Matthew Andrew G, Incze Taylor, Stragapede Elisa, Guirguis Steven, Neil-Sztramko Sarah E, Elterman Dean S
Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Toronto, ON, M5G 1Z6, Canada.
Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, M5T 2SB, Canada.
BMC Health Serv Res. 2025 Jan 22;25(1):123. doi: 10.1186/s12913-024-12092-8.
Sexual dysfunction is prevalent among cancer survivors, significantly impacting patient and partner quality of life. Despite this, sexual health clinics (SHCs) remain rare in cancer centres across Canada. An innovative clinic was developed at Princess Margaret Cancer Centre in Toronto, Canada to address this significant gap in survivorship care. This study examines factors affecting the provision of sexual healthcare and the implementation of a sexual health clinic within a large urban centre.
The Quality Implementation Framework was used to explicate patient and provider experience and identify barriers and facilitators to integrating sexual healthcare into routine cancer care workflows. Healthcare providers and patients representing selected cancer types (prostate, cervical, ovarian, testicular, bladder, kidney, and head and neck cancer) participated in semi-structured interviews. Interviews were transcribed and analyzed using the Framework qualitative analysis protocol.
The analysis identified three organizing domains and ten themes that describe the unique aspects of the sexual healthcare experience and critical factors for sexual health implementation. Both patients and providers described a lack of sexual health support in the oncology setting and emphasized the need for comprehensive and personalized care. Limitations of current care provision included mutual silence between patients and providers due to discomfort in discussing sexual issues, insufficient provider confidence in delivering optimal sexual healthcare, and constraints related to space and time. Key Factors for implementing a sexual health clinic in oncology emphasized the importance of having a dedicated clinic, flexibility in service delivery, proactive patient engagement, and ongoing staff education.
Findings highlight significant challenges in addressing sexual health in an oncology setting, underscoring the need for specialized sexual health clinics that are integrated with, but distinct from, routine oncology care. This study further emphasizes the need for incorporating sexual healthcare in survivorship programs as well as the necessity of conducting thorough implementation research, involving multiple stakeholders, prior to launching new programs.
性功能障碍在癌症幸存者中很普遍，严重影响患者及其伴侣的生活质量。尽管如此，加拿大各地癌症中心的性健康诊所（SHC）仍然很少见。加拿大安大略省多伦多市玛格丽特公主癌症中心开发了一家创新诊所，以填补癌症幸存者护理方面的这一重大空白。本研究探讨了影响性健康护理提供的因素以及在大型城市中心设立性健康诊所的实施情况。
采用质量实施框架来阐述患者和提供者的经验，并确定将性健康护理纳入常规癌症护理工作流程的障碍和促进因素。代表选定癌症类型（前列腺癌、宫颈癌、卵巢癌、睾丸癌、膀胱癌、肾癌和头颈癌）的医疗保健提供者和患者参与了半结构化访谈。访谈记录并使用框架定性分析协议进行分析。
分析确定了三个组织领域和十个主题，描述了性健康护理体验的独特方面以及性健康实施的关键因素。患者和提供者都描述了肿瘤环境中性健康支持的缺乏，并强调了全面和个性化护理的必要性。当前护理提供的局限性包括患者和提供者之间因讨论性问题时的不适而相互沉默、提供者在提供最佳性健康护理方面信心不足以及与空间和时间相关的限制。在肿瘤学中实施性健康诊所的关键因素强调了设立专门诊所的重要性、服务提供的灵活性、积极的患者参与以及持续的员工教育。
研究结果突出了在肿瘤环境中解决性健康问题的重大挑战，强调需要设立与常规肿瘤护理相结合但又有所不同的专门性健康诊所。本研究进一步强调了将性健康护理纳入幸存者计划的必要性，以及在启动新计划之前进行涉及多个利益相关者的全面实施研究的必要性。
