What contributes to promote sexual health in cancer palliative care? A realist review

Donz Roxane; Russia Bruno; Barbaret Cécile; Debbie Braybrook; Perceau-Chambard Elise; Reverdy Thibaut; Economos Guillaume

doi:10.1093/sxmrev/qeae008

What contributes to promote sexual health in cancer palliative care? A realist review

Sex Med Rev. 2024 Mar 20:qeae008. doi: 10.1093/sxmrev/qeae008. Online ahead of print.

Authors

Donz Roxane^{1

2}, Russia Bruno³, Barbaret Cécile⁴, Debbie Braybrook⁵, Perceau-Chambard Elise¹, Reverdy Thibaut^{2

6}, Economos Guillaume^{1

2}

Affiliations

¹ Centre de soins palliatifs, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Benite 69495, France.
² Centre pour l'Innovation en cancérologie de Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon Sud, EA 3738, 69921 Oullins.
³ Hospitalisation à domicile, Centre Léon Bérard, Lyon 69008, France.
⁴ Service de soins palliatifs, CHU de Grenoble, La Tronche 38700, France.
⁵ Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London SE5 9PJ, United-Kingdom.
⁶ Oncology Department, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Benite 69495, France.

PMID: 38508856
DOI: 10.1093/sxmrev/qeae008

Abstract

Introduction: Sexuality is an important determinant of the overall health of a population and remains so at the end of life and in patients with advanced cancers. Despite the abundant literature on sexuality and intimacy, these topics have been rarely discussed in the context of cancer palliative care, and very few interventions to promote sexual health in patients undergoing cancer palliative care have been explored.

Objectives: In this study we sought to identify which factors and mechanisms contribute to promoting sexual health in cancer palliative care.

Methods: A realist review was performed according to the guidelines of the realist and meta-narrative evidence synthesis method guidelines. Articles published between January 2010 and June 2021 were searched in 4 databases. Records were screened for their relevance regarding a predefined list of context-mechanism-outcome (CMO) configurations. Abstracts were independently screened by 2 authors before the data were extracted from the full-text articles selected for inclusion. With the use of abductive and retroductive reasoning techniques, each article was examined for evidence of its contribution to one of the CMO configurations, which could be refined when relevant. The data were summarized according to the final CMO configurations.

Results: Of the 2056 articles identified, 38 articles were included in the review. The data reported in these articles contributed to 7 CMO hypotheses: (1) improving communication skills, (2) healthcare provider training, (3) reorganizing the patient environment in care settings or at home, (4) managing sexual symptoms and also general symptoms, (5 and 6) patient-centered counseling or couple counseling, and (7) lifting the taboo.

Conclusions: The findings reported here highlight various ways to improve sexual health for patients in cancer palliative care but are limited to genital cancers. Further research should consider all types of cancer rather than being restricted to genital cancers.

Keywords: neoplasm; palliative care; realist synthesis; sexual health.