Sexual healthcare in oncology: description of a sexual health clinic utilizing an innovative blended model of in-person and facilitated virtual care

Abstract Introduction Sexual health is compromised by the diagnosis and treatment of virtually all cancer types. Although sexual dysfunction (SD) can manifest uniquely within each cancer population, it consistently involves biological, psychological and relational elements that affect overall health-related quality of life. Breast and pelvic cancers constitute 53% of cancer cases diagnosed in Canada with over 30% of colorectal, 73% of breast, 90% of prostate/gynecological, and 20% of non-breast/non-pelvic cancer survivors experiencing long-term SD. Despite the prevalence and negative impact of SD, sexual health clinics are the exception in cancer centres worldwide. Unfortunately, this gap in care hinders cancer survivors from achieving optimal sexual health recovery, sexual satisfaction, and relationship intimacy post-treatment. Objective We are establishing an innovative Sexual Health Clinic (SHC) that fosters accessibility and efficiency via virtual care, and personalized medicine via in-person care. The goal of the SHC is to assist patients/couples in achieving optimal sexual function, satisfaction (vs distress), and relational intimacy. Methods The SHC evolved from a fusion and expansion of the Prostate Cancer (Sexual) Rehabilitation Clinic (in-person care) at Princess Margaret, and the TrueNorth Sexual Health And Rehabilitation e-Clinic (virtual care). The SHC is theoretically founded in a biopsychosocial framework and utilizes a blended model of in-person and facilitated virtual care. The SHC virtual visits are tailored to the patient via content (text, videos, animations, and graphics) based on gender, cancer type, and treatment type. The SHC virtual platform also allows for chat-based synchronous and asynchronous facilitation with highly trained sexual health counsellors. In-person visits are designed to provide for a comprehensive sexual health assessment and sexual medicine prescription. A Hybrid Type 3 implementation research design will be used as a methodological framework for ensuring seamless integration of the SHC into the patient workflows of a high-volume cancer centre. Results An empirically-based, systematic approach to the development of a SHC based on a blended care model will be presented. Outcomes will include the process of developing: 1) personalize care pathways in a virtual setting; 2) efficient modes of digital facilitation; 3) approaches to integration of in-person and virtual care; and 4) empirically-based procedures for patient workflow implementation. Conclusions Innovative care provision is essential given the prevalence of sexual dysfunction and the limitations of resources within cancer centres. If successful, the proposed SHC will offer an efficient and effective model of care without compromising personalized patient care. Disclosure No