Developing a Framework Addressing the Sexual Health Needs of Patients Treated with Head and Neck Radiation Treatment

Abstract

Aim: Head and neck (H&N) cancer patients do not receive treatment to their sexual organs, but these patients undergo a multimodality approach to treatment and its effects may still negatively affect their sexual health (SH). Radiation therapists (RTs) have a unique opportunity to develop a strong rapport with patients and to discuss sensitive issues related to relationship, body image and intimacy (RBI). This project aimed to address the SH needs of our H&N patients by providing RTs at our institution with the knowledge and skills to provide SH information to our patients. We also addressed increasing our accessibility to SH information by creating a specific SH document tailored to help our patients who are receiving H&N radiation treatment. Process: This Quality Innovation involved a multidisciplinary collaborative effort. We surveyed our staff to identify the perceived barriers in preventing RTs from having a SH conversation with their H&N patients. This needs assessment allowed us to identify how we can best help our staff. Working with our institution's patient education and patient partners groups, we created a patient education document on SH concerns for patients receiving H&N radiation treatment. We also created education sessions for our RTs to improve their knowledge about SH concerns. The workshops covered the impact of sexual dysfunction in oncology; clinical approaches to optimizing sexual healthcare in oncology; and provided future direction on how to access resources for our patients. Finally, we standardized the procedures and improved RT practical skills by creating documentation processes and conversational scripts for staff to help them initiate conversations about these sensitive topics. Benefits/Challenges: A challenge we experienced during our project included inconsistent staffing due to COVID19 interruptions. This project experienced a 7 month pause due to clinical demands at our institution. In addition, our team lost a team champion as they had left the institution. This challenge was rectified by recruiting extra team champions to help facilitate this project. The benefits of our quality initiative interventions included increasing our staff knowledge and comfort levels in having SH conversations with our H&N patients through educational staff workshops. For consistent staff delivery, we standardized the procedure and provided staff with conversational scripts so that staff could start a SH conversation with their patients. Impact/Outcomes: This quality initiative is midway through completion. Four team champions of this project were able to receive SH training in oncology, and other team members have various experience in sexual health care in oncology. So far, we have conducted one educational SH workshop for staff. Based on participant feedback, staff were motivated and eager to increase their knowledge and skill levels. Another education session will be organized for early 2022, focused on H&N sexual health. Prior to clinical implementation, the champions piloted the process with patients. From participant interviews, patients were very appreciative and accepting of SH information from RTs. This initiative will be fully implemented in late January.