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Bentsen L, Aagesen M, Bidstrup P, Hjerming M, Pappot H. Sexuality, intimacy, and body image among adolescents and young adults with cancer: a qualitative, explorative study. Support Care Cancer 2024; 32:219. [PMID: 38460054 PMCID: PMC10924731 DOI: 10.1007/s00520-024-08405-6] [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: 10/13/2023] [Accepted: 02/24/2024] [Indexed: 03/11/2024]
Abstract
AIM The aim of this study was threefold: (1) to explore Danish adolescents and young adults' (AYAs) thoughts concerning sexual health particularly focusing on sexuality, intimacy, and body image throughout a cancer trajectory, (2) to investigate how AYAs experience healthcare professionals address of- and respond to sexual health issues, and (3) to identify AYAs' suggestions on how to support conversation about sexual health. METHODS A qualitative, single-center study was conducted, including AYAs (18-29 years) diagnosed with cancer recruited at the University Hospital of Copenhagen, Rigshospitalet. Individual semi-structured interviews were conducted from January-February 2023, recorded, transcribed verbatim, and analyzed using thematic analysis. RESULTS Twelve participants were interviewed, aged 20-29; five were diagnosed with hematological- and seven with oncological cancer. Our analyses yielded three themes: (1) sexuality and body image as part of the identity, (2) excluding relatives in conversations about sexual health, and (3) uncertainty how to discuss sexual health with healthcare professionals. Finally, the AYAs' suggestions to support conversations about sexual health were organized into six thematic categories. CONCLUSION In this study, participants experienced altered sexual subsequent impacts on body image and self-esteem during their cancer trajectory. While some adapted to these changes, discussing them with healthcare providers was difficult, especially in the presence of relatives, as the AYAs wanted to shield them from additional concerns. To enhance support, AYAs suggest regular discussions on sexual health and the use of a dialog tool by healthcare professionals.
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Affiliation(s)
- Line Bentsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Maria Aagesen
- Occupational Science, User Perspectives and Community-Based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Pernille Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Strandboulevarden 49 2100, Copenhagen, Denmark
| | - Maiken Hjerming
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
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2
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Drizin JH, Kahn JM, Faltesek D, Gorman JR. Health Care Provider Perceptions of Using Social Media to Improve Sexual Health for Adolescent and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2023; 12:935-941. [PMID: 37890085 DOI: 10.1089/jayao.2023.0086] [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] [Indexed: 10/29/2023] Open
Abstract
This study explored (1) health care provider (HCP) perceived barriers and facilitators to social media communication about sexual health with adolescent and young adult survivors, and (2) strategies that can help HCPs navigate social media use for this purpose. Thematic analysis of 11 semistructured HCP interviews resulted in four themes and suggests that social media platforms offer a promising avenue to foster sexual health communication but that resources and training are needed to improve HCP capacity to use this approach ethically and effectively. Future studies are needed to determine specific communication strategies and whether these strategies would lead to improved outcomes.
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Affiliation(s)
- Julia H Drizin
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Jenna M Kahn
- Department of Radiation Oncology, Kaiser Permanente NW, Portland, Oregon, USA
| | - Daniel Faltesek
- College of Liberal Arts, Oregon State University, Corvallis, Oregon, USA
| | - Jessica R Gorman
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
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3
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Savel C, Chausset A, Berland P, Guiguet-Auclair C, Cabane L, Fautrel B, Gaudin P, Guillot P, Hayem G, Lafarge D, Merlin E, Pezière N, Sordet C, Trope S, Tournadre A, Malochet S, Cohen JD. Survey of adolescents' needs and parents' views on sexual health in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2023; 21:95. [PMID: 37670340 PMCID: PMC10478441 DOI: 10.1186/s12969-023-00884-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/28/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Although the advent of new therapeutics for juvenile idiopathic arthritis (JIA) patients has considerably lessened the impact of the disease and reduced its sequelae, the outcomes of JIA remain important in their lives. Disease repercussions and side effects of treatments may affect sexual health and cause psychological distress. This aim of the study was to determine the expectations of adolescent JIA patients and the perceptions of their parents regarding knowledge and communication with healthcare providers (HCPs) in the field of sexual health (SH). METHODS In France, from September 2021 to April 2022, a survey was conducted, using anonymous self-administered questionnaires, among JIA patients (adults (aged 18-45 years) to provide insights from their recollection of their adolescence) and their parents in nine rheumatology centers and three patient associations. RESULTS The responses to the 76 patient questionnaires and 43 parent questionnaires that were collected were analyzed. Half of the patients thought JIA impacted their romantic relationships, but the results were less clear-cut for their sexual activity; and 58.7% of the patients said they would be comfortable discussing the subject with HCPs, but only 26.3% had done so, mainly regarding biomedical issues. The patients and their parents thought that ideally, the topic should be addressed in an individual patient education session at the hospital (51.3% and 34.9%, respectively), in a regular consultation (47.4% and 53.5%), or in a dedicated consultation requested by the adolescent without the adolescent's parents being informed (38.2% and 20.9%). Most of the respondents thought HCPs should be proactive in SH (77.6% of the patients and 69.8% of their parents). More patients than parents said the following digital information tools must be used: videos (29.0% vs. 9.3%, p = 0.0127) and smartphone applications (25.0% vs. 9.3%, p = 0.0372). CONCLUSION HCPs should consider addressing the unmet need for SH discussions during their patient encounters. To meet this need, we propose concrete actions in line with the wishes of patients and parents. CLINICAL TRIAL REGISTRATION NUMBER NCT04791189.
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Affiliation(s)
- Carine Savel
- CRECHE Unit, Department of Pediatrics, INSERM CIC 1405, CHU Clermont-Ferrand, 1 place Lucie & Raymond Aubrac, Clermont-Ferrand, 63100, France.
- Department of Public Health, CHU Clermont-Ferrand, Clermont-Ferrand, France.
| | - Aurélie Chausset
- CRECHE Unit, Department of Pediatrics, INSERM CIC 1405, CHU Clermont-Ferrand, 1 place Lucie & Raymond Aubrac, Clermont-Ferrand, 63100, France
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Claude Bernard University Lyon 1, Lyon, France
| | - Pauline Berland
- Transversal Patient Education Unit, Department of Public Health, CHU Clermont-Ferrand, Clermont- Ferrand, France
| | | | | | - Bruno Fautrel
- Service de Rhumatologie, Sorbonne Université, AP-HP. Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Philippe Gaudin
- University Grenoble Alpes, T-RAIG, TIMC-IMAG, CNRS UMR 5525, Grenoble, France
- Department of Rheumatology, Grenoble Alpes University Hospital, Échirolles, Grenoble, France
| | - Pascale Guillot
- Rheumatology Department, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes, France
| | - Gilles Hayem
- Rheumatology Department, Paris Saint-Joseph Hospital, Paris, France
| | | | - Etienne Merlin
- CRECHE Unit, Department of Pediatrics, INSERM CIC 1405, CHU Clermont-Ferrand, 1 place Lucie & Raymond Aubrac, Clermont-Ferrand, 63100, France
- Department of Pediatrics, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Christelle Sordet
- Department of Rheumatology, National Reference Center for Systemic Autoimmune Diseases (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sonia Trope
- Association Nationale de Défense Contre l'Arthrite Rhumatoïde (ANDAR), Paris, France
| | - Anne Tournadre
- Rheumatology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Jean-David Cohen
- Rheumatology Department, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
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4
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Pecoriello J, Klosky JL, Augusto B, Santiago-Datil W, Sampson A, Reich R, Vadaparampil S, Quinn G. Evolution and growth of the ECHO (Enriching Communication skills for Health professionals in Oncofertility) program: a 5-year study in the training of oncofertility professionals. J Cancer Surviv 2023; 17:1184-1190. [PMID: 35031917 PMCID: PMC8760090 DOI: 10.1007/s11764-021-01139-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/13/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE AYAs with cancer have unique psychosocial needs, with reproductive health being a primary concern. The ECHO training program provides reproductive health communication training to individuals providing care for AYAs with cancer. The purpose of this project is to describe the growth of ECHO and evaluate changes in learner engagement over a 5-year period. METHODS ECHO is an 8-week online training program offered annually, with the program including learning modules, discussion topics and reflections, and synchronous discussions. Reflection quality scores and number of words were compared between the 5 cohorts using ANOVA with a p < .05 level of significance. Descriptive statistics summarized module topics, reflections, and synchronous discussions. RESULTS The average number of reflections per unique learner increased each year (1.4 in cohort 1 vs 4.1 in cohort 5), as did average length and quality of reflections (72.1 words in cohort 1 vs 203.4 words in cohort 5, p < .0001; score of 1.21 in cohort 1 vs 4.46 in cohort 5, p < .0001). The percentage of learners in attendance at synchronous discussions increased between cohorts 4 and 5 (4.8% of learners in cohort 4 vs 18.8% of learners cohort 5). CONCLUSIONS The ECHO program has seen significant growth and improvement in learner engagement over a 5-year period. This is particularly important given that student learning outcomes in online courses can be predicted by the level of engagement with online content. IMPLICATIONS FOR CANCER SURVIVORS As fertility and reproductive health remain a top life goal and discussion priority for AYAs surviving cancer, increasing clinical competencies of AHPs in oncofertility is essential.
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Affiliation(s)
- Jillian Pecoriello
- Department of Obstetrics and Gynecology, New York University, New York, NY, USA.
| | - James L Klosky
- Department of Pediatrics, Emory University School of Medicine & Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Bianca Augusto
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Amani Sampson
- Department of Obstetrics and Gynecology, New York University, New York, NY, USA
| | - Richard Reich
- Biostatistics and Bioinformatics Shared Resource, Moffitt Cancer Center, Tampa, FL, USA
| | - Susan Vadaparampil
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Gwendolyn Quinn
- Department of Obstetrics and Gynecology, New York University, New York, NY, USA
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5
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Bergström C, Lampic C, Roy R, Hedman C, Ahlgren J, Ståhl O, Smedby KE, Hellman K, Henriksson R, Eriksson LE, Wettergren L. Do young adults with cancer receive information about treatment-related impact on sex life? Results from a population-based study. Cancer Med 2023; 12:9893-9901. [PMID: 36748659 PMCID: PMC10166940 DOI: 10.1002/cam4.5672] [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: 10/07/2022] [Revised: 12/23/2022] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Sexual dysfunction is common following a cancer diagnosis in young adulthood (18-39 years) and problems related to sex life are ranked among the core concerns in this age group. Yet, few studies have investigated to what extent adults younger than 40, receive information from healthcare providers about the potential impact of cancer and its treatment on their sex life. METHODS A population-based cross-sectional survey study was conducted with 1010 young adults 1.5 years after being diagnosed with cancer (response rate 67%). Patients with breast, cervical, ovarian and testicular cancer, lymphoma, and brain tumors were identified in national quality registries. Sociodemographic and clinical factors associated with receiving information were examined using multivariable binary logistic regression. RESULTS Men to a higher extent than women reported having received information about potential cancer-related impact on their sex life (68% vs. 54%, p < 0.001). Receipt of information varied across diagnoses; in separate regression models, using lymphoma as reference, both women and men with brain tumors were less likely to receive information (women: OR 0.10, CI = 0.03-0.30; men: OR 0.37, CI = 0.16-0.85). More intensive treatment was associated with higher odds of receiving information in both women (OR 1.89; CI = 1.28-2.79) and men (OR 2.08; CI = 1.09-3.94). None of the sociodemographic factors were associated with receipt of information. CONCLUSIONS To improve sexual health communication to young adults with cancer, we recommend diagnosis-specific routines that clarify when in the disease trajectory to discuss these issues with patients and what to address in these conversations.
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Affiliation(s)
- Charlotta Bergström
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery and Urology, Danderyd Hospital, Stockholm, Sweden
| | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Department of Psychology, Umeå University, Umeå, Sweden
| | - Ricky Roy
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Urology, Karolinska University Hospital, Huddinge, Sweden
| | - Christel Hedman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,R&D Department, Stockholms Sjukhem Foundation, Stockholm, Sweden.,Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Johan Ahlgren
- Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Regional Cancer Center, Mid-Sweden, Uppsala, Sweden
| | - Olof Ståhl
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - Karin E Smedby
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.,Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Hellman
- Department of Gynecologic Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Roger Henriksson
- Department of Radiation Science and Oncology, University Hospital, Umeå, Sweden
| | - Lars E Eriksson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,School of Health and Psychological Sciences, City, University of London, London, UK.,Medical Unit Infectious Diseases, Karolinska University Hospital, Huddinge, Sweden
| | - Lena Wettergren
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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6
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Ait-Kaci F, Vanderosieren S, Lervat C. « Sans tabou » Une web-série pour aborder la sexualité chez les jeunes patients atteints de cancer. PSYCHO-ONCOLOGIE 2022. [DOI: 10.3166/pson-2022-0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Même bouleversée par le cancer, la sexualité peut rester une source de satisfaction pour les jeunes patients. Or, dans l’esprit général, sexualité et cancer figurent comme deux tabous, deux figures antinomiques qui ne peuvent coexister ensemble. Pour dépasser ce paradoxe, la websérie Sans tabou se propose comme un outil de médiation spécifique à la tranche d’âge 17–25 ans abordant avec acuité et humour le thème de la vie amoureuse et sexuelle lors d’un cancer. Ses objectifs sont d’encourager les professionnels de santé à approcher ce sujet de manière ludique et didactique, de combattre les idées reçues sur le cancer, les traitements et la sexualité, de libérer la parole de ces jeunes adultes et de leur partenaire et enfin de les aider à découvrir et/ou préserver une sexualité satisfaisante.
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Sisk BA, Harvey K, Friedrich AB, Antes AL, Yaeger LH, Mack JW, DuBois J. Multilevel barriers and facilitators of communication in pediatric oncology: A systematic review. Pediatr Blood Cancer 2022; 69:e29405. [PMID: 34662485 PMCID: PMC8875310 DOI: 10.1002/pbc.29405] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/03/2023]
Abstract
Multiple factors can facilitate or impede the fulfillment of communication functions in pediatric cancer. In this systematic review, we evaluated 109 studies from the preceding 20 years that presented qualitative or quantitative evidence of barriers or facilitators to communication in pediatric cancer. Using a multilevel framework developed in our prior study, we then analyzed and categorized the levels of barriers and facilitators identified in included studies. The vast majority of studies focused on individual-level barriers, rather than team, organization/system, collaborating hospital, community, or policy-level barriers. Future studies should explore the full range of factors that affect communication.
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Affiliation(s)
- Bryan A. Sisk
- Department of Pediatrics, Division of Hematology/Oncology, Washington University School of Medicine, St. Louis, Missouri.,Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Kieandra Harvey
- Brown School of Social Work, Washington University School of Medicine, St. Louis, Missouri
| | - Annie B. Friedrich
- Albert Gnaegi Center for Health Care Ethics, Saint Louis University, St. Louis, Missouri
| | - Alison L. Antes
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Lauren H Yaeger
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer W. Mack
- Pediatric Oncology and Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts; and Division of Pediatric Hematology/Oncology, Boston Children’s Hospital, Boston, Massachusetts
| | - James DuBois
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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Albers LF, Bergsma FB, Mekelenkamp H, Pelger RC, Manten-Horst E, Elzevier HW. Discussing Sexual Health with Adolescent and Young Adults with Cancer: a Qualitative Study Among Healthcare Providers. JOURNAL OF CANCER EDUCATION 2022; 37:133-140. [PMID: 32557400 PMCID: PMC8816785 DOI: 10.1007/s13187-020-01796-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Sexual health is an important aspect of quality-of-life for adolescent and young adult (AYA) patients with cancer. AYAs report a need for information about sexual health but experience a lack of communication with their healthcare provider. It is known that sexual health is a difficult theme for healthcare providers to discuss. This study aims to gain insight into perspectives of healthcare providers in facilitating AYAs’ needs regarding sexual health. A qualitative study was performed. Six doctors and eight nurses from eight Dutch hospitals, specialized in AYA care, participated in semi-structured interviews. All interviews were audio-recorded, transcribed, and analyzed using a thematic analysis approach. Interviews with the healthcare providers revealed five themes concerning the discussion of sexual health: (1) being responsible for bringing up the topic of sexual health, (2) finding optimal timing to discuss sexual health, (3) acquiring knowledge to enable discussion of sexual health, (4) facilitating communication about sexual health, and (5) providing informative material for AYAs. To facilitate discussing sexual health, clear defined responsibilities within the team and sufficient knowledge are important. Self-report questionnaires, material to hand out, a checklist for healthcare providers, and knowledge of different communication strategies are helpful when discussing sexual health. By applying such means, communication with AYAs might be improved.
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Affiliation(s)
- Leonore F. Albers
- Department of Urology, 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
| | - Folkertje B. Bergsma
- Department of Urology, 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
| | - Hilda Mekelenkamp
- Department of Paediatric, Leiden University Medical Centre, PO-box 9600, 2300 WB Leiden, The Netherlands
| | - Rob C.M. Pelger
- Department of Urology, 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
| | - Eveliene Manten-Horst
- Dutch AYA “Young and Cancer” Platform, Godebaldkwartier 419, 3511 DT Utrecht, The Netherlands
| | - Henk W. Elzevier
- Department of Urology, 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
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9
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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: 19] [Impact Index Per Article: 6.3] [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.
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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
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10
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Markwardt HS, Taghavi SE, Sligar KB, Al Achkar M, Hall BC. Web-Based Psychosocial Care Plan for Adolescent and Young Adult Patients With Cancer: A Proposed Model and Plan for Analysis. JCO Clin Cancer Inform 2021; 5:490-493. [PMID: 33950709 DOI: 10.1200/cci.21.00029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Haley S Markwardt
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX.,UT Southwestern Moncrief Cancer Institute, Fort Worth, TX
| | - Sarah E Taghavi
- UT Southwestern Moncrief Cancer Institute, Fort Worth, TX.,Department of Psychology, Texas Christian University, Fort Worth, TX
| | - Kylie B Sligar
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX.,UT Southwestern Moncrief Cancer Institute, Fort Worth, TX
| | | | - Brittany C Hall
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX.,UT Southwestern Moncrief Cancer Institute, Fort Worth, TX.,Fort Worth Adolescent Young Adult Oncology Coalition, Fort Worth, TX
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11
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Vandekerckhove P, de Mul M, de Groot L, Elzevier HW, Fabels B, Haj Mohammad S, Husson O, Noij J, Sleeman SHE, Verbeek D, Von Rosenstiel I, de Bont AA, Manten-Horst E. Lessons for Employing Participatory Design When Developing Care for Young People with Cancer: A Qualitative Multiple-Case Study. J Adolesc Young Adult Oncol 2020; 10:404-417. [PMID: 33185496 PMCID: PMC8388252 DOI: 10.1089/jayao.2020.0098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: Participatory design (PD) is a collective creative design process involving designers and nondesigners. There is limited reporting on the experience of using PD for adolescent and young adult (AYA) care. This study summarizes lessons from employing PD to develop care for AYAs with cancer. Methods: A qualitative multiple-case study method was conducted of three PD processes addressing food (FfC), intimacy and sexuality (I&S), and integrative medicine (IM) in caring for AYAs with cancer. Results: Local key stakeholders, who were exposed to a problem and had not been successful at solving it individually, were recruited to “dream” together. Through this synergy, a shared understanding of the problem and a joint mission emerged to find a solution. PD tools were used to develop a problem definition. An open mind and explorative research helped to understand the problems, and stakeholders were managed such that idea-sharing and learning were enabled. Designers translated ideas into prototypes. The PD process was prolonged due to the hierarchical hospital environment, business considerations, and additionally required evidence. The FfC program produced an effective new food service for the whole hospital. The I&S initiative developed a podcast, two articles, and a prototype website. The IM project developed a pilot study. Conclusions: For a PD process to successfully develop care for AYAs, one needs to use designers and skilled people, PD tools, and an open-ended approach to visualize and materialize new forms of care. Furthermore, recruitment and facilitation techniques help leverage knowledge and create a synergy in a democratic environment between stakeholders.
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Affiliation(s)
- Pieter Vandekerckhove
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Marleen de Mul
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Henk W Elzevier
- Department of Urology and Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Soemeya Haj Mohammad
- Department of Urology and Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Olga Husson
- Department of Medical Oncology and Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Julian Noij
- Dutch AYA Care Network, Utrecht, The Netherlands
| | | | | | | | - Antoinette A de Bont
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Psychosexual Functioning of Female Childhood Cancer Survivors: A Report From the St. Jude Lifetime Cohort Study. J Sex Med 2020; 17:1981-1994. [PMID: 32723681 DOI: 10.1016/j.jsxm.2020.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/03/2020] [Accepted: 06/07/2020] [Indexed: 01/21/2023]
Abstract
INTRODUCTION There is a growing population of childhood cancer survivors at risk for adverse outcomes, including sexual dysfunction. AIM To estimate the prevalence of and risk factors for sexual dysfunction among adult female survivors of childhood cancer and evaluate associations between dysfunction and psychological symptoms/quality of life (QOL). METHODS Female survivors (N = 936, mean 7.8 ± 5.6 years at diagnosis; 31 ± 7.8 years at evaluation) and noncancer controls (N = 122) participating in the St. Jude Lifetime Cohort Study completed clinical evaluations, Sexual Functioning Questionnaires (SFQ), and Medical Outcomes Survey Short Forms 36 (SF-36). Linear models compared SFQ scores between sexually active survivors (N = 712) and controls; survivors with scores <10th percentile of controls were classified with sexual dysfunction. Logistic regression evaluated associations between survivor characteristics and sexual dysfunction, and between sexual dysfunction and QOL. OUTCOMES Sexual dysfunction was defined by scores <10th percentile of noncancer controls on the SFQ overall, as well as the domains of arousal, interest, orgasm, and physical problems, while QOL was measured by scores on the SF-36 with both physical and mental summary scales. RESULTS Sexual dysfunction was prevalent among 19.9% (95% CI 17.1, 23.1) of survivors. Those diagnosed with germ cell tumors (OR = 8.82, 95% CI 3.17, 24.50), renal tumors (OR = 4.49, 95% CI 1.89, 10.67), or leukemia (OR = 3.09, 95% CI 1.50, 6.38) were at greater risk compared to controls. Age at follow-up (45-54 vs 18-24 years; OR = 5.72, 95% CI 1.87, 17.49), pelvic surgery (OR = 2.03, 95% CI 1.18, 3.50), and depression (OR = 1.96, 95% CI 1.10, 3.51) were associated with sexual dysfunction. Hypogonadism receiving hormone replacement (vs nonmenopausal/nonhypogonadal; OR = 3.31, 95% CI 1.53, 7.15) represented an additional risk factor in the physical problems (eg, vaginal pain and dryness) subscale. Survivors with sexual dysfunction, compared to those without sexual dysfunction, were more likely to score <40 on the physical (21.1% vs 12.7%, P = .01) and mental health (36.5% vs 18.2%, P < .01) summary scales of the SF-36. Only 2.9% of survivors with sexual dysfunction reported receiving intervention. CLINICAL IMPLICATIONS Health care providers should be aware of the increased risk of sexual dysfunction in this growing population, inquire about symptomology, and refer for appropriate intervention. STRENGTHS & LIMITATIONS Strengths of this study include the use of a validated tool for evaluating sexual function in a large population of clinically assessed female childhood cancer survivors. Limitations include potential for selection bias, and lack of clinically confirmed dysfunction. CONCLUSION Sexual dysfunction is prevalent among female childhood cancer survivors and few survivors receive intervention; further research is needed to determine if those with sexual dysfunction would benefit from targeted interventions. Bjornard KL, Howell CR, Klosky JL, et al. Psychosexual Functioning of Female Childhood Cancer Survivors: A Report From the St. Jude Lifetime Cohort Study. J Sex Med 2020;17:1981-1994.
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