A person-centered approach to sexual health

Organization: Public Health Agency of Canada

Date published: May 2024

Strategies for health professionals to build trust and create emotionally safe spaces to talk about sexual health and sexually transmitted and blood-borne infections.

Discussing sexual health with patients

Conversations about sexual health and sexually transmitted and blood-borne infections (STBBI) can be uncomfortable and may deter people from seeking care. Health professionals may also experience discomfort discussing topics related to sexual health. Such discomfort may relate to uncertainty about how to discuss sexual health with patients and to their own values and experiences. Health professionals can help create a safe environment that is free of judgement by being aware of and respecting patients' values, experiences and needs.

Implementing person-centered and trauma-informed approaches to care can help facilitate a welcoming and non-judgmental space during health care visits.

What is a person-centered approach to care?

A person-centered approach to care means being respectful of, and responsive to, the preferences, needs and values of the person receiving care. Through this approach, patients are equal partners in planning, developing and monitoring their care to ensure it aligns with their needs. Employing this approach also involves acknowledging individuals' abilities and capacity to manage and improve their own health, as opposed to perceiving them exclusively as sufferers of disease or passive beneficiaries of health care.^{Footnote 1}

Tips for implementing person-centered care

Do:

• Listen openly, leaving space for patients to determine what they are comfortable sharing
• Consider patients' individual circumstances, culture, values, and goals to ensure support is tailored to their individual needs
• Foster spaces for shared decision-making that draw upon patient strengths
• Encourage patients to involve family, friends and others in their care if they are comfortable
• Allocate enough time for meaningful interactions and to build trust with patients
• Provide access to reliable and inclusive health information for informed decision-making

Don't:

• Rush decision-making
• Pressure patients for details or lead with questions on sensitive topics like substance use
• Dismiss alternative forms of medicine and healing
• Assume patients' level of knowledge or impose goals and solutions without their input
• Rely solely on standardized assessments without considering patients' lived experiences

Benefits of person-centered care^{Footnote 2Footnote 3Footnote 4}

• Aligns medical decisions, therapies and treatments with individual preferences, values and goals, leading to increased satisfaction and improved outcomes.
• Takes a holistic approach to care, addressing physical, emotional, social, and psychological well-being for a more effective healing strategy.
• Cultivates meaningful patient-provider relationships and promotes communication, which can help prevent provider fatigue and burnout.

What is a trauma-informed approach to care?

A trauma-informed approach to care means recognizing that individuals may have experienced trauma in their lives, such as physical or emotional abuse, neglect, accidents, or other distressing events. These traumatic experiences can profoundly affect their sense of safety and well-being, especially in health care settings. This approach focuses on creating environments that prioritize the emotional and psychological safety of patients, to prevent traumatization or re-traumatization.^{Footnote 5}

Tips for implementing trauma-informed care

Do:

• Respect and reassure patients about confidentiality and provide private spaces for care
• Enhance safety by offering patients choices about their care and encouraging the presence of a support person during appointments
• Always explain why certain questions are being asked and provide advance explanations of exams, tests and treatments, so patients know what to expect
• Consult with patients to compare the advantages and disadvantages of various clinical choices
• Shift the focus from behaviours to experiences, eliminating assumptions about choice and autonomy in actions^{Footnote 6}
• Assess the need for referrals to additional services in partnership with the patient

Don't:

• Focus solely on risks and use fear-based or judgmental language (e.g. "drug user" or "unprotected sex")
• Overlook potential trauma triggers that may require adjustments to patients' care (e.g. examining without warning or permission)
• Ignore the potential impacts of power dynamics on the patient-provider relationship
• Disregard how cultural factors influence experiences and expressions of trauma
• Be inflexible to patients' evolving needs, goals, and circumstances

Benefits of trauma-informed care^{Footnote 7Footnote 8}

• Creates a safe and non-judgmental space for patients to feel supported during health care visits.
• Fosters opportunities for choice, collaboration and connection, empowering patients to actively engage in personalized health care.
• Nurtures a welcoming and supportive atmosphere that motivates patients to seek both routine and subsequent follow-up care.

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