CARE ORGANISATION

In order to put sexuality on the agenda within your healthcare institution, it will be important to first understand which (of the aforementioned) challenges are present within your organisation. You then determine a suitable strategy and include the chosen strategy in an internal policy and/or protocol. Through a clearly formulated policy, healthcare providers understand what is expected of them. Integrating the subject in existing protocols and structured meetings (such as departmental meetings and/or patient meetings) can also bring about a change in culture. It is also recommended that the following activities be rolled out to help healthcare providers incorporate the subject of sexuality into their current work processes: (1) dividing and defining tasks and roles, and (2) providing (financial) resources.

Dividing and defining tasks and roles

To ensure that more attention is paid to the sexual health of the patient groups, it is important to determine in departmental consultations who will be responsible for the following tasks. It is recommended that one person be responsible for ensuring that the subject of sexuality is addressed. This could be a coordinating manager, for example. The W-formula can help in defining tasks and roles: Who does What Where at What moment and What do I need for that and When do we evaluate it?

1. Identifying the sexual problems: It is important that sexual problems are identified. This may be done by the treating clinician. Healthcare providers also often see a role for the nurse.
2. Supporting the patient in case of sexual problems: Research has shown that, for example, a nurse practitioner could support a patient with sexual problems. If more specialist care is required, patients can be referred to a sexologist, sexual health consultant or mental health care psychologist.
3. Embedding sexuality as a standard part of the care process: A nurse practitioner could, for example, look at how sexuality could be included as a standard subject, for example by adding it as a standard subject in the patient file.
4. Supporting healthcare providers with questions about sexuality: By involving an internal sexologist / sexual health consultant in patient discussions as standard, they can provide immediate support. However, due to the limited availability of a sexologist, this possibility may not be feasible. In this case, for example, a half-yearly meeting could be considered in which healthcare providers, in addition to receiving sexuality training, come into contact with a sexologist, thus making contact more accessible in the future.
5. Making educational training courses possible for healthcare professionals: Within a healthcare institution, (financial) possibilities can be offered for attending relevant training courses. An internal sexologist can give advice about available training courses.

Providing (financial) resources

A lack of time and low prioritisation of the subject are barriers that cause the subject of sexuality to receive little or no attention at the moment. To make sexuality a standard subject, a time investment will be needed. The extent to which it will be feasible to make more time available will depend on the (financial) capacities of the healthcare institution. For example, the possibilities of offering longer and/or more frequent consultations. In order to offer longer consultations, care providers will have to transfer other tasks. The deployment of, for example, a nurse specialist can be a solution.

In addition, due to a lack of knowledge and conversation skills, it is difficult for caregivers to discuss sexuality and identify problems. As a healthcare institution, it is important to offer support to healthcare providers in this regard. 

Because training often involves time and costs, it is also possible to organise a (multiple) workshop(s) via (internal) sexologists/consultants. The responsibility for offering training opportunities will also have to be assigned to someone in the organisation. In addition, money will have to be made available/allocated for this purpose. If you as an organisation do not have the right resources, such as funding, then including this manual in your internal protocol is already a first step. If healthcare providers do not receive extra training, they can use this manual for tips and resources to increase their knowledge.