- This topic has 7 replies, 8 voices, and was last updated by jfeik.
February 17, 2020 at 4:15 pm #17568
I think this video shows a lot of the anxieties that health care workers have regarding speaking with patients about sexuality. In contrast with other videos wherein the social worker’s advice was clear and specific to the needs of the patient, this conversation felt rushed and uncomfortable. Talking about “bodily fluids and not sharing them with other people” isn’t specific, and though that non-specificity guards against embarrassment, it also shortchanges patients who often do have specific questions and anxieties about how cancer will affect their sexual life. I think opening up the conversation with questions about what the patient wants to know, and then doing our best to either a) answer those questions or b) refer the patient to an information source or other health care practitioner who can, ensures that the patient has their concerns answered and allays health care worker anxiety that they are bringing up something embarrassing or undesired to the patient.February 17, 2020 at 9:12 pm #17574
I agree with you. The professional was doing all the talking and not any listening. It is not clear what concerns the patient is having or what direction the discussion will go. The patient looked uncomfortable because of how the topic of sexuality was brought up. We don’t even know if the patient has a partner, what their sexual identity or orientation is and what questions she has, or even how she is coping with her cancer and sexual health. The BLISSS or BETTER method of approaching sexual health with the patient would have been a great place to open up this discussion.February 21, 2020 at 4:31 pm #17610
I think you bring up a very good point of remembering to be a listener FIRST and then addressing concerns and questions and gaps in care after is important. Address questions directly and specifically, not vaguely and offering specific resources is important. I agree that this will also help take the stigma out of the discussion.February 23, 2020 at 10:11 pm #17640
I agree that it felt rushed, and it was at the end of the session, so it did not leave a lot of time to actually talk more in depth about the things that were mentioned. I feel like she should have allowed for more timeFebruary 24, 2020 at 11:55 am #17643
I agree with all the above comments. The conversation did feel very rushed. I love what @mboulden said about being a listener first. It helps to start where the patients is and allow them to verbalize their fears, concerns and questions. This interaction was way too short and was not a good indicator of the importance of the information being provided or the feelings attached to that info.February 24, 2020 at 3:22 pm #17645
This conversation did appear rushed, and a very one-sided dialogue with the SW doing all the talking, and not using empathic listening or asking any open-ended questions to connect with patient and develop some therapeutic rapport. The SW is not welcoming feedback, questions from patient and not eliciting any info from the patient. I also think SW’s eye contact was not supportive and SW seemed too far spaced away from the patient which seemed uninviting, and aloof to patient’s body language. The patient is providing mannerly nods and short responses and most likely because she doesn’t feel this is the forum for her to express her concerns and ask the questions she may have. I think unless one is a very seasoned SW whom has these type of conversations daily with patients, a brief reference sheet for both SW and patient to follow along is vital so that important subjects are not missed, and it’s nice to give patients info visually.
I would think a good reference sheet would contain pointers to discuss such as –
-effects of chemo on one’s sex life
-reliable contraception to avoid pregnancy
-how patient can protect their partner (barrier methods such as condoms, femidoms, dental dams, etc.)
The SW has no clue if patient even has a partner and is sexaully active. It would be a good starting point in learning from the patient if she has concerns about intimacy, sexual activity during treatment, coping with changes that may happen to her body, and then slowly dive into deeper concerns that can be educational / informative about how chemo changes normal vaginal lubrication, suggestions for water-soluble lubricants, to compassionate discussion about support groups, planning time for sharing that is separate from time for sexual intimacy, using a good sense of humor in relationships to help make the rough spots smoother, and perhaps end discussion again allowing patient time for review and further questions.February 25, 2020 at 10:40 am #17646
What excellent points! Just yesterday, I heard a fellow colleague referring to the transfer of “bodily fluids”. I believe we, as healthcare professionals, need to feel comfortable with talking about sex and sexual health. Patients desire information about sexual health, but feel embarrassed when bringing up the topic. We should be confident and not embarrassed as we have the answers that they desire. This also helps to build our relationships with our patients. We attempted to have a sexual health class for patients, but it was more successful when talking one-on-one rather than in a support group type setting.February 27, 2020 at 5:00 pm #17672
Agreed, this conversation seemed very uncomfortable for everyone involved. Someone above mentioned developing some sort of teaching sheet, which I think is a great idea. It is always a good way to keep the conversation flowing and a resource the patient has for later since we know they can’t always absorb everything we talk about in the moment.
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