Relationships, Body Image, and Intimacy: An Ontario pilot to encourage sexual health conversations between Medical Radiation Therapists and patients during cancer treatment

Abstract

Purpose: Ontario Health-Cancer Care Ontario (OH-CCO) released a guideline in 2016 on sexual health and cancer. This guideline recommends that the first step to addressing sexual health and dysfunction resulting from cancer and its treatment, is for healthcare providers to initiate sexual health conversations with patients. It is important to note that this responsibility lies with all healthcare providers at any step in the patient's cancer journey. To action this guideline, OH (CCO) implemented a pilot in four regional cancer centres (RCCs) in Ontario. Process: The Relationships, Body image, and Intimacy (RBI) pilot was implemented at four RCCs from June 2019 to February 2020. Front line medical radiation therapists (MRT(T)s) participated in the pilot, which included three interventions:1.MRT(T)s were identified at each pilot site to serve as RBI champion role models and facilitate the discussion between their colleagues and cancer patients about their sexual health needs2.RBI champions were trained on RBI issues in the cancer context, trained fellow MRT(T)s at their RCCs, and modelled best practice for sexual health conversations with cancer patients3.RBI scripts and resources were provided to support MRT(T)s in initiating RBI conversations with cancer patients Challenges: Barriers such as the development of needed resources for patients, lack of training and skills for MRT(T)s, and increasing comfort level with RBI topic were successfully addressed with continued education and training throughout the pilot. Additional challenges continue to exist around time constraints and language barriers. Outcomes: Quantitative and qualitative data were collected for pilot evaluation. Analysis has been completed and shared with the pilot sites, as well as with the other regional cancer centres. Before the pilot started, over 80% of MRT(T)s reported they did not initiate RBI conversations with patients. By the end of the pilot, over 52% of MRT(T)s reported initiating RBI conversations with all or almost all patients. Only 4% of MRT(T)s reported that they rarely initiated RBI conservations with patients. Pilot sites were tasked with developing a sustainability plan to help ensure that RBI conversations continue to be an element of best practice in patient education. Feedback from patients was positive and supported the continuation of MRT(T)s initiating RBI conversations. Sixty-five percent of patients reported being asked about RBI by their MRT(T) during radiation treatment. Conclusions: The RBI pilot was a novel initiative to support MRT(T)s addressing patients’ RBI concerns during cancer treatment. Over 57% of MRT(T)s would recommend the RBI champion model for other regional cancer centres. Work is in progress to leverage the learnings from this pilot to other health care provider disciplines and additional RCCs in Ontario, with the aid of the Radiation Therapy Community of Practice.