Experiencing sexuality after intestinal stoma

Abstract

Objective: Identify the Social Representations (SR) of ostomized people in terms of sexuality after the stoma. Methods: An exploratory, descriptive, qualitative study using the Social Representation Theory with 15 ostomized people (8 females), mean age of 57.9 years, between August and September 2005. Data obtained from transcribed interviews were submitted to content analysis, resulting in the thematic unit "Giving new meaning to sexuality" and subthemes. Results: The study demonstrated that the intestinal stoma interferes in the sexuality experience, showing that the meanings attributed to this experience are based on individual life stories, quality of personal relationships established in practice and perception of sexuality, despite the stoma. Conclusions: The Social Representations, in terms of experiencing sexuality after the stoma, are based on meanings attributed to the body, associated with daily life and present in the social imaginary. It is influenced by other factors, such as physiological changes resulting from the surgery and the fact of having or not a partner. Care taken during sexual practices provide greater security and comfort in moments of intimacy, resembling the closest to what ostomized people experienced before the stoma. The self-irrigation technique associated or not with the use of artificial occluder, has been attested by its users as a positive element that makes a difference in sexual practice after the stoma. The support to ostomized people should be comprehensive, not limited to technical care and disease, which are important, but not sufficient. The interdisciplinary health team should consider all aspects of the person, seeking a real meeting between subjects.Keywords: colostomy; sexuality; subjectivity. RESUMO: Objetivo: Identificar as Representações Sociais (RS) da pessoa estomizada intestinal sobre vivência da sexualidade após confecção do estoma. Métodos: Estudo exploratório, descritivo, qualitativo do ponto de vista do referencial da Representação Social. Participaram 15 estomizados, sendo 8 mulheres, com idade média de 57,9 anos, entre agosto e setembro de 2005. Dados obtidos por entrevistas, transcritas, foram submetidos à análise de conteúdo, originando a unidade temática "Ressignificando a sexualidade" e subtemas. Resultados: Demonstrou-se que o estoma intestinal interfere na dinâmica da vivência da sexualidade, desvelando que os significados a ela atribuídos estão ancorados nas histórias individuais de vida, na qualidade das relações pessoais/conjugais estabelecidas na prática e na percepção da sexualidade, apesar do estoma. Conclusões: Representações Sociais sobre vivência da sexualidade após estoma estão ancoradas nos significados atribuídos ao corpo, veiculadas no cotidiano e presentes no imaginário social. É influenciada por outros fatores, como alterações fisiológicas decorrentes do ato cirúrgico e da existência de parceiro. Cuidados adotados nas práticas sexuais propiciam maior segurança e conforto nos momentos de intimidade, tornando-as mais próxima...

Tecnologia para o autocuidado da saúde sexual e reprodutiva de mulheres estomizadas

“…Other studies also show that instructions on health aimed at ostomized individuals are restricted to the management of collection bags and skin (8)(9) . Providing information about sexual and reproductive health -through the educational technology proposed in the present study, in accordance with the Ministry of Health's proposals of design and distribution of technical manuals and educational booklets on sexuality and reproduction -emphasizes a posture of citizenship and comprehensiveness of care for women and empowering regarding rights such as the exercise of autonomy and self-care (3)(4)(5)(6)(7) . Additionally, it contributes to the development of new knowledge, attitudes, behavior and abilities in their new condition of life, which can help them in their process of adaptation and performance of basic needs associated with sexuality, self-image and self-concept (6,9) .…”

“…In Portugal, a survey on the needs for information about sexuality included 135 ostomized participants and identified that 50% of them had not received any information before or after the surgery, 51% of which women (23) . The majority of ostomized patients have some type of difficulty regarding sexuality, whether related to physiological dysfunctions resulting from surgical procedures -such as the reduction in or loss of libido, dyspareunia, vaginal dryness or stenosis (3)(4)8) -or related to the psychological impact resulting from the change in body image, manifested by feelings of insecurity and shame about one's body (5,7) . However, the analysis of national and international scientific productions on health education practices for ostomized individuals performed by nurses revealed the use of a multimedia program and booklet mainly directed towards the rights of such individuals, health care for ostomy, the importance of family for care, and self-care attitude after surgery (24) .…”

“…Alterations in body shape and perception can lead to difficulties to accept this new condition of life, on different levels of intensity and repercussions, including aspects related to care for sexual and reproductive health (3) . Regarding the female body, the impact on sexuality can be even more negative, considering the stereotype of perfect body culturally held by society, represented by the integrity and standardization of good fitness (4) . The psychological impact caused by the strong influence of change in body image on the social concepts of beauty, body and sexuality is also included among the possible physiological dysfunctions secondary to the ostomy surgery.…”

“…For women, the surgical process frequently results in a reduction in or loss of libido, dyspareunia, vaginal dryness and stenosis or even the development of feelings of insecurity due to the device attached to their abdomen, self-disgust and shame regarding the new body (5) . During the process of adaptation to ostomy, the repercussions for the sexual life of some women result from the loss of selfrecognition as an attractive sexual being for their partner, denial of basic sexual needs and perception of sexuality as secondary, thus representing a high level of impact on their quality of life (4,6) . In spite of this, the approach to sexuality in multi-disciplinary care of ostomized individuals is very restricted and influenced by taboos (7) .…”

Autonomy Versus Shame: Body Perceptions Of Colostomized Patients In Southeastern Brazil

“…Paula [15] identified the need for physical and psychological preparation for the reincorporation of sexuality into the daily life of ostomates.…”