From Taboo to Routine Care: Oncology Nurses’ Assessment and Management of Sexual Dysfunction in Patients with Cancer: A Mixed-Methods Systematic Review

Sexual dysfunction affects 50–78% of cancer survivors, representing an overlooked domain of survivorship care. Although oncology nurses are strategically positioned to address this burden, widespread practice deficits persist. This mixed-methods systematic review synthesized evidence on oncology nurses’ assessment and management practices, multilevel barriers, and nurse-led interventions, with attention to Arab and Middle Eastern contexts. Five databases (PubMed, Scopus, CINAHL, ScienceDirect, Web of Science) were searched from 2005 to 2026 under PRISMA guidelines. Eligible quantitative, qualitative, and mixed-methods studies were appraised using the Mixed Methods Appraisal Tool and synthesized via a convergent integrated approach. Fifteen studies comprising 4455 participants (4025 nurses, 421 cancer survivors, 9 multidisciplinary clinicians) across eight countries were included. Oncology nurses consistently demonstrated deficiencies in knowledge, attitudes, and routine practices. Multilevel barriers included inadequate training, personal discomfort, patient embarrassment, gender discordance, time constraints, and absent institutional protocols. Conversely, preliminary evidence from non-randomized and pre–post evaluations suggested that structured frameworks (PLISSIT, BETTER) and nurse-led clinics were associated with encouraging improvements in nursing competence, documentation, and patient-reported sexual function. In the included studies from Egypt and Jordan, sociocultural taboos and gender-related concerns appeared to amplify these challenges. Integrating standardized assessment pathways, protected consultation time, and culturally tailored training into oncology nursing is essential to transition sexual health from taboo to routine practice.