Talking about sex after cancer: A discourse analytic study of health care professional accounts of sexual communication with patients
Talking about sex after cancer: A discourse analytic study of health care professional accounts of sexual communication with patients
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DOI：
10.1080/08870446.2013.811242
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发表时间：
2013-12-01
影响因子：
3.3
通讯作者：
Kirsten, Laura
中科院分区：
文献类型：
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作者：
Ussher, Jane M.;Perz, Janette;Kirsten, Laura
有一致的证据表明，保健专业人员（hcps）没有解决癌症患者的性信息和支持需求。我们采访了38名从事癌症护理工作的澳大利亚卫生保健服务人员，以检查癌症后性行为的结构、与性交流有关的主体立场，以及话语和主体立场塑造性信息提供和交流的方式。参与者从生理、心理和关系方面构建癌症后的性变化，并将这些变化定位为有可能对患者和伴侣的健康产生重大影响。这与广泛采用社会心理支持的话语有关，这种话语使临床咨询中关于性变化的讨论合法化，以减轻痛苦，消除神话并促进对性行为的重新谈判。然而，这并不一定转化为以患者为中心的实践结果，大多数参与者将个人、以患者为中心和情境因素定位为许多临床咨询中讨论性的障碍。这包括：缺乏知识、信心和舒适；将性定位为对某些人无关紧要或不合适的；以及临床环境的局限性。相比之下，那些经常讨论性的人则采用了代理、责任和自信的主体地位。
There is consistent evidence that health care professionals (hcps) are not addressing the sexual information and support needs of people with cancer. Thirty-eight Australian hcps across a range of professions working in cancer care were interviewed, to examine constructions of sexuality post-cancer, the subject positions adopted in relation to sexual communication, and the ways in which discourses and subject positions shape information provision and communication about sexuality. Participants constructed sexual changes post-cancer in physical, psychological and relational terms, and positioned such changes as having the potential to significantly impact on patient and partner well-being. This was associated with widespread adoption of a discourse of psychosocial support, which legitimated discussion of sexual changes within a clinical consultation, to alleviate distress, dispel myths and facilitate renegotiation of sexual practices. However, this did not necessarily translate into patient-centred practice outcomes, with the majority of participants positioning personal, patient-centred and situational factors as barriers to the discussion of sex within many clinical consultations. This included: absence of knowledge, confidence and comfort; positioning sex as irrelevant or inappropriate for some people; and limitations of the clinical context. In contrast, those who did routinely discuss sexuality adopted a subject position of agency, responsibility and confidence.