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Zimmaro LA , Lepore SJ , Beach MC , Reese JB
Patients' perceived barriers to discussing sexual health with breast cancer healthcare providers
Psychooncology. 2020 jul;29(7) :1123-1131
PMID: 32281174    PMCID: PMC7500072    URL: https://www.ncbi.nlm.nih.gov/pubmed/32281174
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Abstract
OBJECTIVES: We characterized barriers reported by women with breast cancer (BC) regarding clinical discussions of sexual health, clustered women by their endorsement of these barriers, and compared these groups. METHODS: BC outpatients (N = 144; M age = 56, 67% White) in a sexual health communication intervention study provided baseline data. Exploratory factor analysis characterized sexual health communication barriers on a standardized measure. Hierarchical cluster analysis detected patient groups with similar response patterns on these factors. ANOVAs, Chi-Square and Fisher's Exact tests compared groups on socio-demographic/medical factors, sexual health communication self-efficacy and outcome expectancies, general clinical self-efficacy, sexual concerns, emotional distress, and discussion about sexual health with an oncology provider. RESULTS: Two factors emerged: patients' own beliefs about or perceived inability to discuss sexual health (self-centered barriers), and patients' perceptions of providers' reactions to discussing sexual health (provider-centered barriers); self-centered barriers were endorsed more than provider-centered (P < .001). Three clusters emerged: women who endorsed (a) high self-centered and high provider-centered (n = 19; 13%), (b) high self-centered and low provider-centered (n = 95; 66%), and (c) low self-centered and low provider-centered (n = 30; 21%). Women endorsing more barriers reported lower sexual communication self-efficacy, outcome expectancies, and general clinical self-efficacy (P's </= .001); no differences in sexual concerns, emotional distress, or discussing sexual health were found. CONCLUSIONS: Women more strongly endorsed self-centered barriers than provider-centered. When grouped according to these barriers, women differed in their confidence and expectations for sexual health communication, regardless of degree of sexual or emotional distress. Interventions are needed to improve both patients' and providers' skills for discussing sexual health.
Notes
1099-1611 Zimmaro, Lauren A ORCID: https://orcid.org/0000-0001-9796-3759 Lepore, Stephen J ORCID: https://orcid.org/0000-0001-7370-6280 Beach, Mary Catherine Reese, Jennifer B ORCID: https://orcid.org/0000-0001-9341-2407 MRSG-14-031-01-CPPB/American Cancer Society 2T32-CA-009035/CA/NCI NIH HHS/United States P30CA006927/CA/NCI NIH HHS/United States Journal Article England Psychooncology. 2020 Apr 13. doi: 10.1002/pon.5386.