Sexuality and Palliative Care

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Sexuality and Palliative Care

• Joy Hall Head of Division Womens Health
• joy.hall_at_uce.ac.uk

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Sexuality
Sexuality is interwoven with every aspect
of human existence, and in its broadest sense,
sexuality is defined as a desire for contact,
warmth, tenderness, or love. Humans express and
live their sexuality in their daily lives.
Sexuality is not limited to an act of seduction
or of intercourse but encompasses every area
of our lives the way we relate to others, our
friends, our family, and our work. It is
evident in what we believe, how we behave and
the way we look Poorman,1988
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Sexuality
Sexual self concept
Sexual function
Sexual role relationships
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Areas of change in which the patient needs
to adapt
Loss grief Body image, body parts, sexual
functioning, possible depression Relationship
effects ? need for intimacy Distressing
symptoms fatigue,chronic pain, nausea,
weakness Changes in self - esteem Medications
narcotic,anti-emetics, tranquilisers anti
depressants, anti-biotics Effects on sexual
desire,sexual arousal Surgical
radiotherapy/chemotherapy/psychogenic)
Dyspareunia, inhibited orgasm.
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Useful questions/areas to explore

• In what ways ( if any) has your illness/surgery
  changed
• the way you see yourself?
• How has illness/surgery interferred with being
• mother/father/wife/husband/partner/friend?
• Some people who have had this type of
  illness/surgery
• find that they have a few problems in their
  sexual
• relationships.Is this something you have
  encountered? If
• so, it is OK to talk to me about it.
• In what ways would you like things to change
• Adapted from Woods,N,F(1984)Sexuality in health
  illness. St Louis Mosby

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Model for helping
P Permission L I Limited Information S S
Specific Suggestions I T Intensive
Therapy Annon 1970
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Hold my hand

• Hold my hand my love
• To know that you are near
• Your touch of warmth I need to feel
• To soothe away my fear,
• That I am waiting all alone
• To face lifes greatest test
• So hold my hand, dont loose my love,
• Till my soul is at rest
• And while you hold my hand, my love
• Then I will close my eyes
• And drift to world of happy peace
• Of blue and sunny skies
• And all the time you hold my hand
• Our hearts and love entwine
• For I am holding your hand too While you are
  holding mine
• When time is past
• And you in turn must face lifes greatest test

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References
Andersen, B,L, Woods, X,A Copeland,L,J
(1997)Sexual self schema and sexual morbidity
amongs gynecologic cancer survivors. Journal of
Consulting and clinical psychology 65 pp
221-229 Dixon,K,D Dixon,P,N (2006) The PLISSIT
modelcare management of patients psychosexual
needs following radical surgery. Lippincotts Case
Management managing the process of patient
care. Gamel,C, Hengeveld,M Davis, B ( 2000)
Informational needs about effects of
gynaecological cancer on sexuality a review of
the literature. Journal of Clinical Nursing. 9 pp
678-688 Hall, J (2001) Problems of the lower
urogenital tract in the postreproductive years,
with associated psychosexual experiences. IN
Gangar,E,A (2001) Gynaecological nursing a
practical guide.EdinburghChurchill
Livingstone Holmes,L, Sharplesss, J et al (2005)
sexuality in gynaecological cancer. Cancer
Nursing Practice. 4 pp 35 - 39
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References continued

• Juraskova, I, Butow, P, Sharpe,L et al (2003)
  Post treatment sexual adjustment
• following cervical and endometrial cancer a
  qualitative insight. Psycho
• Oncology 12 pp 267 -279
• Katz, A (2003) Sexuality after hysterectomy a
  review of the literature
• and discussion of nurses role. Journal of
  Advanced Nursing 42 pp 297
• - 303
• Rice, A, M ( 2000) Sexuality in cancer
  palliative care 1 effects of
• disease and treatment. International Journal of
  Palliative Nursing 6 pp
• 392-397
• Rogers,M Kristjanson, L,J (2002) The impact
  on sexual functioning
• of chemotherapy- induced menopause in women with
  breast cancer.
• Cancer Nursing. 25 pp 57 65
• Schover,L,R (1997)Sexuality fertility after
  cancer.New York John
• Wiley