Objectives: Sexual health needs remain the most prevalent unmet need among prostate cancer survivors. The objective of this research was to developed recommendations to improve sexual wellbeing support for people with prostate cancer using a codesign approach.
Setting: Australian health care setting
Procedures: In conjunction with consumers and stakeholders we undertook co-designed mixed-methods research including: 1) a scoping review; 2) analysis of patient-reported outcomes; 3) a cross-sectional patient survey on help-seeking; 4) qualitative interviews with prostate cancer survivors; and 5) qualitative interviews with healthcare professionals. A synthesis of this evidence was undertaken to identify personal, healthcare provider and system-wide barriers to providing adequate sexual wellbeing support. This evidence informed the development of recommendations to improve sexual wellbeing support for people with prostate cancer. These recommendations were developed and prioritized through a stakeholder workshop, attended by consumers, healthcare professionals and researchers.
Results: High-level concerns identified from the evidence synthesis included the lack of priority given to sexual well-being after prostate cancer, limited resourcing for sexual health support, high costs and restricted access to erectile dysfunction treatments, and inconsistencies in practices across the sector. Findings also highlighted the importance of healthcare professionals initiating and repeating conversations with patients to overcome the reluctance among some patients to discuss their sexual health needs. Recommendations are broad ranging and include: increasing the number of specialist prostate cancer nurses, enhancing multidisciplinary care to include allied health professionals, counsellors and sexologists; subsidizing erectile dysfunction treatments and support services for prostate cancer patients; providing educational resources for healthcare professionals to improve knowledge and confidence to deliver sexual health support; improving online information for consumers; and developing expert guidelines on penile rehabilitation.
Conclusions: Efforts on multiple fronts are required to ensure the delivery of optimal care and support to address the sexual health concerns of people with prostate cancer.