Communication about sexuality and intimacy in couples affected by lung cancer and their clinical‐care providers

Abstract

OBJECTIVE Little is known about the effects of lung cancer on intimate and sexual relationships. This study explores health care provider, patient, and partner perspectives on: 1) the effects of lung cancer on physical and emotional intimacy, 2) the ways in which intimacy affects the experience of living with lung cancer, and 3) communication about intimacy and sexuality in the context of lung cancer. METHODS Qualitative, in-depth interviews with 8 cancer care providers and 13 married couples (ages 43–79) affected by lung cancer were conducted and audiotaped in the clinical setting. Interviews were transcribed, iteratively analyzed, and coded according to the above domains. Coding was performed independently by members of an interdisciplinary team; inter-rater reliability was assessed using the kappa statistic; and analyses were summarized by domain. RESULTS Most cancer care providers and couples affected by lung cancer believed intimacy and sexuality issues were salient, yet few reported discussing these. Couples described negative and positive effects of cancer on intimacy. Negative effects were driven by cancer or its treatment, including physical and psychological effects. Positive effects included an increase in non-coital physical closeness and appreciation of the spouse. Age was perceived as an important factor influencing the relationship between lung cancer and intimacy. CONCLUSIONS Emotional intimacy and sexuality are important concerns for couples affected by lung cancer. The findings suggest previously unrecognized positive effects of lung cancer on emotional and physical intimacy. Couples affected by lung cancer and providers believe these issues are relevant for lung cancer care.

Talking about sex after cancer: A discourse analytic study of health care professional accounts of sexual communication with patients

“…Confirming previous research findings (Haboubi & Lincoln, 2003;Lindau et al, 2011;Stead et al, 2003), the health professionals interviewed in this study acknowledged the existence of sexual changes following cancer, and positioned sexuality as an issue that was important for patients and their partners. In contrast to previous qualitative research conducted in the Australian context (Hordern & Street, 2007a), where acknowledgement of sexual changes focused on erectile functioning, menopause, contraception and fertility, participants in the present study described a wide range of sexual changes, physical, psychological and relational.…”

“…Lack of knowledge, confidence or comfort on the part of health professionals in discussing sexuality with cancer patients has been reported in previous research (Haboubi & Lincoln, 2003;Hautamaki et al, 2007;Lindau et al, 2011;Stead et al, 2003). This has led to the development of brief training programmes (Hordern et al, 2009), and publication of practical strategies to facilitate health professional communication about sex in the context of cancer (Hordern & Currow, 2003;Hughes, 2000;Katz, 2005; National Centre for Gynaecological Cancers, 2011).…”

Development and Validation of a Single-Item Screener for Self-Reporting Sexual Problems in U.S. Adults

“…Limited patient-provider communication about sexual matters has been documented in primary care, 3,4 ob/gyn, 5 cardiology, 6 and oncology. 7,8 Patients can be reluctant to initiate discussions with their providers about sexual function, preferring that providers broach the topic. 7,9 Providers can also be reluctant to raise the subject, 10 especially if they feel they lack the knowledge or skills needed to address this issue, 11 yet there is some evidence that a pre-visit questionnaire can promote patient-provider discussions of sexual dysfunction.…”

Evaluating Depression, Anxiety, Sexuality and Quality of Life in Metastatic Lung Cancer Patients

“…Due to the decreased survival of LC patients, very few studies focused especially on sexual functioning during their treatment period (4,5). So, little is known about the effects of lung cancer or chemotherapeutics on intimate and sexual relationships.…”