N08 Perceived patients’ and nurses’ perspective on barriers to address sexual wellbeing in IBD. An international qualitative study
Authors: Fourie S , Tanaka M , Wakai S , Nozawa M , Kawakami A 
Published: January 2025

Abstract

Background
Addressing sexual wellbeing (SWB) in inflammatory bowel disease (IBD) clinical practice remains a challenge for both patients and nurses. While existing evidence highlights patients' need for these discussions, little is known about the barriers to such conversations from both the patients’ and nurses’ perspectives. Evidence of healthcare professionals' perspectives on addressing SWB is known from oncology, dermatology and cardiovascular nursing perspective, but not from IBD specialist nurses’ perspective.
This study aimed to explore perceived barriers to addressing SWB concerns, from the perspectives of IBD patients and specialist IBD nurses.

Methods
This international qualitative study further analysed prior anonymous interviews with patients and nurses to identify and compare perceived barriers, with a view to inform practice improvements. Qualitative content analysis was used to analyse the data.

Results
The analysis included interviews from 60 IBD patients (43 women, 17 men) across the UK, US, Canada, Ireland, and Australia, as well as 29 IBD specialist nurses (24 women, 5 men) from Japan, the UK, Ireland, Canada, and Australia. The overarching theme developed was Is difficult to discuss sexual wellbeing. Several shared barriers were identified across both groups under the following main themes: Limited time and space to address sexual wellbeing, Demographic differences, and Feelings of shame and embarrassment. Additionally, nurses reported a Lack of training, and patients reported Lack of understanding how disease impacts sexual wellbeing.
The common perspectives on perceived barriers related to challenges in initiating these conversations highlight the need to address the stigma surrounding illness, SWB and bowel symptoms, and the need to normalise sensitive topics in clinical setting. The lack of confidence from nurses in addressing SWB grounded in absence of training corresponded to patients’ perspective on nurses’ lack of understanding of disease impact.

Conclusion
Gaining insights from both patients and nurses may help identify strategies to overcome these barriers. Although certain challenges such as limited time and space arise from organisational and environmental factors, many obstacles could be tackled directly to enhance communication and SWB care, ultimately improving the patient experience. Addressing the stigmatising nature of sexuality and gastrointestinal symptoms calls for greater efforts to integrate SWB discussions into routine clinical appointments, and adequade training for nurses to improve their confidence in supporting SWB concerns in IBD.

References
Fourie, S., Norton, C., Jackson, D., & Czuber-Dochan, W. (2021). ‘These Discussions Aren’t Happening’: Experiences of People Living with Inflammatory Bowel Disease and Talking About Sexual Well-being with Health Care Professionals. Journal of Crohn’s and Colitis, 1–8. https://doi.org/10.1093/ecco-jcc/jjab043
Traa, M. J., De Vries, J., Roukema, J. A., Rutten, H. J. T., & Den Oudsten, B. L. (2014). The sexual health care needs after colorectal cancer: The view of patients, partners, and health care professionals. Supportive Care in Cancer, 22(3), 763–772. https://doi.org/10.1007/s00520-013-2032-z
Flynn, K. E., Reese, J. B., Jeffery, D. D., Abernethy, A. P., Lin, L., Shelby, R. A., Porter, L. S., Dombeck, C. B., & Weinfurt, K. P. (2012). Patient experiences with communication about sex during and after treatment for cancer. Psycho-Oncology, 21(6), 594–601. https://doi.org/10.1002/pon.1947