A brief intervention to enhance breast cancer clinicians' communication about sexual health: Feasibility, acceptability, and preliminary outcomes

Abstract

Objective Sexual concerns are often unaddressed for breast cancer patients; one reason is inadequate clinician training. We examined the feasibility, acceptability, and potential benefits of a novel intervention, improving Sexual Health and Augmenting Relationships through Education (iSHARE) for breast cancer clinicians. Methods Clinicians received training in communicating about sexual concerns with breast cancer patients. Intervention feasibility and acceptability were measured through enrollment/participation and postintervention program evaluations, respectively. Intervention effects were assessed through (1) clinician self‐reported beliefs about sexual health communication, assessed at baseline, post‐intervention, and 1‐ or 6‐month follow‐up, (2) clinical communication coded from audio recorded, transcribed clinic encounters at preintervention or postintervention, and (3) patient satisfaction with clinical care, reported immediately after the clinic visit. Patients also reported sociodemographic characteristics and level of sexual concerns. Results Seven breast cancer clinicians enrolled (88% participation), completed the intervention, and were audio recorded in clinic encounters with 134 breast cancer outpatients (67 each at preintervention or postintervention). Program evaluations supported intervention acceptability. Effect sizes suggest iSHARE increased clinicians' self‐efficacy (d = 0.27) and outcome expectancies for communicating about sexual concerns (d = 0.69) and reduced communication barriers (d = −0.14). Clinicians' sexual health communication behaviors increased from baseline to postintervention, including for raising the topic (28% vs 48%), asking questions (33% vs 45%), and offering information (18% vs 24%). Neither patient satisfaction nor duration of sexual health communication changed (mean duration less than 1 minute at both time points). Conclusions The iSHARE intervention was feasible and well received by clinicians and may change breast cancer clinicians' beliefs and communication behaviors regarding sexual health.

Can the provision of sexual healthcare for oncology patients be improved? A literature review of educational interventions for healthcare professionals

“…The function of 131 participants, either oncologist or nurse, was not specified [ 27 , 39 ]. Two studies focused specifically on healthcare professionals working with breast cancer patients and one on healthcare professionals working with prostate cancer patients [ 40 – 42 ]. The other studies did not specify an area of expertise of the participants.…”

“…The audio recording of clinic encounters was transcribed and coded for analysis. In addition, patients completed a questionnaire about the conversation with the healthcare professional immediately after the visit [ 40 ]. The time of follow-up varied between directly after the intervention and up to 16 months later.…”

“…They contained questions about knowledge, attitude, practice patterns, perceived barriers and comfort level. In addition, one study assessed clinical communication coded from audio-recorded conversations, patient satisfaction via a questionnaire and the duration of sexual health communication [ 40 ]. All measurements are summarized in Table 3 .…”

“…The frequency of discussing sexual health was measured in four studies [ 27 , 40 – 42 ]. In three, the frequency increased.…”

“…Three studies described the effect of the intervention on perceived barriers to discussing sexual health, such as lack of time, privacy, difficult topic to discuss, embarrassment and fear patient will react negatively. All showed a significant decrease in perceived barriers [ 27 , 39 , 40 ].…”