Nurse-patient sexual health communication in gynaecological cancer follow-up: A qualitative study from nurses' perspectives

Self-reported Sexual Health-Related Outcomes in Gynecological Cancer Survivors: Results From a Quasi-experimental Multicenter Intervention Study on Follow-up After Gynecological Cancer Treatment

BACKGROUND

Gynecological cancer survivors often face sexual health challenges posttreatment, making interventions to address these issues essential.

OBJECTIVE

The aim of this study was to investigate changes in sexual health-related outcomes among gynecological cancer survivors comparing 2 different follow-up models.

METHODS

This preplanned substudy utilized data from the Lifestyle and Empowerment Techniques in Survivorship of Gynecologic Oncology study. Participants were assigned to either the intervention or control group based on their treatment hospital. The control group received standard follow-up care, whereas the intervention group received shared follow-up care with sexual health communication. Analyses included 686 participants with sexual activity as the primary outcome. Secondary outcomes included feelings of reduced physical attractiveness for all, sexual enjoyment and vaginal dryness (sexually active participants), and reasons for sexual inactivity (sexually inactive participants). Assessments were conducted at the end of treatment and at 6 and 12 months posttreatment.

RESULTS

No statistically significant group differences were found in any of the outcomes at 12 months. The intervention group showed a more favorable trend in sexual activity at 6 months, not sustained at 12 months. Both groups experienced an increase in vaginal dryness. The absence of a partner was the most common reason for sexual inactivity.

CONCLUSIONS

Findings suggest that nurse-led sexual health communication during routine follow-up consultations may have a limited impact on the sexual health-related outcomes measured in this study.

IMPLICATIONS FOR PRACTICE

More intensive and individualized interventions may be necessary for significant improvements in the outcomes of this study.

Gynecological cancer survivors' experiences with sexual health communication in nurse-led follow-up consultations

INTRODUCTION

Gynecological cancer and its treatment may cause sexual difficulties in terms of physical and psychosocial health. Considering the essential role that nurses play in cancer care, they are well positioned to be ideal providers for addressing sexual health concerns in the follow-up phase of gynecological cancer. The aim of this study was to gain in-depth knowledge of how gynecological cancer survivors experience sexual health communication in nurse-led follow-up consultations.

MATERIAL AND METHODS

Using a qualitative hermeneutic approach, we conducted individual semi-structured interviews with 17 women from five different hospitals in Norway between April 4, 2022, and June 2, 2022. The women participated in a large intervention study on cancer follow-up that included sexual health as one of several topics addressed by trained nurses in three consultations in the first year of follow-up. A five-stage Gadamerian-inspired research method was utilized for data collection and analysis.

RESULTS

We identified three themes: (1) the importance of nurses listening to the women's own perceptions of sexuality, (2) post-treatment sexual challenges influence the women's need to communicate about sexual health, and (3) nursing communication can help women regain their sexual health.

CONCLUSIONS

Women who have undergone treatment for gynecological cancer find communication with trained nurses regarding sexual health beneficial. We recommend integration of trained nurses in the follow-up team. The nurses should adjust communication according to each gynecological cancer survivor's unique understanding of sexuality and inform women with sexual health concerns at that end of treatment, that sexual health can improve during follow-up.