Contents, Methods, and Outcomes of Adolescent Sexual Health Promotion in School Environments: A Scoping Review.

BACKGROUND: Schools play a significant role in adolescent sexual health (SH) promotion. Although adolescents' SH has improved, growing challenges still exist in some areas. Previous studies have noted a lack of knowledge about SH promotion implementation in school environments. The purpose of this review is to describe the contents, methods, and outcomes of adolescent SH promotion in school environments. METHODS: Three databases (Cinahl, ERIC, Medline) were searched for peer-reviewed articles published in 2011 to 2022, to identify SH promotion in school environments for adolescents aged 12 to 19 years old. After critical appraisal, inductive content analysis was conducted. RESULTS: After screening, 25 studies from 8 countries were included. Sexually transmitted diseases and contraception were emphasized in the contents of the methods. Five SH promotion methods were identified: traditional, virtual, interactive, practical skills supporting, and creative. The outcomes were advancement in SH abilities, changes in sexual behavior, and the strengthening of sexual identity. CONCLUSIONS: The contents mostly considered negative consequences of sexual behavior, whereas positive aspects were less discussed. Traditional methods were emphasized, yet positive outcomes were identified regardless of the method. SH promotion should aim to better support adolescents' sexual identity reinforcement.

The marital relationship and health-related quality of life of prostate cancer patients and their spouses: A prospective, longitudinal study.

AIMS: This study aims to measure any changes in the marital relationship during the first year after a diagnosis of prostate cancer, identify the demographic characteristics that influenced such changes, and measure changes related to health-related quality of life (HRQoL). BACKGROUND: Knowledge is limited on the impact of a diagnosis of prostate cancer on the marital relationship and HRQoL of patients and their spouses. DESIGN: A 1-year longitudinal study. METHODS: Data were collected from five Finnish hospitals between October 2013 and January 2017. Of the 350 recruited couples (N = 700), 179 patients and 166 spouses completed the Marital Questionnaire and the RAND 36-Item Health Survey 1 year after diagnosis. RESULTS: No major changes were found in the marital relationship during the follow-up period. The spouses reported statistically significant changes in their marital relationships, but the patients did not. Furthermore, changes in the marital relationship were not associated with the patients' HRQoL. Among spouses, emotional well-being was associated with changes in the marital relationship. CONCLUSION: The marital relationship was relevant in terms of the spouses' HRQoL during the first year after a diagnosis of prostate cancer. Nurses and other healthcare providers should assess counselling and support provided to spouses individually.

Men's experiences of the impact of penile cancer surgery on their lives: A qualitative study.

OBJECTIVE: Surgery is the primary treatment for invasive penile cancer (PC). Postoperative changes in genital anatomy and function may lead to altered body and self-image, compromised sexual function and subsequent psychological problems. The aim of this study is to describe men's experiences of the impact of PC surgical treatment on their lives. METHODS: The institutional databases of two Finnish university hospitals were searched for patients who underwent surgery for invasive PC between 2009 and 2019. Of 107 men, 29 agreed to an interview or a response letter. The data were analysed by thematic analysis. RESULTS: The men experienced that their self-image had changed after PC diagnosis and treatment to a 'cancer-modified me'. They also experienced that physical symptoms after surgery defined their everyday, as well as sexual, lives and that the whole content of life changed. CONCLUSION: Support and counselling for physical, mental, sexual and social factors should be part of the treatment of men with PC.

Health-Related Quality of Life, Self-esteem and Sexual Functioning Among Patients Operated for Penile Cancer - A Cross-sectional Study.

BACKGROUND: Penile cancer surgery affects physical, psychological, and sexual well-being, but the patient- and treatment-related factors predisposing to worse health-related quality of life (HRQoL) have not been well characterized. AIM: We report treatment-related HRQoL changes among penile cancer survivors compared to the general population and the specific deficits that have the most profound effect, and we identify patient-related factors that predispose to a worse perceived HRQoL. METHODS: Patients (n = 107) who underwent operations for invasive penile cancer in two Finnish university hospitals from 2009 to 2019 were sent the Patient Reported Outcomes (PROs) questionnaire designed to measure HRQoL, self-esteem, overall sexual functioning, erections, and change in sexual function. We collected clinical information and socio-demographic characteristics, including age, partner status, children, vocational education, and employment status. Associations between patient- and treatment-related factors and HRQoL were analyzed using descriptive statistics and non-parametric tests. Linear regression models were used to compare the HRQoL differences between patients with penile cancer and the age-standardized average for the Finnish population. OUTCOMES: A generic measure of HRQoL (15D), the Rosenberg Self-Esteem Scale, Overall Sexual Functioning Questionnaire, the Erection Hardness Score, and self-reported change in sexual functioning. RESULTS: Low scores in overall sexual functioning, erectile function, and changes in sexual functioning were associated with a lower HRQoL. An association was found between HRQoL and age, educational level, employment status, and place of residence. The HRQoL had a negative correlation with age. Patients with a high educational level, who were employed, or who lived in urban areas reported higher HRQoL. The mean HRQoL of penile cancer survivors was significantly lower than the age-standardized average HRQoL of the Finnish population. CLINICAL IMPLICATIONS: Enhanced support and counseling is needed among penile cancer patients to improve the HRQoL during survivorship. STRENGTHS & LIMITATIONS: A nationwide sample with detailed information allowed comparisons of HRQoL between penile cancer patients and the general population. Due to cross-sectional nature of the study, the time between the surgery and the study intervention was heterogeneous, and this may have affected the results. CONCLUSION: Penile cancer patients exhibit significant physical and psychological dysfunction, and the lack of sexual activity in general is what most compromises the QoL of penile cancer survivors. Harju E, Pakarainen T, Vasarainen H, et al. Health-Related Quality of Life, Self-esteem and Sexual Functioning Among Patients Operated for Penile Cancer - A Cross-sectional Study. J Sex Med 2021;18:1524-1531.

Perspectives of oncology nurses on peer support for patients with cancer.

PURPOSE: To understand the perspectives of oncology nurses on peer support for patients with cancer and the role of oncology nurses in its provision. METHOD: Thematic semi-structured interviews of 10 oncology nurses working in a single university hospital were conducted. The data were analysed using content analysis. RESULTS: Oncology nurses thought that peer support promotes the psychosocial wellbeing of patients with cancer by increasing their social contact and strengthening their emotional resources. In their daily work, oncology nurses engaged in several activities that promote the interactions between patients with cancer and informal forms of peer support. However, directing patients with cancer to formal peer support services outside specialised health care was not an established practice. Oncology nurses expressed several concerns about the availability of support and the coping ability of peer supporters and expressed scepticism about the reliability of information shared in peer support groups. CONCLUSIONS: The awareness of oncology nurses regarding formal peer support services appears rather limited. This knowledge gap should be reduced, such as through closer collaboration between hospitals and third sector cancer organisations, which does not appear effective at present based on the results. In addition, patients with cancer should be systematically informed about peer support.

Health-related quality of life in patients with prostate cancer and their spouses: Results from a longitudinal study.

PURPOSE: The purpose of this study was to explore changes in HRQoL (health-related quality of life) and identify the associated factors in patients with prostate cancer and their spouses during the year following their diagnosis of prostate cancer. METHODS: The longitudinal study design consisted of 179 patients and 166 spouses, using discretionary sampling, at five Finnish central hospitals. Participants completed a self-reported RAND-36-Item Health Survey at three time-points: time of diagnosis and 6 and 12 months later. Changes in HRQoL were analysed using descriptive statistics and non-parametric tests. Linear mixed-effects models were used to identify the factors associated with the changes in HRQoL in the patients and their spouses. RESULTS: On average, the HRQoL of patients with prostate cancer changed in physical functioning (p = 0.015), emotional well-being (p = 0.029) and general health (p = 0.038) were statistically significant over the 12-month study period. In spouses, statistically significant changes in HRQoL were not observed. Interaction between the age of participants and changes in HRQoL were statistically significant. CONCLUSIONS: Findings in this study suggest that interventions aimed at improving the HRQoL of patients should support a few different dimensions of HRQoL for the patients themselves than for their spouses. Nurses should pay more attention to elderly couples.

Marital relationship and health-related quality of life of patients with prostate cancer and their spouses: A longitudinal clinical study.

AIMS AND OBJECTIVES: To examine changes in the marital relationship 6 months after the diagnosis and the effects of these changes on the health-related quality of life of the patients with prostate cancer and their spouses. BACKGROUND: There is limited knowledge on the impact of a diagnosis of prostate cancer on the marital relationship and health-related quality of life of patients and their spouses. DESIGN: Survey with longitudinal descriptive and comparative elements. METHODS: Of 350 recruited couples (N = 700), 186 couples (n = 372) completed the Marital Questionnaire and RAND 36-Item Health Survey at the two measurement points: time of diagnosis and 6 months later. Changes in the marital relationship were analysed statistically using descriptive statistics and nonparametric tests. The influence of changes in the marital relationship on health-related quality of life was evaluated using linear regression analyses. RESULTS: The patients and their spouses reported lower marital satisfaction 6 months after the diagnosis than at the time of diagnosis. The summary score for marital satisfaction of the spouses significantly decreased during the follow-up period. In contrast, decreasing changes in the marital relationship of the patients were not statistically significant. Furthermore, the marital relationship of the patients and their spouses was not statistically significantly associated with changes in the health-related quality of life of the patients and their spouses within 6 months. CONCLUSIONS: The results of this study add to current knowledge of the marital relationship of patients with prostate cancer and their spouses. The spouses reported that their marital relationship had suffered, whereas the patients reported that the marital relationship remained unchanged. RELEVANCE TO CLINICAL PRACTICE: These findings may be useful when counselling of patients with prostate cancer and their spouses.

The health-related quality of life of patients with prostate cancer and their spouses before treatment compared with the general population.

AIMS: To describe the health-related quality of life (HRQOL) of patients with prostate cancer and their spouses in comparison with the Finnish general population, using the RAND 36-Item Health Survey. An additional purpose was to describe the associations between the background variables of the participants and their HRQOL. BACKGROUND: The HRQOL of patients with prostate cancer and especially their spouses at the time of diagnosis is not well known. DESIGN: A cross-sectional study. METHODS: Responses were received from 232 patients and 229 spouses at 5 central hospitals in Finland between October 2013 and January 2016. RESULTS: Compared to the Finnish general population mean, the HRQOL of the patients and their spouses was, on average, better for all dimensions. Patients' age, the presence of disease, and the treatment method were associated with the dimensions of HRQOL. The dimensions of HRQOL were also associated with spouses' age, basic and vocational education, and the presence of disease. CONCLUSION: The patients and their spouses experienced their HRQOL as very similar; however, on average, it is better than the general population mean. However, the evidence suggests that support from the nurses should focus on emotional well-being, the dimension that received the lowest scores in both groups.

Perceived family health in persons with prostate cancer and their family members.

AIMS AND OBJECTIVES: To describe perceived family health in persons with prostate cancer and their family members. An additional purpose was to describe the associations between the background variables of persons with prostate cancer and their family members and perceived family health. BACKGROUND: Prostate cancer in one family member affects the health of the whole family. It is important to study perceived family health in families of persons with prostate cancer and associated factors. DESIGN: A cross-sectional study. METHOD: Data were collected using the Family Functioning, Health and Social Support (FAFHES) scale, modified for use in this study. Questionnaires were distributed to 100 persons with prostate cancer treated with surgery or radiation therapy and 100 family members at one Finnish university hospital in April-October 2009. Responses were received from 76 persons and 71 family members, a response rate of 74%. RESULTS: Persons with prostate cancer and family members rated family health good despite prostate cancer. Family members reported higher levels of illness-related ill-being than persons with prostate cancer. Family health was associated with the person's age, basic education, employment status, number of family member's visits to the hospitalised patient, first symptom of prostate cancer and previous hospitalisations were associated with. Family health was associated with the family member's basic and vocational education. CONCLUSIONS: The results show that nursing care should pay attention to family members of persons with prostate cancer and that support to them should be a natural part of a good care of persons with prostate cancer. RELEVANCE TO CLINICAL PRACTICE: The quality of prostate cancer care should be improved to provide more individualised and family-focussed services.