Department of Oncology, 4352Mayo Clinic, Rochester, MN, USA.
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 6915Mayo Clinic, Rochester, MN, USA.
Am J Hosp Palliat Care. 2020 Dec;37(12):1053-1061. doi: 10.1177/1049909120910084. Epub 2020 Mar 26.
This study sought to understand the patients' perspective of what contributes to an absence of discussions of sexual orientation (SO), gender identity (GI), and sexual health in cancer care.
Patients were recruited from oncology, gynecology, and a gender transition clinic to participate in semistructured interviews, which were analyzed with qualitative methods.
A total of 25 patients were interviewed, shedding light on 2 themes. The first was that these conversations are important but infrequent. One patient explained, "…. we know people who have had sex changes…[they] would have appreciated that question." In response to whether sexual health was ever brought up, one patient responded, "No doctor ever has." Patients described unaddressed issues: "There have been times, you know, we've wondered if it was okay to make love." The second theme consisted of 4 pragmatic, patient-provided points to facilitate discussions: (1) implementation of a scale of 1 to 10 (with 10 being comfortable) to first gauge patients' comfort in talking about SO, GI, and sexual health; (2) having the health-care provider explore the topic again over-time; (3) making sure the health-care provider is comfortable, as such comfort appears to enhance the patient's comfort ("I have a doctor here, a female doctor, who just matter of fact will ask if I get erections and so on because of the medication she's giving me);" and (4) eliminating euphemisms (one patient stated, "I don't know what you mean by 'sexual health'.").
Oncology health-care providers have a unique opportunity and responsibility to address SO, GI, and sexual health.
本研究旨在了解患者对癌症护理中缺乏讨论性取向（SO）、性别认同（GI）和性健康的看法。
从肿瘤学、妇科和性别过渡诊所招募患者参与半结构化访谈，采用定性方法进行分析。
共采访了 25 名患者，揭示了 2 个主题。第一个主题是这些对话很重要但很少发生。一位患者解释说：“……我们认识一些做过变性手术的人……[他们]会很感激这个问题。”当被问及是否曾提到过性健康问题时，一位患者回答说：“没有医生提过。”患者描述了未解决的问题：“有时候，我们想知道是否可以做爱。”第二个主题由 4 个务实的、由患者提供的观点组成，以促进讨论：（1）实施 1 到 10 的评分（10 为舒适），首先评估患者在谈论 SO、GI 和性健康方面的舒适度；（2）随着时间的推移，让医疗保健提供者再次探讨这个话题；（3）确保医疗保健提供者感到舒适，因为这种舒适似乎会提高患者的舒适度（“我有一位女医生，她会很自然地询问我是否有勃起等问题，因为她给我开的药会有影响”）；（4）避免委婉语（一位患者说：“我不知道你说的‘性健康’是什么意思。”）。
肿瘤学医疗保健提供者有独特的机会和责任来解决 SO、GI 和性健康问题。
