1
|
Chen T, Dai M, Calabrese C, Merrill K. Dyadic and Longitudinal Influences of Sexual Communication on Relationship Satisfaction, Emotional Intimacy, and Daily Affect Among Same-Sex Male Couples. HEALTH COMMUNICATION 2024:1-11. [PMID: 39286898 DOI: 10.1080/10410236.2024.2400813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
The influences of sexual communication on relational outcomes have garnered attention in the current literature, but such dynamics have seldom been explored among same-sex couples using dyadic, longitudinal data. The current study investigates the actor (i.e. on the individual self) and partner (i.e. on the partner) effects of sexual communication (presence and quality) on relationship satisfaction, emotional intimacy, and daily affect among same-sex male couples using dyadic, longitudinal data. Interracial couple status and age discrepancies between partners are tested as moderating variables. One hundred and three diverse cis-gender male couples participated in a one-time pre-survey and a daily survey for 15 consecutive days. The results showed that the presence and quality of sexual communication had positive actor effects on relationship satisfaction, emotional intimacy, and daily affect. The presence of sexual communication also had a positive partner effect on emotional intimacy. Moreover, our results showed significant interactions between interracial couple status, age discrepancies, and sexual communication on several outcome variables. Theoretical contributions, practical implications, and study limitations were discussed.
Collapse
Affiliation(s)
- Tianen Chen
- Department of Communication, College of Agriculture and Life Sciences, Cornell University
| | - Minhao Dai
- School of Communication and Media, Radow College of Humanities and Social Sciences, Kennesaw State University
| | | | - Kelly Merrill
- School of Communication, Film, and Media Studies, University of Cincinnati
| |
Collapse
|
2
|
Shaffer KM, Reese JB, Dressler EV, Glazer JV, Cohn W, Showalter SL, Clayton AH, Danhauer SC, Loch M, Kadi M, Smith C, Weaver KE, Lesser GJ, Ritterband LM. Factorial Trial to Optimize an Internet-Delivered Intervention for Sexual Health After Breast Cancer: Protocol for the WF-2202 Sexual Health and Intimacy Enhancement (SHINE) Trial. JMIR Res Protoc 2024; 13:e57781. [PMID: 39159450 PMCID: PMC11369542 DOI: 10.2196/57781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/15/2024] [Accepted: 06/14/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Although most survivors of breast cancer report substantial sexual concerns following treatment, few receive support for these concerns. Delivering sexual health care to survivors of breast cancer via the internet could overcome many of the barriers to in-person treatment. Even when delivered remotely, survivor time constraints remain a leading barrier to sexual health intervention uptake. OBJECTIVE Guided by the multiphase optimization strategy methodological framework, the primary objective of this study is to identify the most efficient internet-delivered sexual health intervention package that is expected to provide survivors of breast cancer the greatest benefit with the fewest (and least-intensive) intervention components. This study aims to determine how intervention components work (mediators) and for whom they work best (moderators). METHODS Partnered, posttreatment adult female survivors of breast cancer (N=320) experiencing at least 1 bothersome sexual symptom (ie, pain with sex, vaginal dryness, low sexual desire, and difficulty with orgasm) related to their breast cancer treatment will be enrolled. Clinic-based recruitment will be conducted via the Wake Forest National Cancer Institute Community Oncology Research Program (NCORP) Research Base. Participants will be randomly assigned to 1 of 16 combinations of four intervention components with two levels each in this factorial trial: (1) psychoeducation about cancer-related sexual morbidity (receive either enhanced vs standard versions); (2) communication skills training for discussing concerns with health care providers (received vs not received); (3) communication skills training for discussing concerns with a partner (received vs not received); and (4) intimacy promotion skills training (received vs not received). Cores will be fully automated and implemented using a robust internet intervention platform with highly engaging elements such as animation, video, and automated email prompts. Survivors will complete web-based assessments at baseline (prerandomization time point) and again at 12 and 24 weeks later. The primary study aim will be achieved through a decision-making process based on systematically evaluating the main and interaction effects of components on sexual distress (Female Sexual Distress Scale-Desire, Arousal, Orgasm) and sexual functioning (Female Sexual Function Index) using a generalized linear model approach to ANOVA with effect coding. Mediation analyses will be conducted through a structural equation modeling approach, and moderation analyses will be conducted by extending the generalized linear model to include interaction effects. RESULTS This protocol has been reviewed and approved by the National Cancer Institute Central Institutional Review Board. Data collection is planned to begin in March 2024 and conclude in 2027. CONCLUSIONS By identifying the combination of the fewest and least-intensive intervention components likely to provide survivors of breast cancer the greatest sexual health benefit, this study will result in the first internet intervention that is optimized for maximum impact on the undertreated, prevalent, and distressing problem of breast cancer-related sexual morbidity. TRIAL REGISTRATION ClinicalTrials.gov NCT06216574; https://clinicaltrials.gov/study/NCT06216574. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/57781.
Collapse
Affiliation(s)
- Kelly M Shaffer
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | | | - Emily V Dressler
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Jillian V Glazer
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Wendy Cohn
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Shayna L Showalter
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Anita H Clayton
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Suzanne C Danhauer
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Michelle Loch
- Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Mai Kadi
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Caleigh Smith
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Kathryn E Weaver
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Glenn J Lesser
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Lee M Ritterband
- University of Virginia School of Medicine, Charlottesville, VA, United States
| |
Collapse
|
3
|
Lewis S, Stevens E, Harkess-Murphy E, Papadopoulou C. The Effects of Head and Neck Cancer on Relationship Intimacy in Adults: A Systematic Review of the Literature. Semin Oncol Nurs 2024; 40:151689. [PMID: 38997888 DOI: 10.1016/j.soncn.2024.151689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 05/10/2024] [Accepted: 06/10/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVES This systematic literature review aimed to explore the effects of head and neck cancer (HNC) on relationship intimacy in adults and identify the current support available to patients with HNC and their partners in relation to relationship intimacy. METHODS Seven databases (CINAHL, Pubmed, Scopus, Web of Science, SocINDEX, PsycARTICLES, Psychology, and Behavioural Science Collection) were searched using grouped terms "head and neck cancer and intimacy" and "head and neck cancer and support." Studies written in English to assess adult patients with HNC and its effects on relationship intimacy and studies assessing the use of intimacy-specific support tools/methods were included. The review protocol was registered in June 2022 with PROSPERO ID: CRD42022329614. RESULTS Thirty publications were included within the review. Six topics emerged: relationships, communication, sexual interest, barriers, couples-based communication intervention strategies, and assessment tools. While there were positive dyadic changes observed, many patients reported negative experiences relating to changes in relationship roles, sexual issues, and poor communication with partners and health care professionals that affected intimacy. There were 5 interventions identified; of those, the results varied, with some improvements noted in psychological well-being but not necessarily sexual interest and enjoyment. CONCLUSIONS HNC profoundly affects relationship intimacy. However, both patients and health care professionals find it challenging to discuss these issues, often leaving it an unmet need. Appropriate training and development for health care professionals that facilitate communication between clinician and patient are necessary to support conversations on intimacy needs. IMPLICATIONS FOR NURSING PRACTICE There exists a need for patients to receive support in relation to intimacy following diagnosis and treatment, and the evidence suggests that this may be more effective post-treatment and from health care professionals who are appropriately trained. Couples' communication interventions may prove useful, but further research is required on the efficacy of combining both psychological and sexual support together.
Collapse
Affiliation(s)
- Susanne Lewis
- PhD Student and Lecturer, School of Health & Life Sciences, University of the West of Scotland, Paisley Campus, Paisley, UK.
| | - Elaine Stevens
- Senior Lecturer, School of Health & Life Sciences, University of the West of Scotland, Paisley Campus, Paisley, UK
| | - Eileen Harkess-Murphy
- Lecturer, School of Health & Life Sciences, University of the West of Scotland, Paisley Campus, Paisley, UK
| | - Constantina Papadopoulou
- Reader, School of Health & Life Sciences, University of the West of Scotland, Lanarkshire Campus, Hamilton, UK
| |
Collapse
|
4
|
Denes A, Ussher JM, Power R, Perz J, Ryan S, Hawkey AJ, Dowsett GW, Parton C. LGBTQI Sexual Well-Being and Embodiment After Cancer: A Mixed-Methods Study. JOURNAL OF SEX RESEARCH 2024:1-18. [PMID: 39073073 DOI: 10.1080/00224499.2024.2378884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
This study examined lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) cancer patients' sexual well-being post-cancer, and the associations between sexual well-being and social support, physical concerns, distress, quality of life (QOL), and coping. We used a mixed-methods approach, including 430 surveys and 103 interviews, representing a range of tumor types, sexual and gender identities, age groups, and intersex status. The findings indicated that LGBTQI people with cancer experience declines in sexual well-being following cancer, which are associated with reduced QOL, greater physical concerns, and lower social support. The perceived helpfulness of coping mechanisms was associated with greater sexual well-being across genders, with cisgender men reporting the sharpest declines in sexual well-being and highest use of coping mechanisms. Across all groups, searching for information online was the most frequently used coping mechanism, with support groups and counseling the most under-utilized. Qualitative findings facilitated interpretation of these results, providing examples of ways in which cancer impacted sexual well-being and how physical changes influence sexual embodiment or desire to engage in sex. Concerns about reduced sexual desire and activity, associated with changes to breasts, vulva, vagina, penis, erectile dysfunction, incontinence, scarring, and stoma, reflect previous findings in the non-LGBTQI cancer population. Unique to this population are the impact of physical changes on LGBTQI embodiment, including disruption to sexual and gender identities, and feelings of disconnection from queer communities. Addressing LGBTQI sexual well-being within oncology healthcare is a matter of sexual and reproductive justice, for a population whose needs are often overlooked within cancer care.
Collapse
Affiliation(s)
- Amanda Denes
- Department of Communication, University of Connecticut
| | - Jane M Ussher
- Translational Health Research Institute, Western Sydney University
| | - Rosalie Power
- Translational Health Research Institute, Western Sydney University
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University
| | - Samantha Ryan
- Translational Health Research Institute, Western Sydney University
| | | | - Gary W Dowsett
- Australian Research Centre in Sex, Health and Society, La Trobe University
| | - Chloe Parton
- School of Health, Te Herenga Waka - Victoria University of Wellington
| |
Collapse
|
5
|
Liberacka-Dwojak M, Wiłkość-Dębczyńska M, Perkowski R. Breaking the silence: the role of sexual communication on quality of life in women with cervical cancer. Support Care Cancer 2024; 32:503. [PMID: 38985342 PMCID: PMC11236959 DOI: 10.1007/s00520-024-08713-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 07/03/2024] [Indexed: 07/11/2024]
Abstract
INTRODUCTION Cervical cancer (CC) and its treatments impact various dimensions of quality of life (QoL), including physical, psychological, and sexual functioning. Sexual health, a crucial QoL aspect, is often compromised, highlighting the necessity for open sexual communication. MATERIALS AND METHODS This study involved 60 women diagnosed with stage IIb-IIIa CC. The 36-Item Short Form Survey (SF-36) was used to measure physical and psychological components of QoL, the Female Sexual Function Index-6 (FSFI-6) to assess its sexual component, and the Sexual Communication Self-Efficacy Scale (SCSES) to diagnose communication confidence. Self-administered questions gauged patient-provider sexual communication. The results include quotes from participants, providing additional insight. RESULTS Sexual communication self-efficacy and patient-provider communication correlated significantly with QoL components. Only 23.33% discussed sexual issues with their doctors. Participants' experiences highlighted the impact of cancer on sexuality and the need for tailored support. DISCUSSION Post-diagnosis psychosexual changes emphasize the importance of communication in renegotiating sexual identity and needs. Effective communication is associated with improved QoL, highlighting the role of healthcare professionals in addressing psychosexual issues. Integrating PLISSIT and BETTER models provides a comprehensive approach to sexual communication in the cancer context. CONCLUSION The study demonstrates the importance of sexual communication self-efficacy in QoL of CC patients and highlights the need for healthcare professionals to include sexual communication education in cancer care.
Collapse
Affiliation(s)
| | | | - Radosław Perkowski
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| |
Collapse
|
6
|
Donz R, Russia B, Barbaret C, Braybrook D, Perceau-Chambard E, Reverdy T, Economos G. What contributes to promote sexual health in cancer palliative care? A realist review. Sex Med Rev 2024; 12:334-345. [PMID: 38508856 DOI: 10.1093/sxmrev/qeae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 01/23/2024] [Accepted: 01/28/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Sexuality is an important determinant of the overall health of a population and remains so at the end of life and in patients with advanced cancers. Despite the abundant literature on sexuality and intimacy, these topics have been rarely discussed in the context of cancer palliative care, and very few interventions to promote sexual health in patients undergoing cancer palliative care have been explored. OBJECTIVES In this study we sought to identify which factors and mechanisms contribute to promoting sexual health in cancer palliative care. METHODS A realist review was performed according to the guidelines of the realist and meta-narrative evidence synthesis method guidelines. Articles published between January 2010 and June 2021 were searched in 4 databases. Records were screened for their relevance regarding a predefined list of context-mechanism-outcome (CMO) configurations. Abstracts were independently screened by 2 authors before the data were extracted from the full-text articles selected for inclusion. With the use of abductive and retroductive reasoning techniques, each article was examined for evidence of its contribution to one of the CMO configurations, which could be refined when relevant. The data were summarized according to the final CMO configurations. RESULTS Of the 2056 articles identified, 38 articles were included in the review. The data reported in these articles contributed to 7 CMO hypotheses: (1) improving communication skills, (2) healthcare provider training, (3) reorganizing the patient environment in care settings or at home, (4) managing sexual symptoms and also general symptoms, (5 and 6) patient-centered counseling or couple counseling, and (7) lifting the taboo. CONCLUSIONS The findings reported here highlight various ways to improve sexual health for patients in cancer palliative care but are limited to genital cancers. Further research should consider all types of cancer rather than being restricted to genital cancers.
Collapse
Affiliation(s)
- Roxane Donz
- Centre de soins palliatifs, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Benite 69495, France
- Centre pour l'Innovation en cancérologie de Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon Sud, EA 3738, 69921 Oullins
| | - Bruno Russia
- Hospitalisation à domicile, Centre Léon Bérard, Lyon 69008, France
| | - Cécile Barbaret
- Service de soins palliatifs, CHU de Grenoble, La Tronche 38700, France
| | - Debbie Braybrook
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London SE5 9PJ, United-Kingdom
| | - Elise Perceau-Chambard
- Centre de soins palliatifs, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Benite 69495, France
| | - Thibaut Reverdy
- Centre pour l'Innovation en cancérologie de Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon Sud, EA 3738, 69921 Oullins
- Oncology Department, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Benite 69495, France
| | - Guillaume Economos
- Centre de soins palliatifs, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Benite 69495, France
- Centre pour l'Innovation en cancérologie de Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon Sud, EA 3738, 69921 Oullins
| |
Collapse
|
7
|
Matthew AG, McLeod D, Robinson JW, Walker L, Wassersug RJ, Elliott S, Guirguis S, Incze T, Trachtenberg L. Enhancing care: evaluating the impact of True North Sexual Health and Rehabilitation eTraining for healthcare providers working with prostate cancer patients and partners. Sex Med 2024; 12:qfae033. [PMID: 38883808 PMCID: PMC11176973 DOI: 10.1093/sexmed/qfae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/12/2024] [Accepted: 05/16/2024] [Indexed: 06/18/2024] Open
Abstract
Background Educational programs that enhance healthcare providers' competence in managing the care of patients with sexual dysfunction following prostate cancer treatments are needed to facilitate comprehensive sexual health treatments for patients and their partners. Aim In this study we evaluated the impact of a real-world online sexual health educational intervention called the True North Sexual Health and Rehabilitation eTraining Program. This program is designed to increase healthcare providers' knowledge and self-efficacy in providing sexual healthcare to prostate cancer patients and their partners. Methods Healthcare providers were invited to join a 12-week virtual training program. Participants completed precourse surveys (n = 89), retrospective prepost surveys (n = 58), and a 3-month follow-up survey (subset n = 18) to assess retention of relevant outcomes. Additionally, a course satisfaction survey was administered to participants (n = 57) at the end of the course. Outcomes The main outcomes focused on participants' perceived knowledge and self-efficacy in conducting assessments and providing interventions for various relevant physical, functional, psychological, and relational domains of sexual dysfunction in prostate cancer patients and their partners. Results According to the retrospective analysis of post-then-pre-survey results, graduates perceived that their knowledge of and self-efficacy in providing sexual health counseling improved after completing the course. The 3-month follow-up survey indicated that the course graduate self-efficacy remained high 3 months after the course. Furthermore, the satisfaction survey indicated that a vast majority (98.2%) of participants were satisfied with the educational intervention. Clinical Implications This real-world sexual health educational intervention can increase self-efficacy and knowledge in healthcare providers who are supporting prostate cancer patients dealing with sexual dysfunction. Strengths and Limitations The use of a retrospective post-then-pre-survey helped to mitigate response shift bias while minimizing data gaps. However, it is important to note that this investigation was not a traditional research study and lacked a control group, thus limiting causal attributions. Conclusion The True North Sexual Health and Rehabilitation eTraining program acts as an accessible and effective resource for healthcare providers seeking specialized training in providing sexual healthcare for prostate cancer patients and their partners.
Collapse
Affiliation(s)
- Andrew G Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1Z5, Canada
| | - Deborah McLeod
- School of Nursing, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - John W Robinson
- Department of Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Lauren Walker
- Department of Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Richard J Wassersug
- Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Stacy Elliott
- BC Center for Sexual Medicine, Vancouver Coastal Health Authority, Vancouver, BC V6Z 2K5, Canada
| | - Steven Guirguis
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1Z5, Canada
| | - Taylor Incze
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1Z5, Canada
| | - Lianne Trachtenberg
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1Z5, Canada
| |
Collapse
|
8
|
Naert E, Van Hulle H, De Jaeghere EA, Orije MRP, Roels S, Salihi R, Traen KJ, Watty K, Kinnaer LM, Verstraelen H, Tummers P, Vandecasteele K, Denys HG. Sexual health in Belgian cervical cancer survivors: an exploratory qualitative study. Qual Life Res 2024; 33:1401-1414. [PMID: 38396183 DOI: 10.1007/s11136-024-03603-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE To assess experiences of sexuality and of receiving sexual healthcare in cervical cancer (CC) survivors. METHODS A qualitative phenomenological study using semistructured one-on-one interviews was conducted with 15 Belgian CC survivors recruited in 5 hospitals from August 2021 to February 2022. The interviews were audiotaped and transcribed verbatim. Data were analyzed using inductive thematic analysis. COREQ and SRQR reporting guidelines were applied. RESULTS Most participants experienced an altered sexuality after CC treatment with often long-term loss/lack of sex drive, little/no spontaneity, limitation of positions to avoid dyspareunia, less intense orgasms, or no sexual activity at all. In some cases, emotional intimacy became more prominent. Physical (vaginal bleeding, vaginal dryness, dyspareunia, menopausal symptoms) and psychological consequences (guilt, changed self-image) were at the root of the altered sexuality. Treatment-induced menopause reduced sex drive. In premenopausal patients, treatment and/or treatment-induced menopause resulted in the sudden elimination of family planning. Most participants highlighted the need to discuss their altered sexual experience with their partner to grow together toward a new interpretation of sexuality. To facilitate this discussion, most of the participants emphasized the need for greater partner involvement by healthcare providers (HPs). The oncology nurse or sexologist was the preferred HP with whom to discuss sexual health. The preferred timing for information about the sexual consequences of treatment was at treatment completion or during early follow-up. CONCLUSION Both treatment-induced physical and psychological experiences were prominent and altered sexuality. Overall, there was a need for HPs to adopt proactive patient-tailored approaches to discuss sexual health.
Collapse
Affiliation(s)
- Eline Naert
- Department of Medical Oncology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium.
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium.
| | | | - Emiel A De Jaeghere
- Department of Medical Oncology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Marjolein R P Orije
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Sarah Roels
- Department of Radiation Oncology, AZ Sint-Jan, Brugge, Belgium
| | - Rawand Salihi
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Obstetrics & Gynaecology, Ghent University Hospital, Ghent, Belgium
- Department of Gynaecology, AZ Sint-Lucas, Ghent, Belgium
| | - Koen J Traen
- Department of Gynaecology, OLV Hospital, Aalst, Belgium
| | | | - Lise-Marie Kinnaer
- Department of Public Health and Primary Care, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Hans Verstraelen
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Obstetrics & Gynaecology, Ghent University Hospital, Ghent, Belgium
| | - Philippe Tummers
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Obstetrics & Gynaecology, Ghent University Hospital, Ghent, Belgium
| | - Katrien Vandecasteele
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Hannelore G Denys
- Department of Medical Oncology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| |
Collapse
|
9
|
Almont T, Sougué PO, Houpert R, Beaubrun-Renard M, Montabord C, Joachim C, Véronique-Baudin J, Bouhnik AD, Bendiane MK, Mancini J, Huyghe É. Communication and sexual function and frequency in breast cancer patients 2 years after diagnosis: results from the VICAN 2 study. J Sex Med 2024; 21:333-341. [PMID: 38410031 DOI: 10.1093/jsxmed/qdae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 12/18/2023] [Accepted: 12/30/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND Breast cancer treatments may have impacts on several aspects of sexual health, including psychological, psychosexual, physiological, physical, and relational. AIM In this study we sought to assess sexual function and sexual frequency in breast cancer patients 2 years after diagnosis. METHODS We selected all breast cancer participants from the the French national VIe après le CANcer 2 (VICAN 2) longitudinal study. Data sources included patient and medical questionnaires, along with medico-administrative databases. OUTCOMES Outcomes assessed were the dimensions of sexual function and frequency from the Relationship and Sexuality Scale and communication about sexuality with healthcare providers. RESULTS Out of 1350 participating women, 60.2% experienced a decrease in sexual desire, 61.4% reported a lower frequency of intercourse, and 49.5% faced decreased ability to orgasm. In contrast, 64.8% had engaged in sexual intercourse in the previous 2 weeks, 89.5% were "Somewhat" to "Very much" satisfied with the frequency of intimate touching and kisses with their partner, and 81.6% expressed satisfaction with their intercourse frequency. However, a mere 15% of women discussed sexuality with the healthcare providers. Independent factors associated with increased communication about sexuality included age younger than 50 years (OR = 1.90 95% CI [1.28-2.82], P = .001), being in a partner relationship (OR = 2.53 95% CI [1.28-2.82], P = .003), monthly income above 1,500 euros (OR = 1.73 95% CI [1.15-2.60], P = .009), and absence of diabetes (OR = 6.11 95% CI [1.39-26.93], P = .017). CLINICAL TRANSLATION The study findings underscore the need for continuing education in oncosexology and dedicated sexual health interventions that should involve a holistic approach that takes into consideration age, treatments, relationship status, and whether the patient has diabetes. STRENGTHS AND LIMITATIONS Strengths of the study are the sample size, the national representativeness, and data reliability. However, the cross-sectional design could introduce potential recall, recency, or social desirability biases. Also, social determinants influencing sexual health, such as ethnicity or geographic locations, have not been considered in the analyses. CONCLUSIONS This study revealed that sexual disorders persist 2 years after a breast cancer diagnosis, with a noticeable communication gap regarding sexuality between patients and medical teams. These findings underscore the necessity for tailored sexual health interventions, particularly designed for women who are single, older aged, and diabetes patients.
Collapse
Affiliation(s)
- Thierry Almont
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
| | - Prisca Ouowéné Sougué
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Rémi Houpert
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Murielle Beaubrun-Renard
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Christelle Montabord
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Clarisse Joachim
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Jacqueline Véronique-Baudin
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
| | - Anne-Déborah Bouhnik
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
| | - Marc-Karim Bendiane
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
- Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, 270 Boulevard de Sainte Marguerite, 13009 Marseille, France
- ORS PACA, Observatoire Régional de la Santé, 27 Bd Jean Moulin, 13005 Marseille, Provence-Alpes-Côte d'Azur, France
| | - Julien Mancini
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
- Public Health Department, Service Biostatistique et Technologies de l'Information et de la Communication (BIOSTIC), hôpital Timone, APHM, 13005 Marseille, France
| | - Éric Huyghe
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
- Urology Department, Centre Hospitalier Universitaire de Toulouse, 1, avenue du Professeur Jean Poulhès - TSA 50032 - 31059 Toulouse, France
- Francophone Association for Supportive Care in Cancer (AFSOS), 33130 Bègles, France
| |
Collapse
|
10
|
Miranda DPR, Constanza Micolich V, Goset K, Salas SP. Knowledge, practice and communication barriers for oncology doctors in Chile when addressing the sexuality of their patients. Ecancermedicalscience 2024; 18:1665. [PMID: 38439800 PMCID: PMC10911666 DOI: 10.3332/ecancer.2024.1665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Indexed: 03/06/2024] Open
Abstract
Introduction Communication in a doctor-patient relationship constitutes a crucial aspect in medicine, and its multiple dimensions encompass a wide variety of ethical issues. Communication is particularly relevant in oncology, because it requires continually dealing with sensitive topics in one of the most highly vulnerable situations as a human: illness and proximity to death. Sexuality is one of these topics because it constitutes an area that is frequently affected by cancer and cancer treatment, which may include causing significant distress, the reinforcement of a negative self-image, relationship conflicts and a permanent memory of having cancer. The objective of this research is to describe the perception of knowledge and communications practices used by oncology doctors with respect to sexual health in the care of their patients, as well as the barriers found when it comes to confronting the topic. Methods An exploratory quantitative, descriptive and cross-sectional study was carried out, in which a self-administered questionnaire was given to oncology doctors who practise in Chile. This questionnaire had 41 closed questions with answers on a Likert scale and was previously validated by being reviewed and applied to a pilot group of five professionals (one medical bioethics expert and four doctors in the field of oncology). The data were analysed with the SPSS statistical program v. 20, using descriptive statistics. Results The main results show that the surveyed doctors consider sexuality to be an important part of patients' quality of life. However, this finding does not align with the practices given for including it as part of clinical care. The professionals refer as the main barriers those that are attributed to the structural functioning of the institution, giving little value to those barriers related to personal aspects or those associated with patient characteristics and/or behaviors. Conclusion The results of this study show that, despite oncology doctors seeing sexuality as an important aspect of the quality of life of their patients, they do not include the topic in clinical care. Given that one of the main barriers is obstacles relating to the institution, it is necessary to create political institutions that create the conditions for including this area as a relevant part of cancer patient care.
Collapse
Affiliation(s)
| | | | - Karen Goset
- Bioethics Centre, Faculty of Medicine, Clinica Alemana Universidad del Desarrollo, Santiago 7610507, Chile
| | - Sofia P Salas
- Bioethics Centre, Faculty of Medicine, Clinica Alemana Universidad del Desarrollo, Santiago 7610507, Chile
| |
Collapse
|
11
|
Anderson JN, Paladino AJ, Blue R, Dangerfield DT, Eggly S, Martin MY, Schwartzberg LS, Vidal GA, Graetz I. Silent suffering: the impact of sexual health challenges on patient-clinician communication and adherence to adjuvant endocrine therapy among Black women with early-stage breast cancer. J Cancer Surviv 2023:10.1007/s11764-023-01511-0. [PMID: 38114711 PMCID: PMC11216545 DOI: 10.1007/s11764-023-01511-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE Adjuvant endocrine therapy (AET) increases sexual health challenges for women with early-stage breast cancer. Black women are more likely than women of other racial/ethnic groups to report adverse symptoms and least likely to initiate and maintain AET. Little is known about how sexual health challenges influence patient-clinician communication and treatment adherence. This study explores facilitators of and barriers to patient-clinician communication about sexual health and how those factors might affect AET adherence among Black women with early-stage breast cancer. METHODS We conducted 32 semi-structured, in-depth interviews among Black women with early-stage breast cancer in the U.S. Mid-South region. Participants completed an online questionnaire prior to interviews. Data were analyzed using thematic analysis. RESULTS Participants' median age was 59 (range 40-78 years, SD = 9.0). Adverse sexual symptoms hindered participants' AET adherence. Facilitators of patient-clinician communication about sexual health included female clinicians and peer support. Barriers included perceptions of male oncologists' disinterest in Black women's sexual health, perceptions of male oncologists' biased beliefs about sexual activity among older Black women, cultural norms of sexual silence among Southern Black women, and medical mistrust. CONCLUSIONS Adverse sexual symptoms and poor patient-clinician communication about sexual health contribute to lower AET adherence among Black women with early-stage breast cancer. New interventions using peer support models and female clinicians trained to discuss sexual health could ameliorate communication barriers and improve treatment adherence. IMPLICATIONS FOR CANCER SURVIVORS Black women with early-stage breast cancer in the U.S. Mid-South may require additional resources to address sociocultural and psychosocial implications of cancer survivorship to enable candid discussions with oncologists.
Collapse
Affiliation(s)
- Janeane N Anderson
- College of Nursing, University of Tennessee Health Science Center, 874 Union Avenue, Memphis, TN, 38163, USA.
| | - Andrew J Paladino
- College of Medicine, University of Tennessee Health Science Center, 910 Madison Avenue, Memphis, TN, 38103, USA
| | - Ryan Blue
- College of Nursing, University of Tennessee Health Science Center, 874 Union Avenue, Memphis, TN, 38163, USA
| | - Derek T Dangerfield
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave. NW #308, Washington, D.C, 20037, USA
| | - Susan Eggly
- Department of Oncology, School of Medicine, Wayne State University, 87 E. Canfield, Detroit, MI, 48201, USA
| | - Michelle Y Martin
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN, 38163, USA
| | | | - Gregory A Vidal
- West Cancer Center Research Institute, 7945 Wolf River Blvd, Germantown, TN, 38138, USA
| | - Ilana Graetz
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| |
Collapse
|
12
|
Humbert M, Lequesne J, Licaj I, Bon-Mardion N, Bouhnik AD, Huyghe E, Dugue J, Babin E, Rhamati L. Sexual health at 5 years after diagnosis of head and neck cancer. Support Care Cancer 2023; 31:535. [PMID: 37615815 DOI: 10.1007/s00520-023-07949-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/13/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE Sexual health (SH) is an emerging concern in the assessment of quality of life in patients surviving head and neck cancer (HNC). Using data from the French National Prospective VICAN Survey, this study aimed to assess SH deterioration five years after HNC diagnosis and related factors. METHODS Using univariate and multivariate analyses were performed in the 241 HNC survivors. We studied the factors associated between the sexuality and intimate life of these patients with demographic and medical data from the national epidemiological survey VICAN 5. RESULTS Sexuality and body image were altered in 78.8% for men and 79.2% for women. This alteration in sexual quality of life affects both men and women. Dissatisfaction with the frequency of sexual intercourse was associated with being treated with radiotherapy (p=0.024), as well as decrease of sexual desire in patients treated with chemotherapy (p=0.044). Fatigue (p=0.002), impaired physical health (p=0.049), and high disease stage (p=0.001) remained significantly associated, after multivariate analysis, with decreased sexual desire. Among these 3 factors negatively influencing sexual quality of life, two are treatable with appropriate management. CONCLUSION Five years after the diagnosis of HNC, a decrease in sexuality and body image are frequent and significantly impact the quality of life of survivors. These observations imply an adaptation of the management of the professionals involved.
Collapse
Affiliation(s)
- M Humbert
- Department of Otorhinolaryngology Head and Neck Surgery, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France.
- INSERM 1086 ANTICIPE, Caen University, Caen, France.
| | - J Lequesne
- Clinical Research Department, Centre François Baclesse, Caen, France
| | - I Licaj
- Clinical Research Department, Centre François Baclesse, Caen, France
- Department of Community Medicine, The UiT Arctic University of Norway, Tromsø, Norway
| | - N Bon-Mardion
- Department of Otorhinolaryngology Head and Neck Surgery, Mathilde Clinic, 76100, Rouen, France
| | - A D Bouhnik
- Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Aix Marseille Univ, Inserm, IRD, Marseille, France
| | - E Huyghe
- Department of Urology, 36760 University of Toulouse, Toulouse, France
| | - J Dugue
- Department of Otorhinolaryngology Head and Neck Surgery, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | - E Babin
- Department of Otorhinolaryngology Head and Neck Surgery, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
- INSERM 1086 ANTICIPE, Caen University, Caen, France
| | - L Rhamati
- Department of Otorhinolaryngology Head and Neck Surgery, Hopital du Pays Salonais, 13300, Salon de Provence, France
| |
Collapse
|
13
|
Kuan WC, Kong YC, Bustamam RS, Wong LP, Woo YL, Taib NA, Ho GF, Zaharah H, Yip CH, Bhoo-Pathy N. Sexual Wellbeing and Supportive Care Needs After Cancer in a Multiethnic Asian Setting: A Qualitative Study. SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-022-09772-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
14
|
Uzdavines A, Helmer DA, Spelman JF, Mattocks KM, Johnson AM, Chardos JF, Lynch KE, Kauth MR. Sexual Health Assessment Is Vital to Whole Health Models of Care. JMIRX MED 2022; 3:e36266. [PMID: 37725523 PMCID: PMC10414374 DOI: 10.2196/36266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/30/2022] [Accepted: 05/19/2022] [Indexed: 09/21/2023]
Abstract
Sexual health is the state of well-being regarding sexuality. Sexual health is highly valued and associated with overall health. Overall health and well-being are more than the absence of disease or dysfunction. Health care systems adopting whole health models of care need to incorporate a holistic assessment of sexual health. This includes assessing patients' sexual orientation and gender identity (SOGI). If health systems, including but not limited to the Veterans Health Administration (VHA), incorporate sexual health into whole health they could enhance preventive care, promote healthy sexual functioning, and optimize overall health and well-being. Assessing sexual health can give providers important information about a patient's health, well-being, and health goals. Sexual concerns or dysfunction may also signal undiagnosed health conditions. Additionally, collecting SOGI information as part of a sexual health assessment would allow providers to address problems that drive disparities for lesbian, gay, bisexual, transgender, queer, and similar minority (LGBTQ+) populations. Health care providers do not routinely assess sexual health in clinical practice. One barrier is a gap in communication between patients and providers. Providers cite beliefs that patients will bring up sexual concerns themselves or might be offended by discussing sexual health. Patients often report an expectation that providers will bring up sexual health and being comfortable discussing sexual health with their providers. Within the VHA, the lack of a sexual health template within the electronic health record (EHR) adds an additional barrier. The VHA's transition toward whole health and updates to its EHR provide unique opportunities to integrate sexual health assessment into routine care. We highlight system modifications to address this within the VHA. These examples may be helpful for other health care systems interested in moving toward whole health. It will be vital for health care systems integrating a whole health approach to develop both practical and educational interventions to address the communication gap. These interventions will need to target both providers and patients in health care systems that transition to a whole health model of care, not just the VHA. Both the communication gap between providers and patients, and the lack of support within some EHR systems for sexual health assessment are barriers to assessing sexual health in primary care clinics. Routine sexual health assessment would benefit patient well-being and present an opportunity to address health disparities for LGBTQ+ populations. Health care systems (ie, both the VHA and other systems) can overcome these barriers by implementing educational interventions and updating their EHRs and back-end data structures. VHA's expertise in developing and implementing health education interventions and EHR-based quality improvements may help inform interventions beyond VHA.
Collapse
Affiliation(s)
- Alex Uzdavines
- South Central Mental Illness Research, Education, and Clinical Center, Michael E. DeBakey VA Medical Center, Houston, TX, United States
| | - Drew A Helmer
- Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Juliette F Spelman
- VA Connecticut Healthcare System, West Haven, CT, United States
- Yale School of Medicine, New Haven, CT, United States
| | - Kristin M Mattocks
- VA Central Western Massachusetts Healthcare System, Leeds, MA, United States
- University of Massachusetts Medical School, Worcester, MA, United States
| | | | - John F Chardos
- VA Palo Alto Health Care System, Palo Alto, CA, United States
- Stanford University, Palo Alto, CA, United States
| | - Kristine E Lynch
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT, United States
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Michael R Kauth
- South Central Mental Illness Research, Education, and Clinical Center, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- LGBTQ+ Health Program, Patient Care Services, Veterans Health Administration, Washington, DC, United States
| |
Collapse
|
15
|
Wells-Prado DR, Ross MW, Rosser BRS, Polter EJ, Capistrant BD, Haggart R, Kohli N, Konety BR, Mitteldorf D, Talley KMC, West W, Wheldon CW. Prostate cancer disclosure and sexual orientation: Understanding outness to healthcare providers as a situational or consistent phenomenon. PATIENT EDUCATION AND COUNSELING 2022; 105:2033-2037. [PMID: 34865891 PMCID: PMC9126994 DOI: 10.1016/j.pec.2021.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 11/03/2021] [Accepted: 11/19/2021] [Indexed: 06/01/2023]
Abstract
OBJECTIVE In this study, we investigated if outness is more a situational or a consistent characteristic in gay, bisexual, and other men who have sex with men (GBM) treated for prostate cancer and how the disclosure of sexual orientation impacts provider discussions of sexual side effects. METHODS Data came from Restore, an online cross-sectional survey of 193 GBM prostate cancer survivors living in North America and were analyzed using various statistical models. RESULTS Disclosure of sexual orientation and of living with prostate cancer were not significantly correlated. Participants who were out regarding sexual orientation were more likely to report that their surgeons and urologists discussed the sexual side effects of treatment. CONCLUSION Outness appears to be a situational phenomenon. GBM prostate cancer survivors who were out regarding sexual orientation received more discussion surrounding sexual side effects of prostate cancer treatment from their providers. PRACTICE IMPLICATIONS It is important for healthcare providers to inquire about patient's sexual orientation to provide holistic care to these patients to address health disparities within this group.
Collapse
Affiliation(s)
- Daniel R Wells-Prado
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 516 Delaware St SE, Minneapolis, MN 55455, USA.
| | - Michael W Ross
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 516 Delaware St SE, Minneapolis, MN 55455, USA.
| | - B R Simon Rosser
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St., Minneapolis, MN 55454, USA.
| | - Elizabeth J Polter
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St., Minneapolis, MN 55454, USA.
| | - Bea D Capistrant
- School of Social Work, Smith College, Lilly Hall 23 West St., Northampton, MA 01063, USA.
| | - Ryan Haggart
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 516 Delaware St SE, Minneapolis, MN 55455, USA; Department of Urology, University of Minnesota, 909 Fulton Street SE, Minneapolis, MN 55414, USA.
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, 250 Education Sciences Bldg, 56 E River Rd, Minneapolis, MN 55455, USA.
| | - Badrinath R Konety
- Department of Urology, Rush Medical College, 600S Paulina St Suite 524, Chicago, IL 60612, USA.
| | - Darryl Mitteldorf
- Malecare Cancer Support, 63 Avenue A, apt 13i, New York, NY 10009, USA.
| | - Kristine M C Talley
- School of Nursing, University of Minnesota, 308 SE Harvard St, Minneapolis, MN 55455, USA.
| | - William West
- Department of Writing Studies, University of Minnesota, 315 Pillsbury Dr SE, Minneapolis, MN 55455, USA.
| | - Christopher W Wheldon
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA.
| |
Collapse
|
16
|
Ussher JM, Perz J, Allison K, Power R, Hawkey A, Dowsett GW, Hickey M, Parton C, McDonald FEJ, Davis ID, Quinn GP, Boydell K, Robinson KH, Chambers S, Anazodo A. Attitudes, knowledge and practice behaviours of oncology health care professionals towards lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) patients and their carers: A mixed-methods study. PATIENT EDUCATION AND COUNSELING 2022; 105:2512-2523. [PMID: 34998663 DOI: 10.1016/j.pec.2021.12.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/21/2021] [Accepted: 12/11/2021] [Indexed: 05/25/2023]
Abstract
OBJECTIVE There is growing recognition that health care professionals (HCPs) and policy makers are insufficiently equipped to provide culturally competent care to lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) cancer patients and their families. We examined HCP attitudes, knowledge, and practices regarding LGBTQI cancer care using a mixed-methods research design. METHOD Surveys were completed by 357 oncology HCPs in nursing (40%), medical (24%), allied health (19%), and clinical leadership roles (11%); 48 of the surveyed HCPs were interviewed. RESULTS Most HCPs reported being comfortable treating LGBTQI patients, but reported low levels of confidence and knowledge and systemic barriers to LGBTQI cancer care. Most wanted more education and training, particularly on trans and gender-diverse people (TGD) and those born with intersex variations. CONCLUSION Education of HCPs and health system changes are required to overcome barriers to the provision of culturally competent cancer care for LGBTQI patients. PRACTICE IMPLICATIONS These findings reinforce the need for inclusion of LGBTQI content in HCP education and professional training curricula, and institutional support for LGBTQI-inclusive practice behaviours. This includes administrative and visual cues to signal safety of LGBTQI patients within cancer care, facilitating inclusive environments, and the provision of tailored patient-centred care.
Collapse
Affiliation(s)
- Jane M Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia.
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Kimberley Allison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Rosalie Power
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Alexandra Hawkey
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Gary W Dowsett
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and the Royal Women's Hospital, Melbourne, Australia
| | - Chloe Parton
- School of Health, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Fiona E J McDonald
- Canteen and Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ian D Davis
- Eastern Health Clinical School, Monash University and Eastern Health, Melbourne, Australia
| | - Gwendolyn P Quinn
- Departments of OB-GYN, Population Health, Grossman School of Medicine, New York University, NY, USA
| | - Katherine Boydell
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Kerry H Robinson
- School of Social Sciences and Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital and School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| |
Collapse
|
17
|
Ussher JM, Power R, Perz J, Hawkey AJ, Allison K. LGBTQI Inclusive Cancer Care: A Discourse Analytic Study of Health Care Professional, Patient and Carer Perspectives. Front Oncol 2022; 12:832657. [PMID: 35619900 PMCID: PMC9127408 DOI: 10.3389/fonc.2022.832657] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/11/2022] [Indexed: 12/01/2022] Open
Abstract
Background Awareness of the specific needs of LGBTQI cancer patients has led to calls for inclusivity, cultural competence, cultural safety and cultural humility in cancer care. Examination of oncology healthcare professionals' (HCP) perspectives is central to identifying barriers and facilitators to inclusive LGBTQI cancer care. Study Aim This study examined oncology HCPs perspectives in relation to LGBTQI cancer care, and the implications of HCP perspectives and practices for LGBTQI patients and their caregivers. Method 357 oncology HCPs in nursing (40%), medical (24%), allied health (19%) and leadership (11%) positions took part in a survey; 48 HCPs completed an interview. 430 LGBTQI patients, representing a range of tumor types, sexual and gender identities, age and intersex status, and 132 carers completed a survey, and 104 LGBTQI patients and 31 carers undertook an interview. Data were analysed using thematic discourse analysis. Results Three HCP subject positions - ways of thinking and behaving in relation to the self and LGBTQI patients - were identified:'Inclusive and reflective' practitioners characterized LGBTQI patients as potentially vulnerable and offered inclusive care, drawing on an affirmative construction of LGBTQI health. This resulted in LGBTQI patients and their carers feeling safe and respected, willing to disclose sexual orientation and gender identity (SOGI) status, and satisfied with cancer care. 'Egalitarian practitioners' drew on discourses of ethical responsibility, positioning themselves as treating all patients the same, not seeing the relevance of SOGI information. This was associated with absence of LGBTQI-specific information, patient and carer anxiety about disclosure of SOGI, feelings of invisibility, and dissatisfaction with healthcare. 'Anti-inclusive' practitioners' expressed open hostility and prejudice towards LGBTQI patients, reflecting a cultural discourse of homophobia and transphobia. This was associated with patient and carer distress, feelings of negative judgement, and exclusion of same-gender partners. Conclusion Derogatory views and descriptions of LGBTQI patients, and cis-normative practices need to be challenged, to ensure that HCPs offer inclusive and affirmative care. Building HCP's communicative competence to work with LGBTQI patients needs to become an essential part of basic training and ongoing professional development. Visible indicators of LGBTQI inclusivity are essential, alongside targeted resources and information for LGBTQI people.
Collapse
|
18
|
Shivji A, Danilak M, Booker R, Dersch-Mills D, Ghosh S, Fung K. Pharmacists' practices and views regarding management of sexual health in patients with cancer. J Oncol Pharm Pract 2022:10781552221089667. [PMID: 35440225 DOI: 10.1177/10781552221089667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Sexual health issues associated with cancer can significantly impact patients' psychosocial well-being and overall quality of life. These issues are frequently medication-related, placing pharmacists in an opportune position to manage sexual health concerns in patients with cancer. Currently, no literature exists exploring pharmacists' practices related to the management of sexual health in oncology patients. METHODS An anonymous, descriptive, cross-sectional, web-based survey was conducted to elicit pharmacists' views and practices regarding managing sexual health in oncology patients. Pharmacists practicing in Canada who provide care to adult malignant hematology or oncology patients were eligible to participate. The survey was disseminated through the Canadian Association of Pharmacy in Oncology and through informal oncology pharmacy practitioner networks. RESULTS Of the 102 pharmacists who participated, 96 completed the survey in its entirety. Most respondents were female, practiced in Alberta, and primarily saw oncology patients in outpatient cancer facilities. Although 85% of participants felt pharmacists should be involved in giving patients an opportunity to discuss sexual health, only 8% reported managing sexual health in at least 50% of their oncology patients. The most commonly agreed upon barriers to this were presence of family members and friends at appointments, lack of knowledge or training, limited time, and the belief that sexual health is not applicable to all oncology patients. CONCLUSIONS This study explored pharmacists' views and practices regarding managing sexual health in patients with cancer. Several barriers were identified, which may aid in future development of resources to assist pharmacists in routinely addressing sexual health in oncology patients.
Collapse
Affiliation(s)
- Alisha Shivji
- 2125Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | | | - Reanne Booker
- 2125Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | | | - Sunita Ghosh
- Cross Cancer Institute, Edmonton, Alberta, Canada
| | | |
Collapse
|
19
|
Kelder I, Sneijder P, Klarenbeek A, Laan E. Communication practices in conversations about sexual health in medical healthcare settings: A systematic review. PATIENT EDUCATION AND COUNSELING 2022; 105:858-868. [PMID: 34366226 DOI: 10.1016/j.pec.2021.07.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/29/2021] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Many healthcare professionals experience difficulties in discussing sexual health with their patients. The aim of this review was to synthesize results of studies on communication practices in interactions about sexual health in medical settings, to offer healthcare professionals suggestions on how to communicate about this topic. METHODS We searched for studies using five databases. Reference lists and specialist bibliographies were searched to identify additional studies. We included discourse analytic studies that used recordings of medical consultations. RESULTS We identified five studies that met the inclusion criteria. Findings were synthesized into seven categories of practices deployed by patients and healthcare professionals when talking about sexual health: avoiding delicate terms (1), delaying potentially delicate words and issues (2), using assumptive talk (3), generalized advice-giving (4), deploying patients' talk (5), depersonalization (6), and patient-initiated advice (7). CONCLUSION Practices indicate the delicacy associated with discussing sexual health issues, but results also shed light on practices that can help professionals to deal with this delicacy, and to be responsive to patients' needs and concerns. PRACTICE IMPLICATIONS Findings will assist healthcare professionals in broaching topics related to sexual health so they can help patients deal with challenges that affect their sexual health and overall well-being.
Collapse
Affiliation(s)
- Irene Kelder
- Research Group Digital Business & Media, HU University of Applied Sciences Utrecht, Heidelberglaan 15, Utrecht, CS 3584, the Netherlands; Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, AZ 1105, the Netherlands.
| | - Petra Sneijder
- Research Group Digital Business & Media, HU University of Applied Sciences Utrecht, Heidelberglaan 15, Utrecht, CS 3584, the Netherlands.
| | - Annette Klarenbeek
- Research Group Digital Business & Media, HU University of Applied Sciences Utrecht, Heidelberglaan 15, Utrecht, CS 3584, the Netherlands.
| | - Ellen Laan
- Department of Sexology and Psychosomatic OB-GYN, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, AZ 1105, the Netherlands.
| |
Collapse
|
20
|
Urry K, Chur-Hansen A, Khaw C. 'It's Not Really a Part of Standard Practice': Institutional Silencing of Sexuality Within Australian Mental Health Settings. QUALITATIVE HEALTH RESEARCH 2022; 32:543-555. [PMID: 34904865 DOI: 10.1177/10497323211061340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Research seeking to understand and improve sexuality-related practice in mental health settings has paid little attention to the institutional context in which clinicians' practice is embedded. Through a social constructionist lens, we used thematic analysis to examine how 22 Australian mental health clinicians implicated the wider institutional context when discussing and making sense of sexuality-related silence within their work. Interviews were part of a study exploring participants' perceptions of sexuality and sexual health in their work more generally. Broader silences that shaped and reinforced participants' perceptions and practice choices were situated in professional education; workplace cultures; and the tools, procedures and policies that directed clinical practice. We argue that sexuality-related silence in mental health settings is located in the institutional context in which clinicians learn and work, and discuss how orienting to this broader context will benefit research and interventions to improve sexuality-related practice across health settings.
Collapse
Affiliation(s)
- Kristi Urry
- School of Psychology, Faculty of Health and Medical Sciences, 1066University of Adelaide, Adelaide, SA, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, 1066University of Adelaide, Adelaide, SA, Australia
| | - Carole Khaw
- School of Medicine, Faculty of Health and Medical Sciences, 1066University of Adelaide, Adelaide, SA, Australia
- Adelaide Sexual Health Centre, Infectious Disease UnitRoyal Adelaide Hospital, Adelaide, SA, Australia
| |
Collapse
|
21
|
Schweizer A, Toffel K, Braizaz M. L’abord de la sexualité par les professionnel·le·s de santé en oncologie : une revue de la littérature. PSYCHOLOGIE FRANCAISE 2021. [DOI: 10.1016/j.psfr.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
22
|
Lehmann V, Laan ETM, den Oudsten BL. Sexual health-related care needs among young adult cancer patients and survivors: a systematic literature review. J Cancer Surviv 2021; 16:913-924. [PMID: 34669141 PMCID: PMC9300501 DOI: 10.1007/s11764-021-01084-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/02/2021] [Indexed: 01/05/2023]
Abstract
Purpose Young adult cancer patients and survivors have age-specific care needs, but care needs related to sexual health are poorly understood. A systematic literature review was conducted to examine sexual health-related care needs among patients/survivors diagnosed with cancer during young adulthood (age: 18–39 years). The prevalence and types needs were assessed along with associated patient factors. Methods Four major databases were screened to identify relevant studies, which were also assessed for risk of bias; all following PRISMA guidelines. Results Identified studies (N = 35) often assessed sexual health-related care needs by whether participants experienced a generic need for support from providers. The prevalence of such needs ranged between 8 and 61.7% and was higher in female survivors and those with more health impairments. The type of diagnosis could also play a role in these varying prevalence rates, but was not systematically tested in included studies. Types of sexual health-related care needs were clustered into practical/emotional support needs (e.g., coping with physical side effects), information needs (e.g., more details), and communication needs (e.g., providers should initiate conversations, validate concerns, be empathetic/open). Needs should be addressed in-person and/or online. Conclusions The extent of needs related to sexual health varies among young adult patients and survivors, but types of needs center around improving provision of support and information by providers. Implications for Cancer Survivors Sexual health should routinely be addressed alongside other potential effects of cancer treatment to allow for constructive conversations between patients and providers. Referrals to (online) resources or specialists should be tailored to individual preferences. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01084-w.
Collapse
Affiliation(s)
- Vicky Lehmann
- Department of Medical Psychology, Amsterdam University Medical Center, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - Ellen T M Laan
- Department of Sexology and Psychosomatic Gynecology, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - Brenda L den Oudsten
- Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders, Tilburg University, Tilburg, Netherlands
| |
Collapse
|
23
|
Effects of a Brief E-Learning Resource on Sexual Attitudes and Beliefs of Healthcare Professionals Working in Prostate Cancer Care: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910045. [PMID: 34639350 PMCID: PMC8508566 DOI: 10.3390/ijerph181910045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/10/2021] [Accepted: 09/16/2021] [Indexed: 01/22/2023]
Abstract
Sexual issues and treatment side effects are not routinely discussed with men receiving treatment for prostate cancer, and support to address these concerns is not consistent across settings. This study evaluates a brief e-learning resource designed to improve sexual wellbeing support and examine its effects on healthcare professionals' sexual attitudes and beliefs. Healthcare professionals (n = 44) completed an online questionnaire at baseline which included a modified 12-item sexual attitudes and beliefs survey (SABS). Follow-up questionnaires were completed immediately after the e-learning and at 4 weeks. Data were analysed using one-way, repeat measures ANOVAs to assess change in attitudes and beliefs over time. Significant improvements were observed at follow-up for a number of survey statements including 'knowledge and understanding', 'confidence in discussing sexual wellbeing' and the extent to which participants felt 'equipped with the language to initiate conversations'. The resource was seen as concise, relevant to practice and as providing useful information on potential side effects of treatment. In brief, e-learning has potential to address barriers to sexual wellbeing communication and promote delivery of support for prostate cancer survivors. Practical methods and resources should be included with these interventions to support implementation of learning and long-term changes in clinical behaviour.
Collapse
|
24
|
Duthie CJ, Graham K, Rapsey CM, Wibowo E. Factors associated with various strategies for maintaining sexual activity after prostate cancer treatment. Int J Impot Res 2021; 34:769-775. [PMID: 34455426 DOI: 10.1038/s41443-021-00466-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/21/2021] [Accepted: 08/17/2021] [Indexed: 11/09/2022]
Abstract
Many men experience sexual difficulties after receiving prostate cancer treatment. We investigated sexual and relationship factors associated with management strategies to maintain sexual activity in prostate cancer patients. 210 prostate cancer patients (66.7 ± 7.4 years old) completed our survey online. Higher sexual function distress (Incidence rate ratio, IRR = 0.99, p = 0.005) and less frequent relationship strain (IRR = 1.01, p = 0.002) were associated with trying a higher number of sexual management strategies. Higher sexual function distress was associated with the use of oral medication (Odds Ratio, OR = 0.98, p = 0.026), vacuum erection device (OR = 0.98, p = 0.005), and vibrators (OR = 0.97, p = 0.005). Perceived importance of sexual interaction with a partner was associated with using oral medication (OR = 1.95, p = 0.027). Participant's higher ideal frequency of sexual interaction with a partner was a predictor for the use of vibrators (OR = 1.03, p = 0.024). Less frequent relationship strain was associated with the use of vacuum erection device (OR = 1.03, p = 0.002), and vibrators (OR = 1.02, p = 0.012). Lastly, patients' communication with their partner about sexual intimacy was also associated with use of vacuum erection device (OR = 3.24, p = 0.050, CI 1.0-10.5). Few participants (13-27%) were interested in trying penile implant, penile support device, external penile prosthesis, penile sleeve and anal devices. From our qualitative analyses, the main barriers to retaining sexual activity were erectile dysfunction and psychological issues. Three themes participants found useful to maintain sexual activity: preparatory behaviours for initiating or maintaining erections, adapting their sexual activity to fit with what was now possible, and the importance of the relationship or intimacy with their sexual partner. Psychological and relationship factors contribute to patients' motivation to remain sexually active after treatment.
Collapse
Affiliation(s)
- Cassian J Duthie
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Katie Graham
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Charlene M Rapsey
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Erik Wibowo
- Department of Anatomy, University of Otago, Dunedin, New Zealand.
| |
Collapse
|
25
|
Williams M, Addis G. Addressing patient sexuality issues in cancer and palliative care. ACTA ACUST UNITED AC 2021; 30:S24-S28. [PMID: 34037445 DOI: 10.12968/bjon.2021.30.10.s24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The impact of cancer and subsequent treatments can have serious implications for patient sexuality, both physically and psychologically. Patients report inadequate communication and support from professionals in relation to sexual issues. The aim of this literature review was to ascertain the educational requirements of health professionals practising in oncology and palliative care, to enable effective assessment and support in this area of clinical practice. There appear to be numerous barriers preventing professionals from addressing patient sexuality-lack of knowledge and poor confidence levels being among the most common. Appropriate education is required to equip staff, and it appears that short training programmes can be effective. The use of sexuality assessment tools and information cards, and accessing information from cancer charity websites may improve clinical practice. Addressing sexuality concerns is the responsibility of each person in the multidisciplinary team. Patients require open discussion and professionals must skilfully address the topic of sexuality. Education in this area must be accessible, cost effective and sustainable.
Collapse
Affiliation(s)
- Mary Williams
- Senior Lecturer in Cancer, Palliative Care and End of Life Care, School of Health Care and Social Work Buckinghamshire New University, Uxbridge Campus, when this article was written. She is now Lead Nurse for Supportive and Palliative Care and Chaplaincy, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust
| | - Gulen Addis
- Senior Lecturer, School of Health Care and Social Work, Buckinghamshire New University, Uxbridge Campus
| |
Collapse
|
26
|
Low MA, Power E, McGrath M. Sexuality after stroke: Exploring knowledge, attitudes, comfort and behaviours of rehabilitation professionals. Ann Phys Rehabil Med 2021; 65:101547. [PMID: 34091059 DOI: 10.1016/j.rehab.2021.101547] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/19/2021] [Accepted: 03/31/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sexual dysfunction after stroke is common and is associated with poor health and quality of life outcomes. Clinical guidelines for stroke typically recommend that all stroke survivors have access to support relating to sexuality during rehabilitation. However, the extent to which rehabilitation professionals are prepared to address sexuality after stroke is unclear. OBJECTIVE To investigate the knowledge, comfort, approach, attitudes, and practices of rehabilitation professionals toward supporting stroke survivors with their sexuality concerns. METHODS Cross-sectional analytic survey design. Data were collected by using an electronic questionnaire that contained the Knowledge, Comfort, Approaches, and Attitudes towards Sexuality Scale (KCAASS) and sexuality-related practice questions. Participants were recruited from Australia, New Zealand, the United States, Canada, United Kingdom, Ireland, Singapore, and South Africa. Multiple regression was used to explore KCAASS scores and sexuality-related practices. RESULTS A total of 958 multi-disciplinary, stroke rehabilitation professionals participated in the study. Only 23% (n = 216) of health professionals' reported directly initiating sexuality discussions with stroke survivors. On regression analysis, professionals' practices, perception of their role in sexuality rehabilitation, sexuality training, education, age and sex predicted their knowledge of sexuality after stroke (r² = 0.44; p<0.001). Sexuality training, religious affiliation and provision of sexuality-rehabilitation services predicted comfort (r² = 0.21; p<0.001). Professionals' age and provision of sexuality-rehabilitation services predicted approach-related comfort (r² = 0.2; p<0.001). Professionals' perception of health professionals' role in sexuality rehabilitation, religious affiliation and geographical location predicted professionals' attitudes toward sexuality (r² = 0.11; p<0.001). Open-ended responses indicated that participants perceived a need to improve their competency in providing sexuality rehabilitation. The timing of training predicted knowledge (t = 3.99; p<0.001), comfort (t = 3.47; p<0.001) and the provision of sexuality-rehabilitation services (t = 3.68; p<0.001). CONCLUSION Findings confirm that sexuality is neglected in stroke rehabilitation and point to the need for a considered approach to the timing and nature of education.
Collapse
Affiliation(s)
- 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
| | - Margaret McGrath
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| |
Collapse
|
27
|
Shaffer KM, Kennedy E, Glazer JV, Clayton AH, Cohn W, Millard TA, Ritterband LM, Showalter S. Addressing sexual concerns of female breast cancer survivors and partners: a qualitative study of survivors, partners, and oncology providers about Internet intervention preferences. Support Care Cancer 2021; 29:7451-7460. [PMID: 34080054 DOI: 10.1007/s00520-021-06302-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Sexual side effects after breast cancer treatment are common and distressing to both survivors and their intimate partners, yet few receive interventions to address cancer-related sexual concerns. To direct intervention development, this qualitative study assessed the perceptions of female breast cancer survivors, intimate partners of breast cancer survivors, and breast cancer oncology providers about how an Internet intervention for couples may address breast cancer-related sexual concerns. METHODS Survivors (N = 20) responded to online open-ended surveys. Partners (N = 12) and providers (N = 8) completed individual semi-structured interviews. Data were inductively coded using thematic content analysis. RESULTS Three primary intervention content areas were identified by the key stakeholder groups: (1) information about and strategies to manage physical and psychological effects of cancer treatment on sexual health, (2) relationship and communication support, and (3) addressing bodily changes and self-image after treatment. Survivors and partners tended to express interest in some individualized intervention private from their partner, although they also emphasized the importance of opening communication about sexual concerns within the couple. Survivors and partners expressed interest in an intervention that addresses changing needs across the cancer trajectory, available from the time of diagnosis and through survivorship. CONCLUSION Internet intervention for couples to address cancer-related sexual concerns, particularly one that provides basic education about treatment side effects and that evolves with couples' changing needs across the cancer trajectory, was perceived as a valuable addition to breast cancer care by survivors, partners, and providers.
Collapse
Affiliation(s)
- Kelly M Shaffer
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA. .,Center for Behavioral Health and Technology, University of Virginia School of Medicine, PO Box 801075, Charlottesville, VA, 22908, USA. .,Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA.
| | - Erin Kennedy
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA.,Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Jillian V Glazer
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, PO Box 801075, Charlottesville, VA, 22908, USA
| | - Anita H Clayton
- Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Wendy Cohn
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA.,Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Trish A Millard
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA.,Medicine - Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Lee M Ritterband
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA.,Center for Behavioral Health and Technology, University of Virginia School of Medicine, PO Box 801075, Charlottesville, VA, 22908, USA.,Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Shayna Showalter
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA.,Surgery - Surgical Oncology, University of Virginia School of Medicine, Charlottesville, VA, USA
| |
Collapse
|
28
|
A Scoping Review to Identify Barriers and Enabling Factors for Nurse-Patient Discussions on Sexuality and Sexual Health. NURSING REPORTS 2021; 11:253-266. [PMID: 34968203 PMCID: PMC8608105 DOI: 10.3390/nursrep11020025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Sexuality and sexual health (SSH) are essential aspects of care that have evolved since a 1975 World Health Organization (WHO) report on SSH. However, nurses still consider discussing the subject with patients a challenge. This scoping review aimed to map, synthesize, and summarize findings from existing literature regarding barriers and enabling factors for nurse–patient SSH discussions in care contexts. Methods: A scoping review model inspired by Arksey and O’Malley was used to search for and synthesize studies published between 2009 and 2019. The databases searched were the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online, i.e., MEDLARS Online. A total of nineteen articles were eligible to be included. Results: Two main categories of enabling factors were identified, i.e., a professional approach via using core care values and availability of resources. Three major categories of barriers were identified: beliefs and attitudes related to age, gender, and sexual identity; fear and individual convictions; and work-related factors. Conclusions: Applying professionalism and core care values as well as making resources available are likely to promote SSH discussions between nurses and patients. Moreover, there is a need for a norm-critical approach in education and practice.
Collapse
|
29
|
Areskoug Josefsson K, Almborg AH. Using ICF and ICHI to promote sexual health. COGENT MEDICINE 2021. [DOI: 10.1080/2331205x.2021.1898084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- K Areskoug Josefsson
- School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Behavioural Sciences, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - A-H Almborg
- School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Register and Statistics, National Board of Health and Welfare, Stockholm, Sweden
- Department of Classifications and Terminology in Healthcare, Norweigan Directorate of E-health, Nordic WHO-FIC CC, Oslo, Norway
| |
Collapse
|
30
|
Peate M, Saunders C, Cohen P, Hickey M. Who is managing menopausal symptoms, sexual problems, mood and sleep disturbance after breast cancer and is it working? Findings from a large community-based survey of breast cancer survivors. Breast Cancer Res Treat 2021; 187:427-435. [PMID: 33575860 DOI: 10.1007/s10549-021-06117-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/21/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To determine the nature and severity of vasomotor symptoms, sexual problems, mood and sleep disturbance in community-dwelling breast cancer patients, whether and where they received treatment for these symptoms and their satisfaction with treatment received. METHODS Online cross-sectional survey distributed through Breast Cancer Network Australia (BCNA). RESULTS 524/2286 women responded to the invitation to participate. Of these, 74% (385/523) reported symptoms of interest and were included in the analysis. Mean age was 55.2 years and mean time since breast cancer diagnosis was 5.7 years. Most (66%) had received chemotherapy and were taking endocrine therapy (64%). The most common symptoms were hot flushes/night sweats and sleep disturbance (both 89%), vaginal dryness (75%), mood swings (62%) and sexual problems (60%). Symptoms were mild (21-33%) or moderate (21-38%) in around one third and severe in up to one quarter (8-26%). Symptoms affected the ability to "get on with their life" for 36%, predicted by severity of hot flushes (OR 1.4), sleep disturbance (OR 1.3), mood disturbance (OR 1.3), and sexual problems (OR 1.3). Only 32% were offered treatment, mostly delivered by GPs (33%) or oncologists (26%). Only 49% found this "somewhat effective" and 34% found it ineffective. The majority (60%) wanted more support to manage their symptoms. CONCLUSION Menopausal symptoms, sexual problems, mood and sleep difficulties are common after breast cancer and often not effectively managed. There is an unmet need for coordinated care providing effective treatments.
Collapse
Affiliation(s)
- Michelle Peate
- Department of Obstetrics & Gynaecology, University of Melbourne, Level 7, Royal Women's Hospital, 20 Flemington Road, Parkville, VIC, 3052, Australia.
| | - Christobel Saunders
- Division of Surgery, Faculty of Health and Medical Sciences, University of Western Australia School of Surgery, Murdoch, WA, 6150, Australia
| | - Paul Cohen
- Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, WA, 6009, Australia
| | - Martha Hickey
- Department of Obstetrics & Gynaecology, University of Melbourne, Level 7, Royal Women's Hospital, 20 Flemington Road, Parkville, VIC, 3052, Australia
| |
Collapse
|
31
|
Stewart SJ, Roberts L, Brindle L. Romantic partner involvement during oncology consultations: A narrative review of qualitative and quantitative studies. PATIENT EDUCATION AND COUNSELING 2021; 104:64-74. [PMID: 32868161 DOI: 10.1016/j.pec.2020.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 08/05/2020] [Accepted: 08/13/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To review the currently available research into romantic partner involvement during oncology consultations. METHODS Studies were identified via database searches plus hand-searching. A narrative review was performed using the principles of Thematic, and Framework syntheses. The search strategy was performed according to the principles of PRISMA. RESULTS From 631 results, 18 studies were included. The findings indicate that romantic partners are most valued by patients when they provide emotional, practical, and informational support. It is also indicated that psychosocial and sexual concerns are rarely discussed. Couples' self-reported satisfaction with consultations appear related to the extent of romantic partner involvement, the roles that they enacted, and the extent to which psychosocial and sexual concerns were addressed. CONCLUSION This review indicates that romantic partner involvement during clinical consultations enhances the couple's experience. However, there are methodological limitations to this body of research, which are discussed in this review. PRACTICE IMPLICATIONS Research to date has yet to offer an exploration of the social practices and conversational actions relating to romantic partner involvement during triadic oncology consultations. Future studies that draw upon recordings of these consultations, using methods capable of analysing situated social practices can address this gap.
Collapse
Affiliation(s)
- Simon John Stewart
- School of Health Sciences, Faculty of Environment and Life Sciences, University of Southampton, Southampton, UK.
| | - Lisa Roberts
- School of Health Sciences, Faculty of Environment and Life Sciences, University of Southampton, Southampton, UK.
| | - Lucy Brindle
- School of Health Sciences, Faculty of Environment and Life Sciences, University of Southampton, Southampton, UK.
| |
Collapse
|
32
|
McCaughan E, Flannagan C, Parahoo K, Connaghan J, Maguire R, Steele M, Thompson S, Jain S, Kirby M, Brady N, O'Connor SR. The Tablet-Based, Engagement, Assessment, Support, and Sign-Posting (EASSi) Tool for Facilitating and Structuring Sexual Well-Being Conversations in Routine Prostate Cancer Care: Mixed-Methods Study. JMIR Cancer 2020; 6:e20137. [PMID: 33275109 PMCID: PMC7748949 DOI: 10.2196/20137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/22/2020] [Accepted: 10/11/2020] [Indexed: 12/14/2022] Open
Abstract
Background Long-term side-effects associated with different prostate cancer treatment approaches are common. Sexual challenges are the most frequently occurring issues and can result in increased psychological morbidity. It is recognized that barriers to communication can make initiating discussions around sexual concerns in routine practice difficult. Health care professionals need to routinely initiate conversations, effectively engage with patients, and assess needs in order to provide essential support. One proposed method that could support health care professionals to do this involves the use of prompts or structured frameworks to guide conversations. Objective This study aimed to assess feasibility, acceptability, and satisfaction with the tablet-based Engagement, Assessment, Support, and Sign-posting (EASSi) tool designed to facilitate and structure sexual well-being discussions in routine prostate cancer care. Methods Health care professionals (n=8) used the EASSi tool during 89 posttreatment appointments. Quantitative data were recorded based on program usage and surveys completed by health care professionals and patients. Qualitative data exploring perceptions on use of the tool were gathered using semistructured interviews with all health care professionals (n=8) and a sample of patients (n=10). Results Surveys were completed by health care professionals immediately following each appointment (n=89, 100%). Postal surveys were returned by 59 patients (66%). Health care professionals and patients reported that the tool helped facilitate discussions (81/89, 91% and 50/59, 85%, respectively) and that information provided was relevant (82/89, 92% and 50/59, 85%, respectively). The mean conversation duration was 6.01 minutes (SD 2.91). Qualitative synthesis identified the tool’s ability to initiate and structure discussions, improve the “depth” of conversations, and normalize sexual concerns. Conclusions The EASSi tool was appropriate and acceptable for use in practice and provided a flexible approach to facilitate routine brief conversations and deliver essential sexual well-being support. Further work will be conducted to evaluate the effectiveness of using the tablet-based tool in prostate cancer care settings.
Collapse
Affiliation(s)
- Eilís McCaughan
- Institute of Nursing & Health Research, Ulster University, Newtownabbey, United Kingdom
| | - Carrie Flannagan
- Institute of Nursing & Health Research, Ulster University, Newtownabbey, United Kingdom
| | - Kader Parahoo
- Institute of Nursing & Health Research, Ulster University, Newtownabbey, United Kingdom
| | - John Connaghan
- Department of Computing and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Roma Maguire
- Department of Computing and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Mary Steele
- Faculty of Social and Human Sciences, Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, United Kingdom
| | | | - Suneil Jain
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.,Clinical Oncology, Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, United Kingdom
| | - Michael Kirby
- Faculty of Health and Human Sciences, University of Hertfordshire, Hatfield, United Kingdom.,The Prostate Centre, London, United Kingdom
| | - Nuala Brady
- Northern Heath and Social Care Trust, Antrim, United Kingdom
| | - Seán R O'Connor
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, United Kingdom
| |
Collapse
|
33
|
Krouwel EM, Albers LF, Nicolai MPJ, Putter H, Osanto S, Pelger RCM, Elzevier HW. Discussing Sexual Health in the Medical Oncologist's Practice: Exploring Current Practice and Challenges. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:1072-1088. [PMID: 31209770 PMCID: PMC7679345 DOI: 10.1007/s13187-019-01559-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Sexuality is a significant quality-of-life concern for many cancer patients. Patients may be disadvantaged if they are not informed and not offered sexual health care. We sought to reveal oncologists' current practice and opinions concerning sexual counselling. The aim of this study was to explore the knowledge, attitude and practice patterns of Dutch medical oncologists regarding treatment-related sexual dysfunction. Questionnaires were sent to 433 members of the Dutch Society of Medical Oncology. The majority (81.5%) of the 120 responding medical oncologists (response rate 30.6%) stated they discussed sexual function with fewer than half of their patients. At the same time, 75.8% of the participating oncologists agreed that addressing sexual function is their responsibility. Sexual function was discussed more often with younger patients and patients with a curative treatment intent. Barriers for avoiding discussing sexual function were lack of time (56.1%), training (49.5%) and advanced age of the patient (50.4%). More than half (64.6%) stated they had little knowledge about the subject and the majority (72.9%) wanted to acquire additional training in sexual function counselling. Medical oncologists accept that sexual function counselling falls within their profession, yet they admit to not counselling patients routinely concerning sexual function. Only in a minority of cases do medical oncologists inform their patients about sexual side effects of treatment. Whether they counsel patients is related to how they view patient's prognosis, patient's age, and self-reported knowledge. Findings indicate there is a role for developing education and practical training.
Collapse
Affiliation(s)
- E M Krouwel
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - L F Albers
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands.
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands.
| | - M P J Nicolai
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - H Putter
- Department of Medical Statistics, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - S Osanto
- Department of Oncology, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - R C M Pelger
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - H W Elzevier
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| |
Collapse
|
34
|
Vencill JA, Kacel EL, Avulova S, Ehlers SL. Barriers to sexual recovery in women with urologic cancers. Urol Oncol 2020; 40:372-378. [PMID: 33248897 DOI: 10.1016/j.urolonc.2020.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 09/27/2020] [Accepted: 11/04/2020] [Indexed: 01/23/2023]
Abstract
Sexual health concerns are prevalent and distressing in oncology patients and survivors. While urologic cancers are more prevalent in men, women often have more advanced disease at initial diagnosis, require more advanced surgical resection, and experience higher postoperative complication rates, as well as morbidity and mortality. Women with urologic cancers undergo treatment that is highly likely to impact their sexual function and well-being, however, attention to sexual recovery in this patient population has been limited. Barriers to sexual recovery in women with urologic cancers are biopsychosocial in nature and include complications related to treatment procedures, cancer-related distress, sexual anxiety and avoidance, partner and relational dynamics, and sexual communication skills. Healthcare providers do not adequately address sexual difficulties for these patients and their partners. Sexual minority women and transgender patients with urologic cancer have unique psychosocial and sexual health needs though, due to a lack of research, these remain poorly understood. More research is needed to pinpoint the sexual health needs of this specific oncology population and to explore how various treatment options, such as pelvic organ-sparing cystectomy, can impact sexual health outcomes. Evidence-based and multidisciplinary oncologic and survivorship care, which includes licensed mental health providers, certified sex therapists, and other sexual health experts, is essential for assisting women in their sexual recovery following urologic cancer.
Collapse
Affiliation(s)
- Jennifer A Vencill
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN; Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN.
| | | | | | - Shawna L Ehlers
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN
| |
Collapse
|
35
|
Aminnudin AN, Doss JG, Ismail SM, Chai MB, Abidin MZ, Basri CSJM, Kipli NP, Wei LC. Can post-treatment oral cancer patients' concerns reflect their cancer characteristics, HRQoL, psychological distress level and satisfaction with consultation? Ecancermedicalscience 2020; 14:1118. [PMID: 33209109 PMCID: PMC7652548 DOI: 10.3332/ecancer.2020.1118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Indexed: 12/30/2022] Open
Abstract
Background Oral cancer and its treatment impact patients' post-treatment outcomes, challenging clinicians to manage them optimally. Addressing patients' concerns is central to holistic patient-centred care. Objectives This study aimed to determine post-treatment oral cancer patients' concerns and its relationship with patients' clinical characteristics, health-related quality of life (HRQoL), psychological distress and patient satisfaction with the follow-up consultation. Methods A total of 85 oral cancer patients were recruited from a three-armed pragmatic RCT study on the patient concerns inventory for head and neck cancer (PCI-H&N), which was conducted at six hospital-based oral maxillofacial specialist clinics throughout Malaysia. Malaysians aged 18 years and above and on follow-ups from 1 month to 5 years or more were eligible. Patients completed the PCI-H&N, functional assessment of cancer therapy -H&N v4.0 and Distress Thermometer at pre-consultation and satisfaction questionnaire at post-consultation. The data were analysed descriptively; multiple linear regression and multivariate logistic regression analyses were used to determine possible predictors of patients' HRQoL and psychological distress. Results 'Recurrence or fear of cancer coming back' (31.8%) was most frequently selected. 43.5% of patients selected ≥4 concerns. A significantly high number of concerns were associated with patients of '1-month to 1-year post-treatment' (n = 84%; p = 0.001). A significant association existed between 'time after treatment completed' and patients' concerns of 'chewing/eating', 'mouth opening', 'swelling', 'weight', 'ability to perform', 'cancer treatment' and 'supplement/diet-related'. 'Chewing/eating' was predicted for low HRQoL (p < 0.0001) followed by 'appearance' and 'ability to perform recreation activities' (personal functions domain). Patients with high psychological distress levels were 14 times more likely to select 'ability to perform recreation activities' and seven times more likely to select 'feeling depressed'. No significant association was identified between patients' concerns and patients' satisfaction with the consultation. Conclusion Routine follow-up consultations should incorporate the PCI-H&N prompt list to enhance patient-centred care approach as the type and number of patients' concerns are shown to reflect their HRQoL and psychological distress.TRIAL REGISTRATION: NMRR-18-3624-45010 (IIR).
Collapse
Affiliation(s)
- Ainon Natrah Aminnudin
- Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.,Oral Health Program, Ministry of Health Malaysia (MOH), 62590 Putrajaya, Malaysia
| | - Jennifer Geraldine Doss
- Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.,Oral Cancer Research and Coordinating Centre (OCRCC), University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Siti Mazlipah Ismail
- Department of Oro-Maxillofacial Surgical & Medical Sciences, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ma Bee Chai
- Oral Maxillo-Facial Surgery, Sultanah Aminah Hospital, 80100 Johore Bahru, Malaysia
| | - Marzuki Zainal Abidin
- Oral Maxillo-Facial Surgery, Queen Elizabeth Hospital, 88200 Kota Kinabalu, Malaysia
| | | | | | - Lee Chee Wei
- Oral Maxillo-Facial Surgery, Kuala Lumpur General Hospital, 50586 Kuala Lumpur, Malaysia
| |
Collapse
|
36
|
Wazqar DY. Sexual health care in cancer patients: A survey of healthcare providers' knowledge, attitudes and barriers. J Clin Nurs 2020; 29:4239-4247. [PMID: 32786162 DOI: 10.1111/jocn.15459] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/30/2020] [Accepted: 07/24/2020] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To assess the knowledge and attitudes of healthcare providers regarding sexual health care in cancer patients in Saudi Arabia and explore possible barriers influencing their attitudes. BACKGROUND A growing body of research emphasises the importance of healthcare providers addressing the sexual problems of cancer patients. The literature, however, shows that cancer treatment-related sexual problems are not frequently discussed by healthcare providers as expected. In Saudi Arabia, sexual health care in oncology daily practice has not been addressed sufficiently. METHODS A cross-sectional correlational study was conducted with a convenience sample of 150 healthcare providers from a university teaching and referral hospital providing cancer and palliative care in Jeddah City, Saudi Arabia. The study methods were compliant with the STROBE checklist. Data were collected by Sexual Healthcare Attitudes and Knowledge survey. Descriptive and inferential statistics and Pearson's correlations were performed. A content analysis was used to enhance understanding and support study's findings. RESULTS Participants had a poor knowledge related to sexual health care in cancer patients, and the low mean attitudes score also represents negative attitudes and higher levels of barriers. Participants had insufficient knowledge about assessment and evaluation of sexual health in cancer patients, and did not know about sexual dysfunction resulting from cancer and its treatment. Knowledge and attitudes had a significantly positive correlation. CONCLUSION The study findings indicate there is room for improvement in the sexual health-related knowledge among oncology nurses, doctors and radiation oncologists. Helping healthcare providers overcome barriers to discussing cancer patients' sexual issues needs a careful evaluation of the knowledge, attitudes and barriers that keep them from discussing such issues. RELEVANCE TO CLINICAL PRACTICE It is imperative to improve healthcare providers' sexuality knowledge about cancer patients through introducing sexual health-based continuing education programmes, availability of resources (educational materials and clinical checklists) and training in oncology daily practice.
Collapse
Affiliation(s)
- Dhuha Youssef Wazqar
- Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
37
|
Zhu A, Wittmann D. Barriers to sexual recovery in men with prostate, bladder and colorectal cancer. Urol Oncol 2020; 40:395-402. [DOI: 10.1016/j.urolonc.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/13/2020] [Accepted: 08/02/2020] [Indexed: 01/05/2023]
|
38
|
Barisone M, Bagnasco A, Hayter M, Rossi S, Aleo G, Zanini M, Catania G, Pellegrini R, Dasso N, Ghirotto L, Sasso L. Dermatological diseases, sexuality and intimate relationships: A qualitative meta-synthesis. J Clin Nurs 2020; 29:3136-3153. [PMID: 32531872 DOI: 10.1111/jocn.15375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 05/11/2020] [Accepted: 05/17/2020] [Indexed: 02/03/2023]
Abstract
AIMS AND OBJECTIVES To conduct a systematic review and meta-synthesis of findings from qualitative research about sexuality and intimate relationship among patients with dermatological diseases. BACKGROUND Over the last few decades, there has been an increase in clinical research investigating aspects related to sex and sexuality in patients living with dermatological diseases. In fact, studies recognise a negative impact on various aspects of intimacy, such as sexual function, self-esteem and romantic relationships. The body of qualitative literature about sexuality in the context of dermatological diseases is emerging but consists mainly of small studies that would benefit from aggregation, synthesis and interpretation to highlight and summarise the overarching dimensions to this clinical issue. DESIGN A systematic review and meta-synthesis of qualitative studies. METHODS BioMed Central, Cochrane Library, MEDLINE, CINAHL, PsycINFO, PsycARTICLES, ERIC, Scopus, and Web of Science were searched between June-November 2017 with no publication date limits. Screening and selection of studies was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). After retrieval, the qualitative data were subject to meta-synthesis to identify overarching themes. RESULTS Ten qualitative studies were found. We identified four themes: (a) Embarrassment and shame; (b) Impaired sense of attractiveness and sexual avoidance; (c) Relationship issues; and (d) Lack of professional support. The patients in these studies adopted negative coping styles, such as avoidance and hiding their bodies. CONCLUSION When assessing and evaluating patient care in dermatology, it is important that sexuality and the impact the disease could have on relationships is included. RELEVANCE TO CLINICAL PRACTICE An important part of nursing care is ensuring that patients are helped to develop positive coping strategies rather than negative ones. Patients with dermatological conditions also need advice and treatment to address any physically related sexual problems. Nurses need to be the initiators of these sensitive conversations to put patients at ease and work together to implement positive measures to reduce the sexuality-related issues patients face.
Collapse
Affiliation(s)
- Michela Barisone
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Mark Hayter
- School of Health & Social Work, University of Hull, Hull, UK
| | - Silvia Rossi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Nicoletta Dasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Luca Ghirotto
- Arcispedale Santa Maria Nuova - IRCCS, Direzione Scientifica, Reggio Emilia, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
| |
Collapse
|
39
|
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]
|
40
|
Zimmaro LA, Lepore SJ, Beach MC, Reese JB. Patients' perceived barriers to discussing sexual health with breast cancer healthcare providers. Psychooncology 2020; 29:1123-1131. [PMID: 32281174 DOI: 10.1002/pon.5386] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/19/2020] [Accepted: 03/24/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES We characterized barriers reported by women with breast cancer (BC) regarding clinical discussions of sexual health, clustered women by their endorsement of these barriers, and compared these groups. METHODS BC outpatients (N = 144; M age = 56, 67% White) in a sexual health communication intervention study provided baseline data. Exploratory factor analysis characterized sexual health communication barriers on a standardized measure. Hierarchical cluster analysis detected patient groups with similar response patterns on these factors. ANOVAs, Chi-Square and Fisher's Exact tests compared groups on socio-demographic/medical factors, sexual health communication self-efficacy and outcome expectancies, general clinical self-efficacy, sexual concerns, emotional distress, and discussion about sexual health with an oncology provider. RESULTS Two factors emerged: patients' own beliefs about or perceived inability to discuss sexual health (self-centered barriers), and patients' perceptions of providers' reactions to discussing sexual health (provider-centered barriers); self-centered barriers were endorsed more than provider-centered (P < .001). Three clusters emerged: women who endorsed (a) high self-centered and high provider-centered (n = 19; 13%), (b) high self-centered and low provider-centered (n = 95; 66%), and (c) low self-centered and low provider-centered (n = 30; 21%). Women endorsing more barriers reported lower sexual communication self-efficacy, outcome expectancies, and general clinical self-efficacy (P's ≤ .001); no differences in sexual concerns, emotional distress, or discussing sexual health were found. CONCLUSIONS Women more strongly endorsed self-centered barriers than provider-centered. When grouped according to these barriers, women differed in their confidence and expectations for sexual health communication, regardless of degree of sexual or emotional distress. Interventions are needed to improve both patients' and providers' skills for discussing sexual health.
Collapse
Affiliation(s)
- Lauren A Zimmaro
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Stephen J Lepore
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.,Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Mary Catherine Beach
- General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jennifer B Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| |
Collapse
|
41
|
Shartau K, Raffin Bouchal S, Booker R, King-Shier K. The experiences of individuals re-engaging in sexual relationships following a bone marrow transplant: A grounded theory study. Eur J Oncol Nurs 2020; 46:101756. [PMID: 32330861 DOI: 10.1016/j.ejon.2020.101756] [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: 09/12/2019] [Revised: 02/20/2020] [Accepted: 03/30/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Sexual health is often neglected following a bone marrow transplant. The purpose of this study was to develop an in-depth explanation of the process that patients undergo when re-engaging in sexual relationships following a bone marrow transplant. METHODS A Straussian Grounded Theory methodology was employed. Ten bone marrow transplant patients (seven men, three women), participated in a semi-structured interview between October 2018 and April 2019. RESULTS A theoretical model of the process of re-engaging in a sexual relationship following a bone marrow transplant evolved over time. Four categories emerged from the data: identifying importance, taking responsibility, seeking resources, and navigating the partnered-relationship. Gender-specific details permeated all of these categories. These occurred in a non-linear process of 'seeking a new normal' and could apply at any time point during the treatment trajectory. CONCLUSIONS The model offers an explanation of the process participants went through during their illness and identifies ways that participants navigated change. Having intimate conversations often helped in targeting sexual recovery and affected the ease of transition in dealing with the transition to a 'new normal'.
Collapse
Affiliation(s)
- Kristi Shartau
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, T2N 1N4, Alberta, Canada
| | - Shelley Raffin Bouchal
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, T2N 1N4, Alberta, Canada
| | - Reanne Booker
- OASIS (Oncology and Sexuality, Intimacy and Survivorship) Psychosocial Oncology, Tom Baker Cancer Centre, 1331 29 Street NW, Calgary, T2N 4N2, Alberta, Canada
| | - Kathryn King-Shier
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, T2N 1N4, Alberta, Canada; Department of Community Health Sciences, TRW Building, 3D10, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Alberta, Canada.
| |
Collapse
|
42
|
Abstract
Prostate cancer is the second most common cause of cancer-related death in men in the USA, but the effect of prostate cancer diagnosis and treatment on men in a sexual minority group, including men who have sex with men and transgender women, is poorly understood. Efforts to study this population are complicated, as cancer registries do not routinely collect information on sexual orientation. As a result, epidemiological data regarding this population have come from small studies that have included disparate rates of prostate cancer screening, diagnosis and treatment. Qualitative studies indicate that prostate cancer is experienced differently by sexual minorities, with distinct health-care needs that arise owing to differences in sexual practices, social support systems and relationships with the medical community. Notably, sexual minorities have been reported to experience poorer health-related quality of life outcomes than heterosexual men, and tend to have less robust social support systems, experience increased psychological distress caused by sexual dysfunction (areas of which are unmeasured after treatment), experience isolation within the health-care system and express increased levels of dissatisfaction with treatment. The incidence of prostate cancer actually seems to be decreased in men from sexual minorities living with HIV, despite there being no differences in screening and treatment, with poor cancer-specific mortality. Although the literature on patients with prostate cancer in men from sexual minority groups has historically been sparse, peer-reviewed research in this area has grown considerably during the past decade and has become an important field of study.
Collapse
|
43
|
Lee JY, Jang Y, Kim S, Hyung WJ. Uncertainty and unmet care needs before and after surgery in patients with gastric cancer: A survey study. Nurs Health Sci 2020; 22:427-435. [PMID: 31943719 DOI: 10.1111/nhs.12677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 11/11/2019] [Accepted: 11/27/2019] [Indexed: 12/12/2022]
Abstract
Uncertainty and unmet care needs constantly change in patients with cancer. However, there is a lack of information regarding the changing pattern of these variables. This study aimed to examine the changes in uncertainty and unmet care needs at diagnosis and after surgery among patients with gastric cancer. In total, 86 individuals completed a self-reported questionnaire. Data were collected twice - to measure uncertainty and unmet care needs at cancer diagnosis (T1), and after surgery (T2) - and analyzed using descriptive analysis and a dependent t-test. Uncertainty was moderate at both periods but significantly higher at T1. Unmet care needs were highest in the information domain and lowest in the sexuality domain at both T1 and T2. Only the physical/daily living domain were significantly higher at T2, whereas the information, psychological, and patient care/support domains were significantly higher at T1. Different levels of uncertainty and unmet needs were identified at T1 and T2. Healthcare providers should assess changing unmet care needs at each stage of the cancer trajectory and provide related nursing care and information to this population, even immediately after diagnosis.
Collapse
Affiliation(s)
- Ji Yea Lee
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Yeonsoo Jang
- Yonsei University College of Nursing, Mo-Im Kim Research Institute, Seoul, South Korea
| | - Sanghee Kim
- Yonsei University College of Nursing, Mo-Im Kim Research Institute, Seoul, South Korea
| | - Woo Jin Hyung
- Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| |
Collapse
|
44
|
Discussing sexuality in cancer care: towards personalized information for cancer patients and survivors. Support Care Cancer 2020; 28:4227-4233. [PMID: 31900615 DOI: 10.1007/s00520-019-05257-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/20/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The needs of cancer patients and survivors regarding discussing sexuality are frequently unmet, with many not receiving adequate information. To optimize information about sexuality and cancer, patients' perspective is needed. The goals of this study were to investigate what kind of information Dutch cancer patients need, their ideas on how to improve communication, and to identify patients who are more in need of information regarding sexuality. METHODS The Dutch Federation of Cancer Patient Organizations developed and conducted a nationwide 28-item online survey. The survey was distributed among cancer patients and survivors. RESULTS In total, 2657 (ex) cancer patients participated, with a median age of 61 years, and half were male (45.2%). Of the respondents, 65% were in need of information about sexuality. Patients ≤ 61 years (p < 0.001), patients with a self-reported negative effect of cancer on sexuality (p < 0.001) and patients who were diagnosed less than 2 years ago (p < 0.04) reported a higher need for information. Regardless of type of cancer, patients were most in need of practical tips and practical information regarding sexuality. To enhance communication about sexuality, 64% of the respondents suggested that it would be of help if care providers give information as standard care. CONCLUSIONS (Ex) cancer patient prefer to receive standard information about sexuality by their care providers. According to patients' preferences, information must include practical tips. Age, self-reported negative effect on sexuality status and time from diagnoses influenced the need for information.
Collapse
|
45
|
Kim J, Jang M. Stress, Social Support, and Sexual Adjustment in Married Female Patients with Breast Cancer in Korea. Asia Pac J Oncol Nurs 2020; 7:28-35. [PMID: 31879681 PMCID: PMC6927156 DOI: 10.4103/apjon.apjon_31_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/13/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study identified the level of stress, social support, and sexual adjustment in married women with breast cancer in Korea. METHODS This study used a subgroup analysis, prospective, cross-sectional, and descriptive correlation design. Data were obtained using the perceived stress scale, multidimensional scale of perceived social support, and sexual adjustment subscale of the Korean version of the psychosocial adjustment to illness scale. From May 2015 to April 2016, 272 married female patients who had been diagnosed with breast cancer were recruited at a university hospital in Korea. Data were analyzed using SPSS Win 21.0. RESULTS The mean score of stress level was 17.53 ± 4.13, social support was 5.37 ± 1.07, and sexual adjustment was 6.36 ± 3.29. A significant positive correlation emerged between sexual adjustment and stress (r = 0.161, P = 0.008). Significant negative correlations were observed among sexual adjustment and family support (r = -0.177, P = 0.003) and friends' support (r = -0.205, P = 0.001). CONCLUSIONS The assessment of stress level and social support may be used in planning sexual-adjustment interventions appropriate for married female breast cancer patients in Korea.
Collapse
Affiliation(s)
- Jiyoung Kim
- Department of Nursing, Dongeui University, Busan, Korea
| | - Miyoung Jang
- Hallym University Sacred Heart Hospital, Gyeonggi-do, Korea
| |
Collapse
|
46
|
Albers LF, Van Ek GF, Krouwel EM, Oosterkamp-Borgelink CM, Liefers GJ, Den Ouden MEM, Den Oudsten BL, Krol-Warmerdam EEM, Guicherit OR, Linthorst-Niers E, Putter H, Pelger RCM, Elzevier HW. Sexual Health Needs: How Do Breast Cancer Patients and Their Partners Want Information? JOURNAL OF SEX & MARITAL THERAPY 2019; 46:205-226. [PMID: 31762399 DOI: 10.1080/0092623x.2019.1676853] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
It is well known that breast cancer treatment can affect sexuality. This survey evaluated the needs of breast cancer patients and partners regarding sexual care. The majority of patients (80.4%) and partners (73.7%) did not receive any information regarding sexuality. Although only a quarter of all respondents reported a direct need for information regarding sexuality, most valued an opportunity to discuss sexuality. The nurse practitioner was the most preferable care provider to provide information about sexuality, supported by a brochure or website. Patients considered during treatment as most suitable timing of discussing sexuality, and partners before the start of treatment.
Collapse
Affiliation(s)
- L F Albers
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - G F Van Ek
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - E M Krouwel
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - G J Liefers
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - M E M Den Ouden
- Research Center Technology, Health & Care, Saxion University of Applied Sciences, Enschede, The Netherlands
| | - B L Den Oudsten
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - E E M Krol-Warmerdam
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - O R Guicherit
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | | | - H Putter
- Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - R C M Pelger
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - H W Elzevier
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| |
Collapse
|
47
|
Komlenac N, Hochleitner M. Predictors for Low Frequencies of Patient-Physician Conversations Concerning Sexual Health at an Austrian University Hospital. Sex Med 2019; 8:100-106. [PMID: 31680029 PMCID: PMC7042158 DOI: 10.1016/j.esxm.2019.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/28/2019] [Accepted: 09/29/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction Studies concerning barriers to patient-physician conversations about sexual health or, specifically, sexual functioning fail to go beyond descriptive analyses of such barriers. Aim To identify barriers that predict the frequency of patient-physician conversations concerning sexual health or sexual functioning. Methods An online survey among physicians was conducted at an Austrian university hospital. Self-constructed questionnaires assessed physicians’ sociodemographic information, frequency of holding a discussion on sexual health or sexual dysfunctions with their patients, and self-perceived barriers to asking patients about sexual health. Stepwise logistic regression models determined barriers that predicted the frequency of patient-physician conversations concerning sexual health or sexual dysfunctions in everyday clinical practice. Main Outcome Measure The outcome variables in the structural equation models were frequency of patient-physician conversations concerning sexual health or sexual dysfunctions in everyday clinical practice. Results One hundred two physicians (53.9% women, 46.1% men; mean age = 41.3 years; SD = 10.6) provided full responses. Of these physicians, 61.8% reported having a discussion on sexual health or sexual dysfunctions with their patients at least rarely in their everyday clinical practice. The barriers most influencing the frequency of such patient-physician conversations were not feeling responsible for this health issue and expecting the patient to initiate such a conversation. Fear of offending the patient and the physician’s own feelings of shame and discomfort were additional factors influencing the frequency of these patient-physician conversations. Clinical Implications Future physician training should address physicians’ responsibilities that include sexual health. Future physician training should also help physicians in overcoming fears of offending a patient, and one’s own feelings of shame and discomfort when addressing patients’ sexual health. Strengths & Limitations This study included physicians across a range of disciplines, who may encounter patients with sexual problems and with their treatments influence a patient’s sexual health and sexual functioning. However, the low response rate and the limited number of participants prevented generalization of findings. Conclusions At an Austrian university hospital, patient-physician conversations concerning sexual health are seldom part of a physician’s everyday clinical practice. Future training for physicians should focus on demonstrating the relevance of sexual health in the physician’s medical discipline and should tackle a physician’s feelings of shame or how to handle patients’ negative reactions during patient-physician conversations concerning sexual health. Komlenac N, Hochleitner M. Predictors for Low Frequencies of Patient-Physician Conversations Concerning Sexual Health at an Austrian University Hospital. Sex Med 2019; 8:100–106.
Collapse
Affiliation(s)
- Nikola Komlenac
- Gender Medicine Unit, Medical University of Innsbruck, Innsbruck, Austria.
| | | |
Collapse
|
48
|
Ussher JM, Perz J, Rose D, Kellett A, Dowsett G. Sexual Rehabilitation After Prostate Cancer Through Assistive Aids: A Comparison of Gay/Bisexual and Heterosexual Men. JOURNAL OF SEX RESEARCH 2019; 56:854-869. [PMID: 29913078 DOI: 10.1080/00224499.2018.1476444] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The use of assistive aids in sexual rehabilitation after prostate cancer (PCa) was examined in 124 gay, bisexual, and other men who have sex with men (GBM) and 225 heterosexual men. GBM were significantly more likely to use assistive aids (79% versus 56%), to try multiple assistive aids (M = 1.65 versus M = 0.83) including medication, penile injection, penile implant, vacuum pump, and nonmedical sex aids, and to seek information about sexual rehabilitation on the Internet, through counseling, or in a support group. There were no differences between the groups in satisfaction with the use of assistive aids. However, use of aids was a significant negative predictor of sexual functioning for GBM and a significant positive predictor for heterosexual men. Interview accounts described satisfaction with assistive aids in terms of maintaining erectile functioning and relationships. The majority of men in the study also described hindrances, both physical and social, resulting in discontinuation of assistive aids, including perceived artificiality, loss of sexual spontaneity, side effects, failure to achieve erectile response, cost, and lack of access to information and support. It is concluded that the specific needs and concerns of GBM and heterosexual men regarding sexual rehabilitation after PCa need to be addressed by clinicians.
Collapse
Affiliation(s)
- Jane M Ussher
- Translational Health Research Institute, Western Sydney University
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University
| | - Duncan Rose
- Translational Health Research Institute, Western Sydney University
| | - Andrew Kellett
- Translational Health Research Institute, Western Sydney University
| | - Gary Dowsett
- Australian Research Centre in Sex, Health, and Society, La Trobe University
| |
Collapse
|
49
|
Komlenac N, Hochleitner M. Male Medical Students' Gender-Role Conflict Is Associated With Their Discomfort With Dealing With Patients' Sexual Health Issues. JOURNAL OF SEX RESEARCH 2019; 56:930-936. [PMID: 31033349 DOI: 10.1080/00224499.2019.1606155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Recommendations suggest that more sexuality education be implemented in medical school curricula to increase students' comfort with regard to dealing with sexual health issues. For male medical students the adherence to masculine gender-role norms may also contribute to discomfort regarding dealing with this intimate topic. The current study analyzed whether male medical students' knowledge or masculine gender-role conflict (GRC) was associated with their comfort with regard to asking future patients about sexual health issues. A total of 164 male medical students (Mage = 24.4, SD = 2.4) participated. A questionnaire assessed students' self-perceived knowledge of sexual health, how prepared they felt with regard to this topic, and their comfort with regard to asking future patients about sexual health issues. The Gender Role Conflict Scale-Short Form (GRCS-SF) was used to assess GRC. Knowledge was positively associated with comfort. Male students who indicated difficulty expressing affection toward men or expressing emotions were likely to report being uncomfortable asking patients about sexual health issues. Students should be made aware of gender-role norms. Alongside knowledge transfer, the discussion of strategies for overcoming the barriers set by gender-role norms should be part of sexuality education.
Collapse
|
50
|
Uçar MA, Arikan F, Coşkun HŞ, Kondak Y, Tatlı AM, Göksu SS. Fertility in testicular cancer patients: a single-centre study in Turkey. Int J Clin Oncol 2019; 25:495-500. [DOI: 10.1007/s10147-019-01534-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/21/2019] [Indexed: 12/14/2022]
|