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Constructions of sexuality and intimacy after cancer: Patient and health professional perspectives

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  • Hordern, Amanda Jane
  • Street, Annette F.

Abstract

With an increasing emphasis on the provision of psychosocial support for patients in cancer and palliative care, an emerging body of literature has highlighted the importance of providing the opportunity for patients to discuss issues of intimacy and sexuality with their health professionals. Very little is known about why health professionals struggle with this level of communication in clinical practice. The aim of this paper is to discuss constructions of intimacy and sexuality in cancer and palliative care from patient and health professional perspectives. A three stage reflexive inquiry was used to systematically and critically analyse data from semi-structured interviews (n=82), a textual analysis of 33 national and international clinical practice guidelines and participant feedback at 15 forums where preliminary research findings were presented to patients and health professionals in cancer and palliative care. The study was conducted across one public teaching hospital in Australia from 2002 to 2005. Data were further analysed drawing upon the work of Giddens on reflexivity, intimacy and sexuality, to reveal that the majority of health professionals embraced a less reflexive, more medicalised approach about patient issues of intimacy and sexuality after cancer. This was in stark contrast to the expectations of patients. Cancer had interrupted their sense of self, including how they experienced changes to intimate and sexual aspects of their lives, irrespective of their age, gender, culture, type of cancer or partnership status. Key findings from this project reveal incongruence between the way patients and health professionals constructed sexuality and intimacy. Structures which govern cancer and palliative care settings perpetrated the disparity and made it difficult for health professionals to regard patients as people with sexual and intimate needs or to express their own vulnerability when communicating about these issues in the clinical practice setting. A degree of reflexivity about personal and professional constructions of sexuality and intimacy was required for health professionals to confidently challenge these dominant forces and engage in the type of communication patients were seeking.

Suggested Citation

  • Hordern, Amanda Jane & Street, Annette F., 2007. "Constructions of sexuality and intimacy after cancer: Patient and health professional perspectives," Social Science & Medicine, Elsevier, vol. 64(8), pages 1704-1718, April.
  • Handle: RePEc:eee:socmed:v:64:y:2007:i:8:p:1704-1718
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    References listed on IDEAS

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    1. Gott, Merryn & Hinchliff, Sharron, 2003. "How important is sex in later life? The views of older people," Social Science & Medicine, Elsevier, vol. 56(8), pages 1617-1628, April.
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    1. White, I.D. & Faithfull, S. & Allan, H., 2013. "The re-construction of women's sexual lives after pelvic radiotherapy: A critique of social constructionist and biomedical perspectives on the study of female sexuality after cancer treatment," Social Science & Medicine, Elsevier, vol. 76(C), pages 188-196.
    2. Emslie, Carol & Browne, Susan & MacLeod, Una & Rozmovits, Linda & Mitchell, Elizabeth & Ziebland, Sue, 2009. "'Getting through' not 'going under': A qualitative study of gender and spousal support after diagnosis with colorectal cancer," Social Science & Medicine, Elsevier, vol. 68(6), pages 1169-1175, March.
    3. Tucker, Samantha R. & Speer, Susan A. & Peters, Sarah, 2016. "Development of an explanatory model of sexual intimacy following treatment for localised prostate cancer: A systematic review and meta-synthesis of qualitative evidence," Social Science & Medicine, Elsevier, vol. 163(C), pages 80-88.
    4. Catharina Frid Annerstedt & Stinne Glasdam, 2019. "Nurses' attitudes towards support for and communication about sexual health—A qualitative study from the perspectives of oncological nurses," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(19-20), pages 3556-3566, October.

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