Training teaches about disabled patients’ sexuality

Providing healthcare staff with a one-day training course on dealing with the sexual needs of people with an acquired physical disability gave staff a greater understanding of the issues facing patients and enabled providers to address intimate questions more comfortably and proactively, according to an Irish study.

The findings were so encouraging that the authors of the study, published in the November issue of the Journal of Advanced Nursing, have called for all healthcare practitioners to receive sexuality training, regardless of their role or area of practice.

Researchers surveyed 29 nurses, allied health professionals and care staff, before and after the course, on their ability and confidence to address sexual issues with patients. They also held in-depth interviews with 12 participants. Staff ages ranged from 20 to 55, 79% were female and a plurality (41%) had been working at their current hospital for one to five years.

“Changes associated with an acquired physical disability can diminish a person’s self-esteem, sense of attractiveness, relationships and sexual functions,” Agnes Higgins, the study’s lead author and professor of mental health at the School of Nursing and Midwifery, Trinity College Dublin, said in a news release.

“Previous research suggests that people with physical disabilities are dissatisfied with the quality of information and support around sexuality during their rehabilitation.”

Staff reported finding the course helpful. One participant said it made staff more able to respond to difficult issues in a sensitive manner. “I’m less uncomfortable and if [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 more?’ rather than just kind of laughing and then moving onto the next subject, which is easy to do.”

Another participant said the course made staff think of more than a patient’s medical needs, citing the example of a woman who was incontinent and keen to return home and to work. Normally they would have suggested a urinary catheter, without further exploring the impact of this on the person’s life, but the staff member said: “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.”

This was reinforced by other staff members. “I like to think I see the patient as a person, but you don’t always; you honestly don’t,” one said. “That [course] made me very, very aware that there is a person here.”

Participants rated their knowledge of 13 key areas related to patients’ sexuality, including rights, aging, communication and help with specific medical conditions. The average score was 1.9 out of 4 before the course and 2.5 after the course — the equivalent of a 31.5% increase in knowledge.

Participants also rated their ability to deal with 15 situations, ranging from seeing a patient engaging in sexual behavior to giving advice on future sexual ability. The average score was 2.1 out of 4 before the course and 2.6 after the course — the equivalent of a 23.5% increase in ability.

“Patient sexuality is an area that many healthcare practitioners may be reluctant to address or discuss because of embarrassment, particularly when patients have a disability,” Higgins said.

“Our study suggests that systematic education and training in sexuality leads to statistically significant changes in healthcare practitioners’ knowledge, skills and comfort. This course provided an effective learning experience for the healthcare practitioners and could easily be replicated elsewhere. We believe that practitioners require education in patient sexuality, regardless of their discipline.”

The study abstract is available at

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