Sexual Health Tool Kit for Breast and Gynecologic Oncology Providers

Background: Cancer impacts quality of life during and after treatment, and sexual dysfunction is a common, often untreated, side-effect for women diagnosed with breast and gynecologic cancer. Many women are not aware of sexual side effects until after treatment and into survivorship, have unfulfilled sexual health needs, and would prefer their provider initiate conversations. The goal of this quality improvement (QI) project was to increase provider and staff comfortability surrounding sexual health discussions with cancer patients and to create a beneficial toolkit to facilitate discussions surrounding sexual health changes. Local Problem: A local women's health outpatient oncology clinic in Salt Lake City, Utah, lacked adequate resources to facilitate conversations about sexual health changes between patients, providers and staff, and the clinic was not providing adequate sexual health education to patients. Methods: A pre-implementation survey and short discussion were used to gather and evaluate participants demographics, baseline knowledge, behaviors, and comfort regarding sexual health discussions. A sexual health toolkit was created from evidence-based resources and pre- survey/discussion results. A short educational session introduced the participants to the sexual health toolkit, and implementation was reviewed weekly, allowing for rapid change. A post- implementation survey, which evaluated the feasibility, usability, and satisfaction of the toolkit, was distributed. Descriptive statistics were used to analyze qualitative and quantitative data, paired T tests were used to compare continuous data, and ordinal data was compared using the Wilcoxon matched paired test. A two-sided p-value <0.05 was considered significant. Interventions: A sexual health toolkit, based on pre-survey results, was created and implemented. The toolkit was adapted from evidence-based online resources, which addressed IMPLEMENTATION OF SEXUAL HEALTH TOOLKIT the most frequently asked questions, and was created for staff to facilitate discussions in clinic with patients. Results: The survey was sent to thirty-two participants. Eleven (34.4%) participants completed the pre-survey, and 12 (37.5%) participants took the post-survey, of which eight (25.0%) completed both. Comfortability improved post-toolkit implementation, and participants indicated high usability and satisfaction with the implementation of a sexual health toolkit. One hundred percent of participants (n=12) strongly agreed or agreed that the toolkit improved female sexual health knowledge and felt it was a useful tool. Eleven participants (91.7%) strongly agree or agree that they would continue to use the sexual health toolkit with their patients. Conclusion: Participants reported adequate knowledge regarding sexual health for breast and gynecologic cancer patients both pre- and post-implementation but did not always discuss these topics with patients. Though not statistically significant, there was an improvement in participant comfort discussing sexual health topics with patients. Almost all participants found the toolkit a useful patient education tool, and all stated they will continue to use the toolkit. Overall, the sexual health toolkit was beneficial for healthcare staff in discussing sexual health changes with patients.