Sexual health care provision in cancer nursing care

a systematic review on the state of evidence and deriving international competencies chart for cancer nurses

Constantina Papadopoulou*, Caroline Sime, Kevin Rooney, Grigorios Kotronoulas

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

Background
Sexual health care should be an integral part of holistic, person-centred care for patients with cancer. Nurses can have a pivotal role, but nurse-led care in this context has been historically challenging.

Objectives
To update the state of scientific knowledge pertinent to nurses’ competencies in delivering sexual health care to patients with cancer; better understand moderating factors; and evaluate interventions developed/tested to enhance nurses’ competencies.

Design
Systematic literature review in line with published PRISMA Statement guidelines.

Data sources

Electronic bibliographic databases; journal content lists; reference lists of included studies; author/expert contact

Review methods
Nine electronic databases were searched (June 2008-October 2018) to identify studies employing diverse research methods. We applied pre-specified eligibility criteria to all retrieved records and integrated findings in a narrative synthesis.

Results
Of 2,614 returned articles, we included 31 unique studies. Five articles reported on two randomised controlled trials and three single-arm, before-and-after trials. Current evidence suggests that nurses’ knowledge and skill in providing sexual health care still varies widely across different settings, phases and cancers. A plethora of intra-personal, inter-personal, societal and organisational factors may hinder nurse-led care in this context. Nurses’ perceived professional confidence was repeatedly examined as influencing provision of care in this context; unfortunately, it was found lacking and complicated by unhelpful views and beliefs about SHC. Despite the magnitude of the problem, the few trials that tested, sexual health-targeted continuing professional development programmes for nurses, were of low-to-moderate methodological quality, while the associated high risk of methodological bias downgraded the evidence on the interventions’ effectiveness.

Conclusion
Our systematic review replicates previous findings and highlights a continuing problem: nurse-led provision of sexual health care in cancer care remains sub-optimal and challenging, due mainly to nurses’ assumptions and prejudices towards sexuality, lack of professional confidence in dealing with sensitive issues, and a complex health care system environment. To realistically deal with this problem, we propose a flexible, two-level chart to promote development of basic competence among all nurses caring for patients with cancer (entry-level), and facilitate subsequent transition to a more specialised, self-pursued role for a subset of nurses (champion-level). The chart itself can be relevant to an international audience, while it might be transferable to other long-term conditions. Accordingly, we propose additional rigorous research to test multi-component educational programmes, customised to meet entry-level and champion-level requirements to realise continuous nursing provision of sexual health care in cancer care.
Original languageEnglish
Article number103405
Number of pages11
JournalInternational Journal of Nursing Studies
Volume100
Early online date26 Aug 2019
DOIs
Publication statusE-pub ahead of print - 26 Aug 2019

Fingerprint

Oncology Nursing
Reproductive Health
Nursing Care
Nurses
Delivery of Health Care
Neoplasms
Bibliographic Databases
Patient-Centered Care
Nurse's Role
Sexuality
Research
Mental Competency
Nursing
Randomized Controlled Trials

Keywords

  • Nurse competencies
  • Sexuality
  • Fertility
  • Sexual health care
  • Cancer
  • Interventions
  • Systematic review

Cite this

@article{9eb038e146874953894bf3e6ad4a7206,
title = "Sexual health care provision in cancer nursing care: a systematic review on the state of evidence and deriving international competencies chart for cancer nurses",
abstract = "BackgroundSexual health care should be an integral part of holistic, person-centred care for patients with cancer. Nurses can have a pivotal role, but nurse-led care in this context has been historically challenging.ObjectivesTo update the state of scientific knowledge pertinent to nurses’ competencies in delivering sexual health care to patients with cancer; better understand moderating factors; and evaluate interventions developed/tested to enhance nurses’ competencies.DesignSystematic literature review in line with published PRISMA Statement guidelines. Data sourcesElectronic bibliographic databases; journal content lists; reference lists of included studies; author/expert contactReview methodsNine electronic databases were searched (June 2008-October 2018) to identify studies employing diverse research methods. We applied pre-specified eligibility criteria to all retrieved records and integrated findings in a narrative synthesis.ResultsOf 2,614 returned articles, we included 31 unique studies. Five articles reported on two randomised controlled trials and three single-arm, before-and-after trials. Current evidence suggests that nurses’ knowledge and skill in providing sexual health care still varies widely across different settings, phases and cancers. A plethora of intra-personal, inter-personal, societal and organisational factors may hinder nurse-led care in this context. Nurses’ perceived professional confidence was repeatedly examined as influencing provision of care in this context; unfortunately, it was found lacking and complicated by unhelpful views and beliefs about SHC. Despite the magnitude of the problem, the few trials that tested, sexual health-targeted continuing professional development programmes for nurses, were of low-to-moderate methodological quality, while the associated high risk of methodological bias downgraded the evidence on the interventions’ effectiveness.ConclusionOur systematic review replicates previous findings and highlights a continuing problem: nurse-led provision of sexual health care in cancer care remains sub-optimal and challenging, due mainly to nurses’ assumptions and prejudices towards sexuality, lack of professional confidence in dealing with sensitive issues, and a complex health care system environment. To realistically deal with this problem, we propose a flexible, two-level chart to promote development of basic competence among all nurses caring for patients with cancer (entry-level), and facilitate subsequent transition to a more specialised, self-pursued role for a subset of nurses (champion-level). The chart itself can be relevant to an international audience, while it might be transferable to other long-term conditions. Accordingly, we propose additional rigorous research to test multi-component educational programmes, customised to meet entry-level and champion-level requirements to realise continuous nursing provision of sexual health care in cancer care.",
keywords = "Nurse competencies, Sexuality, Fertility, Sexual health care, Cancer, Interventions, Systematic review",
author = "Constantina Papadopoulou and Caroline Sime and Kevin Rooney and Grigorios Kotronoulas",
year = "2019",
month = "8",
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journal = "International Journal of Nursing Studies",
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T1 - Sexual health care provision in cancer nursing care

T2 - a systematic review on the state of evidence and deriving international competencies chart for cancer nurses

AU - Papadopoulou, Constantina

AU - Sime, Caroline

AU - Rooney, Kevin

AU - Kotronoulas, Grigorios

PY - 2019/8/26

Y1 - 2019/8/26

N2 - BackgroundSexual health care should be an integral part of holistic, person-centred care for patients with cancer. Nurses can have a pivotal role, but nurse-led care in this context has been historically challenging.ObjectivesTo update the state of scientific knowledge pertinent to nurses’ competencies in delivering sexual health care to patients with cancer; better understand moderating factors; and evaluate interventions developed/tested to enhance nurses’ competencies.DesignSystematic literature review in line with published PRISMA Statement guidelines. Data sourcesElectronic bibliographic databases; journal content lists; reference lists of included studies; author/expert contactReview methodsNine electronic databases were searched (June 2008-October 2018) to identify studies employing diverse research methods. We applied pre-specified eligibility criteria to all retrieved records and integrated findings in a narrative synthesis.ResultsOf 2,614 returned articles, we included 31 unique studies. Five articles reported on two randomised controlled trials and three single-arm, before-and-after trials. Current evidence suggests that nurses’ knowledge and skill in providing sexual health care still varies widely across different settings, phases and cancers. A plethora of intra-personal, inter-personal, societal and organisational factors may hinder nurse-led care in this context. Nurses’ perceived professional confidence was repeatedly examined as influencing provision of care in this context; unfortunately, it was found lacking and complicated by unhelpful views and beliefs about SHC. Despite the magnitude of the problem, the few trials that tested, sexual health-targeted continuing professional development programmes for nurses, were of low-to-moderate methodological quality, while the associated high risk of methodological bias downgraded the evidence on the interventions’ effectiveness.ConclusionOur systematic review replicates previous findings and highlights a continuing problem: nurse-led provision of sexual health care in cancer care remains sub-optimal and challenging, due mainly to nurses’ assumptions and prejudices towards sexuality, lack of professional confidence in dealing with sensitive issues, and a complex health care system environment. To realistically deal with this problem, we propose a flexible, two-level chart to promote development of basic competence among all nurses caring for patients with cancer (entry-level), and facilitate subsequent transition to a more specialised, self-pursued role for a subset of nurses (champion-level). The chart itself can be relevant to an international audience, while it might be transferable to other long-term conditions. Accordingly, we propose additional rigorous research to test multi-component educational programmes, customised to meet entry-level and champion-level requirements to realise continuous nursing provision of sexual health care in cancer care.

AB - BackgroundSexual health care should be an integral part of holistic, person-centred care for patients with cancer. Nurses can have a pivotal role, but nurse-led care in this context has been historically challenging.ObjectivesTo update the state of scientific knowledge pertinent to nurses’ competencies in delivering sexual health care to patients with cancer; better understand moderating factors; and evaluate interventions developed/tested to enhance nurses’ competencies.DesignSystematic literature review in line with published PRISMA Statement guidelines. Data sourcesElectronic bibliographic databases; journal content lists; reference lists of included studies; author/expert contactReview methodsNine electronic databases were searched (June 2008-October 2018) to identify studies employing diverse research methods. We applied pre-specified eligibility criteria to all retrieved records and integrated findings in a narrative synthesis.ResultsOf 2,614 returned articles, we included 31 unique studies. Five articles reported on two randomised controlled trials and three single-arm, before-and-after trials. Current evidence suggests that nurses’ knowledge and skill in providing sexual health care still varies widely across different settings, phases and cancers. A plethora of intra-personal, inter-personal, societal and organisational factors may hinder nurse-led care in this context. Nurses’ perceived professional confidence was repeatedly examined as influencing provision of care in this context; unfortunately, it was found lacking and complicated by unhelpful views and beliefs about SHC. Despite the magnitude of the problem, the few trials that tested, sexual health-targeted continuing professional development programmes for nurses, were of low-to-moderate methodological quality, while the associated high risk of methodological bias downgraded the evidence on the interventions’ effectiveness.ConclusionOur systematic review replicates previous findings and highlights a continuing problem: nurse-led provision of sexual health care in cancer care remains sub-optimal and challenging, due mainly to nurses’ assumptions and prejudices towards sexuality, lack of professional confidence in dealing with sensitive issues, and a complex health care system environment. To realistically deal with this problem, we propose a flexible, two-level chart to promote development of basic competence among all nurses caring for patients with cancer (entry-level), and facilitate subsequent transition to a more specialised, self-pursued role for a subset of nurses (champion-level). The chart itself can be relevant to an international audience, while it might be transferable to other long-term conditions. Accordingly, we propose additional rigorous research to test multi-component educational programmes, customised to meet entry-level and champion-level requirements to realise continuous nursing provision of sexual health care in cancer care.

KW - Nurse competencies

KW - Sexuality

KW - Fertility

KW - Sexual health care

KW - Cancer

KW - Interventions

KW - Systematic review

U2 - 10.1016/j.ijnurstu.2019.103405

DO - 10.1016/j.ijnurstu.2019.103405

M3 - Article

VL - 100

JO - International Journal of Nursing Studies

JF - International Journal of Nursing Studies

SN - 0020-7489

M1 - 103405

ER -