Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Sex, sleep, survival with a stoma: how people adjust and how we can support them (#88)

Haryana Dhillon 1
  1. Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia

Long-term consequences of colorectal cancer (CRC) are well recognised. A cohort of patients will require a stoma after bowel resection, this may be either temporary or permanent, but either way it commonly results in high levels of distress in people adjusting to this substantial change in their body image and function.  This distress may be exacerbated by response of intimate partners, family members, friends, and caregivers, increasing with their level of discomfort.  Existing data suggest people are not well prepared for the functional, social, and psychological impacts of living with a stoma. In particular, discussion of the impact of stoma on sexual function appears to be very limited or often not addressed at all.

Information interventions to prepare patients for changes using practical, sensory, and emotional information may assist their adjustment to their changed health state. Understanding the experience of patients during adjustment to stoma and beyond is important to improving psychosocial outcomes.

The perceptions and experiences of clinical staff including stoma care nurses are relevant to introducing change. A qualitative study explored 14 stoma care nurses experience discussing sexual matters with patients before and after treatment of CRC. Nurses agreed sex and sexuality is important area of care for patients, but their practice is variable with three primary themes identified; health system factors, health professional setting, roles and responsibilities, and patient factors which appear to negatively impact how they address sex and sexuality with CRC patients.

Implications for Cancer Survivors: Increasing and improving discussions regarding sex and sexual function between CRC patients and stoma care nurses may ensure that the sexual needs of CRC patients do not go unmet.