Despite significant sexual dysfunction and distress after localized prostate cancer treatment, patients typically receive only physiologic erectile dysfunction management. The authors performed a randomized controlled trial of an online intervention supporting couples' posttreatment recovery of sexual intimacy.

/pdf/truenth-sexual-recovery-intervention-for-couples-coping-with-2u35lujn.pdf

TrueNTH Sexual Recovery Intervention for couples coping with prostate cancer: Randomized controlled trial results

Abstract Background Virtual nurse-led care models designed with health care professionals (HCPs) and patients may support addressing unmet prostate cancer (PCa) survivor needs. Within this context, we aimed to better understand the optimal design of a service model for a proposed nurse-led PCa follow-up care platform (Ned Nurse). Methods A qualitative descriptive study exploring follow-up and virtual care experiences to inform a nurse-led virtual clinic (Ned Nurse) with an a priori convenience sample of 10 HCPs and 10 patients. We provide a health ecosystem readiness checklist mapping facilitators onto CFIR and Proctor’s implementation outcomes. Results We show that barriers within the current standard of care include: fragmented follow-up, patient uncertainty, and long, persisting wait times despite telemedicine modalities. Participants indicate that a nurse-led clinic should be scoped to coordinate care and support patient self-management, with digital literacy considerations. Conclusion A nurse-led follow-up care model for PCa is seen by HCPs as acceptable, feasible, and appropriate for care delivery. Patients value its potential to provide role clarity, reinforce continuity of care, enhance mental health support, and increase access to timely and targeted care. These findings inform design, development, and implementation strategies for digital health interventions within complex settings, revealing opportunities to optimally situate these interventions to improve care. 

A qualitative study on healthcare professional and patient perspectives on nurse-led virtual prostate cancer survivorship care

Social work is a long-established profession in health care and rehabilitation. Reviewing the evidence on effects of social work interventions shows inconsistencies, with several studies indicating positive, negative, or no significant effect at all. Against this background, the purpose of this paper is to provide an international overview of the research on social work practice in rehabilitation. Two research questions about the activities performed by social workers in rehabilitation settings and the reported outcomes to evaluate social work interventions were guiding the analysis. A scoping review was conducted in order to identify these activities and reported outcomes. The literature search was carried out in two databases (PubMed, SocINDEX). Additionally, the authors searched manually for literature in rehabilitation science and social work journals. Inclusion criteria encompassed the involvement of social workers and a description of their activities. The context in which social work's practice had to take place was a rehabilitation setting. A total of 2,681 records could be identified by searching the databases, journals, proceedings and reference lists. 66 sources met the predefined inclusion criteria. A majority of the identified activities that social workers perform are case related. Topics that may occur in these case encounters are the social environment of the patient, financial/social security, work-related issues and others. Of particular note are activities such as assessment, counseling and education. When applying the ICF framework, the outcomes are distributed across almost all components with an emphasis on Participation. This review demonstrates that social work has a vital role in the interprofessional rehabilitation team on an international level. However, there is still a need for more research about the effectiveness of social work interventions. We identified internationally common social work core activities/issues and derived a proposal for specific outcomes for future evaluation research. 

Social work practice and outcomes in rehabilitation: a scoping review

INTRODUCTION
Prostate cancer survivors experience a multitude of late treatment effects, resulting in greater unmet needs, elevated symptom burden, and reduced quality of life. Survivors can engage in appropriate self-management strategies post-treatment to help reduce the symptom burden. The objectives of this study were to: 1) explore the unmet needs of prostate cancer survivors using the validated Cancer Survivor Unmet Needs instrument; 2) explore predictors of high unmet needs; and 3) explore prostate cancer survivors' willingness to engage in self-management behaviors.


METHODS
Survivors were recruited from a prostate clinic and a cross-sectional survey design was employed. Inclusion criteria was having completed treatment two years prior. Descriptive statistics were used to summarize participant characteristics. Univariate and multivariate analyses were done to determine predictors of unmet needs and readiness to engage.


RESULTS
A total of 206 survivors participated in the study, with a mean age of 71 years. Most participants were university/college-educated (n=123, 61%) and had an annual household income of ≥$99 999 (n=74, 38%). Participants reported erectile dysfunction (81%) and nocturia (81%) as the most frequently experienced symptoms with the greatest symptom severity (χ̄ =5.8 and χ̄ =4.5, respectively). More accessible parking was the greatest unmet need in the quality-oflife domain (n=34/57, 60%). Overall, supportive care unmet needs were predicted by symptom severity on both univariate (p<0.001) and multivariate analyses (odds ratio [OR] 1.81, 95% confidence interval [CI] 0.92-1.00, p<0.001). Readiness to engage in self-management was predicted by an income of less than $49 000 (OR 3.99, 95% CI 1.71-9.35, p=0.0014).


CONCLUSIONS
Income was the most significant predictor of readiness to engage in self-management. Consideration should be made to establishing no-cost and no-barrier education programs to educate survivors about how to engage in symptom self-management.

/pdf/predictors-of-prostate-cancer-survivors-engagement-in-self-3exd3577.pdf

Predictors of prostate cancer survivors' engagement in self-management behaviors.

Abstract Background: Prostate cancer survivors (PCa) can experience a range of unmet needs over a long horizon of survivorship. Thin healthcare services and specialist-led follow-up care models may not adequately address these needs. Digitally mediated nurse-led virtual care models may help support PCa survivors who have unmet survivorship needs in current healthcare systems. Methods: This qualitative descriptive study explores 10 patients’ experiences with follow-up and virtual care, informing the design of a nurse-led virtual clinic (the “ Ned Nurse ” Clinic) to provide integrated healthcare services. Results: Patient follow-up care experiences included uncertainty regarding care gaps despite new telemedicine modalities and the need for personalized wellbeing support. Patient recommendations for virtual care related to improving integration of existing care connections, supporting patient self-management, and addressing accessibility. Patients anticipate nurse-led PCa virtual care will: (1) clarify patient and provider roles and responsibilities; (2) improve care ease and access to care; (3) enhance mental wellbeing, and (4) reinforce continuity of care. Conclusion: Patients are keen to benefit from the flexibility and increased resources that digital health may provide, but remain concerned about digital literacy and service changes to support these innovations. Future work should evaluate the efficacy of digitally mediated nurse-led virtual care models to support PCa survivorship. 

/pdf/nurse-led-virtual-prostate-cancer-clinic-for-survivorship-1gb7y20f.pdf

Nurse-led virtual prostate cancer clinic for survivorship care: Qualitative study of patient experiences and needs

The primary objective was to determine the feasibility of implementing the TrueNTH SHAReClinic as a pan-Canadian sexual health and rehabilitation intervention for patients treated for localized prostate cancer. The feasibility study was designed to evaluate the accessibility and acceptability of the intervention. Participants from five institutions across Canada were enrolled to attend one pre-treatment and five follow-up online clinic visits over 1 year following their prostate cancer (PC) treatment. Sixty-five patients were enrolled in the intervention. Website analytics revealed that 71% completed the intervention in its entirety, including the educational modules, with an additional 10% completing more than half of the intervention. Five thousand eighty-three views of the educational modules were made along with 654 views of the health library items. Over 1500 messages were exchanged between participants and their sexual health coaches. At 12 months, the intervention received an overall average participant rating of 4.1 out of 5 on a single item satisfaction measure. Results support the TrueNTH SHAReClinic as highly acceptable to participants as defined by intervention adherence and engagement. The TrueNTH SHAReClinic demonstrated promise for being a feasible and potentially resource-efficient approach to effectively improving the sexual well-being of patients after PC treatment.

/pdf/an-online-sexual-health-and-rehabilitation-eclinic-truenth-2gra8u7yem.pdf

An online Sexual Health and Rehabilitation eClinic (TrueNTH SHAReClinic) for prostate cancer patients: a feasibility study

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An online Sexual Health and Rehabilitation eClinic (TrueNTH SHAReClinic) for prostate cancer patients: a feasibility study