Purpose: The provision of evidenced-based sexual wellbeing support is considered a key metric of quality prostate cancer care. However, patients continually report high rates of sexuality-related unmet needs, even 15 years post-diagnosis. To identify what issues or challenges healthcare professionals (HCPs) face in the delivery of sexual wellbeing support, we conducted a qualitative study.
Methods: HCPs were recruited via professional organisations/networks and snowballing. Interviews were semi-structured, conducted via telephone/video, and transcribed verbatim. Interviews explored work experience, sexual health support provided, challenges faced, and areas of prioritisation to improve care delivery. Data was analysed using reflexive thematic analysis.
Results: Twenty-one HCPs were interviewed, including nurses, pharmacists, sexologists, a physiotherapist, and an oncologist. Eight key themes were identified. Themes 1-5 describe the challenges faced by HCPs in providing sexual wellbeing support to prostate cancer patients: (1) reliance on other HCPs, (2) logistical issues in providing support, (3) the involvement of partners/family in patient care, (4) specific regional/rural challenges, and (5) navigating and overcoming patient barriers. The remaining three themes describe the areas of change identified by HCPs needed to improve their delivery of support: (6) increased awareness for the importance of sexual wellbeing in survivorship care, (7) increased awareness, accessibility (and existence) of support services, and (8) standardised guidelines for penile rehabilitation after prostate cancer diagnosis.
Conclusions: HCPs face several challenges providing sexual wellbeing support to prostate cancer patients. Key priority areas to improve support provision were identified, particularly the need for specialist and general practitioners to receive further training/education on sexual wellbeing clinical management, and for the creation and implementation of penile rehabilitation clinical guidelines. Addressing HCP support delivery needs will ultimately improve patient experiences and outcomes. Unfortunately, the study lacked representation from urology/radiology specialists; further research to explore their perspectives and needs is recommended.