Sexologie, corporéité et culture palliative : proposition du modèle de communication JASE
Mots-clés :
Soins palliatifs et de fin de vie, sexualité, intimité, corporéité, communication, agentivité sexuelleRésumé
La sexualité et l’intimité demeurent largement absentes des trajectoires palliatives, malgré l’importance que leur accordent les personnes en soins palliatifs et de fin de vie (SPFV). Ancré dans une approche humaniste mobilisant le concept de corporéité (embodiment), cet article propose une revue exploratoire de la littérature visant deux objectifs : documenter les facteurs influençant les interactions entourant l’intimité et la sexualité en milieux palliatifs, et élaborer un modèle de communication bilatérale adapté à la culture palliative. La recension des écrits a permis de dégager des thématiques illustrant les perspectives respectives des personnes soignées et des personnes soignantes. Chez les personnes soignées, les résultats mettent en lumière les transformations du rapport au corps, les dynamiques relationnelles, la diversité des significations attribuées à l’intimité et le désir d’aborder ces enjeux avec le personnel soignant, à condition que celui-ci prenne l’initiative d’ouvrir le dialogue. Du côté des personnes soignantes, les obstacles identifiés incluent des conceptions normatives de la sexualité, un inconfort personnel, un manque de formation et une interprétation variable du mandat palliatif. En réponse à ces constats, le modèle de communication JASE (Jugement suspendu, Accueil, Savoir expérientiel, Expression) est proposé en intégrant l’agentivité sexuelle des personnes soignées dans un dialogue égalitaire et cyclique. Centré sur la notion de corporéité, le modèle JASE offre un cadre de référence préliminaire adapté aux principes fondateurs des SPFV.
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