Abstract
BackgroundLong-term side-effects associated with different prostate cancer treatment approaches are common. Sexual challenges are the most frequently occurring issues and can result in increased psychological morbidity. It is recognized that barriers to communication can make initiating discussions around sexual concerns in routine practice difficult. Health care professionals need to routinely initiate conversations, effectively engage with patients, and assess needs in order to provide essential support. One proposed method that could support health care professionals to do this involves the use of prompts or structured frameworks to guide conversations.ObjectiveThis study aimed to assess feasibility, acceptability, and satisfaction with the tablet-based Engagement, Assessment, Support, and Sign-posting (EASSi) tool designed to facilitate and structure sexual well-being discussions in routine prostate cancer care.MethodsHealth care professionals (n=8) used the EASSi tool during 89 posttreatment appointments. Quantitative data were recorded based on program usage and surveys completed by health care professionals and patients. Qualitative data exploring perceptions on use of the tool were gathered using semistructured interviews with all health care professionals (n=8) and a sample of patients (n=10).ResultsSurveys were completed by health care professionals immediately following each appointment (n=89, 100%). Postal surveys were returned by 59 patients (66%). Health care professionals and patients reported that the tool helped facilitate discussions (81/89, 91% and 50/59, 85%, respectively) and that information provided was relevant (82/89, 92% and 50/59, 85%, respectively). The mean conversation duration was 6.01 minutes (SD 2.91). Qualitative synthesis identified the tool’s ability to initiate and structure discussions, improve the “depth” of conversations, and normalize sexual concerns.ConclusionsThe EASSi tool was appropriate and acceptable for use in practice and provided a flexible approach to facilitate routine brief conversations and deliver essential sexual well-being support. Further work will be conducted to evaluate the effectiveness of using the tablet-based tool in prostate cancer care settings.
Highlights
BackgroundProstate cancer is the single most common cancer among men [1,2], and long-term side-effects associated with different treatment approaches are common [3]
Health care professionals and patients reported that the tool helped facilitate discussions http://cancer.jmir.org/2020/2/e20137/
Changes to sexual function are subsequently regarded as a major issue that can result in higher levels of anxiety, depression, relational dissatisfaction, and reduced overall quality of life [9,10]
Summary
BackgroundProstate cancer is the single most common cancer among men [1,2], and long-term side-effects associated with different treatment approaches are common [3]. Current guidelines [11,12] support delivery of psychosexual care for prostate cancer patients and recommend a minimal level of support throughout all phases of care. This includes provision of information tailored to needs, advice about potential adverse effects of treatment, and ongoing access to specialist services including erectile dysfunction clinics. Men frequently report that they do not receive adequate information and support to manage sexual concerns. This has been associated with increased psychological morbidity [16,17]. One proposed method that could support health care professionals to do this involves the use of prompts or structured frameworks to guide conversations
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