Addressing sexual issues in palliative care: A qualitative study on nurses' attitudes, roles and experiences.

Abstract

To explore palliative care nurses' attitudes, roles and concrete experience with regard to addressing sexual issues in their daily practice. Patients and their partners in palliative care might experience dramatic changes in their sexuality and want nurses to provide the opportunity to address them. Moreover, it is argued that the holistic philosophy of palliative care encourages nurses working in this area to include sexual issues in their daily care. It is, however, unknown how palliative care nurses address sexual issues. A generic qualitative study was performed. In total, 21 in-depth interviews were done with nurses from different facilities of palliative care networks in Flanders. Data were collected between September 2014 - September 2016 and thematic analysis was used to analyse the data. It was found that the way palliative care nurses addressed sexual issues was clearly influenced by their own interpretation of the philosophical principles underlying palliative care. The different interpretations of these basic principles create tensions for nurses about how to address sexual issues in the daily practice of palliative care and nurses vary in their reactions to these tensions. The present findings show that palliative care nurses - when they were able to overcome these tensions - use a "sex-positive approach" that fits with their tendency to focus on quality of life. Out of the results of this study, we made a list of good practices for palliative care nurses addressing sexual issues. This list can be used in nursing educational programs.