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FACET - European Journal of Cancer Care July 2005. Evidence-based cancer care: sexuality White, I. 1. Search strategy Inclusion criteria: Years 1999-2004 inclusive English language only Keywords: SEX* AND CANCER Databases: PsycINFO Cinahl
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FACET - European Journal of Cancer Care July2005 Evidence-based cancer care: sexuality White, I.1 • Search strategy • Inclusion criteria: • Years 1999-2004 inclusive • English language only • Keywords: SEX* AND • CANCER • Databases: • PsycINFO Cinahl • BNI AMED • DH-Data Kings Fund Slide One *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • Search strategy • Exclusion criteria: • Fertility / infertility • Altered body image • Paediatric patients • AIDS – related cancers • Screening : sexuality as • cancer risk factor • Non-cancer patients / • professionals Slide Two *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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%) Slide Three *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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 • Women’s cancers papers 10 Slide Four *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • Patient populations(2) • Number of papers: • Testicular cancer 8 • Advanced cancer 8 • Haematological cancers 7 • Head & neck cancer 6 Slide Five *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • Patient populations(3) • Number of papers: • Bladder cancer 3 • Colorectal cancer 3 • Men’s cancers 3 • Radiotherapy patients 3 • Lung cancer 2 Slide Six *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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 Slide Seven *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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) Slide Eight *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • Relationship context • Individual focus 195 papers • Couple focus 30 papers prostate cancer 16 generic cancer 4 breast cancer 4 gynaecological cancer 3 • Others 3 papers Slide Nine *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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 Slide Ten *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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 Slide Eleven *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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 patient’s 1 attitudes to sexuality Slide Twelve *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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 Slide Thirteen *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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 Slide Fourteen *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) Professional communication regarding sexual concerns • 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 Slide Fifteen *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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 Slide Sixteen *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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 Slide Seventeen *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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 Slide Eighteen *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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-Oncology12, 267-279. • Katz A. (2003) Sexuality after Hysterectomy: a review of the literature and discussion of nurse’s role. Journal of Advanced Nursing 42, (3) 297-303. • Kelly D. (2004) Male sexuality in theory a nd practice. Nursing Clinics of North America39, 341-356. • 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 Institute92, (19) 1582-1591. Slide Nineteen *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • 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 & Physics44, (3) 497-506. • Rogers M. & Kristjanson LJ. (2002) The Impact on Sexual Functioning of Chemotherapy-induced Menopause in Women with Breast Cancer. Cancer Nursing25, (1) 57-65. • 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, 53-64. Slide Twenty *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc
FACET - European Journal of Cancer Care July 2005 Evidence-based cancer care: sexuality (continued) • Further reading (continued) • Waterhouse J. (1996) Nursing practice related to sexuality: a review and recommendations. Nursing Times Research1, (6) 412-418. • 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. Slide Twenty One *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwellpublishing.com/journals/ecc