Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs
Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs
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DOI：
10.5694/j.1326-5377.2007.tb00877.x
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发表时间：
2007-03-05
影响因子：
11.4
通讯作者：
Street, Annette F.
中科院分区：
文献类型：
--
作者：
Hordern, Amanda J.;Street, Annette F.
目标：探讨患者和卫生专业人员沟通的方式，在癌症和姑息治疗settings.Design的亲密和性的变化：一个定性研究，采用三阶段的反思性询问的方法，半结构化，参与者访谈（n = 82），文本分析的国家和国际癌症和姑息治疗临床实践指南（n = 33）;在15个针对癌症患者或健康专业人员的教育论坛上，收集了参与者的反馈。地点：2002年至2005年间，澳大利亚一家大型公立教学医院。参与者：50名诊断为癌症的患者和32名从事癌症和/或姑息治疗至少12个月的卫生专业人员。主要结果指标：亲密关系和性的沟通：病人的需要和经验，卫生专业人员的态度和经验。结果：有不匹配的期望之间的患者和卫生专业人员和未满足的病人需要的性和亲密的沟通。大多数患者寻求有关如何在癌症治疗后与亲密和性变化一起生活的信息，支持和实用策略，即使他们的癌症类型不影响生育能力或性表现。与此相反，许多卫生专业人员认为，病人分享他们的专业重点是对抗疾病，而不管病人的情感和身体代价。卫生专业人员绝大多数将他们对患者性行为的理解局限于生育、避孕、绝经或勃起状态。基于年龄、性别、诊断、文化和伴侣关系状况，对患者的性行为做出了许多陈规定型的假设。有一个关系，提供以病人为中心的沟通，亲密关系和性和卫生专业人员的理解自己的态度和believes.Conclusion：资源是必要的，以帮助卫生专业人员从事探索自己的定义的亲密关系和性，并了解这些如何影响与癌症患者的互动。
Objective: To explore the ways that patients and health professionals communicate about intimate and sexual changes in cancer and palliative care settings.Design: A qualitative study using a three-stage reflexive-inquiry approach, with semi-structured, participant interviews (n = 82); textual analysis of national and international cancer and palliative care clinical practice guidelines (n = 33); and participant feedback at 15 educational forums for cancer patients or health professionals.Setting: A large Australian public teaching hospital between 2002 and 2005.Participants: 50 patients diagnosed with cancer, and 32 health professionals who had worked in cancer and/or palliative care for a minimum of 12 months.Main outcome measures: Communication about intimacy and sexuality: patients' needs and experiences and health professionals' attitudes and experiences.Results: There were mismatched expectations between patients and health professionals and unmet patient needs in communication about sexuality and intimacy. Most patients sought information, support and practical strategies about how to live with intimate and sexual changes after treatment for cancer, even if their cancer type did not affect fertility or sexual performance. In contrast, many health professionals assumed that patients shared their professional focus on combating the disease, irrespective of the emotional and physical costs to the patient. Health professionals overwhelmingly limited their understanding of patient sexuality to fertility, contraception, menopausal or erectile status. Many stereotypical assumptions were made about patient sexuality, based on age, sex, diagnosis, culture, and partnership status. There was a relationship between providing patient-centred communication about intimacy and sexuality and health professionals' understanding of their own attitudes and beliefs.Conclusion: Resources are needed to help health professionals engage in an exploration of their own definitions of intimacy and sexuality and understand how these affect interactions with patients with cancer.