Sexual issues in the palliative care population.

OBJECTIVES: To briefly review the integration of sexual health into the palliative and end-of-life care settings, and to examine the patient/partner's reaction to the progression into palliative care and how the nurse can contribute to healthy sexual function. DATA SOURCES: Review and research articles. CONCLUSION: Whenever physical and emotional changes take place due to illness, feelings of femininity/masculinity may be threatened. Many patients/partners will feel a sense of contentment and well-being when encouraged to continue or resume a loving and close relationship. IMPLICATIONS FOR NURSING PRACTICE: The nurse must examine and assess the patient/partner's reaction to sexual health in the palliative and end-of-life care setting. The nurse can contribute to healthy sexual function through appropriate support and intervention.

The longitudinal effects of cancer treatment on sexuality in individuals with lung cancer.

PURPOSE/OBJECTIVES: To examine changes in sexual functioning during treatment for lung cancer and the extent to which age, gender, social support, and mood status affect sexual dysfunction. DESIGN: Prospective, exploratory. SETTING: Outpatient cancer clinic. SAMPLE: 59 of 84 eligible patients diagnosed with small cell or non-small cell lung cancer. METHODS: The Derogatis Interview for Sexual Function, Self-Report, to measure sexual functioning; the Social Provisions Scale to measure social support; and the Derogatis Affects Balance Scale to measure mood status were administered at diagnosis and at two and four months during treatment. MAIN RESEARCH VARIABLES: Level of sexual function, treatment, age, gender, social support, and mood status. FINDINGS: Results indicate a decrease in sexual function but no significant change in sexual function between the two treatment groups. Age was a significant factor affecting sexual function. Gender significantly affected sexual function at time 2 only. Between times 1 and 2, mood status had a significant relationship with sexual function. Social support did not affect sexual function directly; social support was found to significantly affect mood status. CONCLUSIONS: Most patients reported below-normal sexual function at baseline. Sexual function worsened over time. Further research is warranted to examine time, place, and type of intervention needed. IMPLICATIONS FOR NURSING: New data encourage assessment, intervention, and research related to the sexual function of patients with lung cancer.

Sexuality and body image concerns after treatment for breast cancer.

A mastectomy left this patient with sexual problems and an altered sense of femininity. Communication models exist that can facilitate nurse-patient conversations about sexuality.

Including sexuality in your nursing practice.

One would think that today's exposure of the topic of sexuality in the electronic and print media would elevate the medical professional's comfort level with communication regarding sexuality issues. However, writers continue to comment on clinician discomfort or lack of discussion with their patients about sexual concerns and anxieties. Many patients want to learn about the implications of their treatment and medications on their sexuality. Nurses who care for chronically ill patients may help foster a more positive self-esteem for the patient, and may influence patient-partner attitudes about worthiness, self-concept, and body image, by providing opportunities to talk about feelings and fears about how treatment may affect their sexuality.

Evidence-based practice for symptom management in adults with cancer: sexual dysfunction.

PURPOSE/OBJECTIVES: To provide a systematic review in relation to evidence-based practice for the management of sexual dysfunction in adults with cancer and to define the current state of knowledge about intervention for this symptom, the gaps and barriers in the current state of knowledge, and recommendations for public education and future research direction. DATA SOURCES: Articles published from 1980-2000, books, and practice standards. DATA SYNTHESIS: Few tested interventions are available to treat sexual dysfunction in patients with cancer. Those dysfunctions investigated include hot flashes, vaginal dryness, bladder control, and sexual functioning in two breast cancer populations, and psychosocial issues in a remaining few. Many diverse interventions have been reported based on expert opinion and case study. CONCLUSIONS: Although an abundance of literature exists related to the provision of interventions for sexual dysfunction in patients with cancer, few results are from randomized controlled clinical trials. Sexual dysfunction has been addressed extensively in the literature in relation to patients with cancer, but information is needed to ascertain the best assessment strategy and the best intervention, along with appropriate outcome criteria and research design. Description and control of the disease and treatment variables as outcome moderators are needed. IMPLICATIONS FOR NURSING PRACTICE: Reliable and valid interventions to promote sexual function are necessary as nurses intervene with patients and their partners. Practice guidelines are available but must begin to be based on research as well as expert opinion. As more research-based intervention information becomes available, clinicians will be able to provide care with greater confidence and certainty.