An interactive training module for health professionals: Addressing the psychosexual care of women affected by gynaecological cancers P. Yates, K. Nattress, K. Hobbs, I. Juraskova, K. Sundquist, L. Carnew.

Introduction Treatment for a gynaecological cancer (GC) can alter a woman’s behaviours, attitudes and feelings towards sexuality and intimacy. Health professionals require knowledge and skills to minimise the risk of these concerns, and to effectively treat them should they occur. The aim of this project was to develop a psychosexual care framework and educational resource to improve health professionals’ skills and confidence in providing effective psychosexual care.

Project team and project working group guide development of the modules The Project Team, a group of specialists developing the modules include: The Project Working Group provides feedback and comment on developed resources at each stage of the process. Patsy Yates Palliative care research and education Kath Nattress Registered nurse, and post-graduate educator Ilona Juraskova Lecturer in Health Psychology at The University of Sydney, and a clinical psychologist Kim Hobbs Social Worker, Westmead Hospital, Department of Gynaecological Oncology. Kendra Sundquist Educator, expertise in sexual and reproductive health, sexuality, and psychosocial care in cancer

Module development process Phase 1 Scoping Phase 2 Development Phase 3 Piloting -Literature review -Web based review -Framework -Module outlines -Case study and module development -Review of materials by health professionals -Web and content editors ensure a succinct and usable structure -Piloting within test sites ensures usability of materials Phase 4 Implementing -Implementation of the final resource after addressing pilot feedback

Phase 1: Scoping Method All studies which explored, described and/or explained the psychosexual issues experienced by women affected by GC and their partners were included. The search strategy was limited to the years 1999 to mid October Databases searched included: CINAHL, PubMed, PsycINFO, and Medline

Phase 1: Scoping Results The literature searches identified 116 papers addressing: psychosexual sequelae, supportive care and quality of life health professional practices (including interventions) These topics were analysed to: identify competencies relevant to health professionals in various practice settings guide the development of the framework and educational resource

Phase 2: Developing the framework UniversalExtended Specialist Universal All women with gynaecological cancer Extended Some women with gynaecological cancer Specialist A few women with gynaecological cancer Caring for women affected by gynaecological cancers Universal Appropriate for all health professionals who interact with women affected by gynaecological cancers. Universal Appropriate for all health professionals who interact with women affected by gynaecological cancers.

UniversalExtended Universal All women with gynaecological cancer Extended Some women with gynaecological cancer Specialist A few women with gynaecological cancer Caring for women affected by gynaecological cancers Extended Appropriate for health professionals who are involved with the treatment and care of women affected by gynaecological cancers. Extended Appropriate for health professionals who are involved with the treatment and care of women affected by gynaecological cancers. Specialist Phase 2: Developing the framework

UniversalExtended Specialist Universal All women with gynaecological cancer Extended Some women with gynaecological cancer Specialist A few women with gynaecological cancer Caring for women affected by gynaecological cancers Specialist Discussion of topics which will aid health professionals’ care for women with gynaecological cancer who are exhibiting severe distress. Due to the highly specialised and often sensitive nature of required care at this level, identification of cases and appropriate referral techniques are required, as well as strategies to resolve problems. Specialist Discussion of topics which will aid health professionals’ care for women with gynaecological cancer who are exhibiting severe distress. Due to the highly specialised and often sensitive nature of required care at this level, identification of cases and appropriate referral techniques are required, as well as strategies to resolve problems. Phase 2: Developing the framework

Successful completion of modules 1, 2 and 3 will provide a broad level of capabilities and knowledge. Reviewing modules 1,2 &3; successful completion of modules 4,5& 6 at an in depth level, accessing additional readings, activities, & supporting resources will develop specialist capabilities, confidence and skill, including identification of cases and appropriate referral techniques Reviewing modules 1, 2 and 3 and successful completion of modules 4, 5 and 6 will achieve an extended level of capability, knowledge, confidence and skill.

Phase 2: Developing the modules A total of six modules have been developed to fit within the framework. 1.Understanding sexuality 2.Understanding the experience of the psychosexual effect of a gynaecological cancer 3.Enquiring and responding to the psychosexual sequalae of gynaecological cancers 4.Understanding psychosexual sequalae: pathophysiological, psychosocial and cultural aspects 5.Undertaking a comprehensive sexual health assessment 6.Evidence based approaches to the treatment of psychosexual sequelae of gynaecological cancers

Each module comprises… Key Concepts Case Studies Thinking Points Short Answer Q’s Multiple Choice Q’s

Search function Use the search function for quick access to relevant topics Located top right hand corner all pages of the resource

Phase 3: Pilot testing Many health professionals expressed the need for a resource to guide/improve their ability to deal with psychosexual issues in gynaecological cancer Health professionals reported improved confidence and knowledge following the workshop The range of issues addressed in the modules, coupled with case studies and learning activities, provided an interactive environment beneficial for learning

Phase 4: Implementation

What are we doing at the moment? website live on Self record option for CPD Workshop packages for group learning Freely available for online self-directed learning

Acknowledgements Funded by: Cancer Australia Project team: Professor Patsy Yates Kath Nattress Kim Hobbs Ilona Juraskova Kendra Sundquist Project Officer: Lynda Carnew Project Working Group: Dr Margaret Davy (Chairperson) Disciplines represented in Project Working Group & module review : Consumer Gynaecological Oncologist General Practitioner Radiation Oncologist Gynaecological Clinical Nurse Specialist Gynaecological Clinical Nurse Consultant Psychologist Research Psychologist Social Worker Education Services Manager Patient Programs Officer Sexual Health Educator