A digital health intervention: development and validation of a social media nursing program for sexual dysfunction following cervical cancer radical hysterectomy
Objective
This mixed-methods study utilized an exploratory sequential design to develop and evaluate a digital health intervention delivered via social media for sexual dysfunction following cervical cancer surgery. The intervention aimed to improve sexual function and promote health empowerment—conceptualized as the knowledge, skills, and self-efficacy to manage one’s health—thereby enhancing the overall sexual well-being of survivors.
Methods
Implemented at a Chinese tertiary hospital, this study adopted an exploratory sequential mixed-methods design. We first conducted in-depth qualitative interviews with 12 post-operative cervical cancer patients to investigate their sexual health experiences and unmet needs. Guided by these findings, a social media-based intervention was developed and delivered on WeChat, integrating three key elements: interactive multimedia education, a moderated peer support community, and specialist counseling. The efficacy of this digital intervention was then rigorously tested in a randomized controlled trial with 92 participants.
Results
The qualitative interviews ( n = 12) revealed five primary themes: physiological and psychological impacts, dynamic shifts in partnership, evolving self-perception, gaps in professional support, and conflicting expectations. These findings constructed a framework for a social media-based intervention. The subsequent randomized controlled trial ( n = 92) demonstrated that the intervention group achieved a 19.08% increase in the total Female Sexual Function Index (FSFI) score at the 3-month follow-up ( p < 0.001), with the most substantial improvement observed in sexual satisfaction (+49.79%). Notably, the intervention also led to a significant 13.97% increase in health empowerment (FACT-Cx, p < 0.001) and a 20.19% reduction in stigma (SIS, p < 0.001). Importantly, improvements in sexual function were strongly correlated with gains in health empowerment and reductions in stigma ( p < 0.001).
Conclusion
This digitally-enabled intervention bridges the principles of accessible public health communication with patient-centered care. By leveraging a widely-used social media platform, we delivered a holistic program that significantly enhanced sexual function, empowered patients, and mitigated stigma. This work establishes a practical, transferable solution for improving health literacy and quality of life among cancer survivors, demonstrating the potential to bridge service gaps in supportive care.