Introduction
Methods
Search strategy and outcome
Items | Eligibility criteria |
---|---|
Participant | All healthcare providers who work with oncology patients |
Study design | Quantitative interventions study |
Language | English |
Date of search | No limitation |
Type of intervention | All educational/training interventions for healthcare providers with the aim of enhancing provision of sexual healthcare to oncology patients |
Type of outcome | Studies reported at least one pre-intervention measurement and one a post-intervention measurement |
Level of evidence and quality appraisal
Data abstraction
Source | Intervention type | Sample | Patient type | Work setting | Country | Follow-up | End response | Level of evidence |
---|---|---|---|---|---|---|---|---|
Pre−/post-questionnaires without control group | ||||||||
Hordern (2009) | Single workshop (4.5 h) | 155 oncology nurses and allied HCPs | Not specified | Unknown | Australia | Immediately post-workshop, 8 weeks | 58.6% | 3 |
Wang (2015) | Single training (30–45 min) | 9 oncology physicians, 62 nurses/allied HCPs | Breast cancer | Suburban, four-hospital healthcare system | USA | Three to 6 months | 50% | 3 |
Afiyanti (2016) | Five days’ training (35 h) | 46 oncology nurses | Not specified | Hospitals specialized in cancer services | Indonesia | Three weeks | 100% | 3 |
Jonsdottir (2016) | Comprehensive long-term educational intervention project (2 years) | 210 oncology nurses and physicians | Not specified | University hospital | Iceland | 10 months, 16 months | 38% | 3 |
3 | ||||||||
Grondhuis (2019) | One symposium (1 day) | 55 uro-oncology HCPs | Prostate cancer | Various | The Netherlands | Six months | 75% | |
Pre-/post-questionnaires with randomized control group | ||||||||
Kim (2014) | Eight e-learning sessions (total 16 h, 8 weeks) | 31 oncology nurses (15 interventions, 16 controls) | Not specified | Tertiary hospital | Korea | Three months | 100% | 2 |
Mixed methods: pre-/post-questionnaire and audio records | ||||||||
Reese (2019) | One self-study module (15 min), one workshop (60 min) | 5 oncologists, 1 nurse practitioner, 1 physician assistant 134 breast cancer patients | Breast cancer | Cancer centre | USA | Healthcare professionals: direct post-intervention, 1 month, 6 months Patients: immediately after the visit | 100% | 3 |
Jonsdottir (2016) | Intervention type | Hospital-wide educational intervention project lasting 2 years to integrate sexual health into oncology, consisting of: - Identification of a team of 25 ‘change agents’ who act as role models on their wards - Establishment of a sexuality counselling service for cancer patients - Education and training of staff (40 staff members from 10 different units): two 5-h workshops focused on attitudes and practices. Teaching methods applied were lectures, group discussion, taking sexual history. The second workshop focused on more role play exercises to practice communication - Educational meetings between staff and (ward) change agents (20–30 min), about communication strategies; practical issues and screening possibilities were discussed - Development of a staff pocket-guide for nurses and physicians as an aid to initiate communication - Development of patient information material - Development of a website about cancer and sexuality for healthcare providers and patients |
Measurement | Self-report questionnaire, enquiring about: practice issues (8, 5-point Likert scale), attitudes (8, 5-point Likert scale), frequency of discussing topic (1, multiple choice), barriers (1, multiple choice), responsibility for initiative (1, multiple choice) | |
Outcomes | - Change in mean scores before the intervention and at 16 months - Knowledge and training (1), practices issues (2), frequency of discussing topic (3), initiative (4), barriers (5) | |
Results | (1) Have acquired sufficient knowledge and training; resp. p = 0.01, p = 0.006 (2) 5/8 practice issues improved; p < 0.01 (3) No change in frequency of discussing topic (4) No change in initiative (5) Fewer perceived barriers; p = 0.038 | |
Kim (2014) | Intervention type | - Online problem-based learning (e-PBL); case videos with eight tutorials involving sexual healthcare problem scenarios; one session presented each week (1–2 h). - Posting solutions to the scenarios and discussions with others. - Additional online tools, such as video lectures, chat, discussion forum, databases, external website links were available |
Measurement | Self-report questionnaire containing: ‘Sexual healthcare knowledge scale’ (33, yes/no), ‘Sexual healthcare attitude scale’ (17, 3-point Likert scale), ‘Sexual health practice scale‘(21, yes/no) | |
Outcomes | - Change in mean change for scores between intervention and control group at 3 months’ follow-up - Knowledge (1), attitude (2), practice (3) | |
Results | (1) Higher knowledge score; p = 0.04 (2) No change in attitude score (3) No change in practice score | |
Wang (2015) | Intervention type | Single session, face-to-face, targeted sexual health training, 30–45 min. Traditional didactic education and communication skills training via brief role play and introduction of a user-friendly sexual health assessment tool |
Measurement | Self-reported questionnaire, enquiring about: comfort level (2, 5-point Likert scale), frequency (6, 5-point Likert scale), access to sexual health resource (1, 5-point Likert scale) | |
Primary outcomes | - Changes in mean Likert scores between baseline and 6 months’ follow-up - Comfort level (1), self-reported frequency of addressing sexual issues (2) | |
Results | 1. Higher comfort level; p < 0.0001 2. Higher frequency of addressing issues; p < 0.0001 | |
Reese (2019) | Intervention type | Single session self-study via information workbook (15 min) and single session workshop (90 min); skills-based, engagement in the first two steps of PLISSIT framework |
Measurement | Healthcare providers:- Self-reported questionnaire enquiring about: self-efficacy (3, 11-point scale), expected outcome regarding communication (7, 11-point scale), perceived barriers (14, 6-point scale) - Audio recording of clinic encounters Patients: - Satisfaction Index (4, 5-point Likert scale) | |
Primary outcomes | Healthcare professionals: - Changes in mean scores between baseline and 6 months - Self-efficacy (1), outcome expectation (2), perceived barriers (3) - Odds/rate ratio; - Requesting/offering information about sexual health (4), complex issues involved in requesting/offering information (5), raising the topic(6), duration of sexual health communication(7) Patients: - Changes in mean score, between baseline and immediately after the consultation- Satisfaction (8) | |
Results | (1) Increased self-efficacy; d = 0.27 (2) Increased outcome expectation; d = 0.69 (3) Reduced barriers; d = − 0.14 (4) Increased frequency of requesting/offering information; OR = 1.66/1.44, respectively (5) Increased complexity; OR = 1.65 (6) Increased frequency of raising the topic; OR = 2.38 (7) No change in duration; RR = 1.04 (8) No change in patient satisfaction | |
Grondhuis (2019) | Intervention type | One-day symposium with lectures on sexual dysfunction following several types of prostate cancer treatment and two workshops focusing on counselling techniques and tools to address sexual dysfunction in uro-oncological patients |
Measurement | Self-reported questionnaire (different for doctors, nurses/PAs, sexologists), enquiring about: knowledge (5-point Likert scale), discussion of sexual dysfunction (5-point Likert scale), rate of referral (5-point Likert scale), competence (3 polar questions: discussion of sexual function, advising on SD and actively enquiring about sexual issues | |
Primary outcomes | - Changes in mean between baseline and six-months’ post-intervention - Knowledge (1), competence (2), frequency (3), referral rate (4) | |
Results | (1) No change in knowledge; p = 0.39 (2)No change in competence; p = 0.25 (3) Higher frequency; p < 0.01 (4) No change in referral rate; p = 0.75 | |
Afiyanti (2016) | Intervention type | Five-day competency-based training, 35 h in total, consisting of 6 sessions in the classroom or 3 days of lectures and 4 practice sessions. After the training, a 3-week mentorship process |
Measurement | Questionnaire including knowledge test (13 items, each with 5 answer options), and addressing attitudes/belief (14, 5-point Likert scale), self-efficacy (5, 5-point Likert scale), practice (11, 5-point Likert scale) | |
Primary outcomes | - Changes in mean between baseline and 3 weeks post-intervention - Knowledge (1), attitude/belief (2), self-efficacy(3), practice(4) | |
Results | (1) Higher knowledge score; p < 0.001 (2) Higher attitude/belief score; p = 0.008 (3) Higher self-efficacy score; p = 0.017 (4) No change in practice; p = 0.062 | |
Hordern (2009) | Intervention type | Single-session, face-to-face workshop (4.5 h) with a professionally trained actor in the role of cancer patient to practice communication. The participants received feedback from the group |
Measurement | Self-reported questionnaire, addressing: barriers (20, 5-point Likert scale), confidence (7, 5-point Likert scale), practice (8, 5-point Likert scale) | |
Primary outcomes | - Changes in means scores between baseline and 8 weeks’ follow-up - Barriers(1), confidence (2), practice (3) | |
Results | (1) 16/20 barriers decreased; p < 0.01 (2) 7/7 confidence issues increased; p < 0.001. There were no significant effects of age or work experience on the participants’ confidence scores (3) 8/8 practice items increased; p < 0.003 |