Effectiveness of a couple-based intervention on sexuality and intimacy among women in active cancer treatment: A quasi-experimental study.

PURPOSE: To evaluate the effectiveness of a strenghts-oriented therapeutic conversation intervention on confidence about how illness beliefs affect sexuality and intimacy and on perceived relationship quality among women in active cancer treatment and their partners. METHODS: A quasi-experimental single-group pre-post-follow-up design was used. Women in active cancer treatment and their intimate partners were randomly assigned to a nurse-managed couple-based intervention (experimental group, n = 30 couples) or wait-list (delayed intervention) control group (n = 27 couples) plus 4 additional couples who pilot tested feasibility of the intervention, prior to the RCT. However, baseline differences in demographic and clinical variables prevented comparisons between groups. Therefore, a repeated-one-group pre-post test setup was used, comparing women with cancer and their partners over three time points. The intervention consisted of three Couple-Strengths-Oriented Therapeutic Conversations (CO-SOTC) sessions. The participants also had access to web-based evidence-based educational information. Data were collected before intervention (T1, baseline), one to two weeks post-intervention (T2), and after a follow-up session at three months (T3). Data from 60 couples (N = 120) were analyzed. RESULTS: Significant differences were observed, for both women and intimate partners, over time in more confidence about how illness beliefs affected sexuality and intimacy (T1 versus T2, and T1 versus T3), and increased overall quality of the relationship (T1 versus T2, and T1 versus T3). No differences were found between dyad members' scores on illness beliefs or relationship quality at any time point. CONCLUSIONS: The CO-SOTC intervention was effective in supporting sexual adjustment among women in cancer treatment and their intimate partners. TRIAL REGISTRATION NUMBER: NCT03936400 at clinicaltrials.gov.

The Benefit of a Couple-Based Intervention Among Women in Active Cancer Treatment on Sexual Concerns: A Quasi-Experimental Study.

BACKGROUND: Sexuality-related problems are common in women with cancer, threatening their sexual well-being and intimate relationships. Evidence-based interventions addressing the full range of sexual concerns among women in active cancer treatment are scarce. OBJECTIVE: The aim of this study was to evaluate the benefits of a novel couple-based intervention focusing on sexual concerns among women undergoing cancer treatment, including a subgroup of women with breast cancer. A secondary aim was to assess changes in illness intrusiveness in daily life. METHODS: A quasi-experimental single-group pre-post follow-up design was used. The study was initially planned as a randomized controlled trial with waitlist control group receiving delayed intervention. However, substantial differences were observed in clinical and demographic variables between the treatment group and control group, resulting in using a single-group pre-post follow-up design. The intervention consists of 3 advanced nurse-led, face-to-face couple-based sessions supported by access to web-based information. RESULTS: Women in active cancer treatment participated in the study (n = 60) together with their partners (n = 60). The main results showed significant differences between time points in the outcome measures for concerns related to the sexual adverse effects of cancer treatment (T1 vs T2, and T2 vs T3), sexual concerns related to the women's partners (T1 vs T2), and for concerns related to communication with healthcare providers about sexuality-related issues (T1 vs T2). No significant changes were found over time with respect to illness interference on the intimacy or instrumental subscales. CONCLUSIONS: The results demonstrated that the approach of 3 couple-based therapeutic conversations is beneficial in reducing sexual concerns among women in active cancer treatment. IMPLICATIONS FOR PRACTICE: Advanced nurse practitioners can develop and offer brief psychoeducational support that is helpful in reducing sexual concerns among women in active cancer treatment.

A systematic review of characteristics of couple-based intervention studies addressing sexuality following cancer.

AIM: To describe the characteristics of couple-based intervention studies that address sexuality following cancer. BACKGROUND: Sexuality-related problems are common among cancer survivors and their partners. DESIGN: Systematic literature review with a narrative summary of results. DATA SOURCES: Electronic searches were conducted in PubMed, CINAHL and PsychINFO. We included studies published from 1 January 2009 - 31 December 2016. Additional information was retrieved by scrutinizing reference lists, conducting citation tracking and contacting authors. We included all types of quantitative intervention studies published in the English language which contained outcome measures corresponding to the neo-theoretical framework of sexuality-sexual function, sexual relationship and sexual self-concept. REVIEW METHODS: Our review was guided by the Joanna Briggs Institute reviewer's manual. Data were extracted and appraised using the standardized checklists for quantitative studies. This assessment was conducted independently by two reviewers. A third reviewer was involved if consensus could not be reached. RESULTS: Fourteen studies were included. Interventions were delivered face-to-face, by telephone or via the Internet. Sessions ranged from 1-8, with a duration from 2-22 weeks. Most studies offered ≥3 sessions. Interventions addressed unique concerns and/or provided general education. There was little agreement on the use of outcome measures. Most studies inadequately described fidelity to the study protocol and the training of interventionists. CONCLUSION: There was no clear consensus about how couple-based interventions are best structured. The results provide tentative evidence for how the quality of future research studies can be improved and how knowledge can be used in clinical practice.

Changes in attitudes, practices and barriers among oncology health care professionals regarding sexual health care: Outcomes from a 2-year educational intervention at a University Hospital.

PURPOSE: To examine the attitudes, practices and perceived barriers in relation to a sexual health care educational intervention among oncology health care professionals at the Landspítali-National University Hospital of Iceland. METHODS: The design was quasi experimental, pre - post test time series. A comprehensive educational intervention project, including two workshops, was implemented over a two year time period. A questionnaire was mailed electronically to all nurses and physicians within oncology at baseline (T1, N = 206), after 10 months (T2, N = 216) and 16 months (T3, N = 210). RESULTS: The response rate was 66% at T1, 45% at T2 and 38% at T3. At all time points, the majority of participants (90%) regarded communication about sexuality part of their responsibilities. Mean scores on having enough knowledge and training, and in six of eight practice issues increased significantly over time. Overall, 10-16% reported discussing sexuality-related issues with more than 50% of patients and the frequency was significantly higher among workshop attendants (31%) than non-attendants (11%). Overall, the most common barriers for discussing sexuality were "lack of training" (38%) and "difficult issue to discuss" (27%), but the former barrier decreased significantly by 22% over time. CONCLUSIONS: The intervention was successful in improving perception of having enough knowledge and training in providing sexual health care. Still, the issue remains sensitive and difficult to address for the majority of oncology health care professionals. Specific training in sexual health care, including workshops, should be available to health care professionals within oncology.