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King A, Hanley H, Popenhagen M, Perez F, Thompson K, Purvis D, Garcia N, Steinlein I, Werkentoft M, Lightfoot M, Lahat M, Begum K, Tanabe J. Supporting sexuality for people living with epidermolysis bullosa: clinical practice guidelines. Orphanet J Rare Dis 2021; 16:9. [PMID: 33407706 PMCID: PMC7789698 DOI: 10.1186/s13023-020-01640-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/09/2020] [Indexed: 12/21/2022] Open
Abstract
This article presents evidence-based Clinical Practice Guidelines (CPG) for the provision of healthcare services to address sexuality for people living with epidermolysis bullosa (EB). Currently, a lack of EB-specific research limits these services to sexual health assessment and intervention strategies designed for the general population. Due to the unique challenges of EB, a rare skin-fragility condition causing blistering responses to minor skin trauma and other systemic and secondary complications, condition-specific strategies are needed to support people with EB in achieving valued sexual lifestyles. This CPG represents the work of an international panel comprised of thirteen members including a medical doctor, nurses, psychologists, a social worker, an occupational therapist, and patient population involvement members living with EB. It describes the development of EB-specific recommendations for two primary domains of assessment and intervention related to sexuality: psychosocial and mechanical. Following a rigorous evidence-based guideline development process, this CPG establishes the first internationally actionable clinical practice recommendations for sexuality-related assessment and intervention for this population. Future research priorities are identified. Supplemental materials included provide additional support to clinicians in developing the necessary understanding and skills to promote equity and efficacy in this care domain.
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Affiliation(s)
- Alex King
- Department of Rehabilitation, Phoenix Children's Hospital, 1919 East Thomas Rd, Phoenix, AZ, 85016, USA.
| | - Humphrey Hanley
- DEBRA New Zealand, 123 Daniell Street, Newtown, Wellington, 6021, New Zealand
| | - Mark Popenhagen
- Department of Rehabilitation, Phoenix Children's Hospital, 1919 East Thomas Rd, Phoenix, AZ, 85016, USA
| | - Florencia Perez
- DEBRA Chile, Francisco de Villagra 392, 7760099, Ñuñoa, Santiago, Chile
| | - Kerry Thompson
- Royal Adelaide Hospital, Port Road, Adelaide, SA, 5000, Australia
| | - Diana Purvis
- Starship Children's Hospital, Park Road, Grafton, Auckland, 1023, New Zealand
| | - Nora Garcia
- DEBRA Spain, Asociación DEBRA-Piel de Mariopsa, C/ Jacinto Benavente No 12, 29601, Marbella, Málaga, Spain
| | | | | | - Matthew Lightfoot
- DEBRA UK, The Capitol Building, Oldbury, Bracknell, Berkshire, RG12 8FZ, UK
| | - Michelle Lahat
- Children's Hospital of Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA, 90027, USA
| | - Kalsoom Begum
- University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK
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Martin K, Geuens S, Asche JK, Bodan R, Browne F, Downe A, García García N, Jaega G, Kennedy B, Mauritz PJ, Pérez F, Soon K, Zmazek V, Mayre-Chilton KM. Psychosocial recommendations for the care of children and adults with epidermolysis bullosa and their family: evidence based guidelines. Orphanet J Rare Dis 2019; 14:133. [PMID: 31186066 PMCID: PMC6560722 DOI: 10.1186/s13023-019-1086-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/01/2019] [Indexed: 12/13/2022] Open
Abstract
Epidermolysis Bullosa (EB) is a group of rare genetic disorders resulting in skin fragility and other symptoms. Commissioned by DEBRA International and funded by DEBRA Norway, this evidence-bases guideline provides recommendations to optimise psychosocial wellbeing in EB.An international multidisciplinary panel of social and health care professionals (HCP) and people living with EB was formed. A systematic international literature review was conducted by the panel following the Scottish Intercollegiate Guidelines Network (SIGN) methodology. The resulting papers underwent systematic selection and critique processes. Included papers were allocated to 6 different outcome groups to allow data synthesis and exploration: quality of life, coping, family, wellbeing, access to HCP and pain. Based on the evidence in those papers, recommendations were made for individuals living with EB, family and caregivers and HCP working in the field.Few studies have investigated interventions and which factors lead to better outcomes, but general recommendations can be made. EB is a complex disease impacting enormously on every aspect of psychosocial life. People and families living with EB need access to multidisciplinary support, including psychological guidance, in order to improve quality of life and psychosocial wellbeing. Interventions should stimulate social participation to prevent isolation. People with EB and their families should be able to access a supportive network. HCP should be well supported and educated about the complexity of EB. They should work collaboratively with those around the individual with EB (e.g. schools, employers etc.) to provide psychosocial opportunity and care.Attention should be paid to the psychosocial impact of EB as well as physical needs. Directions for research are indicated.
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Affiliation(s)
- K. Martin
- University Hospitals Birmingham NHS Trust, Solihull Hospital, Solihull, B91 2JL, UK
| | - S. Geuens
- Universital Hospitals Leuven, Leuven, Belgium
| | - J. K. Asche
- DEBRA Norge and person living with JEB, Stavanger, Norway
| | - R. Bodan
- California State University, Fullerton, CA USA
| | - F. Browne
- Our Lady’s Children’s Hospital Crumlin, Dublin, Ireland
| | - A. Downe
- Guy’s and St Thomas’ Hospitals NHS Foundation Trust, London, UK
| | | | - G. Jaega
- Psychology graduate and person living with EBS, Liverpool, UK
| | - B. Kennedy
- Our Lady’s Children’s Hospital Crumlin, Dublin, Ireland
| | - P. J. Mauritz
- The University Medical Center Groningen, Groningen, the Netherlands
| | | | - K. Soon
- Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | | | - K. M. Mayre-Chilton
- Guy’s and St Thomas’ Hospitals NHS Foundation Trust, London, UK
- DEBRA International, Vienna, Austria
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