Assessing the utility of a distress screening tool at capturing sexual concerns in a gyne-oncology follow-up clinic
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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.
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.
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.
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.
KeywordsCancer Oncology Distress screening Gynecologic oncology Sexual distress Sexuality
Thank you to Dr. Linda Carlson for reviewing and providing helpful feedback on this manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 3.Hautamäki K, Miettinen M, Kellokumpu-Lehtinen PL et al (2007) Opening communication with cancer patients about sexuality-related issues. Cancer Nurs 30:399–404. https://doi.org/10.1097/01.ncc.0000290808.84076.97 CrossRefPubMedGoogle Scholar
- 6.Picker NCR (2013) Alberta Health Services Corporate Report: February–August 2013Google Scholar
- 7.Steele R, Fitch MI (2008) Supportive care needs of women with gynecologic cancer. Cancer Nurs 31:284–291. https://doi.org/10.1097/01.ncc.0000305743.64452.30 CrossRefPubMedGoogle Scholar
- 8.Bourgeois-Law G, Lotocki R (1999) Sexuality and gynecological cancer: a needs assessment. CJHS 8:231Google Scholar
- 11.Schover LR (1997) Sexuality and fertility after cancer. Wiley, New YorkGoogle Scholar
- 16.Watson L (2014) Screening for distress: evaluation data updateGoogle Scholar
- 17.Carlson LE, Waller A, Groff SL et al (2012) Online screening for distress, the 6th vital sign, in newly diagnosed oncology outpatients: randomized controlled trial of computerized vs personalized triage. Br J Cancer 107:617–625. https://doi.org/10.1038/bjc.2012.309 CrossRefPubMedPubMedCentralGoogle Scholar
- 22.Tamagawa R, Groff S, Looyis J et al (2016) The effects of a provincial-wide implementation of screening for distress on healthcare professionals’ confidence and understanding of person-centered care in oncology. JNCCN 6:1259–1266Google Scholar
- 23.Howell D, Keshavarz H, Esplen MJ, et al. (2015) A pan-Canadian practice guideline: screening, assessment and care of psychosocial distress (depression, anxiety) in adults with cancer, Toronto: Canadian Partnership Against Cancer (Cancer Journey Advisory Group) and the Canadian Association of Psychosoci. CAPOGoogle Scholar
- 26.College of physicians and surgeons of Ontario (2012) CPSO Policy Statement-Medical RecordsGoogle Scholar
- 31.Corney RH, Crowther ME, Everett H et al (1993) Psychosexual dysfunction in women with gynecological cancer following radical pelvic surgery. BJOG 100:73–79. https://doi.org/10.1111/j.1471-0528.1993.tb12955.x CrossRefGoogle Scholar