Hong Kong health care and hospitals

Hong Kong women battling sexual dysfunction after cancer can be helped by nurse-led rehab

PUBLISHED : Thursday, 22 March, 2018, 5:23pm
UPDATED : Thursday, 22 March, 2018, 10:56pm

As more women in Hong Kong are able to survive gynaecological cancer, discussion of sexual dysfunction, prevalent among such survivors, becomes imperative.

Sexuality remains a sensitive topic in Chinese societies. Our recent research revealed that almost half of the Chinese gynaecological cancer survivors in Hong Kong were hesitant to resume sexual activities after completion of treatment, possibly owing to their fear of the recurrence of cancer or transmission of the disease to their partner.

In fact, once patients were diagnosed with gynaecological cancer, their sexual function was disrupted. They also reported a reduced desire for an intimate relationship with their partner and a fall in sexual interest. In addition, disrupted sexual function exerts direct and indirect effects on patients’ quality of life, and psychosocial adjustment to illness plays a significant role in mediating such effects.

There is generally a lack of training among general practitioners and oncology specialists in assessing and diagnosing sexual dysfunction

In light of this, patients’ sexual function and psychosocial adjustment should be routinely assessed, so that early intervention can be implemented in order to improve their quality of life. However, research has revealed barriers that prevent patients from discussing sexuality. These include feeling of embarrassment, shame and inability to communicate with physicians about their sexual impairments.

Notably, there is generally a lack of training among general practitioners and oncology specialists in assessing and diagnosing sexual dysfunction.

Hence, we propose the development and implementation of a nurse-led sexual rehabilitation programme, to provide holistic and restorative care to gynaecological oncology patients and their partners, in order to fill the health care service gap in addressing sexual dysfunction among such patients.

An individualised approach, taking into consideration patients’ symptoms, overall prognosis, family dynamics, cultural beliefs and personal values should be adopted.

The well-known PLISSIT nursing model of sexual assessment: permission, limited information, specific suggestions and intensive therapy would be used as a guide for sexual assessment and intervention. It is a brief, user-friendly and practical guide for use during routine outpatient follow-up visits.

Carmen W.H. Chan, professor, and Ka Ming Chow, assistant professor, Nethersole School of Nursing, Chinese University of Hong Kong