Nurses' Roles in Managing Erectile Dysfunction: A Mixed-Method Systematic Review

A systematic review of 14 studies maps RN and NP roles in ED care — organizational, not clinical

Journal: American Journal of Men's Health | Published: 2026-03-09 | Type: Mixed-Methods Systematic Review | PMID: 41802935 Authors: Chen Hui-Chun (Chang Gung University of Science and Technology); Liu Chieh-Yu (National Yang Ming Chiao Tung University); Liao Chun-Hou (Cardinal Tien Hospital / Fu-Jen Catholic University) — all Taiwan Funding/COI: Funding not reported. Authors declare no conflicts of interest.

Summary

Chen et al., 2026 conducted a mixed-methods systematic review across six databases to characterize what registered nurses (RNs) and nurse practitioners (NPs) actually do when caring for men with erectile dysfunction. From 14 included studies, they identified five nursing role categories and drew a line between RN and NP scope. The paper is a role taxonomy, not a clinical outcomes study — it describes what nurses do, not whether nursing interventions improve ED.

Claims

• Five nursing responsibilities in ED care were identified: (1) risk factor assessment, (2) needs clarification and/or diagnosis, (3) individual or couple education, (4) treatment facilitation/provision, and (5) continuous monitoring
• RNs focus on problem identification, sexual health promotion, treatment adherence education, and internal referrals
• NPs have a distinct scope: laboratory and diagnostic monitoring, direct counseling and treatment, and specialist referrals
• Both roles operate within a multidisciplinary framework
• Review authors call for expanded education programs for both RNs (assessment and ED knowledge) and NPs (diagnosis, counseling, treatment, monitoring)
• No effect sizes, clinical endpoints, or outcome data are reported — the review is descriptive by design

Study Quality

This is a legitimate mixed-methods systematic review using a defensible methodology: six-database search, dual independent reviewers, and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for quality assessment. JBI is a respected tool for mixed-methods synthesis. The dual-extraction and integration process is appropriate for combining quantitative and qualitative findings.

The corpus is small — only 14 studies total, 12 quantitative and 2 qualitative — which limits the conclusions that can be drawn. The abstract does not report the aggregate sample sizes of included studies, the range of study designs within the 12 quantitative papers, or the geographic distribution of the literature, all of which matter for assessing generalizability. The synthesis produces a framework, not a statistical estimate.

Red Flags

• N=14 included studies is a thin evidence base for a systematic review
• No clinical outcomes reported anywhere — this cannot tell you whether nursing involvement improves ED, only that nurses perform certain tasks
• Funding source not disclosed, which is a gap in transparency
• Abstract omits sample sizes, effect sizes, and even basic descriptive statistics from included studies — unusual for a quantitative-dominant corpus
• "Needs clarification and/or diagnosis" as an RN role raises scope-of-practice questions that vary by jurisdiction; the review doesn't address this variation
• The call for "enhanced education programs" in the conclusion is unsupported by outcome data within the review itself

Strengths

• Six-database search is thorough for this literature type
• JBI appraisal tool is appropriate and validated for mixed-methods work
• Independent dual-reviewer design reduces extraction bias
• Clearly distinguishes RN versus NP scope, which is a real clinical distinction often conflated
• Addresses a genuine gap: nursing roles in ED care are undercharacterized in the literature

Verdict

This paper does its narrow job competently: it taxonomizes nursing roles in ED care using sound systematic review methods. But "competent taxonomy" is the ceiling here — there are no clinical endpoints, no effect sizes, and no evidence that nurse-led ED care produces better outcomes than any alternative. The 14-study corpus and missing funding disclosure are real limitations. If you're designing a multidisciplinary urology unit and want a framework for nursing scope, this is useful. If you want to know whether nurses improve ED outcomes, this paper cannot answer that.