Clinician barriers to initiating sexual health conversations with breast cancer survivors: The influence of assumptions and situational constraints

Mollie Rose Canzona, Christy J.W. Ledford, Carla L. Fisher, David Garcia, Meghan Raleigh, Virginia B. Kalish

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Introduction: Sexual health (SH) is an important dimension of physical, emotional, and social functioning after breast cancer (BC). Research suggests that survivors' SH concerns are not being adequately addressed in oncology or primary care settings. It is important to understand why these conversations are not taking place and what can be done to enhance care for women in this context. This research aims to identify when clinicians initiate SH conversations with survivors and to uncover factors that influence these decisions. Method: Thirty-six clinicians from family medicine, internal medicine, oncology, and gynecology participated in semistructured interviews. Analysis uncovered themes that influence clinicians' decisions about initiating SH conversations with survivors. Attention was given to capturing the personal, professional, and system-level issues that inform clinicians' communication choices. Results: Clinicians reported their decisions are based on (a) beliefs about patients, (b) inability to address survivors' concerns, (c) time constraints that affect the delivery of care, and (d) views of professional function in survivor health care. Discussion: Clinician decisions are based on sometimes-erroneous assumptions and situational constraints. This suggests the need for medical education and support regarding SH care. Several practice points are outlined to facilitate clinicians' efforts to improve SH care for female BC survivors.

Original languageEnglish (US)
Pages (from-to)20-28
Number of pages9
JournalFamilies, Systems and Health
Volume36
Issue number1
DOIs
StatePublished - Mar 2018
Externally publishedYes

Keywords

  • Breast cancer
  • Patient-clinician communication
  • Sexual health
  • Survivorship

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

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