Using the BETTER Model to assess sexuality.

A component of the American Nurses Association (ANA) and the Oncology Nursing Society (ONS) standards of nursing practice is systematic assessment and collection of data about the health status of each patient; this process includes sexuality (ONS & ANA, 1996). Many tools are available to nurses when obtaining a sexual history, assessing sexual function, and providing interventions that will assist patients in the management of any identified problems. Models such as PLISSIT, PLEASURE, and ALARM can support nurses by providing a guide for appropriate steps to address sexuality with patients (Andersen, 1990; Krebs, 2001; Mick, Hughes, & Cohen, 2003; Shell, 2001). The BETTER model also can be used to provide information to help oncology nurses conduct sexuality assessments more effectively (Mick et al.) (see Figure 1). Test your knowledge of sexuality assessment by answering the following questions, which are based on the BETTER model. 1. Sexuality is best described by which of the following definitions? a. Sexual function b. A composite of feelings and behaviors specific to gender c. Sexual activity and the love and caring that accompany it d. Body image, gender roles, patterns of affection, family and social roles, and genital sex 2. Mrs. A, a 63-year-old woman with stage II breast cancer, comes to the clinic for her chemotherapy follow-up visit. While the nurse performs her assessment, Mrs. A states that she has been feeling very tired most of the time. The nurse can use this comment to bring up the topic of sexuality and accurately provide information by saying, a. “Tiredness can change your sexual life, too. Many women notice changes in their sexual lives. If you have any conJoAnn Mick, RN, MSN, MBA, AOCN®, is a patient care nurse manager at the University of Texas M.D. Anderson Cancer Center in Houston and a doctoral student at Texas Woman’s University in Houston; Mary Hughes, MS, RN, CNS, is a clinical nurse specialist in the Psychiatry Section of the Neuro-oncology Department at the University of Texas M.D. Anderson Cancer Center; and Marlene Z. Cohen, RN, PhD, FAAN, is a John S. Dunn, Sr., distinguished professor in oncology nursing in the School of Nursing at the University of Texas Health Science Center at Houston and the director of applied nursing research at the University of Texas M.D. Anderson Cancer Center.