Cancer Nursing Interventions for Sexual Function and Satisfaction in Men with Prostate Cancer: A Systematic Review and Meta-analysis

14-study meta-analysis finds nurse-led psychoeducational programs improve sexual function (SMD=0.31) and satisfaction (SMD=0.27) — effects just clear zero

Journal: Seminars in Oncology Nursing | Published: 2026-02-27 | Type: Systematic Review, Meta-Analysis | PMID: 41763947 Authors: Birimoğlu Okuyan C, Kerkez M, Bilgin A (Sakarya University, Çukurova University — Turkey) Funding/COI: No funding listed. Authors declare no competing interests.

Summary

Nurse-led psychoeducational and physical activity interventions produce statistically significant but small improvements in sexual function and satisfaction among prostate cancer patients. The pooled effects are real but modest — both SMDs sit between 0.27 and 0.31, and the confidence intervals only barely clear zero. Fourteen studies is a thin base for meta-analytic conclusions.

Claims

• Psychoeducational interventions improved sexual function: SMD = 0.31 (95% CI: 0.03–0.60, P = .03)
• Interventions improved sexual satisfaction: SMD = 0.27 (95% CI: 0.04–0.50, P = .02)
• Combined approaches (counseling + physical activity) showed the most consistent benefit
• "Moderate heterogeneity" across included studies (I² not reported in abstract)
• Search covered PubMed, Scopus, Web of Science, CINAHL; studies from 2010–2023

Study Quality

This is a systematic review with random-effects meta-analysis — the right design for this question. The 13-year search window and four-database search are appropriate. Random-effects modeling is the correct choice given acknowledged heterogeneity. The review does not report an I² statistic in the abstract, which makes "moderate heterogeneity" impossible to evaluate without the full text.

The sample is small at 14 included studies. Effect sizes of SMD ~0.3 are by convention "small" on Cohen's scale, and confidence intervals whose lower bounds are 0.03 and 0.04 are borderline — a minor shift in any included study's data would push them to non-significance. The conclusions in the abstract overstate the findings: "significantly improved" is technically true by p-value but the clinical magnitude is modest and the claim that nurse-led programs "can significantly improve sexual outcomes" in the nursing implications section runs ahead of the data.

Red Flags

• Only 14 included studies — small pool for meta-analytic claims
• Lower confidence interval bounds barely clear zero (0.03 and 0.04) — results are fragile
• I² not disclosed in abstract; "moderate heterogeneity" is vague
• Published in a nursing journal, not a urology journal — peer review audience may be less critical of effect size interpretation
• No funding source reported — unclear who supported the research
• Conclusions use advocacy language ("reinforces the need," "prioritize sexual health") that goes beyond what the data supports
• All three authors from Turkish universities; geographic concentration may affect generalizability of included studies

Strengths

• Correct statistical approach (random-effects model) given heterogeneous interventions
• Multi-database search across 13 years
• Standardized quality assessment of included studies
• No industry funding declared — reduces commercial bias concern
• Addresses a genuine gap: sexual health in cancer survivorship is under-studied relative to survival outcomes

Verdict

A competent meta-analysis on a real clinical question that gets undermined by overselling its results. Effect sizes of SMD ~0.3 with confidence intervals that barely exclude zero are signal worth noting, not grounds for claiming nurse-led programs "can significantly improve" sexual outcomes. The 14-study pool is thin, heterogeneity is acknowledged but not quantified in the abstract, and the implications section reads more like a policy argument than a data summary. Worth filing as preliminary evidence that structured support programs do something — but this paper hasn't established how much, for whom, or which components drive the effect.