N25 A qualitative study exploring health professionals’ experiences and understanding of the sexual health and associated care needs in men with Inflammatory Bowel Disease
Authors: Ma S , Knapp P , Galdas P 
Published: January 2025

Background

Inflammatory Bowel Disease (IBD) can negatively affect men’s sexual well-being and alter the way in which they engage in sexual activities (1). People with IBD in the UK have reported that health professionals are reticent to initiate discussions about their sexual health (1, 2). There is a paucity of research exploring men’s sexual health in IBD (3). This study aimed to describe and interpret the experiences of healthcare practitioners (HCPs) working in IBD within the UK to explore current practice in relation to the assessment of sexual health of men with IBD, understand the perceived barriers and facilitators to engaging with men about their sexual health and inform recommendations for clinical practice, education, and research.

Methods

A qualitative interpretive description design (4) using individual, online semi-structured interviews. Participants were UK health professionals purposively sampled and recruited through advertising the study through professional IBD organisations, conferences and online networks. Interviews were transcribed verbatim and analysed using thematic analysis.

Results

19 HCPs participated in the study: 10 nurses, 6 medical doctors, 2 clinical psychologists and 1 dietitian. Participants had worked with IBD patients for between 6 months and 22 years (mean 13 years, SD 9.66),14 were female, 5 were male. Participants’ experiences of sexual health discussions, assessment, and provision of care were apparent through two emergent themes. The first theme, ‘it’s difficult to discuss sex’ represented personal, professional, and societal barriers to discussing sexual health with male IBD patients. The second theme, ‘service transformation is needed’, encapsulated the service-related barriers faced by both patients and HCPs and the possible adjustments required to facilitate the identification and support of men’s sexual health and well-being needs within clinical practice. Several sub-themes reflected the perceived barriers faced by HCPs including: 'feeling ill-equipped', 'ask the IBD nurses, they’ll know', 'men tend to bravado', 'a fire-fighting service', and 'creating a safe environment'.

Conclusion

IBD healthcare practitioners working in the UK may face personal, professional, organisation, and societal barriers to providing assessment and support for the sexual health and care needs of men with IBD. It is likely that these barriers may be moderated by improving the availability of sexual healthcare resources and developing treatment pathways that promote cohesive multi-disciplinary working. Future research should focus on how HCPs can be supported to become comfortable and proficient at initiating sexual health conversations that are inclusive of psychosocial-sexual needs.

References

(1)Ma S, Knapp P, Galdas P. "My sexual desires, everything, my normal life just stops"; a qualitative study of male sexual health in inflammatory bowel disease. Journal of Clinical Nursing. 2024. doi:10.1111/jocn.17292

(2)Fourie S, Norton C, Jackson D, Czuber-Dochan W. "These discussions aren’t happening". Experiences of people living with inflammatory bowel disease talking about sexual well-being with healthcare professionals. Journal of Crohn’s and Colitis. 2021;15(10):1641-1648. doi:10.1093/ecco-jcc/jjab043

(3)Ma S, Veysey M, Ersser S, Mason-Jones A, Galdas P. The impact of inflammatory bowel disease on sexual health in men: A scoping review. Journal of Clinical Nursing. 2020:(19-20):3638-3652. doi:10.1111/jocn.15418

(4)Thorne S. Interpretive Description: Qualitative Research for Applied Practice. Routledge; 2016.