(383) Sexual Healthcare in Oncology: Description of a Sexual Health Clinic Utilizing an Innovative Blended Model of In-person and Facilitated Virtual Care
Bibliographic record
Abstract
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
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.026 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".