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Assessing the utility of a distress screening tool at capturing sexual concerns in a gyne-oncology follow-up clinic

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Abstract

Purpose

Communication and assessment of sexual health within cancer care is poor despite high rates of sexual dysfunction in cancer survivors. Screening for distress programs have been implemented, as a standardized part of cancer care across Canada, with the aim of increasing identification and improving access to support. Alberta Health Services uses a general distress screening form, containing the Canadian Problem Checklist, which includes a list of possible problems, one of which is “intimacy/sexuality.” Theoretically, the discreet nature of the screening for distress form may reduce patient discomfort in disclosing sexual concerns verbally, and therefore help health care providers identify patients requiring intervention. This study aims to determine the adequacy of this distress screening tool in identifying gynecological cancer patients who have an intimacy/sexuality concern.

Methods

A chart review was conducted on all follow-up visits in a gyne-oncology clinic over 1 year. Each patient’s chart was reviewed to determine the prevalence of the distress screening form completion, prevalence of the “intimacy/sexuality” item being checked, and documentation of actions taken to address any reported intimacy/sexuality problems.

Results

Seven hundred thirty patient visits were recorded during this period with completed distress screening forms found on 79.0% (n = 577) of charts. Only 6% of the patients indicated an intimacy/sexuality concern on this form. Of those, only one third had documentation that their problem was addressed.

Conclusions

These results call into question the utility of the intimacy/sexuality item on the Canadian Problem Checklist to identify gynecological cancer patients who have sexual concerns. Furthermore, even among those patients who indicated concerns, there is evidence that their problems are rarely addressed. Providers need to directly inquire with patients about their sexual health.

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Notes

  1. Note patients may have been offered more than one piece of advice.

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Acknowledgements

Thank you to Dr. Linda Carlson for reviewing and providing helpful feedback on this manuscript.

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Authors and Affiliations

  1. Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Lauren M. Walker & John W. Robinson

  2. Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB, Canada

    Lauren M. Walker & John W. Robinson

  3. Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Majken P. Villiger

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  1. Lauren M. Walker
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Correspondence to Lauren M. Walker.

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Walker, L.M., Villiger, M.P. & Robinson, J.W. Assessing the utility of a distress screening tool at capturing sexual concerns in a gyne-oncology follow-up clinic. Support Care Cancer 26, 887–893 (2018). https://doi.org/10.1007/s00520-017-3905-3

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