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Table 1 TrueNTH Sexual Recovery Intervention Content

From: TrueNTH sexual recovery study protocol: a multi-institutional collaborative approach to developing and testing a web-based intervention for couples coping with the side-effects of prostate cancer treatment in a randomized controlled trial

Module Theme Goal Content
1 Pre-treatment education Preparation for the sexual side-effects of prostate cancer treatment, rehabilitation, emotional response and working on recovery as a team. Video: couple modeling acceptance of working together on sexual recovery.
Education: etiology and nature of treatment-related sexual dysfunction, its effect on relationships, goal and type of rehabilitation, individual and couple emotional work that supports recovery.
Activity: sharing concerns and goals for recovery.
Request for tailored strategies: specific concerns will trigger a tailored response delivered to patient and/or partner by email.
2 Preparation for the resumption of sexual activity Understanding of sexual rehabilitation as it relates to erectile dysfunction, female post-menopausal challenges; normalizing of feelings of grief about sexual losses; maintenance of feeling connected in the face of the sexual challenges ahead. Video: patient discussing changes after prostate cancer treatment and engagement in rehabilitation
Education: description of penile rehabilitation methods, maintenance of vaginal health and taking pressure off the sexual relationship during the early phase of rehabilitation.
Activity: treatment-related sexual changes and post-menopausal changes, determination of use of sexual aids for rehabilitation by both man and partner, introduction of rehabilitation diary, staying connected.
Request for tailored strategies: specific concerns will trigger a tailored response delivered to patient and/or partner by email.
3 Beginning to recover sexual intimacy as a couple Recognition that sexual changes will require adaptation by the man and the partner, likely use of sexual aids and a need to adopt a flexible approach to sexual interactions. Video: A sex therapist encourages the work on sexual recovery, movement towards a ‘new sexual normal.’
Education: Coping with sexual changes, role of grief, management of expectations, understanding the role of the partner, flexible approach to sexual intimacy, potential barriers, review of sexual aids for men and partners, sensate focus exercises.
Activity: Draw body maps to use for sensate focus exercises. Staying connected.
Request for tailored strategies: Specific concerns will trigger a tailored response delivered to patient and/or partner by email.
4 Integrating sex into life’s routine Acceptance of “new sexual normal.” Video: Couple talking about engaging in regular, intentional sexual activity.
Education: Importance of communication, finding time to have sexual activity, review of choices of sexual aids, role of non-penetrative sex and affection, mutuality in the sexual relationship.
Activity: Develop a plan for regular sexual activity, including sexual aids and how each partner will contribute. Identify barriers to regular sexual activity and how they can be overcome. Staying connected.
Request for tailored strategies: Specific concerns will trigger a tailored response delivered to patient and/or partner by email.
5 Effective sexuality after prostate cancer Review the work on sexual recovery with a sense of accomplishment Video: Couple discusses where they are 6 months after treatment.
Education: Review of sexual changes, rehabilitation, use of sexual aids, expanded sexual repertoire, grief work, communication, participation in the study.
Activity: Worksheet to identify sexual activities practiced, including frequency, aids used, the degree to which emotional acceptance was reached, and what goals were reached. Staying connected.
Request for tailored strategies: Specific concerns will trigger a tailored response delivered to patient and/or partner by email.
10 How to speak to medical providers about sexual problems Empower men and partners to feel comfortable addressing sexual concerns Video: Couple talking about how difficult it can be to discuss sexual problems with their provider, and how to overcome barriers.
Education: Emphasize the importance of engaging providers about sexual concerns, discuss strategies for preparing to do it, discuss roles that the man and partner can take, encourage rehearsal.
Activity: Review of worries, priority list of questions important to patient and partner, role-play.
Request for tailored strategies: Specific concerns will trigger a tailored response delivered to patient and/or partner by email.
  1. Additional Modules that will be part of the website, but not part of the Randomized Control Trial
  2. Module 6: Maintaining a sexual relationship for the long term
  3. Module 7: One month after biochemical relapse
  4. Module 8: Sexuality during advanced stages of prostate cancer
  5. Module 9: Overcoming barriers to sexual recovery