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

Patient engagement in designing and publishing research in prostate cancer: a scoping review

Patients with cancer have the unique ability of being able to offer valuable insights into how cancer therapeutics may impact the overall patient experience and improve clinical outcomes. Patient engagement could therefore contribute to tailoring treatment strategies and research design according to patient needs. This study evaluated patient engagement in prostate cancer research by identifying patient input in the prostate cancer literature. We performed a keyword cluster analysis of articles from multiple databases and congresses in which patients provided input on disease management or were involved in study design, manuscript authorship or presentation of results (patient voice). In total, 112 studies were included. Patients were involved in the design of 11 studies and were credited as authors in four studies. This review suggests a lack of meaningful patient involvement in prostate cancer research and publications.

Feasibility and effectiveness of communication tools for addressing intimacy and sexuality in patients with cancer: a systematic review

PURPOSE

Patients diagnosed with cancer might experience changes in intimacy and sexuality due to the illness itself, treatment, or psychological and social factors. Healthcare professionals (HCPs) often feel reluctant to discuss these changes. This study aimed to provide an overview of the feasibility and effectiveness of communication tools that support communication regarding changes in intimacy or sexuality among patients with cancer.

METHODS

This is a systematic review. Databases are PubMed, Embase, CINAHL, PsycInfo, Web of Science and Cochrane Library from inception to June 2023. The Mixed Methods Appraisal Tool was used to assess included studies. Data were summarized in data charting forms.

RESULTS

In total 35 studies were included, published between 2001 and 2023. Most had a quantitative design and moderate methodological quality. In 11 studies, the PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy) was used. Tools were integrated in counselling sessions or training programmes for individual patients, couples, groups of patients, or HCPs. All tools were considered feasible by patients or HCPs. Twenty studies reported significant improvement in sexual functioning, quality of life, quality of care or combined outcomes.

CONCLUSION

Tools to support communication about changes in intimacy and sexuality among patients with cancer seem feasible and effective. The most commonly used tool, the PLISSIT model, proved to be feasible for HCPs and to have a positive effect on patients' and partners' sexual functioning and quality of life. Giving attention to changes in intimacy and sexuality seems to be important in itself, regardless of the communication tool or approach used.

Effects of a Brief E-Learning Resource on Sexual Attitudes and Beliefs of Healthcare Professionals Working in Prostate Cancer Care: A Pilot Study

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.

An evaluation of a therapeutic radiographer led "sexual care after radiotherapy" clinic

INTRODUCTION

Changes to sexuality and intimacy are a common consequence of a cancer diagnosis and treatment. Difficulties with sexual functioning and body image have been reported in over 50% of those treated for pelvic malignancies or breast cancer. The provision of sexual care support after radiotherapy is not adequately addressed by oncology professionals yet patients who have the opportunity to discuss sexual issues experience reduced sexual morbidity. This paper describes the evaluation and patient satisfaction of a novel and innovative clinic led by therapeutic radiographers for the management of sexual dysfunction.

METHOD

Quantitative data was collected from NHS Friends and Family Test (FFT) patient questionnaires to assess how patients rated the service on a scale from not likely to extremely likely to recommend the service. A qualitative, thematic analysis of the comments provided insight into patient satisfaction and experience.

RESULTS

Overall, 33 patients attended the clinic from 2019 to 2020. An 82% return rate of FFT questionnaire's showed 94% of patients were extremely likely and 6% were likely to recommend the service. Three emergent themes were the quality of information provision, the conduct of the staff member and the consultation experience. Patients stated that they were given a range of solutions and many cited a better understanding of their sexual issues.

CONCLUSION

Sexual function is an important component of quality of life and sexual dysfunction can cause on-going distress, interfering with recovery. This clinic offers an opportunity to discuss issues and provides an important mechanism of support for patients to live with and beyond their cancer diagnosis.

IMPLICATIONS FOR PRACTICE

Oncology professionals should receive training and education to raise sexual issues with their patients and ensure relevant services are provided.