Development and validation of a guideline on sexual and reproductive health of breast cancer survivors in Iran: a mixed methods study protocol

Abstract

Background Sexual and reproductive health problems significantly decrease quality of life in survivors of breast cancer. The best approach is to provide services according to evidence-based guidelines developed based on their practical context. Here, we aim to develop and validate a guideline on the sexual and reproductive health of breast cancer survivors in Iran. Methods The guideline will be developed and validated using an exploratory sequential mixed methods approach in three phases: (1) describing sexual and reproductive health needs of survivors of breast cancer in Iran and the health services they receive in this regard, (2) performing a systematic review of existing guidelines, resources, and documents on the sexual and reproductive health of breast cancer survivors worldwide, and (3) developing and validating a guideline on the sexual and reproductive health of women who survived breast cancer in Iran based on the results of phases 1 and 2 through multiple steps. Discussion A comprehensive and practical guideline on the sexual and reproductive health of breast cancer survivors in Iran will be developed which will be compatible with their specific needs and culture, considering the limited resources available. This guideline can significantly improve the quality of life in breast cancer survivors in Iran. In addition, the approach we will use here can be utilized to develop guidelines on sexual and reproductive health of female cancer survivors in general.

Cultural Adaptation and Validation of the EORTC QLQ-BR45 to Assess Health-Related Quality of Life of Breast Cancer Patients

“…However, the results should be cautiously considered as the sexuality items were calculated from a small number of patients (11 patients for the sexual functioning scale and 13 patients for the endocrine sexual functioning scale) because most of the patients refused to answer these questions and felt that sexuality items were upsetting and intrusive. A trial on Iranian patients found that both the patients and the therapist were reluctant to talk about sexual health, although it was deteriorated tremendously in breast cancer patients compared to healthy women [26]. This trial proposed the requirement of valid clinical guidelines to provide suitable evidence-based care for sexual health in breast cancer cohorts.…”

Sexual function index adaptation for breast cancer patients (FSFI-BC)- translation and psychometric properties of Persian version

“…During breast cancer treatment, addressing sexual problems is not a priority. Both patient and therapist avoid talking about sexual concerns due to embarrassment, lack of privacy, time, or required skills [ 23 ]. Furthermore, in most Asian countries, including Iran, sexual issues are considered as taboo and talking about these issues is associated with feelings of shame and guilt.…”