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

• Published in: Psychology & health Vol. 28; no. 12; pp. 1370 - 1390
• Main Authors: Ussher, Jane M., Perz, Janette, Gilbert, Emilee, Wong, W.K. Tim, Mason, Catherine, Hobbs, Kim, Kirsten, Laura
• Format: Journal Article
• Language: English
• Published: England Routledge 01.12.2013; Taylor & Francis Ltd
• Subjects: Adaptation, Psychological; Attitude of Health Personnel; Australia; Cancer; Clinical Competence; Communication; discourse analysis; Female; Health care; health care professional; Health Personnel - psychology; Health Services Needs and Demand; Humans; Male; Middle Aged; Neoplasms - complications; Neoplasms - psychology; Neoplasms - therapy; Practice Patterns, Physicians' - statistics & numerical data; Professional-Patient Relations; Qualitative Research; Self Efficacy; Sex education; Sexual Dysfunction, Physiological - etiology; Sexual Dysfunction, Physiological - psychology; Sexual Partners - psychology; Sexuality; Social Support; Australia
• ISSN: 0887-0446; 1476-8321; 1476-8321
• DOI: 10.1080/08870446.2013.811242

There is consistent evidence that health care professionals (hcps) are not addressing the sexual information and support needs of people with cancer. Thirty-eight Australian hcps across a range of professions working in cancer care were interviewed, to examine constructions of sexuality post-cancer, the subject positions adopted in relation to sexual communication, and the ways in which discourses and subject positions shape information provision and communication about sexuality. Participants constructed sexual changes post-cancer in physical, psychological and relational terms, and positioned such changes as having the potential to significantly impact on patient and partner well-being. This was associated with widespread adoption of a discourse of psychosocial support, which legitimated discussion of sexual changes within a clinical consultation, to alleviate distress, dispel myths and facilitate renegotiation of sexual practices. However, this did not necessarily translate into patient-centred practice outcomes, with the majority of participants positioning personal, patient-centred and situational factors as barriers to the discussion of sex within many clinical consultations. This included: absence of knowledge, confidence and comfort; positioning sex as irrelevant or inappropriate for some people; and limitations of the clinical context. In contrast, those who did routinely discuss sexuality adopted a subject position of agency, responsibility and confidence.