Development of a conceptual framework to improve sexual wellbeing communication in routine prostate cancer care

Eilís McCaughan; Kader Parahoo; Carrie Flannagan; Roma Maguire; John Connaghan; Mary Steele; Samantha Thompson; Suneil Jain; Mike Kirby; Nuala Brady; Seán R O'Connor

doi:10.1016/j.pec.2020.01.014

Development of a conceptual framework to improve sexual wellbeing communication in routine prostate cancer care

Patient Educ Couns. 2020 Jun;103(6):1150-1160. doi: 10.1016/j.pec.2020.01.014. Epub 2020 Jan 20.

Authors

Affiliations

¹ Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland, UK. Electronic address: em.mccaughan@ulster.ac.uk.
² Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland, UK.
³ Department of Computer and Information Sciences, University of Strathclyde, Glasgow, UK.
⁴ Centre for Clinical and Community Applications of Health Psychology, Psychology, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.
⁵ Urology Department, Belfast City Hospital, Belfast, Northern Ireland, UK.
⁶ Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Northern Ireland, UK; Clinical Oncology, Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, Northern Ireland, UK.
⁷ Faculty of Health and Human Sciences, University of Hertfordshire and The Prostate Centre, London, UK.
⁸ Northern Health and Social Care Trust, Northern Ireland, UK.
⁹ Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland, UK; Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK.

PMID: 32029296
DOI: 10.1016/j.pec.2020.01.014

Abstract

Objective: To systematically develop a framework to improve sexual wellbeing communication in routine prostate cancer care.

Methods: The Theoretical Domains Framework was used to guide a multi-phase process used to identify components of the framework based on evidence reviews, semi-structured interviews and stakeholder workshops. 'Think-aloud' testing was used to explore usability, potential barriers and other factors relevant to implementation.

Results: A conceptual communication framework consisting of 'Engagement' (E), 'Assessment' (A), information and 'Support' (S) and 'Sign-posting' (Si) sections was developed. The framework emphasises routine engagement to normalise sexual concerns, brief, non-sensitive assessment, personalised advice based on treatment type and relationship status, and a mechanism for referral to additional support or self-management resources in the form of a patient and partner handout. Usability testing identified strategies to promote implementation.

Conclusions: The proposed framework is appropriate for use in routine practice and appears to be acceptable to patients, partners and healthcare professionals. Its use may help address gaps in sexual wellbeing support for men and partners living with prostate cancer. Further work will be conducted evaluating an online engagement tool, modelled on the framework.

Practice implications: The EASSi framework can facilitate and structure sexual wellbeing conversations and ensure fundamental but individualised support is provided routinely in prostate cancer care.

Keywords: Communication; Prostate cancer; Quality of life; Sexual wellbeing.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Communication
Health Personnel
Humans
Male
Models, Theoretical
Prostatic Neoplasms* / therapy
Sexual Behavior*