Initiation of sexual discussion in social work practice with cancer patients: A nationwide survey of social workers.

摘要

In the United States, it is estimated that 12 million Americans are living with a history of cancer, with over 1.6 million new cases expected to be diagnosed yearly. The 5-year survival rate is approximately 67% and projected to increase as cancer detection and treatment continue to improve. However, improved survival rates also increase the risk for compromised quality of survivorship. Unaddressed sexuality changes are known to be amongst the most negative influences on the well-being of the cancer survivor, yet sexuality counseling is not part of routine social work oncology care. The current study is the first national survey of social workers studying the extent to which social workers initiate discussions about sexuality with their cancer patients and the factors that influence their practice. The data was obtained from 143 oncology social workers who responded to the online researcher-prepared questionnaire. The findings confirm that social workers view cancer patients' sexual concerns as an integral area of care and believe that it is their professional responsibility to address them. However, the findings also indicate that initiating discussions about sexuality is not formalized into social work practice by the vast majority of social workers, with lack of education and training reported as the biggest barrier. Social workers report a paucity of educational opportunity in the area of human sexuality, particularly in Social Work degree programs. As predicted in the hypotheses, the findings indicate that higher levels of education and training are correlated with increased levels of perceived knowledge and more favorable attitudes towards discussing sexual concerns. All of these are correlated with significant increases in initiation of sexual discussions in social workers' practice with oncology patients. Implications of these findings for education, training and practice are discussed.