomised controlled trials concerning the effect of communication skills training on nurses' abilities to communicate with patients, inclusive of non-cancer settings. The direct impact of educational interventions on nurses' communication skills is difficult to measure arising from non-standardised outcome measurement tools. Further research is particularly needed in acute, chronic illness, aged care and community settings.
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Affiliation(s)
- Debra Kerr
- Centre for Quality and Patient Safety Research (QPS), School of Nursing and Midwifery, Faculty of Health, Deakin University, Victoria, Australia; Centre for Organisational Change in Person-Centred Healthcare, Deakin University, Australia.
| | - Joan Ostaszkiewicz
- Centre for Quality and Patient Safety Research (QPS), School of Nursing and Midwifery, Faculty of Health, Deakin University, Victoria, Australia; Barwon Health Partnership, Bellerine Street, Geelong, Victoria, Australia
| | - Trisha Dunning
- Centre for Quality and Patient Safety Research (QPS), School of Nursing and Midwifery, Faculty of Health, Deakin University, Victoria, Australia; Barwon Health Partnership, Bellerine Street, Geelong, Victoria, Australia
| | - Peter Martin
- Centre for Organisational Change in Person-Centred Healthcare, Deakin University, Australia; School of Medicine, Faculty of Health, Deakin University, Victoria, Australia
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Suzanna, Nurjannah I, Hartini S. Nursing practice in sexual dimension of patients: Literature review. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2020.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Al-Kalaldeh M, Amro N, Qtait M, Alwawi A. Barriers to effective nurse-patient communication in the emergency department. Emerg Nurse 2020; 28:29-35. [PMID: 32285654 DOI: 10.7748/en.2020.e1969] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND It has been identified that ineffective nurse-patient communication in the emergency department can lead to frustration, mistrust and inadequate pain management. Therefore, it is important to recognise the potential barriers to effective communication, including nurse and patient-related factors. AIM To identify what emergency nurses perceive as barriers to nurse-patient communication, and if there is any difference in the perception of communication barriers between nurses' demographic subgroups. METHOD A total of 199 emergency nurses were recruited using convenience sampling, from nine hospitals in the West Bank, Palestine. These nurses completed a 27-item questionnaire that encompassed six domains of barriers that may affect nurse-patient communication: demographic, knowledge-related, environmental, social, economic and psychological factors. RESULTS Of the six domains covered by the questionnaire, environmental factors scored the highest, meaning that emergency nurses perceived these to be the most significant barriers to effective nurse-patient communication. This was followed by knowledge-related and psychological factors. Knowledge-related factors were perceived to be a greater communication barrier by male nurses more than female nurses, and by younger nurses more than older nurses. CONCLUSION To enhance nurse-patient communication, it is important to establish a comfortable working environment and to provide ongoing training for nurses to develop their communication skills.
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Affiliation(s)
| | - Nawaf Amro
- Al-Zaytoonah University of Jordan, Amman, Jordan
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Papadopoulou C, Sime C, Rooney K, Kotronoulas G. Sexual health care provision in cancer nursing care: A systematic review on the state of evidence and deriving international competencies chart for cancer nurses. Int J Nurs Stud 2019; 100:103405. [DOI: 10.1016/j.ijnurstu.2019.103405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 07/02/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022]
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18
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Fennell R, Grant B. Discussing sexuality in health care: A systematic review. J Clin Nurs 2019; 28:3065-3076. [DOI: 10.1111/jocn.14900] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 03/17/2019] [Accepted: 04/14/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Reginald Fennell
- School of Nursing and Health Sciences Simmons University Boston Massachusetts
| | - Blair Grant
- School of Nursing and Health Sciences Simmons University Boston Massachusetts
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Annerstedt CF, Glasdam S. Nurses' attitudes towards support for and communication about sexual health-A qualitative study from the perspectives of oncological nurses. J Clin Nurs 2019; 28:3556-3566. [PMID: 31165516 DOI: 10.1111/jocn.14949] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/02/2019] [Accepted: 05/02/2019] [Indexed: 12/20/2022]
Abstract
AIM AND OBJECTIVES To explore nurses' articulations of support and communication regarding sexual health with patients. BACKGROUND Sexual health is adversely effected by cancer and various oncological treatments. Patients' often have the experience that healthcare professionals do not talk about sexual health. METHOD Semi-structured interviews were conducted with seven nurses in Southern Sweden. Content analyses were made, inspired by Foucault's concepts of power, discipline and normalisation. SRQR checklist was used. RESULTS Patients' sexual health had low priority in the oncological clinic from the perspective of nurses. The medical logic directed nurses' articulations about sexual health towards a physical view, understood as sex, and sexual problems, which could be treated pharmacologically. Further, nurses articulated a sexual norm that sex belongs to young people and younger persons in permanent, monogamous and heterosexual relationships. This norm-governed nurses' inclusion and exclusion of patients in communication about sexual health. According to nurses, most patients did not mention sex, but some patients challenged the clinic's norms. Assessing sexual health problems, nurses often engaged other professions and thereby became gatekeepers for patients' options for getting help. CONCLUSIONS From the perspective of nurses, nurses' support and communication regarding sexual health with patients with cancer diagnosis were relatively absent and had a low priority in an oncological clinic. Overall, the nurses had the power to set the agenda about patients' sexual health in the oncological clinic. The clinical gaze became a disciplinary technique that tacitly defined by whom, in what way and how sexual health could be articulated in an oncological clinic. RELEVANCE TO CLINICAL PRACTICE By illuminating nurses' preconceptions, thoughts and actions in relation to cancer patients' sexual health, the results invite practitioners to reflect upon and discuss the challenges, opportunities and limitations in providing inclusive and supportive sexual health care to cancer patients.
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Affiliation(s)
| | - Stinne Glasdam
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
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20
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O'Connor SR, Connaghan J, Maguire R, Kotronoulas G, Flannagan C, Jain S, Brady N, McCaughan E. Healthcare professional perceived barriers and facilitators to discussing sexual wellbeing with patients after diagnosis of chronic illness: A mixed-methods evidence synthesis. PATIENT EDUCATION AND COUNSELING 2019; 102:850-863. [PMID: 30578104 DOI: 10.1016/j.pec.2018.12.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 11/19/2018] [Accepted: 12/12/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To explore healthcare professional perceived barriers and facilitators to discussing sexual health and wellbeing with patients after diagnosis of chronic illness. METHODS Five databases were searched and included data were synthesised using a meta-ethnographic approach. Confidence in findings was assessed using the GRADE-CERQual framework. Searches, extraction and quality assessment procedures were conducted independently by at least two authors. RESULTS Concepts extracted from 30 included studies were used to develop a conceptual framework based on five overarching themes. These were [1] individual and societal attitudes to sex and sexual wellbeing [2], patient specific factors [3], organizational and professional factors [4], strategies to overcome barriers in practice and [5] perceived training needs. Healthcare professionals acknowledged the importance of discussing and providing support for sexual wellbeing needs, but recognized it is not routinely provided. CONCLUSIONS While patient specific factors and organizational issues such as lack of time were frequently identified as barriers, intra-personal and social perceptions appear to have the strongest influence on healthcare professional perspectives. PRACTICE IMPLICATIONS Brief education and tools to support healthcare professionals to have effective conversations with patients are required. These should address social barriers, normalise sexual issues, and support healthcare professionals to initiate discussions around sexual concerns.
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Affiliation(s)
- Seán R O'Connor
- Institute of Nursing and Health Research, Ulster University, Jordanstown, UK
| | - John Connaghan
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, UK
| | - Roma Maguire
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, UK
| | | | - Carrie Flannagan
- Institute of Nursing and Health Research, Ulster University, Jordanstown, UK
| | - Suniel Jain
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, UK; Clinical Oncology, Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, UK
| | - Nuala Brady
- Northern Health and Social Care Trust, Northern Ireland, UK
| | - Eilís McCaughan
- Institute of Nursing and Health Research, Ulster University, Jordanstown, UK.
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21
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Heiden-Rootes KM, Salas J, Gebauer S, Witthaus M, Scherrer J, McDaniel K, Carver D. Sexual Dysfunction in Primary Care: An Exploratory Descriptive Analysis of Medical Record Diagnoses. J Sex Med 2018; 14:1318-1326. [PMID: 29110803 DOI: 10.1016/j.jsxm.2017.09.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND The prevalence of sexual dysfunction (SDx) diagnoses in primary care settings is not well known, which is a concern because of the high prevalence of comorbid chronic health conditions in patients diagnosed with SDx. AIM To explore the relation of SDx diagnosis, chronic health conditions, and prescription medications commonly associated with SDx for men and women in primary care using medical records diagnoses. METHODS Exploratory descriptive analyses were used to interpret secondary data from a primary care patient database. The database included patient data from 3 family and internal medicine clinics in the St Louis metropolitan area from July 1, 2008 to June 30, 2015. Analysis included key demographic variables, chronic illness, and health conditions of hypertension, pain, prostate disorder, menopause, substance abuse, depression, anxiety, and associated medications. Analysis of the database yielded 30,627 adult patients (men: n = 12,097, mean age = 46.8 years, 65.6% white race; women: n = 18,530, mean age = 46.6 years, 59.2% white race) with significant comorbid associations between SDx and other chronic illness, health conditions, and medication prescription. RESULTS Depression, anxiety, pain, hypertension, diabetes, and psychotropic medication use were significantly associated with SDx for men and women. Examination of specific SDx diagnoses showed erectile dysfunction to be significantly associated with all tested variables for men. For women, pain-related SDx diagnoses were associated more with chronic illness, health conditions, and medication use than were psychosexual SDx diagnoses (eg, orgasm), except for menopause. Prevalence varied by sex, with a higher prevalence rate of any SDx for men (13.5%) than for women (1.0%), although sex comparisons were not part of the analytics. CLINICAL TRANSLATION This study suggests the diagnosis of SDx is closely associated with other common chronic illness and health conditions and could go underdiagnosed in women in primary care. STRENGTHS AND LIMITATIONS The cross-sectional nature of the study limits the ability to draw causal conclusions related to the nature of the associated conditions with SDx diagnoses. The generalizability of the findings also might be limited given the specific demographic or health makeup of the St Louis area where the study was conducted. CONCLUSION The high comorbidity of SDx with mental health, chronic pain and illnesses, and medication use adds to the growing evidence that sexual health and functioning are essential components of overall well-being and holistic care for men and women. Heiden-Rootes KM, Salas J, Gebauer S, et al. Sexual Dysfunction in Primary Care: An Exploratory Descriptive Analysis of Medical Record Diagnoses. J Sex Med 2017;14:1318-1326.
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Affiliation(s)
- Katie M Heiden-Rootes
- Department of Family and Community Medicine, Saint Louis University, St Louis, MO, USA.
| | - Joanne Salas
- Department of Family and Community Medicine, Saint Louis University, St Louis, MO, USA
| | - Sarah Gebauer
- Department of Family and Community Medicine, Saint Louis University, St Louis, MO, USA
| | - Matthew Witthaus
- Department of Family and Community Medicine, Saint Louis University, St Louis, MO, USA
| | - Jeffrey Scherrer
- Department of Family and Community Medicine, Saint Louis University, St Louis, MO, USA
| | - Kristin McDaniel
- Department of Family and Community Medicine, Saint Louis University, St Louis, MO, USA
| | - Dasha Carver
- Department of Family and Community Medicine, Saint Louis University, St Louis, MO, USA
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22
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Laursen BS, Rasmussen P, Conroy T. Experiences of Scandinavian nurses in discussing sexuality with patients, clients and residents: a qualitative systematic review protocol. ACTA ACUST UNITED AC 2018; 15:1812-1818. [PMID: 28708745 DOI: 10.11124/jbisrir-2016-003183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The objective of this review is to critically appraise, synthesize, and present the best available evidence to address the question: How do Scandinavian nurses experience discussing sexual issues with patients, residents and clients?
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Affiliation(s)
- Birgitte Schantz Laursen
- 1Clinical Nursing Research Unit, Aalborg University Hospital, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark 2Adelaide Nursing School, University of Adelaide, Adelaide, Australia 3The Centre for Evidence-based Practice South Australia (CEPSA): a Joanna Briggs Institute Centre of Excellence
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23
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Williamson S, Beaver K, Gardner A, Martin-Hirsch P. Telephone follow-up after treatment for endometrial cancer: A qualitative study of patients' and clinical nurse specialists' experiences in the ENDCAT trial. Eur J Oncol Nurs 2018; 34:61-67. [PMID: 29784140 DOI: 10.1016/j.ejon.2018.02.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/23/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Endometrial cancer is the sixth most common female cancer worldwide. There is little evidence that routine hospital surveillance increases survival or decreases morbidity following treatment. Gynaecology Oncology clinical nurse specialists (CNSs) are ideally placed to provide the care, information and support to enable women with a gynaecological cancer to self-manage and live well. A multi-centre randomised controlled trial (RCT) compared hospital follow-up (HFU) with telephone follow-up (TFU) by CNSs. The structured telephone intervention focused on information provision to meet patients psychosocial and information needs. This study aimed to explore the views of women who had received TFU and the CNS's who had delivered the service. METHOD A qualitative study to complement the RCT using semi-structured interviews was conducted. Twenty-five patients were randomly selected from participants in the TFU arm stratified by study site. Seven CNSs were interviewed. RESULTS Patient and CNS regarded TFU positively; Three themes emerged from the patient interviews; Convenient Care, Discrete Personalised Care, Confidence and Reassurance. Themes arising from the CNS interviews were Patient Centred Care, Holistic Care and, Confidence and Skills. Patients found that TFU with CNS's was convenient and enabled discussion of issues and information provision at time-points relevant to them. The CNS's found the structured format of TFU enabled them to utilise their skills and knowledge to identify and meet patients holistic needs. CONCLUSIONS Alternative models of care such as TFU provided by CNSs provides the care, information and support to enable women treated for endometrial cancer to self-manage and live well.
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Affiliation(s)
- S Williamson
- School of Health Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK.
| | - K Beaver
- School of Health Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK
| | - A Gardner
- Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, Lancashire PR2 9HT, UK
| | - P Martin-Hirsch
- Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, Lancashire PR2 9HT, UK
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Vassão FV, Barbosa LR, Moraes GMD, Domenico EBLD. Abordagem da sexualidade no cuidado ao paciente oncológico: barreiras e estratégias. ACTA PAUL ENFERM 2018. [DOI: 10.1590/1982-0194201800078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Resumo Objetivo: Identificar os fatores intervenientes para a abordagem da sexualidade, pelo paciente e profissional, e descrever as estratégias empenhadas para a abordagem da sexualidade no cuidado ao paciente com câncer. Métodos: Revisão integrativa de literatura, baseada em etapas sistemáticas, nas bases de dados e ou bibliotecas eletrônicas: LILACS, PUbMed, MEDLINE, IBECS, ScIELO, UpToDate, BDEnf. As buscas ocorreram entre dezembro de 2016 a julho de 2017. Criterios de inclusão: estudos com pacientes oncológicos, idade acima de 18 anos; publicados nos últimos dez anos (2007-2017); disponíveis na íntegra; nos idiomas português, espanhol e inglês. Excluídos: teses, dissertações, revisões (sistemática, narrativa e integrativa), artigos de opinião e editoriais. Resultados: Incluídos 18 artigos, seis artigos referentes a fatores intervenientes e 12 artigos referentes a estratégias adotadas para abordagem da sexualidade. A maioria dos artigos evidenciou a dificuldade com a qual o tema é tratado na prática profissional, nas perspectivas da comunicação e das relações interpessoais entre pacientes e profissionais, reiterando a premissa que a saúde sexual do paciente é, normalmente, negligenciada. Os estudos que versavam sobre as intervenções empreendidas para sanarem as lacunas, demonstraram diferentes graus de positividade e demonstraram que é necessária a capacitação dos profissionais com estratégias de orientação e aconselhamento. Há modelos de intervenção disponíveis na literatura. Conclusão: A sexualidade é negligenciada no cuidado ao paciente com câncer. A atenção multidisciplinar em oncologia precisa reconhecer esta realidade e empreender, numa ação conjunta, atividades de educação e apoio psicossocial, para que esta necessidade humana básica seja satisfeita pelos pacientes.
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Miner M. We Have Yet to Illustrate the Tapestry of Sexual Medicine in US Medical Education. J Sex Med 2018; 15:1-3. [DOI: 10.1016/j.jsxm.2017.10.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 11/15/2022]
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Eeltink CM, Witte BI, Stringer J, Liptrott S, Babic A, Greenfield DM, Salooja N, Incrocci L, Visser O, Verdonck-de Leeuw IM, Duarte RF, Zweegman S. Health-care professionals' perspective on discussing sexual issues in adult patients after haematopoietic cell transplantation. Bone Marrow Transplant 2017; 53:235-245. [PMID: 29247220 DOI: 10.1038/s41409-017-0027-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 12/23/2022]
Abstract
The majority of adult patients have sexual concerns after post-haematopoietic cell transplantation. Even so, health-care professionals (HCP) do not routinely discuss these problems. We, therefore, surveyed all the members of the European Society for Blood and Marrow Transplantation to evaluate the barriers and facilitators to discussing sexual issues. The 73-item web-survey was completed by 166 registered nurses (RNs) and 126 medical doctors (MDs). Sixty-eight percent reported that they seldom discussed sexual issues. Younger MDs (p < 0.001) and those who work in non-western European countries (p = 0.003), RNs with probably less sexual education themselves (p = 0.002), MDs and RNs who have limited knowledge about sexual complications (p < 0.001) and MDs and RNs who feel uncomfortable discussing sexual issues (p < 0.001) are all less likely to discuss these matters. The major perceived barriers were that patients might be embarrassed if sexual issues were discussed in the presence of a relative (60% RNs, 67% MDs) and that professionals prefer patients to raise sexual issues themselves (54% RNs, 44% MDs). The most important perceived facilitator was for the patient to initiate discussion (≥ 90% for RNs and MDs). Overall, haematopoietic cell transplantation survivors may not be receiving the support on sexual issues they probably need.
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Affiliation(s)
- Corien M Eeltink
- Cancer Center Amsterdam, Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Birgit I Witte
- Cancer Center Amsterdam, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Jacqui Stringer
- Department of Complementary Health and Wellbeing, The Christie NHS Foundation Trust, Manchester, UK
| | - Sarah Liptrott
- Department of Haemato-oncology, European Institute of Oncology, Milan, Italy
| | - Aleksandra Babic
- IOSI-Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
| | - Diana M Greenfield
- Specialised Cancer Services, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.,Department of Oncology and Metabolism, University of Sheffield, England, UK
| | - Nina Salooja
- Department of Hematology, Hammersmith hospital, Imperial College, London, UK
| | - Luca Incrocci
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Otto Visser
- Department of Hematology, Isala Hospital, Zwolle, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Cancer Center Amsterdam, Department of Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Department of Otolaryngology, VU University Medical Center, Amsterdam, The Netherlands.,EMGO+ Institute, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Rafael F Duarte
- Department of Hematology, University Hospital Puerta de Hierro, Madrid, Spain
| | - Sonja Zweegman
- Cancer Center Amsterdam, Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
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Efficacy of Standardized Nursing Fertility Counseling on Sperm Banking Rates in Cancer Patients. Urology 2017; 104:90-96. [PMID: 28267604 DOI: 10.1016/j.urology.2017.01.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/08/2016] [Accepted: 01/02/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the effect of brief nurse counseling on sperm banking rates among patients prior to initiating chemotherapy. MATERIALS AND METHODS A retrospective chart review was performed for men aged 18-50 with newly diagnosed cancer, from 1998 to 2003, prior to initiation of chemotherapy. A standardized nursing education session including brief fertility counseling was implemented at one institution in 2008 (Institution A). Rates of sperm banking among patients who received counseling were compared to those without counseling at institution A and to those at institution B where a counseling program was never initiated. RESULTS A total of 766 male patients, 402 treated at institution A and 364 at institution B, were included. At institution A, sperm banking rates prior to 2008 were 6.4% and 8.3% after 2008 for those who did not receive counseling. The rate of sperm banking for those patients who did receive counseling was significantly higher at 17.6% (P = .002). The odds of banking increased 2.9 times for those who received counseling compared to those who did not (P = .003). At institution B, where counseling was never initiated, rates of banking remained low before and after 2008. Additional analysis revealed that younger patients and those patients who did not have children were more likely to perform sperm banking. CONCLUSION The rates of sperm banking among cancer patients increased with the receipt of a brief, formalized nurse counseling session prior to initiation of chemotherapy. These findings may validate the use of a formalized fertility counseling prior to initiation of chemotherapy.
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CESNIK VM, ZERBINI T. Sexuality education for health professionals: A literature review. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2017. [DOI: 10.1590/1982-02752017000100016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The objective of this study was to review the scientific literature addressing educational actions related to the training of health professionals in sexuality between 2003 and 2013. The results obtained show that college seniors, recent college graduates, or those working in hospitals and other health care facilities are not adequately prepared to meet patients' needs regarding sexuality. Several studies have shown improvement in the health practitioners' ability to deal with patients' sexuality issues after participating in training programs in sexuality, regardless of the course load. According to the articles reviewed, in order to improve the performance and comfort level of health practitioners to deal with patients' sexuality concerns, investments in educational actions are necessary.
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Krouwel EM, Nicolai MPJ, van Steijn-van Tol AQMJ, Putter H, Osanto S, Pelger RCM, Elzevier HW. Fertility preservation counselling in Dutch Oncology Practice: Are nurses ready to assist physicians? Eur J Cancer Care (Engl) 2016; 26. [PMID: 28026055 DOI: 10.1111/ecc.12614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2016] [Indexed: 12/30/2022]
Abstract
Cancer and its treatments may result in impaired fertility, which could cause long-term distress to cancer survivors. For eligible patients, fertility preservation (FP) is available to secure future reproductive potential. Many physicians, however, feel inhibited about discussing FP. Oncology nurses may serve as an initiator for discussing the subject and provide additional support. Our aim was to investigate their knowledge about FP, the way they apply this, and possible barriers to discussing FP with patients of reproductive age. A questionnaire was administered via mail, Internet and the Dutch Oncology Nursing Congress. Four hundred and twenty-one oncology nurses participated, a third of whom (31.1%) had "sufficient" knowledge of FP. Twenty-eight per cent of participants reported that they "never/hardly ever" discussed FP; 32.2% "almost always/always." FP discussions were more frequently performed by graduate nurses, academic nurses, experienced nurses and nurses with sufficient knowledge. Reasons for not discussing FP were a "lack of knowledge" (25.2%), "poor prognosis" (16.4%) and "lack of time" (10.5%). In conclusion, several obstacles may result in FP not being routinely discussed, specifically a lack of knowledge. Yet nurses feel responsible for addressing the issue, indicating that assistance with FP discussions should be encouraged. Educational training about FP is recommended.
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Affiliation(s)
- E M Krouwel
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
| | - M P J Nicolai
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - H Putter
- Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - S Osanto
- Department of Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - R C M Pelger
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
| | - H W Elzevier
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
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Benedict C, Thom B, Kelvin JF. Fertility preservation and cancer: challenges for adolescent and young adult patients. Curr Opin Support Palliat Care 2016; 10:87-94. [PMID: 26730794 DOI: 10.1097/spc.0000000000000185] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW With increasing survival rates, fertility is an important quality of life concern for many young cancer patients. There is a critical need for improvements in clinical care to ensure patients are well informed about infertility risks and fertility preservation options and to support them in their reproductive decision-making prior to treatment. RECENT FINDINGS Several barriers prevent fertility from being adequately addressed in the clinical context. Providers' and patients' incomplete or inaccurate understanding of infertility risks exacerbate patients' reproductive concerns. For female patients in particular, making decisions about fertility preservation before treatment often leads to decision conflict, reducing the likelihood of making informed, value-based decisions, and posttreatment regret and distress. Recent empirically based interventions to improve provider training around fertility issues and to support patient decision-making about fertility preservation show promise. SUMMARY Providers should be knowledgeable about the infertility risks associated with cancer therapies and proactively address fertility with all patients who might one day wish to have a child. Comprehensive counseling should also include related issues such as contraceptive use and health implications of early menopause, regardless of desire for future children. Although the negative psychosocial impact of cancer-related infertility is now well accepted, limited work has been done to explore how to improve clinical management of fertility issues in the context of cancer care. Evidence-based interventions should be developed to address barriers and provide psychosocial and decision-making support to patients who are concerned about their fertility and interested in fertility preservation options.
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Affiliation(s)
- Catherine Benedict
- aDepartment of Medicine, Hofstra North Shore-LIJ School of Medicine, Manhasset bSurvivorship Center, Memorial Sloan Kettering Cancer Center, New York, USA
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Sung SC, Jiang HH, Chen RR, Chao JK. Bridging the gap in sexual healthcare in nursing practice: implementing a sexual healthcare training programme to improve outcomes. J Clin Nurs 2016; 25:2989-3000. [DOI: 10.1111/jocn.13441] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Su-Ching Sung
- Graduate Institute of Health Care; Chang Gung University of Science and Technology; Taoyuan City Taiwan
| | - Huey-Hwa Jiang
- Department of Nursing; Taipei Veterans General Hospital Yuli Branch; Yuli Township Hualian County Taiwan
| | - Ru-Rong Chen
- Medication & Health Center; Banqiao Veterans Home; Veterans Affairs Council; New Taipei City Taiwan
| | - Jian-Kang Chao
- Department of Psychiatry; Pingtung Branch; Kaohsiung Veterans General Hospital; Pingtung Taiwan
- Department of Health Administration; Tzu Chi
University of Science and Technology; Hualien County Taiwan
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Hachfeld L, MacWilliams B, Schmidt B. Physical Awareness a Key to Improving Adolescent Male Health: A Grounded Theory Study of the Perception of Testicular Self-examination in Male Student Athletes. J Nurse Pract 2016. [DOI: 10.1016/j.nurpra.2015.10.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shepherd L, Watt C, Lovell B. The role of social-cognitive and emotional factors on testicular self-examination. Psychooncology 2016; 26:53-59. [DOI: 10.1002/pon.4097] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 12/04/2015] [Accepted: 01/18/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Lee Shepherd
- Department of Psychology; Northumbria University; Newcastle UK
| | - Callum Watt
- Department of Psychology; Northumbria University; Newcastle UK
| | - Brian Lovell
- Department of Psychology; Northumbria University; Newcastle UK
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Jonsdottir JI, Zoëga S, Saevarsdottir T, Sverrisdottir A, Thorsdottir T, Einarsson GV, Gunnarsdottir S, Fridriksdottir N. Changes in attitudes, practices and barriers among oncology health care professionals regarding sexual health care: Outcomes from a 2-year educational intervention at a University Hospital. Eur J Oncol Nurs 2016; 21:24-30. [PMID: 26952675 DOI: 10.1016/j.ejon.2015.12.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 11/30/2015] [Accepted: 12/19/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To examine the attitudes, practices and perceived barriers in relation to a sexual health care educational intervention among oncology health care professionals at the Landspítali-National University Hospital of Iceland. METHODS The design was quasi experimental, pre - post test time series. A comprehensive educational intervention project, including two workshops, was implemented over a two year time period. A questionnaire was mailed electronically to all nurses and physicians within oncology at baseline (T1, N = 206), after 10 months (T2, N = 216) and 16 months (T3, N = 210). RESULTS The response rate was 66% at T1, 45% at T2 and 38% at T3. At all time points, the majority of participants (90%) regarded communication about sexuality part of their responsibilities. Mean scores on having enough knowledge and training, and in six of eight practice issues increased significantly over time. Overall, 10-16% reported discussing sexuality-related issues with more than 50% of patients and the frequency was significantly higher among workshop attendants (31%) than non-attendants (11%). Overall, the most common barriers for discussing sexuality were "lack of training" (38%) and "difficult issue to discuss" (27%), but the former barrier decreased significantly by 22% over time. CONCLUSIONS The intervention was successful in improving perception of having enough knowledge and training in providing sexual health care. Still, the issue remains sensitive and difficult to address for the majority of oncology health care professionals. Specific training in sexual health care, including workshops, should be available to health care professionals within oncology.
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Affiliation(s)
| | - Sigridur Zoëga
- Landspítali - The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland; University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland
| | - Thorunn Saevarsdottir
- Landspítali - The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland
| | - Asgerdur Sverrisdottir
- Landspítali - The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland
| | - Thora Thorsdottir
- Landspítali - The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland
| | | | - Sigridur Gunnarsdottir
- Landspítali - The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland; University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland
| | - Nanna Fridriksdottir
- Landspítali - The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland; University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland
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Lefebvre S, Diebold S. [Nursing consultation for sexual problems in multiple sclerosis]. REVUE DE L'INFIRMIÈRE 2015:27-8. [PMID: 26145692 DOI: 10.1016/j.revinf.2015.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Patients with multiple sclerosis often complain of sexual problems. Nurses in a neurology department have decided to explore the sexual health of these patients. They also intend to assess the need for a neurosexuality nurse consultation.
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Affiliation(s)
- Sandrine Lefebvre
- Département de neurologie 1, Pôle des maladies du système nerveux, Groupe hospitalier Pitié-Salpêtrière Charles-Foix, 47, boulevard de l'Hôpital, 75013 Paris, France.
| | - Sandrine Diebold
- Département de neurologie 1, Pôle des maladies du système nerveux, Groupe hospitalier Pitié-Salpêtrière Charles-Foix, 47, boulevard de l'Hôpital, 75013 Paris, France
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