Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel.
Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel.
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前列腺癌患者性保健指南：国际专家组的建议。
DOI：
10.1016/j.jsxm.2022.08.197
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发表时间：
2022
期刊：
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H
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作者：
Wittmann,Daniela;Mehta,Akanksha;McCaughan,Eilis;Faraday,Martha;Duby,Ashley;Matthew,Andrew;Incrocci,Luca;Burnett,Arthur;Nelson,ChristianJ;Elliott,Stacy;Koontz,BridgetF;Bober,SharonL;McLeod,Deborah;Capogrosso,Paolo;Yap,Tet;H
背景前列腺癌患者在治疗后遭受严重的性功能障碍，这对他们及其伴侣的心理产生了负面影响，并使他们的关系紧张。目的我们召集了一个国际小组，旨在制定指导方针，告知临床医生，患者和伴侣前列腺癌治疗（PCT）对患者和伴侣的性健康，他们的关系，和关于前列腺癌（PC）survivorship.MethodsThe指南小组包括国际专家研究人员和临床医生，和一个指南方法学家的生物心理社会康复。根据科克伦干预措施系统综述手册，使用奥维德MEDLINE、Scopus、CINAHL、PsychINFO、LGBT Life和Embase数据库对文献进行了系统综述（1995-2022）。研究选择基于系统性综述和荟萃分析（PRISMA）指南的首选报告项目。根据美国泌尿外科协会（AUA）的命名法，根据获益/风险评估，为每个陈述分配证据强度（A-C）和建议水平（强、中等、有条件）。数据综合包括荟萃分析的研究被认为是足够的质量（3），使用测量工具来评估系统评价（AMSTAR）。OutcomesGuidelines为前列腺癌患者的性健康护理制定，根据现有的证据和专业知识的国际panel.ResultsThe指南帐户患者的文化，民族和种族的多样性。他们照顾不同性取向和性别认同的个人的独特需求。该指南基于文献综述、PCT后性恢复的理论模型和6项原则，这些原则促进临床医生发起讨论对性结局的现实期望，并通过生物心理社会康复减轻性副作用。47份声明涉及性心理、关系和功能领域，此外还有关于生活方式改变、评估、提供者教育、和系统性的挑战，以提供性健康护理的PC survivorship。临床意义该指南为临床医生提供了一个全面的方法，性健康护理的前列腺癌患者。优势&局限性本研究的优势在于对前列腺癌患者性功能障碍和康复的现有证据进行了全面评估，沿着现有的专业知识，最好地加强了临床实践。限制是变化的证据支持的干预措施和缺乏对前列腺癌患者面临的问题的研究在低收入和中等收入countries.ConclusionThe指南文件PCT的痛苦的性后遗症，提供循证性康复的建议，并概述了未来的研究领域。
BackgroundPatients with prostate cancer suffer significant sexual dysfunction after treatment which negatively affects them and their partners psychologically, and strain their relationships.AimWe convened an international panel with the aim of developing guidelines that will inform clinicians, patients and partners about the impact of prostate cancer therapies (PCT) on patients’ and partners’ sexual health, their relationships, and about biopsychosocial rehabilitation in prostate cancer (PC) survivorship.MethodsThe guidelines panel included international expert researchers and clinicians, and a guideline methodologist. A systematic review of the literature, using the Ovid MEDLINE, Scopus, CINAHL, PsychINFO, LGBT Life, and Embase databases was conducted (1995–2022) according to the Cochrane Handbook for Systematic Reviews of Interventions. Study selection was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Each statement was assigned an evidence strength (A-C) and a recommendation level (strong, moderate, conditional) based on benefit/risk assessment, according to the nomenclature of the American Urological Association (AUA). Data synthesis included meta-analyses of studies deemed of sufficient quality (3), using A Measurement Tool to Assess Systematic Reviews (AMSTAR).OutcomesGuidelines for sexual health care for patients with prostate cancer were developed, based on available evidence and the expertise of the international panel.ResultsThe guidelines account for patients’ cultural, ethnic, and racial diversity. They attend to the unique needs of individuals with diverse sexual orientations and gender identities. The guidelines are based on literature review, a theoretical model of sexual recovery after PCT, and 6 principles that promote clinician-initiated discussion of realistic expectations of sexual outcomes and mitigation of sexual side-effects through biopsychosocial rehabilitation. Forty-seven statements address the psychosexual, relationship, and functional domains in addition to statements on lifestyle modification, assessment, provider education, and systemic challenges to providing sexual health care in PC survivorship.Clinical ImplicationsThe guidelines provide clinicians with a comprehensive approach to sexual health care for patients with prostate cancer.Strengths & LimitationsThe strength of the study is the comprehensive evaluation of existing evidence on sexual dysfunction and rehabilitation in prostate cancer that can, along with available expert knowledge, best undergird clinical practice. Limitation is the variation in the evidence supporting interventions and the lack of research on issues facing patients with prostate cancer in low and middle-income countries.ConclusionThe guidelines document the distressing sexual sequelae of PCT, provide evidence-based recommendations for sexual rehabilitation and outline areas for future research.