Introduction: Advances in diagnosis and treatment have led to more people living with and beyond cancer. Cancer and its treatments can cause ongoing sexual function and intimacy (SFI) concerns. Despite being frequent and one of the highest reported unmet needs, detection and management of SFI concerns is not routinely part of a comprehensive approach to supportive care. Nurses have an important role in diagnosis, treatment, and follow-up care of patients with cancer and are well positioned to address SFI concerns. This systematic review explored nurse-led interventions for managing SFI concerns in individuals with cancer.
Methods: This study was registered on PROSPERO (CRD42021227607). Electronic databases were searched from 1980 to December 2021 using terms “sexual function”, “cancer,” and “intervention”. Two reviewers assessed full texts against eligibility criteria. Data extraction included: study design; population; intervention conditions; and patient-reported, health service and implementation outcomes. Interventions were categorized by content and analyzed using descriptive quantification and narrative summary of intervention effectiveness.
Results: Thirty-eight studies involving 4331 participants were included; 15 trials, 10 feasibility studies, and four single arm, quasi experimental or other designs. Nurse-led interventions were categorized as educational (n=23), psychological (n=21), behavioral (n=10), and PLISSIT (n=4). Multi-component interventions were most common, with 60% containing an educational component. Of the multi-component interventions, six (50%) with educational, four (33%) with psychological, three (50%) with behavioral and one (100%) with PLISSIT components improved SFI-related outcomes. Among single-component interventions, three (100%) educational, four (83%) psychological, two (100%) behavioral and two (66%) PLISSIT interventions improved SFI-related outcomes when compared to standard care.
Conclusions:
Single-component nurse-led interventions were effective in improving SFI-related outcomes in cancer survivors. Multi-component nurse-led interventions had mixed results. Screening for and management of SFI concerns by nurses could be a routine part of supportive care available to all who need it.