Table 2.

Thematic framework of the data generated with the participants

Theme	Sub-themes	Codes
Perceptions of sexuality	Value of sexual life	When it is healthy/good, everything is healthy/good
	Male sexual leadership	Women in the Arab world do not orgasm
	Poor sexual education	We receive couples who know nothing about the genital anatomy and how to have penetrative sex … the problem relates to the absence of proper sexual education
Initiating the discussion about the individuals’ sexual issues	Establishing a suitable relation	… you initiated the conversation… you allowed the patient to talk…
	Trigger the patients to talk	Every day during my morning rounds, I interview every patient and ask him/her about his/her concerns. Otherwise, the patient does not talk…
Muting the discussion around the individuals’ sexual issues	Sexual healthcare is not part of the culture	We learned in our upbringing that the topic is intimate. That is why we have not yet reached the point where we can easily approach it or consider it a concern like other topics
	Lack of knowledge	We were not informed in our childhood and when we got older and we did not learn… I can’t do it…
	Taboo	I answer if I am asked. But to do it by myself! No
	Not a priority for ill patients	Of course, yes; not easy on her; losing the breast! Of course it is even traumatising. But still, there are issues more vital. Does she care [about sex] while her life is threatened?
Coping with embarrassment	Delegating sexual healthcare	I am sure that he is better [the physician]… these issues, too complicated… He knows, he knows things well, he is familiar with the couples…
	Avoiding sexual healthcare	For my part, I am shy. If I ask her, she will notice my perplexity. For us also, the subject is taboo
Promoting nurses' and midwives' role in sexual healthcare	Suggestions to deal with the barriers	Personal, educational, professional, and social