Sexual healing: is there something we are missing?

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Abstract

Background

Psychosexual health concerns in life limiting illness can result from treatments, altered body image, carer strain, depression, symptoms and medication (Shell, 2008). However, there is evidence that under-assessment of sexual health concerns leads to unmet need (Taylor 2009).

Aim

This study seeks to explore how well psychosexual assessment is undertaken within a hospice inpatient unit. The aim was to identify areas of strengths and weakness in order to guide future staff education and support.

Method

An audit tool was developed and piloted. Data was collected on documented assessment of altered sexuality, libido, intimate relationships, and the presence of any symptoms or medications known to influence sexual function. Data was obtained from 15 randomly selected patient notes.

Results

14/15 patients received a psychosocial assessment including the impact of illness on mood and relationships. However, none of the clinical notes included an assessment of psychosexual health concerns despite identifications of common risk factors including medication and symptomatic effects.

Conclusion

Good assessment and psychosocial care in life limiting illness is the key to enable the patients to achieve a maximum quality of life. Although the study found a range of psychosocial foci by the multidisciplinary team, there was much less of a focus on needs around sexuality and intimacy. Plans for future work include multiprofessional education, introduction of a personalised care plan, and research to identify barriers to discussing sexuality.

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