Sexuality in palliative care: patient perspectives

Abstract

This qualitative study investigated the meaning of sexuality to palliative patients. Face-to-face interviews were conducted with ten patients receiving care in a tertiary palliative care unit, a hospice or by palliative home care services in their homes. Several themes emerged. Emotional connection to others was an integral component of sexuality, taking precedence over physical expressions. Sexuality continues to be important at the end of life. Lack of privacy, shared rooms, staff intrusion and single beds were considered barriers to expressing sexuality in the hospital and hospice settings. Only one subject had previously been asked about sexuality as part of their clinical care, yet all felt that it should have been brought up, especially after the initial cancer treatments were completed. Home care nurses and physicians were seen as the appropriate caregivers to address this issue. Subjects unanimously mentioned that a holistic approach to palliative care would include opportunities to discuss the impact of their illness on their sexuality.

Brief psychosexual therapy: reflections on the provision of a time-limited therapy service in a sexual health clinic

“…This is a highly unusual situation as studies consistently indicate a marked reluctance on the part of many health workers to discuss patients' sexual concerns (e.g. Kedde, van de Wiel, Schultz, Vanwesenbeeck & Bender, 2012;Lemieux, Kaiser, Pereira & Meadows, 2004;Stead, Fallowfield, Brown & Selby, 2001), and its benefits, in terms of quality and continuity of care, should not be underestimated.…”

First-person narratives around sexuality in residential healthcare settings: a meta-ethnographic synthesis

“…Jootun, McGhee, and Marland (2009) argue that the inclusion of a reflexive account should be part of qualitative enquiry to increase the rigour of the research process and add credibility. Only one study (Lemieux, Kaiser, Pereira, & Meadows, 2004) described the researchers as having made their biases explicit during the data collection phase, however these were not expanded on within the text; none of the other studies reported on the relationship between the researcher(s) and participants. None of the studies reported their epistemological or ontological perspectives.…”

“…Three studies offered an account of participants perceiving staff as unwilling to engage with discussions around sexuality (Brown et al, 2014;Lemieux et al, 2004;Östman, 2008), suggesting that the approach of care staff moderated how sexuality was discussed.…”

“…Eight stu dies made reference to the hopes and fears that participants had regarding their sexuality as patients in residential healthcare settings and for the future (Frankowski & Clark, 2009;Jenkins et al, 2010;Lemieux et al, 2004;McCann, 2000;Röndahl et al, 2006;Stein et al, 2010).…”

“…"…I still can't feel human enough to be a sexual being in this environment" (Brown et al, 2014, p.250) Eight studies (Brown et al, 2014;Frankowski & Clark, 2009;Lemieux et al, 2004;Nay, 1992;Östman, 2008;Stein et al, 2010;Villar et al, 2014) described participants as having experienced an 'adapted' sexuality; their experiences of their sexuality had changed as a result of their ailment and/or the residential healthcare environment. The shift in how sexuality was conceptualised was described more concretely by participants in residential healthcare settings for physical health needs, for example, aging participants described a shift in associations with sexuality, from procreation and marriage, to intimacy, spirituality and beauty, (Nay, 1992).…”