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Patient-provider communication about sexual concerns in cancer: a systematic review.

ABSTRACT: PURPOSE:Cancer survivors' needs around sexual concerns are often unmet. The primary objective of this systematic review was to examine the prevalence of and factors associated with patient-provider communication about sexual concerns in cancer. METHODS:Using PRISMA guidelines, we searched PubMed/MEDLINE, PsychInfo, and CINAHL databases for peer-reviewed quantitative research papers (2000-2015) in cancer samples. Search terms across three linked categories were used (sexuality, communication, and cancer). The National Comprehensive Cancer Network (NCCN) Sexual Function Guidelines were used as a framework to categorize communication reported in each study. RESULTS:Twenty-nine studies from 10 countries (29 % in USA) were included. Studies assessed patients only (21), providers only (4), and both (4). Communication measures differed across studies and many lacked validity data. When reported by patients or providers, the average prevalence of discussing potential treatment effects on sexual function was 50 (60 % for men and 28 % for women) and 88 %, respectively. As reported by patients or providers, respectively, assessing patients' sexual concerns (10 and 21 %) and offering treatments (22 and 17 %) were measured in fewer studies and were reported less frequently. Both patients and providers (28 and 32 %, respectively) reported a low prevalence of other non-specific communication. Greater prevalence of communication was associated with male patient gender and more years of provider experience. CONCLUSIONS:Sexual issues go unaddressed for many cancer survivors, particularly women. Both patient and provider interventions are needed. IMPLICATIONS FOR CANCER SURVIVORS:Enhancing patient-provider communication about sexual concerns through evidence-based interventions could improve patient sexual function and quality of life.

SUBMITTER: Reese JB

PROVIDER: S-EPMC5357584 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Patient-provider communication about sexual concerns in cancer: a systematic review.

Reese Jennifer Barsky JB Sorice Kristen K Beach Mary Catherine MC Porter Laura S LS Tulsky James A JA Daly Mary B MB Lepore Stephen J SJ

Journal of cancer survivorship : research and practice 20161117 2

<h4>Purpose</h4>Cancer survivors' needs around sexual concerns are often unmet. The primary objective of this systematic review was to examine the prevalence of and factors associated with patient-provider communication about sexual concerns in cancer.<h4>Methods</h4>Using PRISMA guidelines, we searched PubMed/MEDLINE, PsychInfo, and CINAHL databases for peer-reviewed quantitative research papers (2000-2015) in cancer samples. Search terms across three linked categories were used (sexuality, com ...[more]

PMID: 27858322

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Project description:BACKGROUND:Limited patient-provider communication about sexual health is a crucial barrier to patients receiving treatment for sexual problems, and little is known about how patient sexual orientation is associated with patient-provider communication about sexual problems. OBJECTIVE:To describe the prevalence of patient-provider communication about sexual problems and the associations between communication and (1) persistent sexual problems and (2) whether those who identified as lesbian, gay, or bisexual had disclosed their sexual orientation to their clinicians. DESIGN:Cross-sectional, online survey PARTICIPANTS: 4325 English-speaking US adults from KnowledgePanel®, a probability-based sample of the civilian, noninstitutionalized population. MAIN MEASURES:Sexual orientation, disclosure of sexual orientation (being "out") to a health care provider, communication with health care providers regarding sexual problems or concerns, and persistent sexual problems or concerns. KEY RESULTS:In the past year, 8-15% of US adults discussed a sexual problem or concern with a health care provider. Between 23 and 42% of US adults reported persistent sexual problem(s) in the past year, and of those, 18% of gay/lesbian women, 20% of heterosexual women, 22% of bisexual women, 30% of gay men, 31% of heterosexual men, and 37% of bisexual men had discussed a sexual concern with a clinician. Eighty percent of gay/lesbian women and 70% of gay men had disclosed their sexual orientation to their regular health care provider, versus only 24% of bisexual men and women. Among those who were "out," 30% had ever talked to a clinician about a sexual problem compared with 17% of those who were not "out." A smaller proportion of lesbian women had ever received care or treatment for a sexual problem, 6% compared with 14-23% in the other groups. CONCLUSIONS:There are significant unmet needs among US adults with regard to patient-provider communication about sexual problems or concerns. Improving patient-provider communication about sexual health is critical.

Project description:BackgroundMost research on transitions of care has focused on the transition from acute to outpatient care. Little is known about the transition from outpatient to acute care. We conducted a systematic review of the literature on the transition from outpatient to acute care, focusing on provider-to-provider communication and its impact on quality of care.MethodsWe searched the MEDLINE, CINAHL, Scopus, EMBASE, and Cochrane databases for English-language articles describing direct communication between outpatient providers and acute care providers around patients presenting to the emergency department or admitted to the hospital. We conducted double, independent review of titles, abstracts, and full text articles. Conflicts were resolved by consensus. Included articles were abstracted using standardized forms. We maintained search results via Refworks (ProQuest, Bethesda, MD). Risk of bias was assessed using a modified version of the Downs' and Black's tool.ResultsOf 4009 citations, twenty articles evaluated direct provider-to-provider communication around the outpatient to acute care transition. Most studies were cross-sectional (65%), conducted in the US (55%), and studied communication between primary care and inpatient providers (62%). Of three studies reporting on the association between communication and 30-day readmissions, none found a significant association; of these studies, only one reported a measure of association (adjusted OR for communication vs. no communication, 1.08; 95% CI 0.92-1.26).DiscussionThe literature on provider-to-provider communication at the transition from outpatient to acute care is sparse and heterogeneous. Given the known importance of communication for other transitions of care, future studies are needed on provider-to-provider communication during this transition. Studies evaluating ideal methods for communication to reduce medical errors, utilization, and optimize patient satisfaction at this transition are especially needed.

Dataset Information

Patient-provider communication about sexual concerns in cancer: a systematic review.

Publications

Patient-provider communication about sexual concerns in cancer: a systematic review.

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