Sexual Performance and Reproductive Health of Patients with an Ostomy: A Qualitative Content Analysis

Sexual and reproductive health while living with rheumatoid arthritis: The impact of the disease stage on patient perspectives

BACKGROUND

Rheumatoid arthritis (RA) is one of the most prevalent rheumatic diseases that harms all aspects of patients' lives, including sexual and reproductive health (SRH), often neglected in patients' care. The study aimed to explore the sexual and reproductive experiences of Mexican outpatients with RA from a narrative perspective.

PATIENTS AND METHODS

From July 2020 to October 2021, 30 adult patients with RA from the Department of Immunology and Rheumatology outpatient clinic of a national referral center for rheumatic diseases had in-depth interviews audiotaped, transcribed, and analyzed using a thematic analysis approach. Results are presented in a descriptive and interpretative manner and integrated into a theoretical model for the topic understanding.

RESULTS

Five intertwined major themes emerged: I) RA onset: Absence of SRH contents, II) Healthcare for RA: Emerging SRH contents, III) RA's impact: Proliferation of SRH contents, IV) Coping with the process of living with RA: SRH-related strategies, and V) The impact of the COVID-19 pandemic on patients' experiences: Increased SRH burden. SRH contents emerged through these major themes (but at RA onset), mostly when inquired and mainly when narrating the RA impact and coping. Patients identified that RA affected their couple dynamics, sexual function, and reproductive project. The SRH care was considered relevant but limited and focused on reproductive contents. It worsened during the COVID-19 pandemic. We proposed a theoretical model where patients' SRH experiences are embedded across their RA biography and integrated with the RA impact and the copy with the disease process. These intertwined experiences were also evident during the COVID-19 pandemic, which challenged participants' biopsychosocial resources.

CONCLUSIONS

The sexual and reproductive experiences narrated by the RA outpatients concerning their disease-related biography showed that even when the SRH appeared as not prioritized at the disease onset, it was widely expressed during the process of living and coping with the disease and was additionally affected by the COVID-19 pandemic.

The sexuality experience of stoma patients: a meta-ethnography of qualitative research

BACKGROUND

As the quality of life of stoma patients has become a research hotspot, sexual health as an integral part of patients' lives has received more and more attention. However, there is a lack of comprehensive reviews on the sexual experiences of patients with stomas. This study aims to synthesize the qualitative literature on the subjective experience of stoma patients' sexual life, to identify their sexual needs, and to provide evidence for the content and methods of sexual health interventions for healthcare professionals.

METHODS

PubMed, Embase, Web of Science, CINAHL, and Scopus were searched for qualitative studies on the sexual experience of stoma patients (from the inception to January 2023). Titles, abstracts, and full texts were reviewed by two researchers. We used the Critical Appraisal Program (CASP) checklist to assess the quality of included articles.

RESULTS

A total of 1388 articles were retrieved, and eight studies were included. Data was extracted, including three main themes: 1) sexual problems due to changes in physical function and psychological disorders; 2) the relationship with spouse changes; 3) the cognition of sexual life and the need for sexual knowledge.

CONCLUSION

Healthcare professionals should pay attention to the sexual life status and sexual health needs of stoma patients and their partners, and give professional guidance and support in treatment and nursing to improve the quality of sexual life of stoma patients.

SEXUALITY OF MEN EXPERIENCING INTESTINAL OSTOMIES: STORIES ABOUT FEELINGS AND MEANINGS

Objective: To apprehend the feelings and meanings about the sexuality of adult men with intestinal ostomies. Method: Thirty adult men with stomas participated of a qualitative, historical-analytical and comprehensive exploratory study. Data were obtained from interviews, followed by analysis anchored in thematic oral history, and data interpretation based on Ágnes Heller’s theory of feelings. Results: It has been shown that adult men with intestinal ostomies experience multiple feelings related to their sexuality, including impulsive, emotional, affective, and orienting feelings. Conclusion: The relevance of specialized and multidisciplinary care is highlighted to better meet the demands of sexual health, which is intertwined with psychic-social health, of men with stomas.

SEXUALIDADE DE HOMENS EM VIVÊNCIA DE ESTOMIAS INTESTINAIS: HISTÓRIAS SOBRE SENTIMENTOS E SIGNIFICADOS

Objetivo:Apreender os sentimentos e significados acerca da sexualidade de homens adultos com estomias intestinais. Método: Estudo qualitativo, histórico-analítico e compreensivo-exploratório no qual participaram 30 homens adultos estomizados. Os dados foram obtidos de entrevistas, seguidas de análise ancorada na história oral temática e interpretação dos dados com base na teoría de los sentimientos, de Ágnes Heller. Resultados: Demonstrou-se que homens adultos com estomias intestinais vivenciam múltiplos sentimentos vinculados à sua sexualidade, entre eles sentimentos impulsivos, emocionais, afetivos e orientativos. Conclusão: Salienta-se a relevância de uma assistência especializada e multidisciplinar para melhor atender às demandas de saúde sexual, que se entrelaça com a saúde psíquico-social, dos homens com estomia

Hopelessness and suicide ideation in ostomy patients: a mixed method study

Introduction It is important to characterize patients’ mental health problems since the association between mental adjustment and life expectancy has stabilized in these patients. So, the present study was conducted to determine the prevalence of suicidal ideation and hopelessness in patients with ostomy.

Method A mixed method strategy (cross-sectional and content qualitative analysis) was done in Educational Hospitals in Tehran in 2019. Beck Suicide Ideation (19 item) and Beck Hopelessness (20 item) self-assessment questionnaires and unstructured interview were used for data collection. Data were expressed as frequency and percentage and independent t-test. Analysis was done in the Statistical Package for the Social Sciences (SPSS) 16.0 and conventional content analysis.

Results Three months after surgery, 3% had low suicidal ideation and 97% had high risk suicidal ideation. This rate 6 months after surgery was 16% with low suicidal thoughts and 84% with high risk suicidal thoughts. In the case of hopelessness 3 months after the surgery, 20% had mild hopelessness, 79% had moderate hopelessness, and 1% had severe hopelessness. These figures 6 months after surgery were 11% hopeless, 31% mildly disappointed, 58% moderately disappointed. The results of the qualitative study resulted in the extraction of three main categories that included enduring the initial suffering, social isolation, and lag of ostomy admission.

Conclusion The relative improvement in suicidal ideation and hopelessness in the present study showed that the mental status of ostomy patients requires more careful attention.