Definition of the central concept
The central concept synthesised for this model is the facilitation of supportive care for male sexual health. The sub-concepts facilitation, supportive care and male sexual health were defined using scholarly sources and reputable online dictionaries (Collins Dictionary 2024; Cramp & Bennett 2013; Henwood & Taket 2008; Merriam-Webster Dictionary 2025a; World Health Organization [WHO] 2006). The operational definition of the central concept is the delivery of comprehensive support to patients receiving radiotherapy for prostate cancer by addressing their informational, emotional, spiritual, social and physical needs, fostering whole-person care throughout radiotherapy.
Facilitation: The Collins Dictionary (2024) defines facilitation as an action or process, especially one that an individual would like to happen, which means making it easier or more likely to occur. The spectrum of facilitation is broad, ranging from creating a space in which everybody can have their say to facilitating processes where people can:
‘Face and take on board the unknown, through letting go of old knowledge, habits or ways of seeing … to step over existing boundaries, entering and transcending the threshold of change.’ (Soal 2004:55).
Supportive care: The concept of supportive involves actively helping someone in need of help, whereas care means paying serious attention, especially to the details of a situation or thing (Cambridge Dictionary 2025a). The Merriam-Webster Merriam-Webster Dictionary 2025a defines care as a feeling of interest or concern. In the study context, supportive care is the provision of necessary support to those living with or affected by cancer to meet their informational, emotional, spiritual, social and physical needs during their diagnosis, treatment and follow-up phases (Hui 2014).
Men’s sexual health: To define men’s sexual health, the concept was divided into three sub-concepts: men, sexual and health. In the Cambridge Dictionary (2025b), men are defined as those belonging to or related to the male gender. Man is an individual human being, particularly an adult male Merriam-Webster Dictionary 2025b. The adjective sexual is related to the instincts, physiological processes and activities connected with physical attraction or intimate physical contact between individuals (Bab.la 2025). Health refers to well-being that encompasses a person’s physical, mental and social aspects with specific reference to reproductive and sexual functions, soundness of the body or mind and freedom from disease or ailments Dictionary.com 2023; Merriam-Webster Dictionary 2025c.
The structure and nature of the model
The outer white frame with square borders in Figure 3 represents the context of public and private healthcare facilities. The inner frame represents the oncology department within the public and private institutions where men’s sexual health support should be offered. The red puzzle piece at the bottom of the model, connected to the orange interconnecting puzzle piece, represents the problem that this model seeks to address. The violet figurine on the bottom left side represents the facilitator (agent), whereas the grey figurine on the right side represents the male patient (recipient). The dark orange centre puzzle piece at the bottom depicts an opportunity for two-way communication on men’s sexual health issues between the oncology health professional or RTT (left) and the male patient (right).
On the left side of the large central arrow is a blue upward-curved arrow with a broad base that gradually becomes thinner towards the end. The tapering nature of the blue arrow and the transition from dark to light blue towards the arrowhead represent the intensity of facilitator involvement throughout the model process. On the right side of the large central arrow is a narrow blue-green (teal) arrow that curves upward with a broadened endpoint, symbolising the improved experience of male patients regarding SCMSH. The intensity of blue-green changes as the curve widens from the base to the arrowhead. This indicates the extent to which the male patient is engaged in and responsive to SCMSH facilitated by an oncology health professional. As the patient receives sexual health support, the widening arrow suggests that the patient develops stability in the internal environment during the initiation, working and reflection phases.
The central upward orange-yellow arrow gradually widens to reflect a positive change in the facilitation of SCMSH in oncology. In the context of this model, the medium orange colour used symbolises a warm, conducive space for male patients to interact with an oncology health professional and freely share their feelings about their experience of living with erectile dysfunction (McLeod 2016). The widened arrowhead indicates the improved SCMSH as a result of the model process.
Model process
The SCMSH facilitation process has three phases: initiation, working and reflection. The green zigzag loop, intertwining the large upward-pointing, widening orange-to-yellow arrow, illustrates these phases. Green represents physical, emotional and mental rejuvenation during episodes of distress about erectile dysfunction (Cherry 2023; Learn Laugh Speak 2022). The intensity of the green colour differs to represent the level of engagement of the oncology health professional with the male patient.
Initiation phase: The oncology health professional in this context is an RTT approaching the patient with open arms and extending his or her hands towards the patient, showing confidence and commitment to offering SCMSH to a patient with prostate cancer. This implies that the oncology health professional should initiate dialogue with the patient rather than the patient having to take the lead. The facilitator’s gender is irrelevant, even though the violet figurine representing the oncology health professional shown in Figure 3 indicates a male person. In this phase, the facilitator develops a therapeutic bond with the patient by establishing a safe, trusting and non-judgemental environment for the patient to speak freely. This phase is the largest of the three because the facilitator needs ample time to build a therapeutic relationship with the patient. The dark green hue representing this phase indicates the effort and energy (intensity) the facilitator requires to initiate SCMSH with new patients. During this phase, the facilitator and patient set actionable goals.
The grey figurine, portraying a male patient seeking supportive care for his sexual health concerns from the oncology health professional, symbolises someone experiencing low morale, stress, frustration and hopelessness. The facilitator’s level of involvement is indicated by the blue arrow, which has a broad base during the initiation phase. The curved arrow gradually becomes narrower as it passes through the working and reflection phases, thereby representing a decrease in the level of facilitator involvement. The facilitator’s engagement level is high in the initiation phase, as the oncology health professional attempts to build a safe, trusting and amicable environment so that the patient can speak freely. The gradual change in the intensity of the blue colour from the initiation phase to the reflection phase throughout the facilitation process explains this.
The engagement process of the male patient is represented by the curved blue-green (teal) arrow with a narrow base in the initiation phase, which becomes progressively thicker in the working and reflection phases. Variation in the hue of the teal colour from light to dark indicates the extent to which the patient engages with the oncology health professional during the facilitation of men’s sexual health. The changing thickness of this arrow represents an increase in the self-confidence and trust of the patient during the process. This change is symbolic of the gradual improvement in men’s positive experiences with supportive care for their sexual health. The facilitator transitions to the working phase only when the patient is prepared to discuss sexual health challenges. If the patient is not ready, the facilitator can offer reassurance with phrases such as, ‘Today may not be the best time to discuss your sexual health challenges with me, but please let me know when you feel comfortable having this conversation.’
Working phase: During this phase, the communication between the facilitator and the patient evolves into a two-way conversation. The facilitator must continue to value and respect the patient’s preferences, health beliefs, culture, religion and societal norms because these factors are often barriers to sexual health dialogue that can result in a patient not engaging in the process (Arousell & Carlbom 2016; Degni et al. 2012). The goal of this phase is to help the patient restore balance in their body, mind and spiritual dimensions that have been disrupted by a decline in sexual health and challenges causing intimate-relationship problems. Supportive care for men’s sexual health moves from the initiation phase to the reflection phase with the facilitator utilising the whole-person-care approach. The patient is given time to develop mental strength and cope with external environmental stressors that exert pressure on him to regain erectile function. The progression of supportive care is subtle and marked in the model by the gradual colour change of the spiral loop from dark green to lighter green. In practical terms, this means that the patient starts to achieve balance in the internal environment of their body, mind and spirit to overcome stressors. Lastly, when complex issues arise beyond the facilitator’s expertise while the facilitator is engaging with the patient, it is essential to refer the patient to a specialist, such as a clinical psychologist or sex therapist, for expert advice.
Reflection phase: The reflection phase is the last phase and is represented in light green, indicating renewal and optimism (Cherry 2020). In this phase, the oncology health professional and male patient engage in debriefing to reflect on the facilitation of the patient’s sexual health. This final phase is smaller and less intensive than the initiation and working phases. In this phase, the patient reflects on the gaps, successes and strengths of the facilitation process. The oncology health professional and male patient reflect on whether their shared objectives were met and evaluate the successes and shortcomings of the entire model process. Furthermore, the oncology health professional and male patient contemplate interventions that the patient could use to cope with erectile function challenges or rehabilitate sexual functioning to improve the quality of life during and after radiotherapy for prostate cancer. The facilitator’s involvement in this phase is limited and is mainly geared towards the patient, who reflects on his satisfaction following the facilitation of SCMSH during radiotherapy for prostate cancer. The upper third portion of this model shows the outcome of the initiation, working and reflection phases. The outcome is improved facilitation of SCMSH. The male patient, initially portrayed in grey, as shown in Figure 3, is now transformed into green. This figurine represents a happy man with enhanced self-confidence who is content with himself and ready to deal with external environmental factors that may destabilise his internal environment. The assumption here is that, at this stage, the patient will have worked out a way to cope with his sexual health challenges. Theoretically, this means that the male patient has regained a balance in the internal environment of body, mind and spirit to overcome the stressors of the external environment, achieving whole-person care. As the patient starts to restore balance in the body, mind and spirit during the initiation, working and reflection phases, the role of the facilitator gradually decreases, as indicated by the tapering end of the curved arrow and its narrow arrowhead at the top left-hand side of the model. The male patient engagement process curve, culminating in a thick, dark blue-green arrowhead at the top right-hand side, signifies the positive SCMSH experience that the patient received in the oncology department.
The regression of the male patient’s engagement process defines a relapse activity. The dashed red line indicates a scenario in which the patient either did not actively participate or chose to withdraw from the interaction, leading to no positive outcomes. A relapse in the model process indicates that the patient may revert to or persist in an unbalanced internal state, marked by hopelessness, loneliness, reduced confidence and fear of intimate relationships, symbolised by the grey male figurine. The red hue signifies potential flaws or challenges in the facilitation process, which might necessitate termination, repetition or referral to a specialist (Fikrlova et al. 2019) based on the patient’s wishes.