Constructions of sexuality and intimacy after cancer: Patient and health professional perspectives
Constructions of sexuality and intimacy after cancer: Patient and health professional perspectives
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DOI：
10.1016/j.socscimed.2006.12.012
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发表时间：
2007-04-01
影响因子：
5.4
通讯作者：
Street, Annette F.
中科院分区：
文献类型：
--
作者：
Hordern, Amanda Jane;Street, Annette F.
随着越来越重视为癌症和姑息治疗患者提供心理社会支持，一个新兴的文献机构强调了为患者提供机会与他们的卫生专业人员讨论亲密关系和性问题的重要性。很少有人知道为什么卫生专业人员在临床实践中与这种水平的沟通斗争。本文的目的是从病人和健康专业人员的角度讨论癌症和姑息治疗中亲密和性的构建。一个三阶段的反思性调查被用来系统地和批判性地分析半结构化访谈（n = 82）的数据，33个国家和国际临床实践指南和参与者反馈的文本分析在15个论坛，初步研究结果被提交给癌症和姑息治疗的患者和卫生专业人员。该研究于2002年至2005年在澳大利亚的一家公立教学医院进行。根据吉登斯关于反身性、亲密关系和性行为的工作，对数据进行了进一步分析，结果显示，大多数卫生专业人员对癌症后患者的亲密关系和性行为问题采取了一种不那么反身、更医学化的方法。这与患者的期望形成了鲜明的对比。癌症打断了他们的自我意识，包括他们如何经历生活中亲密和性方面的变化，无论他们的年龄，性别，文化，癌症类型或伴侣关系状况如何。该项目的主要发现揭示了患者和卫生专业人员构建性行为和亲密关系的方式之间的不一致。管理癌症和姑息治疗环境的结构造成了这种差异，使卫生专业人员难以将患者视为有性和亲密需求的人，或者在临床实践环境中就这些问题进行沟通时难以表达自己的脆弱性。卫生专业人员需要对性和亲密关系的个人和专业结构有一定程度的反思，才能自信地挑战这些主导力量，并参与患者寻求的沟通类型。(c)2007爱思唯尔有限公司保留所有权利。
With an increasing emphasis on the provision of psychosocial support for patients in cancer and palliative care, an emerging body of literature has highlighted the importance of providing the opportunity for patients to discuss issues of intimacy and sexuality with their health professionals. Very little is known about why health professionals struggle with this level of communication in clinical practice. The aim of this paper is to discuss constructions of intimacy and sexuality in cancer and palliative care from patient and health professional perspectives. A three stage reflexive inquiry was used to systematically and critically analyse data from semi-structured interviews (n = 82), a textual analysis of 33 national and international clinical practice guidelines and participant feedback at 15 forums where preliminary research findings were presented to patients and health professionals in cancer and palliative care. The study was conducted across one public teaching hospital in Australia from 2002 to 2005. Data were further analysed drawing upon the work of Giddens on reflexivity, intimacy and sexuality, to reveal that the majority of health professionals embraced a less reflexive, more medicalised approach about patient issues of intimacy and sexuality after cancer. This was in stark contrast to the expectations of patients. Cancer had interrupted their sense of self, including how they experienced changes to intimate and sexual aspects of their lives, irrespective of their age, gender, culture, type of cancer or partnership status. Key findings from this project reveal incongruence between the way patients and health professionals constructed sexuality and intimacy. Structures which govern cancer and palliative care settings perpetrated the disparity and made it difficult for health professionals to regard patients as people with sexual and intimate needs or to express their own vulnerability when communicating about these issues in the clinical practice setting. A degree of reflexivity about personal and professional constructions of sexuality and intimacy was required for health professionals to confidently challenge these dominant forces and engage in the type of communication patients were seeking. (c) 2007 Elsevier Ltd. All rights reserved.