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Sexuality is not a priority when disease and treatment side effects are severe: conceptions of patients with malignant blood diseases
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.ORCID iD: 0000-0002-0944-5650
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. (Omvårdnad)
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.ORCID iD: 0000-0003-1382-4386
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.ORCID iD: 0000-0003-0417-6161
2013 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, 3503-3512 p.Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES:

To describe how patients with malignant blood diseases conceive the influence of chemo- or chemoimmunotherapy on sexuality, and their need of support related to this issue.

BACKGROUND:

Sexuality is often negatively affected in cancer patients with sex-specific diagnoses. For patients with malignant blood diseases, the research is limited with regard to the effect on sexuality. Knowledge about their need for support related to sexuality is also needed as nurses are found to often avoid this area of their responsibility.

Place, publisher, year, edition, pages
John Wiley & Sons, 2013. Vol. 22, 3503-3512 p.
Keyword [en]
cancer patients, malignant blood diseases, nursing, phenomenography, sexuality, support
National Category
Medical and Health Sciences
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-30520DOI: 10.1111/jocn.12333ISI: 000326650400028PubMedID: 24003940OAI: oai:DiVA.org:kau-30520DiVA: diva2:668810
Available from: 2013-12-02 Created: 2013-12-02 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Sexuality in patients treated for hematologic malignancies - Problems and need for support from patients’ and nurses’ perspectives
Open this publication in new window or tab >>Sexuality in patients treated for hematologic malignancies - Problems and need for support from patients’ and nurses’ perspectives
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis was to describe and explore how sexuality, body image and HRQoL were affected in patients treated for hematologic malignancies, and their need for support. A further aim was to describe nurses’ conceptions of dialogues about sexuality.

Methods: Ten nurses in cancer care (I) and twelve patients were interviewed (II). Data were analysed according to phenomenography (I-II). Data were also collected from patients (≥45 years) included consecutively: at baseline (n=32), one month (n=25; III-IV) and six months (n=20; IV) after treatment. Three instruments were used: SAQ-S, BIS and EORTC QLQ-C30. The data were analysed statistically.

Main findings: The nurses (I) conceived that they should talk about sexuality with cancer patients, but usually did not due to their own attitudes, lack of knowledge about sexuality, communication skills and environmental conditions. The patients (II) experienced negative effects on sexual function and sexual relationship due to affected strength and sexual desire. The patients’ sexuality, body image and HRQoL were affected during (II-III) and one month after treatment (III-IV). Patients recovered with regard to these issues within six months, except for sexual relationship (IV). However, when the disease and side effects were experienced as severe, thoughts about and interest in sexuality were overshadowed, and the need or wish for support related to this issue was low (II). Sexuality and body image seemed to influence changes in HRQoL (IV).

Conclusion: Patients above the age of 45 treated for hematologic malignancies with chemoimmunotherapy experienced problems related to sexuality, body image and HRQoL. However, as sexuality was found to be of low priority due to concerns for life when the disease and side effects were severe, support must be timely and individualized. Patient-centered care, with patients continuously meeting a nurse guided by the idea of holistic individual nursing care throughout the care trajectory, is suggested.

Abstract [en]

Sexuality is to a large extent seen as a private and sensitive topic by both patients and nurses in cancer care. The patients in this thesis were above the age of 45 and treated with chemo- or chemoimmunotherapy for hematologic malignancies. They experienced affected sexuality, body image and HRQoL during and after treatment. The importance of sexuality was low and sexuality seemed to be overshadowed when the disease and side effects were experienced as severe. Few patients described that information might have been helpful.  In order to avoid violating patients’ integrity, one challenge is to identify patients who ascribe importance to sexuality and who also want support regarding sexuality. One way is to organize care in a patient-centered way, with patients continuously meeting a nurse guided by the idea of holistic individual nursing care throughout the care trajectory. Furthermore, nurse educators’ need to acknowledge this area and the health care leaders should provide nurses opportunities to discuss attitudes and personal barriers to sensitive issues such as sexuality

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2014
Series
Karlstad University Studies, ISSN 1403-8099 ; 2014:28
Keyword
cancer patients, hematologic malignancies, nursing, nurse-patient communication, support, sexuality, body image, health related quality of life
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-31827 (URN)978-91-7063-560-1 (ISBN)
Public defence
2014-05-28, Lagerlöfsalen, Universitetsgatan 2, Karlstad, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2014-05-08 Created: 2014-04-02 Last updated: 2015-08-03Bibliographically approved

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