Is There a Place for Sexuality in the Holistic Care of Patients in the Palliative Care Phase of Life?

Abstract

Being diagnosed with a life-limiting condition is a traumatic event. The journey to the moment of death is usually only done once--so it is a time of fears and uncertainty. Sexuality is particularly vulnerable at this time. It may be difficult for both patient and partner to deal with the changes in sexuality without professional assistance. It is "sexuality" rather than "sex" that defines the meaningful relationships people have with themselves and significant others. When sexuality is lost or changed, important benefits may be lost. Studies show that many patients do value sexuality and want assistance in making the best of their sexual potential during the palliative care phase. Health professionals regularly acknowledge the importance of sexuality for their patients but have difficulties acting on their beliefs. Sexuality, within the patient's functional ability and desire for it, must be acknowledged and included in holistic management. It is the health professional's responsibility to raise this issue.

Sexual issues in early and late stage cancer: a review

“…Health professionals do not address the sexual concerns because of fears of being intrusive, personal discomfort, inadequate knowledge, time constraints, and poor confidence with intimate communication [37]. The discomfort of health professionals in addressing sexuality in advanced cancer patients is confirmed by the finding that only one out of ten patients in a palliative care setting had been asked about their sexuality [38].…”

“…However, most patients are willing to talk about their sex lives and the impact of the disease on their sexual function [39]. Sexuality continues to be important at the end of life, although it is often emotional connection to others that is more important than the physical expression [37]. Thus, within the patient's ability to function and desire for it, sexuality should be acknowledged and included in the holistic patient management.…”

Voices from the periphery: A narrative study of the experiences of sexuality of disabled women in Zimbabwe

“…As postulated by Redelman (2008), sexuality does not necessarily mean the conflation of male and female genitals but it also includes friendship, cuddling, masturbation, vaginal selfstimulation, relaxation, touching and kissing (Madunagu, 2007;Redelman, 2008). However, prevalent within the family of contextual heteronormative practices is the sub-theme of reproduction and motherhood, which I discuss below.…”

A time to look within curricula—Nursing students’ perception on sexuality and gender issues

“…Although it has been reported that patients had found it appropriate to discuss their sexual concerns with nurses [2][3][4], this was rarely included in their interactions with their patients. Several perceived barriers during health care professional-patient interactions have been reported such as lack of knowledge and difficulty with the concept of including sexuality within holistic care [5]; boundary issues with fears of causing offense, seeming intrusive or inappropriate; personal discomfort, anxiety and inappropriate skills to address such issues especially with its multitude of variations; and time/privacy constraints [6].…”

“…As part of this holistic care, nurses and other health care providers are often required to help people [2][3][4][5][6][7] overcome problems related to sexual matters. They may be faced with questions about family planning, fertility regulation methods and pregnancy and concerns about sexual functioning.…”