Evidence summary and nurse-led algorithm development of clinical guidance documents on sexual health for female breast cancer survivors: A systematic review.

AIM: To develop a nurse-led clinical algorithm based on recommendations from high- and average-quality clinical guidance documents (CGDs), using the nursing process as a framework, to standardize sexual healthcare for female breast cancer survivors (FBCS) and clarify core nursing roles in multidisciplinary care.

BACKGROUND

Sexual health is a prevalent yet frequently neglected concern among FBCS, significantly impacting their quality of life. Current evidence-summary literature synthesizes recommendations from CGDs, yet often fails to translate them into executable clinical pathways due to thematic fragmentation, definitional inconsistency and unclear leadership.

METHODS

A systematic review was conducted for CGDs published from May 1, 2015, to May 1, 2025, following systematic review reporting guidelines. A structured problem-establishment model was applied. Methodological quality was assessed using a guideline-appraisal instrument. Recommendations for managing sexual health in FBCS were summarized from a nursing perspective to develop a nurse-led algorithm.

RESULTS

Out of 2110 identified records, 13 CGDs were included. Thirty-five recommendations were synthesized into a framework comprising five categories: Fundamental Principles, Nursing Assessment, Nursing Diagnosis, Nursing Planning & Intervention, and Nursing Evaluation & Follow-up. This framework informed the development of a nurse-led clinical algorithm.

CONCLUSIONS

By translating high-quality evidence into a structured nursing process framework, this algorithm operationalizes CGD recommendations into actionable interventions and standardizes survivorship care, potentially enhancing team coordination and clarifying nursing roles. In the future, we should focus on continuously refining the algorithm by incorporating emerging evidence. Additionally, researchers could further explore the integration of adjacent themes within the nursing process framework.

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