| Room 518 | Sexuality and Health (Oncologie) Monday, July 11, 2005 Time: 2:30 PM-4:30 PM |
Health professionals talking to patients about issues of intimacy and sexuality after a cancer diagnosis: Why is it so hard?
Hordern, Amanda1, Street, Annette, Akkerman, Doreen*,2, 1 Latrobe University/ Austin Health Clinical School of Nursing, Heidelberg, Victoria, Australia2 The Cancer Council Victoria, Carlton, Victoria, Australia
ABSTRACT- Objective: The aim of this paper is to present the health professional perspective on communication with patients about issues of intimacy and sexuality in the context of cancer and palliative care. Methods: This reflexive inquiry involved a systematic and critical analysis of data from semi structured interviews (n=82), 33 national and international clinical practice guidelines and feedback from participants at 15 forums where preliminary research findings were presented to consumers and health professionals in cancer and palliative care. Results: Whilst there were a range of participant responses, the majority of health professionals engaged with patients in a very traditional manner, where they frequently made assumptions about patient need based on the patients age, diagnosis, treatment as well as gender and culture. There was an overwhelming assumption that patients would remain solely focused on medicalised concepts of cancer such as cure and survival outcomes. When patient sexuality was ever discussed by health professional, the topic usually became reduced to a genital, functional level, whereas patients were usually searching for information and support about how to live with the changes their cancer treatment had induced. It became increasingly apparent that the structure and culture of the cancer and palliative care settings made it difficult for patients to be regarded as individuals with divergent views about the importance of sexuality and intimacy when they were communicating with health professionals. Conclusion: Much has been written on the importance of raising the topic of intimacy and sexuality with patients in cancer and palliative care. Very little has been published about the reflexivity required for health professionals to confidently engage in communication with a patient about sexuality and intimacy after a cancer diagnosis. At a clinical practice level, this paper presents an in depth exploration of the avoidance, vulnerability, and risk taking underpinning the communication exchange between patient and health professional when health professionals attempt to address issues of intimacy and sexuality with patients in their care.
Key words: communication, cancer and palliative care, health professional, sexuality, intimacy