Giving healthcare professionals a one-day training session on managing the sexual needs of patients with acquired physical impairment allowed a better understanding of problems patients can face and resulted in equipped staff capable of addressing private questions with appropriate and empathetic responses.

Published in the November issue of the Journal of Advanced Nursing, these results are so promising that the authors are pushing for all healthcare practitioners to obtain sexuality training, regardless of their position or speciality of healthcare.

During the study, the team of researchers questioned 29 nurses, health professionals, and associated staff on their capability and confidence to talk about sexual issues with their patients, before and after the informational course. In-depth interviews were also given to 12 of them. The participants were mostly female (79 percent), ranged in age from 20 to 55 years old, and the majority had been working in their current hospital for one to five years (41 percent).

Lead author Agnes Higgins, Professor of Mental Health at the School of Nursing and Midwifery, Trinity College Dublin, Ireland, explains:

“Changes associated with an acquired physical disability can diminish a person’s self-esteem, sense of attractiveness, relationships and sexual functioning.”

Earlier research points out that many physically disabled patients are dissatisfied with the amount of information and support available concerning sexuality during their rehabilitation.

Topics addressed during the information session included strategies to deal with patients’ sexual behavior in the hospital setting, the influence of disability on sexual expression, and how to answer questions such as when will they be able to have sex in the future.

  • Study participants assessed 13 different areas relating to patients’ sexuality such as: aging, communication, rights, help with medical conditions, and rights. The mean score before the session was 1.9 out of four, and 2.5 after the course, showing a 31.5 percent increase in knowledge.
  • The largest increase in knowledge was seen in sexual rights and disability, as well as brain injury and sexuality. Other major increases included the influence of stroke on sexuality and dealing with inappropriate sexual behavior.
  • Participants rated their ability to address 15 situations, starting with seeing a patient taking part in sexual activity, and ending with looking for advice on their future sexual ability.
  • The greatest increases in ability were how to address walking in on a patient masturbating or engaging in sexual foreplay with their partner. Other prominent increases were how to answer to a patient who asked if it was OK for them to have sex, and giving guidance to young and old patients who want to know if they will ever have an erection or an orgasm again.

One participant commented:

“I’m less uncomfortable and if they [patients] raise an issue, even in a joking manner, I’m kind of happy to say ‘Well is that an issue for you… would you like to talk about that a little bit more?’ rather than just kind of laughing and then moving onto the next subject, which is easy to do.”

A different participant expressed that they now could consider the personal needs of the patient more, citing a case where a woman was returning home and a catheter was being considered, saying, “Because I’d done the sexuality course it made me think well actually one of the person’s goals is she’s got a fiancé, and relationships are important, and that [catheter] would be a huge barrier.”

Participants also commented that they are now equipped with the proper tools to address sexual advances or comments made to them by their patients without feeling embarrassed.

Patient sexuality is a topic that is frequently overlooked because of embarrassment, especially if a disability is involved. This study establishes that education and training in this particular field creates important changes in health professionals’ knowledge, comfort, and skills.

With this essential education, staff can create a supportive listening environment for patients and have the ability to raise issues for discussion. The authors believe this effective learning experience can be easily duplicated elsewhere and will be beneficial for all health professionals.

Written by Kelly Fitzgerald