Procedure

ActionRationale

1. 1.Show
   Invite the patient to a confidential place and ensure they have time to engage with the assessment and conversation.
   Respect, confidentiality and dignity; create an environment where the patient feels they can talk about a subject that may be sensitive or embarrassing (Oguchi et al. [214], C).
2. 2.Show
   1. Use the Holistic Needs Assessment (see Section c27-sec-0003) or one of the tools described in this section to guide a conversation with the patient about their sexual health.
      If this is done to establish a baseline it is important to explain this to the patient.
   2. Reassess using the same assessment tool post cancer treatment to initiate a focused conversation around any changed sexual health needs.
   To obtain baseline assessment to set expectations regarding the likelihood of sexual consequences arising from cancer treatments.

   Using a recognized assessment tool can help structure and guide sensitive conversations (LCA [148]). E, C

   Early treatment for sexual health concerns can manage expectations, reduce anxiety and improve some functional outcomes. Use of a short survey can initiate a productive exchange including options for improvement (Kennedy and Leiserowitz [139]). E
3. 3.Show
   If necessary, explore concerns further. Neutral non‐judgemental questions may be helpful, taking account of cultural, religious and personal beliefs. It can help to begin with closed easy‐to‐answer questions:

   • Is sexual function important to you at the moment?”
   • Are you able to achieve the same level of sexual function after your surgery/treatment that you had beforehand?
   • How is this affecting your relationship at the moment?
   Begin a conversation to assess the patient's identified needs. Allow them the opportunity to feel at ease and talk. E

   Presenting an opportunity to discuss sexual health concerns is more effective than waiting for the individual to ask for help (Ussher et al. [277]).
4. 4.Show
   Communicate to the patient's medical or surgical team the concerns raised and discuss preferred treatments options and referrals to appropriate services.
   To ensure the most appropriate individuals are involved in supporting the patient's needs. E
5. 5.Show
   Refer to specialist services or teams. This could include:

   • the patient's GP for monitoring and follow‐up
   • local post‐treatment effects clinics, including erectile dysfunction/hormone management
   • a psychosexual counsellor.
   To ensure suitable professionals are involved to meet the patient's identified needs. C, E

   Provide the patient with information to enable them to make an informed decision. P
6. 6.Show
   Document on the holistic needs assessment/care plan or in the patient's hospital notes the concerns raised and the agreed plan of care.
   Nurses/healthcare professionals should keep clear and accurate records (NMC [201], C).