Efficacy, usage and acceptability of an online self-management intervention designed to maximise sexual wellbeing in men living with prostate cancer: a single-arm study

Sean O'Connor, Carrie Flannagan, Kader Parahoo, Mary Steele, Samantha Thompson, Suneil Jain, Michael Kirby, Nuala Brady, Roma Maguire , John Connaghan, Eilis McCaughan

Research output: Contribution to journalArticlepeer-review

Abstract

Abstract
Background:
Sexual dysfunction is a frequent side-effect associated with different prostate cancer treatment approaches. It can have a substantial impact on men and partners and is associated with increased psychological morbidity. Despite this, sexual concerns are often not adequately addressed in routine practice. Evidence-based online interventions have potential to provide ongoing information and sexual wellbeing support throughout all stages of care.

Objectives:
To examine the efficacy of an online self-management intervention designed to maximise sexual wellbeing in men living with prostate cancer and explore user perspectives on usability and acceptability.

Methods:
Using a single-arm study design, participants were provided with access to the five-step intervention for a period of 3 months. Intervention content was tailored based on responses to brief screening questions on treatment type, relationship status and sexual orientation. Efficacy was assessed using paired-sample t-tests comparing mean differences between pre and post intervention measurements exploring participant’s self-reported knowledge and understanding, sexual satisfaction, and comfort discussing sexual issues. Usability and acceptability were determined based on programme usage data and a post intervention survey exploring perceived usefulness.

Results:
A total of 109 participants were recruited to the study. Significant post intervention improvements at follow-up were observed in overall survey scores (12.23/20 (SD: 2.46) versus 13.62/20 (SD: 2.31): t = 9.570; P =0.001) as well as in individual item scores on the extent to which participants agreed that they had sufficient information to manage the impact of prostate cancer on their sex life (2.31/4 (SD: 0.86) versus 2.57/4 (SD: 0.85): t = 3.660; P =0.001) and had the potential to have a satisfying sex life following treatment (2.38/4 (SD: 0.79) versus 3.17/4 (SD: 0.78): t = 7.643; P =0.001). The median number of intervention sessions was 3.0 (Range 1 to 11 sessions) with a median duration of 22.0 minutes (Range: 8 to 77 minutes). Acceptable usability scores were reported with the highest result observed for the question on the extent to which the intervention provided relevant information.

Conclusions:
This study provides evidence for the efficacy of a tailored, online intervention to maximise sexual wellbeing in men living with prostate cancer. Results indicate that the intervention may improve self-perceived knowledge and understanding of how to manage sexual issues, and increase self-efficacy or a belief that a satisfactory sex life could be achieved following treatment. Findings will be used to refine the intervention content prior to testing as part of a larger longitudinal study examining its effectiveness.


KEYWORDS
prostate cancer, sexual wellbeing, digital interventions, self-management
Original languageEnglish
JournalJournal of Medical Internet Research
Publication statusAccepted/In press - 11 Mar 2021

Keywords

  • prostate cancer
  • self-management
  • Digital interventions
  • sexual wellbeing

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