Monday 10th September 2012
Sue Lennon, Macmillan Nurse Specialist and Psychosexual Therapist, has developed a sexual support service for people affected by cancer.
Cancer and its treatment can interrupt life on many levels and the impact on relationships and sexuality is being increasingly recognised.
I trained as a psychosexual therapist with Relate and recently set up a psychosexual therapy (PST) service for people with cancer and their partners, with support from Macmillan.
The service gives people who have suffered a sexual impact from their cancer or cancer treatment the opportunity to explore and understand this. We set mutually acceptable goals to recover intimacy, sexual confidence or activity (with their partner if there is one), and patients are guided by me to achieve those goals.
The service has been in development for 10 months and has offered a number of learning points:
1. Having taken advice from other general PST services, there was concern that the service might be swamped by referrals, so tight referral criteria were put in place. However, this tidal wave of referrals didn’t materialise, possibly because there was a need for awareness and education to help staff to talk about sexuality with their patients.
2. Although there was evidence of good practice already, I was concerned about alienating staff who were less confident. I’ve taken every available opportunity to raise awareness and challenge assumptions. I offer stock phrases to help staff start conversations and I’ve introduced the PLISSIT model (see the Let's talk article in this edition of Mac Voice) to help manage the consequences of these.
Evaluation suggests that many staff now feel empowered to approach the issue with more confidence. Those already doing so were able to share good practice.
3. Patient information leaflets needed to be written. A number of examples were sought from general PST service providers, and the local patient information and communication group provided input.
4. I liaised with the multidisciplinary teams to ensure that as many consultants as possible were aware of the service and to open up discussion about whose job it was to do this work. The hospital newsletter also featured an article about the service.
5. While staff needed help to ask the questions, patients needed help to talk about their concerns. Leaflets about the service were placed in all new patient information packs and information was posted in the chemotherapy unit.
6. I have presented at numerous support groups and survivorship events. These presentations have received positive feedback and resulted in some patients sharing their stories.
7. Given the extremely sensitive nature of discussions in the therapy room, I arranged for notes to be stored separately with medical records (as often happens within psychology services).
The service has 13 patients and referrals are increasing as staff confidence grows.
1. Annon. J. The PLISSIT model: A proposed conceptual scheme for the behavioural treatment of sexual problems. Journal of Sexual Education Therapy
.1976. 2: 1-15.
2. Department of Health.Cancer Reform Strategy
. 2008. Department of Health. UK.
3. Kotranoulas. G. Papadopoulou. C. Patiraki. E. Nurses’ knowledge, attitudes and practices regarding provision of sexual health care in patients with cancer: a critical review of the evidence
. Support Cancer Care
. 2009. 17. 479–501.