Neurosurgeons’ opinions on discussing sexual health among brain tumor patients: Room for improvement?

Laldjising, Eric; Sekercan, Ayda; Gadjradj, Pravesh S.

doi:10.1016/j.jocn.2021.10.040

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…We identified a total of three [ 10 , 24 , 25 ] studies, which address SD incidence and/or associations between SD and QoL ( Figure 1 ). Handsearching of articles revealed 60 additional articles [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ...…”

Section: Resultsmentioning

confidence: 99%

“…Importantly, as LGG patients are of childbearing age, the desire for pregnancy and hence fertility preservation (FP) should also be discussed during this interview [ 13 ]. Given the difficulties in carrying out those interviews, it is not surprising that Laldjising et al [ 26 ] reported that nearly 60% of interrogated neurosurgeons treating brain tumor patients never discussed sexual health with them, claiming that lack of knowledge and insufficient time were the main reasons. Discussing sexual health with tumor patients appears to also be challenging in clinical routine for oncologists and radiotherapists [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Sexual Dysfunction of Patients with Diffuse Low-Grade Glioma: A Qualitative Review of a Neglected Concern

Lombard

Duffau

2022

Cancers

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Diffuse low-grade gliomas (LGG) commonly affect young adults and display a slow evolution, with a life expectancy that can surpass 15 years, thanks to multimodal therapeutic management. Therefore, preservation of quality of life (QoL), including sexual health, is mandatory. We systematically searched available medical databases of Pubmed, Cochrane, and Scopus for studies that reported data on sexual activity or dysfunction (SD) in LGG patients. We analyzed results to determine incidence of SD and its association with QoL in this population. Three studies focused on SD incidence in patients presenting specifically LGG, or brain tumors including LGG. They comprised 124 brain tumor patients, including 62 LGG, with SD incidence ranging from 44 to 63%. SD was reported by more than 50% of interrogated women in the three studies. Regarding QoL, two out of the three studies found significant associations between SD and alterations of QoL parameters, particularly in the field of social and functional wellbeing. Finally, we discussed those results regarding methods of evaluation, inherent biases, and therapeutic implications regarding antiseizure medications and also planning of surgery, chemo-, and radiotherapy. Our review showed that SD is highly prevalent but still poorly studied in LGG patients. As those patients are usually young and enjoy an active life, there is a need to assess more systematically the occurrence of SD in clinical routine, in order to adapt cancer treatments accordingly, to manage actively these troubles, and finally to improve patients’ QoL in the long run.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sexual Dysfunction of Patients with Diffuse Low-Grade Glioma: A Qualitative Review of a Neglected Concern

Lombard

Duffau

2022

Cancers

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“…Insufficient time during visits (46.6%), followed by patients' embarrassment (44.8%), and lack of training, are the most important reasons that contributed to not assess SD in the daily practice. On the contrary other healthcare professionals as well as gastroenterologists, car-diologists, nephrologists, neurologists, and neurosurgeons reported that the most important reasons are lack of knowledge and training, insufficient time during the visits and embarrassment (19). Despite these, 34.4% of rheumatologists are conscious that a specific training in sexual medicine could be useful in SD treatments.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the evidence shows that it is also a neglected problem in other specialist fields such as cardiology, neurology and gastroenterology. Several reasons such as lack of knowledge/training, lack of time during visits, and embarrassment have been reported (16)(17)(18)(19)(20). To the best of our knowledge, there are no study evaluating how the rheumatologists discuss and manage their patients' sexual problems.…”

Section: Introductionmentioning

confidence: 99%

Sexual dysfunctions of rheumatological patients are a neglected issue: Results from a national survey of Italian Society of Rheumatology

Napolitano,

Pantano,

Romano

et al. 2023

Arch Ital Urol Androl

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Introduction: Sexual dysfunctions (SD) are frequently encountered in patients with rheumatologic diseases. In this scenario, a multidisciplinary approach to rheumatologic diseases is often mandatory. The aim of this survey was to assess whether Italian rheumatologists routinely explore sexual health of their patients, their knowledge on the topic, and the barriers to discussing SD in clinical practice. Methods: A 32-items anonymous questionnaire was mailed to members of the Italian Society of Rheumatology (rheumatologists and residents in rheumatology training) in February 2023. The questionnaire aimed to determine attitudes, knowledge, and practice patterns regarding the discussion of SD with rheumatologic patients. A descriptive analysis of responses was performed. Results: A total of 162 responses were received. Overall, 50.0% of respondents occasionally asked patients about SD related to their rheumatologic pathologies, while 37.1% never did so. Respondents declared that patients occasionally (82.3%) or never (16.1%) reported SD related to rheumatologic diseases. The main barriers to discussing sexual health were lack of time during medical examination (46.6%), patients’ discomfort (44.8%), and lack of knowledge/experience (39.7%). Overall, 41.9% and 33.9% of respondents respectively totally and partially agreed that rheumatologists should routinely investigate patients' sexual health. Most of the respondents (79.0%) thought that discussing sexual health problems could help patients cope with their rheumatologic diseases. Of all respondents, 74.2% felt the need to broaden their personal knowledge about SD. Finally, 45.9% and 34.4% of respondents respectively partially and totally agreed that training courses for rheumatologists could be helpful in the management of sexual health in rheumatological patients. Conclusions: SD was not routinely discussed in rheumatology practice, still remaining a neglected issue. The most frequent explanations for the lack of attention toward SD were lack of time, patients’ discomfort, and lack of knowledge/experience. Most of the respondents expressed the possible usefulness of attending SD courses to improve knowledge about these conditions.

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“…Unfamiliarity with the concept of "moral distress" may have reduced responses, but our response rate (5.8%) aligns with that of recent Congress of Neurological Surgeons member surveys (2.2%-8.0%). 42,43 Second, we defined "morally injured" neurosurgeons as those contemplating leaving a position because of moral distress. This definition may be too narrow and underestimate moral injury.…”

Section: Limitationsmentioning

confidence: 99%

Moral Distress and Moral Injury Among Attending Neurosurgeons: A National Survey

Mackel¹,

Alterman²,

Buss

et al. 2022

Neurosurgery

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BACKGROUND:“Moral distress” describes the psychological strain a provider faces when unable to uphold professional values because of external constraints. Recurrent or intense moral distress risks moral injury, burnout, and physician attrition but has not been systematically studied among neurosurgeons.OBJECTIVE:To develop a unique instrument to test moral distress among neurosurgeons, evaluate the frequency and intensity of scenarios that may elicit moral distress and injury, and determine their impact on neurosurgical burnout and turnover.METHODS:An online survey investigating moral distress, burnout, and practice patterns was emailed to attending neurosurgeon members of the Congress of Neurological Surgeons. Moral distress was evaluated through a novel survey designed for neurosurgical practice.RESULTS:A total of 173 neurosurgeons completed the survey. Half of neurosurgeons (47.7%) reported significant moral distress within the past year. The most common cause was managing critical patients lacking a clear treatment plan; the most intense distress was pressure from patient families to perform futile surgery. Multivariable analysis identified burnout and performing ≥2 futile surgeries per year as predictors of distress (P < .001). Moral distress led 9.8% of neurosurgeons to leave a position and 26.6% to contemplate leaving. The novel moral distress survey demonstrated excellent internal consistency (Cronbach alpha = 0.89).CONCLUSION:We developed a reliable survey assessing neurosurgical moral distress. Nearly, half of neurosurgeons suffered moral distress within the past year, most intensely from external pressure to perform futile surgery. Moral distress correlated with burnout risk caused 10% of neurosurgeons to leave a position and a quarter to consider leaving.

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Neurosurgeons’ opinions on discussing sexual health among brain tumor patients: Room for improvement?

Cited by 8 publications

References 21 publications

Sexual Dysfunction of Patients with Diffuse Low-Grade Glioma: A Qualitative Review of a Neglected Concern

Sexual Dysfunction of Patients with Diffuse Low-Grade Glioma: A Qualitative Review of a Neglected Concern

Sexual dysfunctions of rheumatological patients are a neglected issue: Results from a national survey of Italian Society of Rheumatology

Moral Distress and Moral Injury Among Attending Neurosurgeons: A National Survey

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