Nursing School, Guilin Medical University, Guilin, China.
Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
J Sex Med. 2020 Jul;17(7):1326-1358. doi: 10.1016/j.jsxm.2020.03.004. Epub 2020 Apr 21.
Greater understanding of patient-reported barriers and facilitators to seeking and accessing sexual health services will help formulate strategies to assist gynecologic and breast cancer patients to overcome obstacles to accessing sexual health support because they typically do not seek sexual education and/or treatment when confronted with sexual concerns.
The objectives of this systematic review were to (i) explore the patient-reported barriers to seeking and accessing support for sexual problems in gynecologic and breast cancer survivors, and (ii) identify strategies used to successfully overcome the barriers to accessing sexual health information and/or treatment.
The main outcome measures included factors that prevent and/or facilitate gynecologic and breast cancer patients with sexual concerns seeking and accessing sexual health-related services.
Systematic searches of major electronic databases (Ovid MEDLINE, PsycINFO, CINAHL, ProQuest, and Chinese database CNKI) from January 2009 to July 2019 were used to identify the barriers and facilitators to seeking sexual education/treatment from the perspective of gynecologic and breast cancer survivors. A narrative synthesis was conducted.
20 studies met the inclusion criteria including 12 qualitative, 6 quantitative, and 2 mixed methods studies. 4 interconnected themes were derived from 13 subthemes relating to the barriers/facilitators to seeking and accessing sexual health support. The most common barriers were embarrassment/discomfort in discussing sexual concerns, perceived discomfort of healthcare providers in discussing sexual issues, limitations of the healthcare system to address sexual problems, and the multidimensional nature of sexuality. Help-seeking for sexual health concerns was facilitated by: (i) oncology health professionals initiating and conducting open, honest discussions around sexual concerns with patients; (ii) the availability of information in multiple forms; and (iii) appropriate timing of information provision according to women's preferences.
Oncology health professionals need to develop an open, honest, accepting communication style and be accessible to women with cancer and their partners within healthcare systems.
STRENGTHS & LIMITATIONS: The systematic review was conducted in accordance with guidelines. Variability in the primary aims and outcomes of the included studies precluded a meta-analysis.
Training programs for providers of oncology care should enhance their knowledge of sexual issues in gynecologic and/or breast cancer, enhance their communication skills with patients, and improve their ability to consult or refer patients to psycho-oncologists or other mental health professionals. Dai Y, Cook OY, Yeganeh L, et al. Patient-Reported Barriers and Facilitators to Seeking and Accessing Support in Gynecologic and Breast Cancer Survivors With Sexual Problems: A Systematic Review of Qualitative and Quantitative Studies. J Sex Med 2020;17:1326-1358.
更深入地了解患者在寻求和获得性健康服务方面的报告障碍和促进因素，将有助于制定策略，帮助妇科和乳腺癌患者克服获得性健康支持方面的障碍，因为当她们面临性问题时，通常不会寻求性教育和/或治疗。
本系统综述的目的是：(i)探讨妇科和乳腺癌幸存者报告的寻求和获得性问题支持方面的障碍；(ii)确定成功克服获得性健康信息和/或治疗障碍的策略。
主要观察指标包括阻止和/或促进有性问题的妇科和乳腺癌患者寻求和获得性健康相关服务的因素。
系统检索主要电子数据库(Ovid MEDLINE、PsycINFO、CINAHL、ProQuest 和中国数据库 CNKI)，从 2009 年 1 月至 2019 年 7 月，以确定从妇科和乳腺癌幸存者的角度来看，寻求性教育/治疗的障碍和促进因素。进行叙述性综合。
符合纳入标准的 20 项研究包括 12 项定性研究、6 项定量研究和 2 项混合方法研究。从与寻求和获得性健康支持相关的 13 个子主题中得出了 4 个相互关联的主题。寻求性健康支持的最常见障碍包括讨论性问题时的尴尬/不适、医疗保健提供者讨论性问题时的不适、医疗保健系统解决性问题的局限性，以及性的多维性质。寻求性健康问题的帮助受到以下因素的促进：(i)肿瘤学健康专业人员与患者就性问题进行开放、诚实的讨论；(ii)提供多种形式的信息；以及(iii)根据女性的喜好提供信息的适当时间。
肿瘤学健康专业人员需要在医疗体系内发展出开放、诚实、接受的沟通方式，并为癌症患者及其伴侣提供服务。
系统综述是按照指南进行的。纳入研究的主要目标和结果存在差异，因此无法进行荟萃分析。
为肿瘤学护理提供者提供的培训计划应增强他们对妇科和/或乳腺癌患者性问题的了解，增强他们与患者的沟通技巧，并提高他们咨询或转介患者给心理肿瘤学家或其他心理健康专业人员的能力。
