The sexual health care needs after colorectal cancer: the view of patients, partners, and health care professionals

Abstract

Purpose

Sexual dysfunction among patients with colorectal cancer is frequently reported. Studies examining patients’ sexual health care needs are rare. We examined the sexual health care needs after colorectal cancer treatment according to patients, partners, and health care professionals (HCPs). Factors that impede or facilitate the quality of this care were identified.

Method

Participants were recruited from three Dutch hospitals: St. Elisabeth, TweeSteden, and Catharina hospitals. Patients (n = 21), partners (n = 9), and 10 HCPs participated in eight focus groups.

Results

It is important to regularly evaluate and manage sexual issues. This does not always occur. Almost all participants reported a lack of knowledge and feelings of embarrassment or inappropriateness as barriers to discuss sexuality. HCPs reported stereotypical assumptions regarding the need for care based on age, sex, and partner status. The HCPs debated on whose responsibility it is that sexuality is discussed with patients. Factors within the organization, such as insufficient re-discussion of sexuality during (long-term) follow-up and unsatisfactory (knowledge of the) referral system impeded sexual health care. The HCPs could facilitate adequate sexual health care by providing patient-tailored information and permission to discuss sex, normalizing sexual issues, and establishing an adequate referral system. It is up to the patients and partners to demarcate the extent of sexual health care needed.

Conclusions

Our findings illustrate the need for patient-tailored sexual health care and the complexity of providing/receiving this care. An adequate referral system and training are needed to help HCPs engage in providing satisfactory sexual health care.

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References

  1. 1.

    Park ER, Norris RL, Bober SL (2009) Sexual health communication during cancer care: barriers and recommendations. Cancer J 15:74–77. doi:10.1097/PPO.0b013e31819587dc

    PubMed  Article  Google Scholar 

  2. 2.

    Traa MJ, De Vries J, Roukema JA, Den Oudsten BL (2012) Sexual (dys)function and the quality of sexual life in patients with colorectal cancer: a systematic review. Ann Oncol 23:19–27. doi:10.1093/annonc/mdr133

    CAS  PubMed  Article  Google Scholar 

  3. 3.

    Flynn KE, Reese JB, Jeffery DD, Abernethy AP, Lin L, Shelby RA, Porter LS, Dombeck CB, Weinfurt KP (2012) Patient experiences with communication about sex during and after treatment for cancer. Psychooncology 21:594–601. doi:10.1002/pon.1947

    PubMed Central  PubMed  Article  Google Scholar 

  4. 4.

    Li WW, Lam WW, Au AH, Ye M, Law WL, Poon J et al (2012) Interpreting differences in patterns of supportive care needs between patients with breast cancer and patients with colorectal cancer. Psychooncology 22:792–798. doi:10.1002/pon.3068

    PubMed  Article  Google Scholar 

  5. 5.

    Hall S, Gray N, Browne S, Ziebland S, Campbell NC (2012) A qualitative exploration of the role of primary care in supporting colorectal cancer patients. Support Care Cancer 20:3071–3078. doi:10.1007/s00520-012-1434-7

    PubMed  Article  Google Scholar 

  6. 6.

    Traa MJ, De Vries J, Roukema JA, Den Oudsten BL (2013) Dyadic coping and relationship functioning in couples coping with cancer: a systematic review. Posterior Presentation, 6th Biennal Cancer Survivorship Research Conference, Arlington, Virginia

  7. 7.

    Berg CA, Upchurch RA (2007) Developmental-contextual model of couples coping with chronic illness across the adult life span. Psychol Bull 133:920–954

    PubMed  Article  Google Scholar 

  8. 8.

    Hordern AJ, Street AF (2007) Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs. Med J Aust 186:224–227

    PubMed  Google Scholar 

  9. 9.

    Romito F, Corvasce C, Montanaro R, Mattioli V (2011) Do elderly cancer patients have different care needs compared with younger ones? Tumori 97:374–379. doi:10.1700/1125.12410

    PubMed  Google Scholar 

  10. 10.

    Rutten LJ, Arora NK, Bakos AD, Aziz N, Rowland J (2005) Information needs and sources of information among cancer patients: a systematic review of research (1980–2003). Patient Educ Couns 57:250–261

    PubMed  Article  Google Scholar 

  11. 11.

    Tong A, Sainsbury P, Craig J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 19:349–357

    PubMed  Article  Google Scholar 

  12. 12.

    Krueger RA (1988) Focus groups: a practical guide for applied research. Sage, Newbury Park

    Google Scholar 

  13. 13.

    Corbin J, Strauss A (1990) Grounded theory research: procedures, canons, and evaluative criteria. Qual Sociol 13:3–21

    Article  Google Scholar 

  14. 14.

    Glaser BG, Strauss A (1967) Discovery of grounded theory. Strategies for qualitative research. Sociology, Mill Valley

    Google Scholar 

  15. 15.

    Grol R, Wensing M (2004) What drives change? Barriers to and incentives for achieving evidence-based practice. Med J Aust 180:s57–s60

    PubMed  Google Scholar 

  16. 16.

    Wensing M, Bosch M, Foy R et al (2005) Factors in theories on behavior change to guide implementation and quality improvement in healthcare. Centre for Quality of Care Research, Nijmegen

    Google Scholar 

  17. 17.

    Taylor B, Davids S (2007) The extended PLISSIT model for addressing the sexual wellbeing of individuals with an acquired disability or chronic illness. Sex Disabil 25:135–139

    Article  Google Scholar 

  18. 18.

    Annon J (1976) The PLISSIT model: a proposed conceptual scheme for the behavioural treatment of sexual problems. J Sex Educ Ther 2:1–15

    Google Scholar 

  19. 19.

    Katz A (2005) The sounds of silence: sexuality information for cancer patients. J Clin Oncol 23:238–241

    PubMed  Article  Google Scholar 

  20. 20.

    Ayaz S, Kubilay G (2009) Effectiveness of the PLISSIT model for solving the sexual problems of patients with stoma. J Clin Nurs 18:89–98. doi:10.1111/j.1365-2702.2008.02282.x

    PubMed  Article  Google Scholar 

  21. 21.

    Hayter M, Ayaz S, Kubilay G (2009) Effectiveness of the PLISSIT model for solving the sexual problems of patients with stomas. J Clin Nurs 18:154–156. doi:10.1111/j.1365-2702.2008.02626.x

    PubMed  Article  Google Scholar 

  22. 22.

    Dutch guidelines nursing care: changed sexual functioning. http://www.oncoline.nl/veranderd-seksueel-functioneren. Accessed May 22 2013

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Acknowledgments

This research is supported by the Dutch Cancer Society (UvT 2009–4495) to Brenda Den Oudsten, Jan Anne Roukema, and Jolanda De Vries. We thank all patients, partners, and HCPs for their participation. In addition, we thank the following hospitals for their cooperation: Catharina Hospital (Eindhoven), St. Elisabeth Hospital (Tilburg), and TweeSteden Hospital (Tilburg and Waalwijk). Finally, we would like to thank Marianne De Vries, Marieke Van Der Sanden, and Lindy Arts for their help in transcribing the focus groups verbatim and for their assistance during the focus groups.

Conflict of interest

None of the authors have conflicts of interest. The authors have full control of all primary data, and if needed, we allow the journal to review the data.

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Correspondence to Brenda L. Den Oudsten.

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Traa, M.J., De Vries, J., Roukema, J.A. et al. The sexual health care needs after colorectal cancer: the view of patients, partners, and health care professionals. Support Care Cancer 22, 763–772 (2014). https://doi.org/10.1007/s00520-013-2032-z

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Keywords

  • Sexuality
  • Intimacy
  • Health care needs
  • Colorectal cancer
  • Focus group