Sexuality and ageing in palliative care environments? Breaking the (triple) taboo

Abstract

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A Pilot Study on the Quality of Sexual Life of Patients Receiving Home Palliative Care in Poland

“…Health professionals also indicated a need for support and training in this area [15,16]. Additionally, common reasons reported by medical staff were lack of time, prioritizing disease management over conversations about sexual health, or lack of understanding that adults in the final stages of chronic illness and in older age may still value their sexuality [7,[16][17][18]. Numerous studies also indicated difficulties in engaging in conversations about sexuality, and poor understanding of patient concerns.…”

“…[19,20]. Interestingly, in most situations, patients, especially older patients, expect the initiative to start conversations about sexuality and intimacy to be taken by medical staff [17,21]. An additional problem, apart from the lack of proper knowledge or staff training on sexual health problems of patients undergoing palliative care, is the lack of tools available in the Polish language (e.g., corresponding to the Brief Sexual Symptom checklist or Sexual Health: Your Needs after Cancer), which would allow for a simple conduct of such a conversation highlighting the most important issues from both patient and medical point of view.…”

Experiences and opinions of nurses working in psychiatric wards on assessing patients' sexual health: A qualitative study

“…The sexual health of individuals with mental disorders has been mostly ignored by both clinicians and academicians. 1 This is attributed to a social and historical process in which sexual activity has been considered taboo, 2 as well as to the belief that many mental disorders and the medications used to treat them cause asexuality. 3 A study using the functional health patterns model and diagnoses from the North American Nursing Diagnosis Association to evaluate nurses' patient care plans in a Turkish psychiatric clinic determined that the nurses never assessed the sexuality and reproductive functions of 80% of the patients.…”

“…10,11 Factors causing sexual dysfunction in individuals with mental illness include both psychopathological factors (e.g., poor social functionality, low self-esteem, and social stigma) and biological factors (e.g., the effects of psychotropic drugs and the functional and structural disruption in the brain regions mediating sexual behavior). 2,10,12 Though disease severity, duration, and recurrence differ across mental illnesses, sexual dysfunction is reported in 25%-75% of all cases before treatment. 13 Nurses, especially in multidisciplinary teams, are central to sexual health counseling.…”

“…Patients' inability to express their sexual problems, healthcare professionals' belief that individuals with mental illnesses do not have sex lives and clinicians' avoiding talking about these issues with patients further increase patients' problems 10,11 . Factors causing sexual dysfunction in individuals with mental illness include both psychopathological factors (e.g., poor social functionality, low self‐esteem, and social stigma) and biological factors (e.g., the effects of psychotropic drugs and the functional and structural disruption in the brain regions mediating sexual behavior) 2,10,12 . Though disease severity, duration, and recurrence differ across mental illnesses, sexual dysfunction is reported in 25%–75% of all cases before treatment 13 …”