Implementation of a sexual health clinic in an oncology setting: patient and provider perspectives

Abstract Background Sexual dysfunction is prevalent among cancer survivors, significantly impacting patient and partner quality of life. Despite this, sexual health clinics (SHCs) remain rare in cancer centres across Canada. An innovative clinic was developed at Princess Margaret Cancer Centre in To...

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Main Authors: Andrew G. Matthew, Taylor Incze, Elisa Stragapede, Steven Guirguis, Sarah E. Neil-Sztramko, Dean S. Elterman
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-024-12092-8
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author Andrew G. Matthew
Taylor Incze
Elisa Stragapede
Steven Guirguis
Sarah E. Neil-Sztramko
Dean S. Elterman
author_facet Andrew G. Matthew
Taylor Incze
Elisa Stragapede
Steven Guirguis
Sarah E. Neil-Sztramko
Dean S. Elterman
author_sort Andrew G. Matthew
collection DOAJ
description Abstract Background Sexual dysfunction is prevalent among cancer survivors, significantly impacting patient and partner quality of life. Despite this, sexual health clinics (SHCs) remain rare in cancer centres across Canada. An innovative clinic was developed at Princess Margaret Cancer Centre in Toronto, Canada to address this significant gap in survivorship care. This study examines factors affecting the provision of sexual healthcare and the implementation of a sexual health clinic within a large urban centre. Methods The Quality Implementation Framework was used to explicate patient and provider experience and identify barriers and facilitators to integrating sexual healthcare into routine cancer care workflows. Healthcare providers and patients representing selected cancer types (prostate, cervical, ovarian, testicular, bladder, kidney, and head and neck cancer) participated in semi-structured interviews. Interviews were transcribed and analyzed using the Framework qualitative analysis protocol. Results The analysis identified three organizing domains and ten themes that describe the unique aspects of the sexual healthcare experience and critical factors for sexual health implementation. Both patients and providers described a lack of sexual health support in the oncology setting and emphasized the need for comprehensive and personalized care. Limitations of current care provision included mutual silence between patients and providers due to discomfort in discussing sexual issues, insufficient provider confidence in delivering optimal sexual healthcare, and constraints related to space and time. Key Factors for implementing a sexual health clinic in oncology emphasized the importance of having a dedicated clinic, flexibility in service delivery, proactive patient engagement, and ongoing staff education. Conclusions Findings highlight significant challenges in addressing sexual health in an oncology setting, underscoring the need for specialized sexual health clinics that are integrated with, but distinct from, routine oncology care. This study further emphasizes the need for incorporating sexual healthcare in survivorship programs as well as the necessity of conducting thorough implementation research, involving multiple stakeholders, prior to launching new programs.
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spelling doaj-art-76c432bb2b5f4696bdc84fc0385e67e92025-01-26T12:22:00ZengBMCBMC Health Services Research1472-69632025-01-0125111010.1186/s12913-024-12092-8Implementation of a sexual health clinic in an oncology setting: patient and provider perspectivesAndrew G. Matthew0Taylor Incze1Elisa Stragapede2Steven Guirguis3Sarah E. Neil-Sztramko4Dean S. Elterman5Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health NetworkDepartment of Surgical Oncology, Princess Margaret Cancer Centre, University Health NetworkDepartment of Surgical Oncology, Princess Margaret Cancer Centre, University Health NetworkDepartment of Surgical Oncology, Princess Margaret Cancer Centre, University Health NetworkFaculty of Health Sciences, McMaster UniversityDivision of Urology, Department of Surgery, University Health Network, University of TorontoAbstract Background Sexual dysfunction is prevalent among cancer survivors, significantly impacting patient and partner quality of life. Despite this, sexual health clinics (SHCs) remain rare in cancer centres across Canada. An innovative clinic was developed at Princess Margaret Cancer Centre in Toronto, Canada to address this significant gap in survivorship care. This study examines factors affecting the provision of sexual healthcare and the implementation of a sexual health clinic within a large urban centre. Methods The Quality Implementation Framework was used to explicate patient and provider experience and identify barriers and facilitators to integrating sexual healthcare into routine cancer care workflows. Healthcare providers and patients representing selected cancer types (prostate, cervical, ovarian, testicular, bladder, kidney, and head and neck cancer) participated in semi-structured interviews. Interviews were transcribed and analyzed using the Framework qualitative analysis protocol. Results The analysis identified three organizing domains and ten themes that describe the unique aspects of the sexual healthcare experience and critical factors for sexual health implementation. Both patients and providers described a lack of sexual health support in the oncology setting and emphasized the need for comprehensive and personalized care. Limitations of current care provision included mutual silence between patients and providers due to discomfort in discussing sexual issues, insufficient provider confidence in delivering optimal sexual healthcare, and constraints related to space and time. Key Factors for implementing a sexual health clinic in oncology emphasized the importance of having a dedicated clinic, flexibility in service delivery, proactive patient engagement, and ongoing staff education. Conclusions Findings highlight significant challenges in addressing sexual health in an oncology setting, underscoring the need for specialized sexual health clinics that are integrated with, but distinct from, routine oncology care. This study further emphasizes the need for incorporating sexual healthcare in survivorship programs as well as the necessity of conducting thorough implementation research, involving multiple stakeholders, prior to launching new programs.https://doi.org/10.1186/s12913-024-12092-8Sexual healthCancer survivorshipImplementation researchCFIROncosexology
spellingShingle Andrew G. Matthew
Taylor Incze
Elisa Stragapede
Steven Guirguis
Sarah E. Neil-Sztramko
Dean S. Elterman
Implementation of a sexual health clinic in an oncology setting: patient and provider perspectives
BMC Health Services Research
Sexual health
Cancer survivorship
Implementation research
CFIR
Oncosexology
title Implementation of a sexual health clinic in an oncology setting: patient and provider perspectives
title_full Implementation of a sexual health clinic in an oncology setting: patient and provider perspectives
title_fullStr Implementation of a sexual health clinic in an oncology setting: patient and provider perspectives
title_full_unstemmed Implementation of a sexual health clinic in an oncology setting: patient and provider perspectives
title_short Implementation of a sexual health clinic in an oncology setting: patient and provider perspectives
title_sort implementation of a sexual health clinic in an oncology setting patient and provider perspectives
topic Sexual health
Cancer survivorship
Implementation research
CFIR
Oncosexology
url https://doi.org/10.1186/s12913-024-12092-8
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