Sexual well-being in cancer and palliative care: an assessment of healthcare professionals’ current practice and training needs

A Pilot Study on the Quality of Sexual Life of Patients Receiving Home Palliative Care in Poland

Background: Quality of life, physical, psychic, and social functioning assessments in patients suffering from chronic, progressive, and incurable diseases are one of the most significant aims of the palliative care home teams. Sexuality and intimacy can be one of the most important elements of a person’s life, even at the end of it. Unfortunately, there is very little interest in this topic among medical staff of palliative care units. The objective of the study: The aim of this study was to assess the health status, the quality of life, the quality of sexual life, and the recognition and resolution of sexual problems by the palliative care team in adult patients in the advanced stage of terminal illness, who were receiving home palliative care. Research methods: The study involved 342 adult patients in the advanced stage of incurable, progressive disease, covered by home palliative care in 15 facilities in Poland. A generic EuroQoL 5-Dimension 3-Level health and quality of life assessment questionnaire and a questionnaire developed by the researchers, including questions about sexual problems, were used in this prospective study. Results: The presented results are the part of the more extensive study. The assessment of health status and quality of life of the study patients showed that the evaluation was the lowest for performing ordinary daily activities. The quality of sexual life after diagnosis in more than half of the study patients has worsened. Almost half of the respondents felt that the palliative care team did not recognize or address their sexual concerns. Patients indicated nurses and physicians as the members of the palliative care team most helpful in identifying and addressing sexual concerns. Conclusions: Members of the palliative care team should receive training in communication with patients concerning their sexual life, their needs and expectations and have knowledge about options for obtaining specialized sexological care. It is necessary to prepare and validate simple tools that will facilitate the initiation of appropriate communication between patients and members of the medical staff. It will be important to conduct more detailed and targeted research on sexuality and intimacy in the Polish palliative care patient population.

Correlation Between Needs Satisfaction and Behavioral Intentions of Sexual Health Care

BACKGROUND

This study aimed to evaluate correlations between female nurses' needs satisfaction and behavioral intentions for providing sexual health care and to assess moderating effects of learning needs on that correlation.

METHOD

A total of 300 female RNs were enrolled. Two validated instruments were used to collect information on participants' learning needs, needs satisfaction, and behavioral intentions for providing sexual health care.

RESULTS

Adjusted multivariable regression analysis revealed significant moderating effects of medium and low learning needs on correlations between needs satisfaction and behavioral intentions (medium learning needs: β = 0.282, 95% CI = 0.075, 0.490; p = .008; low learning needs: β = 0.293, 95% CI = 0.033, 0.553; p = .027), while no moderating effect was observed in those with high learning needs.

CONCLUSION

Needs satisfaction was significantly correlated with behavioral intentions of sexual health care in medium and low learning needs groups. [J Contin Educ Nurs. 2020;51(10):457-464.].

Feasibility of advanced practice nursing in lung cancer consultations during early treatment: A phase II study

PURPOSE

There are limited data on the effectiveness of Advanced Practice Nurses in Lung Cancer (APNLC). Previous studies have demonstrated barriers to investigation including low recruitment and high attrition rates in lung cancer population. The primary aim of this study was to assess the feasibility of APNLC consultations and the ability to collect patient-reported outcome measures (PROMs) during first-line treatment. The secondary aim was to describe changes in self-efficacy for managing lung cancer-related symptoms, symptom intensity/burden and unmet supportive care needs of APNLC patients during first-line treatment.

METHODS

An exact single-stage phase II design was applied. We recruited a consecutive sample of newly diagnosed lung cancer patients receiving systemic treatment in a Swiss oncology outpatient center. The intervention consisted of four systematic, alternating face-to-face/telephone consultations during first line-treatment. Feasibility of the study was defined by at least 55% of patients receiving all scheduled APNLC-led consultations and completing PROMs assessments at the three timepoints.

RESULTS

In total, 35/46 (76%) (95% CI, 0.61 to 0.87) of patients met the feasibility criteria receiving all scheduled APNLC consultations. Fifty-six percent (26/46) (95% CI, 0.41 to 0.71) completed the PROMs at the three timepoints. Self-efficacy for managing symptoms remained stable, intensity of predominant symptoms increased. Unmet information needs decreased significantly while psychological and sexuality related needs increased over time.

CONCLUSION

Results were promising for the feasibility of the APNLC consultation and the ability to collect PROMs. Further investigations are needed to increase the impact of the APNLC consultations on symptom intensity and sexual and psychological needs.