Early nursing sexual consultation and psychoeducation for improving sexual life quality of breast cancer patients: a systematic meta-analysis
Authors: Lin Zichao , Shou Zhihong , Wang Qiaoqiao 
Published: March 2023

Abstract
Background
Breast cancer (BC) is a common malignancy in humans and ranks first among female malignancies. As increasing incidence, it is now a major public health problem in current society. The study of BC has important practical implications for women's life health. This article aims to describe the current state of research on sexual function in breast cancer patients with sexual counseling and psychological education to make recommendations for future nursing research.
Methods
A systematic literature search was performed for English language articles published in PubMed and Web of Science Core Collection from 2020 to March 2023 and for Chinese articles published in CNKI from 2020 to March 2023. Search terms included "breast cancer " or "sexual function" or a combination of "counseling" and "education", duplicates and unrelated studies were excluded. The text words contained in the title and abstract of the retrieved articles and the index words used to describe the articles were analyzed. Data synthesis a pooled estimate of effect size was generated using Rev Man 5.4.1. The Cochrane risk of bias tool was used to assess the risk of bias of the included studies.
Results
There are 8 randomized controlled trials in total. A total of 814 female patients(age 27–45)with breast cancer after treatment received sexual nursing consultation and psychological education intervention follow-up after intervention into the meta-analysis. According to FSFI indicators, the quality of sexual life of patients after intervention was evaluated from sexual function, libido, sexual satisfaction, and sexual intercourse difficulties. The sexual counseling model was divided into 144 individuals by multimedia counseling, 386 by WeChat or app counseling, 143 by PLISSIT or BETTER counseling, 109 by physical and mental education and 32 by group education. The standardized mean difference (SMD) for effect of sexual counseling and psychoeducation on orgasm for BC patients values was 0.50 (95% confidence interval [CI] = 0.61 to 1.28),p < 0.00001.The SMD for effect of sexual counseling and psychoeducation on sexual arouse for BC patients values was 0.76 (95% confidence interval [CI] = 0.65 to 0.88),p < 0.00001.The SMD for effect of sexual counseling and psycholeducation on dyspareunia for BC patients values was 0.40 (95% confidence interval [CI] = 0.00 to 0.80),p = 0.65.The SMD on sexual arouse for BC patients values was 0.76 (95% confidence interval [CI] = 0.65 to 0.88),p < 0.00001.The SMD on sexual function for BC patients values was 1.76(95% confidence interval [CI] = 1.70 to 1.82),p < 0.00001.
Conclusions
After sexual counseling intervention and PLISSIT or BETTER model intervention, patients' sexual function and sexual satisfaction were significantly improved. Health education, including physical and psychological education and multimedia intervention had a positive effect on cancer patients' orgasm, sexual satisfaction and vaginal lubrication. It shows that sexual counseling and psychoeducation are of positive significance to the sexual function of cancer patients after treatment. To improve the prognosis of patients, we should continue to focus on sexual education for cancer patients in the future, to improve the sexual function and sexual life of breast cancer patients.