Managing sexual dysfunction for women with breast cancer: the perspective of healthcare providers in North East Malaysia

Abstract

Purpose: Management of female sexual dysfunction (FSD) is vital for women with breast cancer due to the devastating consequences, which include marital disharmony and reduced quality of life. We explore healthcare providers' (HCPs) perceptions and experiences in managing FSD for women living with breast cancer using phenomenological approach.Methods: This qualitative study was conducted using a face-to-face interview method to HCPs from two tertiary hospitals in North East Malaysia. The interviews were recorded, transcribed verbatim, and transferred to NVivo ® for data management. The transcriptions were analyzed using thematic analysis.Results: Three key barriers were identi ed through the thematic analysis: a scarcity of related knowledge; the in uence of socio-cultural ideas about sex; and the speciality-centric nature of the healthcare system.Most HCPs interviewed had a very narrow understanding of sexuality, were unfamiliar with the meaning of FSD, and felt their training on sexual health issues to be very limited. They viewed talking about sex to be embarrassing to both parties that is, both to HCPs and patients and was therefore not a priority. They focused more on their specialty hence limited the time to discuss sexual health and FSD with their patients.Conclusion: Therefore, interventions to empower the knowledge, break the sociocultural barriers and improve the clinic settings are crucial for HCPs in managing FSD con dently.

Healthcare providers' experiences in providing sexual health care to breast cancer survivors: A mixed‐methods systematic review

“…Of the four mixed methods, two were a mixture of qualitative and descriptive studies (Ray et al., 1984; Reese et al., 2022), and the two others were a mixture of qualitative and experimental studies (Reese et al., 2019, 2021). As regards quality, 10 of the qualitative studies were of moderate quality (Canzona et al., 2016; Chanmekun et al., 2022; Lavin & Hyde, 2006; Masjoudi et al., 2019; Reese et al., 2017, 2021, 2022; Shaffer et al., 2021, 2022; Vieira et al., 2013), whereas the two others were of low quality (Ray et al., 1984; Reese et al., 2019). As regards the quality of the descriptive studies, one study provided strong evidence (Smith et al., 2011), four were of moderate quality (Dikmans et al., 2018; Krouwel, Hagen, et al., 2015; Krouwel, Nicolai, et al., 2015; Reese et al., 2022) and one each was of adequate (Takahashi et al., 2006) and low quality (Ray et al., 1984).…”

“…Being aware and concerned about the needs of patients were identified as one's ability to be aware and concerned about the needs of BSCs and about the importance of sexual health care. The HCPs fully understand that sexuality is a complex concept that has multiple impacts on one's physical, emotional and intellectual health, as well on one's relationship adjustment and overall quality of life as a result of breast cancer and its treatment (Chanmekun et al., 2022; Lavin & Hyde, 2006; Masjoudi et al., 2019; Ray et al., 1984; Reese et al., 2017; Vieira et al., 2013).

Sexuality is as important as [the] other effects, and it should be approached if we are to provide holistic care… (Lavin & Hyde, 2006)

Providers should initiate conversations about sexual health and let patients know [that] these issues can be further addressed at any time.

…”

“…The most common barriers to the provision of sexual health care were as follows: insufficient knowledge and skill in providing sexual health care, limited education and training (Chanmekun et al., 2022; Lavin & Hyde, 2006; Reese et al., 2017; Vieira et al., 2013), and failure to perceive patient's hidden needs (Canzona et al., 2016; Masjoudi et al., 2019; Reese et al., 2017, 2022; Vieira et al., 2013).…”

“…The insufficient knowledge and skills in sexual health care of the HCPs indicate their level of understanding of sexuality concepts and thus are a barrier to sexual health care (Chanmekun et al., 2022; Lavin & Hyde, 2006; Vieira et al., 2013). This lack resulted in their unfamiliarity with the management of sexual issues, in not doing comprehensive assessments (Chanmekun et al., 2022; Reese et al., 2017).

I think it is a major issue that they are dealing with, and I am the first to say that I don't necessarily have the skills to deal with it [sex].

…”

“…Being aware and concerned about the needs of patients were identified as one's ability to be aware and concerned about the needs of BSCs and about the importance of sexual health care. The HCPs fully understand that sexuality is a complex concept that has multiple impacts on one's physical, emotional and intellectual health, as well on one's relationship adjustment and overall quality of life as a result of breast cancer and its treatment (Chanmekun et al, 2022;Lavin & Hyde, 2006;Masjoudi et al, 2019;Ray et al, 1984;Reese et al, 2017;Vieira et al, 2013).…”