title: Challenges having conversations about sexuality in ambulatory settings: Part I--patient perspectives.
abstract: BACKGROUND
  A cancer diagnosis and treatment can have a significant impact on an individual's quality of life. In particular, body image and sexuality can be compromised. However, there is increasing evidence that conversations about these consequences are not happening often between cancer patients and their health care providers. This is especially the case in busy ambulatory settings.
  
  
  OBJECTIVE
  This study was undertaken to explore the perspectives of cancer patients concerning the conversations that happen about sexuality following a cancer diagnosis in daily practice. There was a desire to understand more about the barriers that exist with regards to having this type of conversation.
  
  
  METHODS
  Thirty-two cancer patients participated in interviews that explored their experiences with having conversations about sexuality. Transcripts of the interviews were subjected to a standard qualitative content and theme analysis.
  
  
  RESULTS
  Patients described many changes in their bodies following cancer treatment that had the potential to impact on sexuality, but actual concerns or problems about sexuality were highly individualized. Few had had conversations about sexuality with their health care providers. Most thought it was the responsibility of the cancer care team to "open the door" to the topic area.
  
  
  CONCLUSIONS
  The results support the idea that few conversations are taking place between cancer patients and their providers about sexuality. Innovative approaches are required to better meet patient needs.
authors.affiliation: Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5. marg.fitch@sunnybrook.ca
authors.forename: Margaret I
authors.initials: MI
authors.lastname: Fitch
authors.forename: Gerry
authors.initials: G
authors.lastname: Beaudoin
authors.forename: Beverley
authors.initials: B
authors.lastname: Johnson
mesh_terms: D000554:Ambulatory Care Facilities; D002170:Canada; D006801:Humans; D009369:Neoplasms / Q000503:physiopathology*; D019529:Sexuality