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FACET - European Journal of Cancer Care July 2005 slides available at: www.blackwellpublishing.com/journals/ecc Evidence-based cancer care: sexuality White,

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Presentation on theme: "FACET - European Journal of Cancer Care July 2005 slides available at: www.blackwellpublishing.com/journals/ecc Evidence-based cancer care: sexuality White,"— Presentation transcript:

1 FACET - European Journal of Cancer Care July 2005 slides available at: Evidence-based cancer care: sexuality White, I. 1 Slide One *Click on View; Notes Page for explanatory notes Search strategy Inclusion criteria: Years inclusive English language only Keywords: SEX* AND CANCER Databases: PsycINFOCinahl BNIAMED DH-Data Kings Fund

2 FACET - European Journal of Cancer Care July 2005 slides available at: Evidence-based cancer care: sexuality (continued) Slide Two *Click on View; Notes Page for explanatory notes Search strategy Exclusion criteria: Fertility / infertility Altered body image Paediatric patients AIDS – related cancers Screening : sexuality as cancer risk factor Non-cancer patients / professionals

3 FACET - European Journal of Cancer Care July 2005 slides available at: Evidence-based cancer care: sexuality (continued) Slide Three *Click on View; Notes Page for explanatory notes Search results: 263 sources Quantitative research 90 (34%) papers Qualitative research 82 (31%) papers Professional opinion 65 (25%) papers Literature reviews 21 (8%) Books / book chapters 5 (2%)

4 FACET - European Journal of Cancer Care July 2005 slides available at: Evidence-based cancer care: sexuality (continued) Slide Four *Click on View; Notes Page for explanatory notes Patient populations (1) Number of papers: Prostate cancer papers 80 Breast cancer papers 63 (included 1 x male breast cancer) Gynaecological cancer 32 papers Generic cancer papers 21 Womens cancers papers 10

5 FACET - European Journal of Cancer Care July 2005 slides available at: Evidence-based cancer care: sexuality (continued) Slide Five *Click on View; Notes Page for explanatory notes Patient populations (2) Number of papers: Testicular cancer 8 Advanced cancer 8 Haematological cancers 7 Head & neck cancer 6

6 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Six *Click on View; Notes Page for explanatory notes slides available at: Patient populations (3) Number of papers: Bladder cancer 3 Colorectal cancer 3 Mens cancers 3 Radiotherapy patients 3 Lung cancer 2

7 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Seven *Click on View; Notes Page for explanatory notes slides available at: Treatment context (1) Number of papers: Multi-modal cancer 152 therapy or modality not defined Active surveillance 3 (prostate cancer) Surgery (includes 44 prophylactic & reconstructive procedures) Radiotherapy 15

8 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Eight *Click on View; Notes Page for explanatory notes slides available at: Treatment context (2) Number of papers: Chemotherapy 13 BMT / Stem Cell 8 Transplant Hormone therapy 8 Palliative / terminal care 9 Medication effects 2 (e.g. chronic opioid use)

9 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Nine *Click on View; Notes Page for explanatory notes slides available at: Relationship context Individual focus 195 papers Couple focus 30 papers prostate cancer 16 generic cancer 4breast cancer 4gynaecological cancer 3 Others 3 papers

10 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Ten *Click on View; Notes Page for explanatory notes slides available at: Development / evaluation of assessment methods: research context (including QOL studies ) Total number of papers 20 QOL tool validation 10 with sexuality component Patient specific assessment 5 methods with sexuality component e.g. mastectomy adjustment scale Sexual behaviour / attitude 5 assessment methods

11 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Eleven *Click on View; Notes Page for explanatory notes slides available at: Implementation / evaluation of clinical assessment methods Total number of papers 3 Assessing psychological morbidity in women with breast cancer (included sexuality component) Assessing sexual function post radiotherapy Use of the better model of sexuality

12 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Twelve *Click on View; Notes Page for explanatory notes slides available at: Development or testing of a psychosexual intervention Total number of papers 13 Cognitive / behavioural & 7 other brief therapy intervention (group or individual) Sexuality patient education 3 programme (group or individual) Provision of sexuality 2 patient information booklets Addressing patients 1 attitudes to sexuality

13 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Thirteen *Click on View; Notes Page for explanatory notes slides available at: Evaluation of a service or role addressing sexuality issues Total number of papers 16 Provision of patient 5 information booklets Impact of Clinical Nurse 3 Specialist (CNS) role on sexual concerns Role and efficacy of patient 2 support groups addressing sexual concerns

14 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Fourteen *Click on View; Notes Page for explanatory notes slides available at: Evaluation of a service or role addressing sexuality issues 1 paper addressed each of the following: Role of social worker (palliative care) Supportive care service provision (included sexual counselling) Sexuality counselling provision Cancer nurses role in addressing sexuality Sexual health programme evaluation Needs assessment re sexual concerns

15 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Fifteen *Click on View; Notes Page for explanatory notes slides available at: Total number of papers 10 Improving patient / HCP 5 communication about sexual issues Facilitating patient discussion 2 of sexual concerns and treatment choice Social construction of gender 2 and sexuality in medical literature Raising profile of sexual 1 health assessment among health care professionals Professional communication regarding sexual concerns

16 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Sixteen *Click on View; Notes Page for explanatory notes slides available at: Evidence deficits for practice (1) Descriptive studies of prevalence or nature of sexual morbidity dominates Limited study of sexuality as an element of QOL research as opposed to main focus Functionalist perspective defines sexual morbidity Biomedical perspective defines clinical interventions

17 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Seventeen *Click on View; Notes Page for explanatory notes slides available at: Evidence deficits for practice (2) Limited focus on colorectal, head and neck or haemato-oncology patients, despite presence of significant sexual morbidity in practice Limited focus on couple perspective yields an incomplete understanding of the sexual difficulty Inadequate focus on clinical assessment of sexual difficulties in cancer care Inadequate focus on clinical interventions

18 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Eighteen *Click on View; Notes Page for explanatory notes slides available at: Evidence development priorities for sexuality in cancer care Study sexual consequences of cancer in its own right as well as a component of QOL Draw on existing psychosexual research themes and methods in designing studies within cancer care Incorporate analysis of patient, partner, relationship and health professional perspectives in study of sexual difficulties and their resolution Increase the number of studies that address clinical assessment of sexual difficulties in cancer care Increase the number of intervention studies

19 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Nineteen *Click on View; Notes Page for explanatory notes slides available at: Further reading Heath H. & White I. (2002) The Challenge of Sexuality in Healthcare, Blackwell Science, Oxford. Juraskova I, Butow P, Robertson R, Sharpe L, McLeod C & Hacker N (2003) Post-Treatment Sexual Adjustment Following Cervical and Endometrial Cancer: A Qualitative Insight. Psycho-Oncology 12, Katz A. (2003) Sexuality after Hysterectomy: a review of the literature and discussion of nurses role. Journal of Advanced Nursing 42, (3) Kelly D. (2004) Male sexuality in theory a nd practice. Nursing Clinics of North America 39, Potosky AL., Legler J., Albertsen PC., Stanford JL., Gilliland FD., Hamilton AS., Eley JW., Stephenson RA. & Harlan LC. (2000) Health Outcomes After Prostatectomy or Radiotherapy for Prostate Cancer: Results from the Prostate Cancer Outcomes Study. Journal of the National Cancer Institute 92, (19)

20 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Twenty *Click on View; Notes Page for explanatory notes slides available at: Further reading (continued) Roberts H. (2002) Sexuality Expression for People with Disfigurement. In: Heath H & White I (eds) The Challenge of Sexuality in Healthcare. Blackwell Science, Oxford. Robinson JW., Faris PD. & Scott CB. (1999) Psychoeducational Group Increases Vaginal Dilation for Younger Women and Reduces Sexual Fears for Women of all Ages with Gynaecological Carcinoma Treated with Radiotherapy. International Journal of Radiation Oncology, Biology & Physics 44, (3) Rogers M. & Kristjanson LJ. (2002) The Impact on Sexual Functioning of Chemotherapy-induced Menopause in Women with Breast Cancer. Cancer Nursing 25, (1) Schover LR. (1997) Sexuality and fertility after cancer. John Wiley & Sons Inc. New York. Shell JA. & Miller ME. (1999) The Cancer Amputee and Sexuality. Orthopaedic Nursing Sept/Oct,

21 FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Slide Twenty One *Click on View; Notes Page for explanatory notes slides available at: Further reading (continued) Waterhouse J. (1996) Nursing practice related to sexuality: a review and recommendations. Nursing Times Research 1, (6) Wells D. (ed) (2000) Caring for Sexuality in Health & Illness. Churchill Livingstone, Edinburgh. White I. (2003) Sexuality and Fertility In: Faithfull S & Wells M (eds) Supportive Care in Radiotherapy. Churchill Livingstone, Edinburgh.


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