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癌症患者的性健康问题——放射治疗师认知水平的探索性混合方法研究

Sexual Health Issues in Patients with Cancer-An Exploratory Mixed Methods Study of the Awareness Levels of Radiation Therapists.

作者信息

Turner Angela

机构信息

Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Med Imaging Radiat Sci. 2019 Mar;50(1):106-112. doi: 10.1016/j.jmir.2018.08.005. Epub 2018 Nov 10.

Abstract

INTRODUCTION

Patients with cancer report dissatisfaction with care they receive in relation to changes affecting intimacy and relationships. Health care professionals describe barriers in providing support in these areas due to lack of time, training, education, and privacy. Radiation therapists (RTs) play a key role in cancer care, but there is little evidence in the literature of their role in sexual health care. This project investigated awareness levels of RTs in sexual health issues related to patients with cancer receiving radiation therapy.

METHODS

A prospective mixed methods approach was used for this investigation. Quantitative data was collected via an online questionnaire developed from the literature. Two hundred eighty-four RTs from two large cancer centers were eligible to participate; 84 responded (29%). Two focus groups were conducted with 15 volunteer RTs to validate questionnaire data and further explore the topic. Content analysis was used to identify key themes from the qualitative data.

RESULTS

RT respondents acknowledged the complexity of sexual health issues in patients with cancer. Eighty-five percent (n = 56) strongly agreed/agreed that all patients with cancer, regardless of cancer site, can experience issues which may affect sexual health. Ninety-two percent (n = 61) strongly agreed/agreed that sexual health is important for a persons' quality of life. As part of the radiation therapy treatment planning process, 54.5% of RTs (n = 31) strongly agreed/agreed that they consider the impact of physical side effects of radiation therapy on the sexual health of patients; during treatment delivery, 56% (n = 36) agreed/strongly agreed that they consider the physical side effects on their patients' sexual health.

CONCLUSIONS

Data indicated that RTs are aware that a cancer diagnosis and the subsequent treatments may lead to issues that affect sexual health. They are aware of the complex nature of sexual health and understand its importance in a persons' quality of life and that all patients with cancer regardless of site may experience issues which can impact their sexual health. Their responses suggest that they can relate their training and clinical practice to sexual health issues experienced by patients in their care. Current RT involvement in sexual health care is limited due to various process and environmental factors similar to those found in other health care professionals practice. By eliminating these barriers and supporting the inclusion of sexual health into the clinical practice of RTs, health care resources can be maximized to support the resolution of unmet needs of patients and their partners. In that way the quality of patient care services can be improved.

摘要

引言

癌症患者表示对他们所接受的与影响亲密关系和人际关系变化相关的护理不满意。医疗保健专业人员称,由于缺乏时间、培训、教育以及隐私问题,在这些领域提供支持存在障碍。放射治疗师(RTs)在癌症护理中发挥着关键作用,但文献中几乎没有关于他们在性健康护理方面作用的证据。本项目调查了放射治疗师对接受放射治疗的癌症患者性健康问题的认知水平。

方法

本调查采用前瞻性混合方法。通过从文献中开发的在线问卷收集定量数据。来自两个大型癌症中心的284名放射治疗师有资格参与;84人做出回应(29%)。与15名志愿放射治疗师进行了两个焦点小组讨论,以验证问卷数据并进一步探讨该主题。内容分析用于从定性数据中识别关键主题。

结果

参与调查的放射治疗师承认癌症患者性健康问题的复杂性。85%(n = 56)的人强烈同意/同意所有癌症患者,无论癌症部位如何,都可能经历影响性健康的问题。92%(n = 61)的人强烈同意/同意性健康对一个人的生活质量很重要。作为放射治疗治疗计划过程的一部分,54.5%的放射治疗师(n = 31)强烈同意/同意他们会考虑放射治疗的身体副作用对患者性健康的影响;在治疗实施过程中,56%(n = 36)的人同意/强烈同意他们会考虑身体副作用对患者性健康的影响。

结论

数据表明,放射治疗师意识到癌症诊断及后续治疗可能导致影响性健康的问题。他们意识到性健康的复杂性,理解其在一个人的生活质量中的重要性,并且所有癌症患者,无论部位如何,都可能经历影响其性健康的问题。他们的回答表明,他们能够将自己的培训和临床实践与所护理患者经历的性健康问题联系起来。由于与其他医疗保健专业人员实践中发现的类似的各种流程和环境因素,目前放射治疗师在性健康护理方面的参与有限。通过消除这些障碍并支持将性健康纳入放射治疗师的临床实践,可以最大限度地利用医疗保健资源,以支持解决患者及其伴侣未满足的需求。这样可以提高患者护理服务的质量。

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