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Quality improvement in sexual health care for oncology patients: a Canadian multidisciplinary clinic experience

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Abstract

Purpose

With the goal of improving the quality of sexual health care provision at our tertiary cancer centre, we developed, implemented, and assessed a multidisciplinary sexuality in an oncology program, to identify patient needs and apply interventions that could be effective in a broader oncology care context.

Methods

The establishment of our institution’s first oncology-focused sexual health program is described within a quality improvement framework. A complementary retrospective chart review was performed to evaluate clinicodemographic data, including responses to validated sexual health questionnaires, from a 2-year clinical pilot.

Results

A sexual health program was introduced for cancer patients identified by health care providers or self-referred, receiving 130 referrals and conducting 64 consultation and 75 follow-up visits within a 2-year pilot period. Patients attending the program were 75% female, of mean age 52 years, and had most often breast (33%) or hematologic (30%) malignancies. Most (84%) had completed curative-intent treatment, with no evidence of disease, with 34% on ongoing endocrine therapy. The most frequent reasons for referral were sexual pain (38%), decreased libido (35%), and vaginal dryness (35% of females). All female patients demonstrated sexual dysfunction on the Female Sexual Function Index, and 80% of male patients demonstrated moderate to severe erectile dysfunction on the Sexual Health Inventory for Men. Patients waited a median of 63 days (SD 107, range 3–516) from referral to consultation, suggesting that demand for multidisciplinary sexual health care overwhelmed existing resources.

Conclusions

We have demonstrated unmet sexual health needs across a diverse oncology patient population and have presented a framework for addressing these issues, highlighting the challenges encountered and proposing improvements. Insights emerging from a quality improvement perspective included the role of group-based sexual health support to improve accessibility and the need for staff education to encourage proactive intervention before referral for specialized care is needed.

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Authors and Affiliations

  1. Division of Radiation Oncology, Department of Oncology, Cross Cancer Institute, 11560 University Ave NW, Edmonton, AB, T6G 1Z2, Canada

    Adele Duimering, Ashley Ayume & Ericka Wiebe

  2. Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, AB, Canada

    Lauren M. Walker & John W. Robinson

  3. Department of Psychosocial & Spiritual Resources, Cross Cancer Institute, Edmonton, AB, Canada

    Jill Turner

  4. Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology, Cross Cancer Institute, Edmonton, AB, Canada

    Elisha Andrews-Lepine

  5. Department of Rehabilitation Medicine, Cross Cancer Institute, Edmonton, AB, Canada

    Amy Driga

Authors
  1. Adele Duimering
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  2. Lauren M. Walker
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  3. Jill Turner
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  4. Elisha Andrews-Lepine
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  6. Ashley Ayume
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Correspondence to Adele Duimering.

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Duimering, A., Walker, L.M., Turner, J. et al. Quality improvement in sexual health care for oncology patients: a Canadian multidisciplinary clinic experience. Support Care Cancer 28, 2195–2203 (2020). https://doi.org/10.1007/s00520-019-05040-4

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  • DOI: https://doi.org/10.1007/s00520-019-05040-4

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