The stories of colleagues, patients and their partners reflecting on the impact a life threatening cancer has on intimacy and sexual needs

Abstract

This thesis explores the impact a life threatening illness may have on the intimacy, sexuality and sexual needs of a person living with metastatic cancer. Intimacy, sexuality and sexual needs are an integral part of every human being and lived everyday of a person's life. It is a pervasive life force that includes a person's total feelings, attitudes, beliefs and behaviours that relate to being a man or a woman. Cancer and the treatments for cancer can have a profound affect on the body and subsequently on how a person may feel about themselves, and their quality of life, within the constraints of their illness. Most people desire a level of intimacy with another. Whether we are young, middle aged, elderly, single or in an opposite or same sex partnership, handicapped, suffering ill health or terminally ill. Expressing one self as a sexual being is a life long process from birth to death and yet it is an aspect of life that is not fully understood. It is also an aspect of life that people are not comfortable talking about. There is limited research into the intimacy and sexual needs of people living with metastatic life threatening cancer. My belief was that health professionals, and that includes myself, patients and their partners are reluctant to discuss this sensitive aspect of a person's life. This is even more so when people are terminally ill and have an average age of sixty five years. Narrative (Storytelling) is the methodological form of inquiry used for this qualitative research project. Data collection resulted in a collection of stories that are included in their entirety. Data analysis is achieved through a reflective interpretive strategy. Each story concludes with my reflections, insights gained through my reflections and the implications for practice. The participants in this study included two colleagues, a nurse and a doctor who have an interest in assisting patients meet their intimacy and sexual needs. A nursing colleague, who is bereaved, reflects on the impact of her husband's illness on their intimacy and sexual needs. Six patients, four couples and two single people referred to a hospice programme and being cared for by the hospice team at home or in the inpatient unit, share their story of how their illness has impacted on their intimacy and sexual needs. The main findings of this small qualitative study are that the diagnosis of the recurrence of cancer has a devastating effect on the patient and those closest to them. Survival is paramount and the need for open, gentle and honest communication between themselves and health professionals. There was a profound need for closeness, hugs and kisses and the need to talk and share what they were thinking and feeling. The couples all shared how the diagnosis of cancer had brought them closer together. The study confirmed the opinion that cancer and the treatments for cancer do have an impact on feelings of self worth and dignity and can cause intimacy, sexuality and sexual difficulties. However, a caring, open, honest and loving relationship sustained and transcended these difficulties. The absence of a significant other created an aloneness for the single participants in this study. The participants found that health professionals are reluctant to discuss this sensitive aspect of life. They recommended that it is the health professionals responsibility to sensitively inquire if the patient and partner are experiencing difficulties in meeting their intimacy and sexual needs. They also advised that appropriate literature needs to be provided and discussed. My reflections on their stories suggested to me that comprehensive education and experiential workshops need to be provided for health professionals to explore their thoughts and feelings about intimacy and sexuality. Health professionals need to practice with one another ways of communicating comfortably with patients and their partners about intimacy and sexuality.