采用改良 Delphi 法筛选评估前列腺癌治疗后被忽视的性功能副作用的筛查项目。

A modified Delphi study to identify screening items to assess neglected sexual side-effects following prostate cancer treatment.

机构信息

Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, 719 Umbilo Rd, Umbilo, Berea, 4001, South Africa.

Clinical Head of Unit: Paediatrics, King Edward VIII Hospital, and Clinical Researcher Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, 719 Umbilo Rd, Umbilo, Berea, 4001, South Africa.

出版信息

BMC Urol. 2022 Mar 11;22(1):34. doi: 10.1186/s12894-022-00982-0.

DOI:10.1186/s12894-022-00982-0

PMID:35277157

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8915514/

Abstract

BACKGROUND

Neglected sexual side effects (NSSE) are a group of less common sexual side effects that may present after Prostate Cancer (PCa) treatment. There is currently no valid and reliable tool to identify these side effects. A modified Delphi study is an effective way of developing the content of such a screening tool.

METHODS

A modified Delphi study was used to obtain consensus from a multi-disciplinary group of experts over 3 rounds during a 12 week period. Ten statements were presented containing 8 closed-ended statements on individual NSSEs, and 2 open-ended statements on psychosocial impact related to NSSE. Consensus was defined as a 75% strongly agree achievement on each statement, or the final statement evolution at the end of 3 rounds. Statement support in each round was determined by mean, standard deviation and range, after a numerical value was allocated to each statement during specific rounds. All three rounds were structured and suggestions and additions were incorporated in the statement evolution of the three rounds.

RESULTS

Thirty-five participants were invited, and 27 completed Round 1 (RD 1), 23 participants completed RD2, and 20 participants completed RD3. All 3 rounds were completed in 12 weeks. Statement 1 (sexual arousal incontinence), statement 2 (climacturia) and statement 3 (orgasm intensity) reached consensus after RD2, and statement 9 (sexual dysfunction impact) and statement 10 (experiences) were removed after RD3. Statement 4 (orgasmic pain), statement 5 (anejaculation), statement 6 (sensory disturbances), statement 7 (penile length shortening) and statement 8 (penile curvature) were finalised after the conclusion of RD3. Statements 1-3 were the most stable statements with the most support and least amount of disagreement. Statements 4-8 were less stable, but support for them improved over the 3 rounds. Statements 9-10 both had good stability, but the support indicated that they needed to be removed from the set of statements. Statement 5 had the poorest range due to an outlier opinion.

CONCLUSIONS

Consensus was reached on the items making up the NSSE screening tool. Health care practitioners will be able to use this tool to identify the evidence of NSSE after PCa treatment. Further testing will be undertaken to confirm the reliability and validly of the tool.

摘要

背景

被忽视的性功能副作用（NSSE）是一组不太常见的性功能副作用，可能在前列腺癌（PCa）治疗后出现。目前没有有效的、可靠的工具来识别这些副作用。改良 Delphi 研究是一种开发此类筛选工具内容的有效方法。

方法

改良 Delphi 研究在 12 周内通过 3 轮，从多学科专家小组获得共识。提出了 10 项陈述，其中包括 8 项关于个体 NSSE 的封闭式陈述，以及 2 项与 NSSE 相关的心理社会影响的开放式陈述。共识定义为每项陈述的 75%强烈同意，或在 3 轮结束时的最终陈述演变。在特定轮次中为每个陈述分配数值后，通过平均值、标准差和范围确定每个轮次的陈述支持度。所有 3 轮都进行了结构化处理，并在 3 轮的陈述演变中提出了建议和补充。

结果

邀请了 35 名参与者，其中 27 名完成了第 1 轮（RD1），23 名参与者完成了第 2 轮（RD2），20 名参与者完成了第 3 轮（RD3）。所有 3 轮都在 12 周内完成。第 2 轮完成后，第 1 项（性唤起性尿失禁）、第 2 项（射精后尿失禁）和第 3 项（性高潮强度）达成共识，第 3 轮完成后，第 9 项（性功能障碍影响）和第 10 项（经历）被删除。第 4 项（性高潮疼痛）、第 5 项（不射精）、第 6 项（感觉障碍）、第 7 项（阴茎长度缩短）和第 8 项（阴茎弯曲）在第 3 轮结束后最终确定。第 1-3 项是最稳定的陈述，得到了最多的支持和最少的分歧。第 4-8 项的稳定性较差，但在 3 轮中得到了改善。第 9-10 项都具有良好的稳定性，但支持表明需要将它们从陈述集中删除。第 5 项的范围最差，因为有一个离群值的意见。