Why Don't Healthcare Professionals Talk About Sex? A Systematic Review of Recent Qualitative Studies Conducted in the United Kingdom

Abstract

Dyer, Kerry and das Nair, Roshan (2013) Why don't healthcare professionals talk about sex?: a systematic review of recent qualitative studies conducted in the United Kingdom. Journal of Sexual Medicine, 10 (11 A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.For more information, please contact eprints@nottingham.ac.uk A B S T R A C TIntroduction. Sexuality is considered to be an important aspect of holistic care, yet research has demonstrated that it is not routinely addressed in healthcare services. A greater understanding of this can be achieved through synthesizing qualitative studies investigating healthcare professionals' experiences of talking about sex. In doing so, policy makers and healthcare providers may be able to better address the sexual issues of service users. Aim. To gain an in-depth understanding of healthcare professionals' subjective experience of discussing sexuality with service users by identifying the factors that impede and facilitate such discussions. Main Outcome Measures. Review of healthcare professionals' experience of discussing sexuality with service users. Methods. Electronic databases and reference lists of published articles were searched in July 2011. Primary research studies were included in the review if they explored health professionals' experiences of discussing sexuality with adult service users, used qualitative methods, and were conducted in the United Kingdom over the last 10 years. Each study was reviewed and assessed. A secondary thematic analysis method was used where key themes were extracted and grouped and key concepts were explored. Results. Nineteen interconnected themes emerged relating to healthcare professionals' experience of discussing sexuality with service users, including fear about "opening up a can of worms," lack of time, resources, and training, concern about knowledge and abilities, worry about causing offense, personal discomfort, and a lack of awareness about sexual issues. Some themes were particularly marked relating to the sexuality of the opposite-gender, black and ethnic minority groups, older and nonheterosexual service users, and those with intellectual disabilities. Conclusions. The majority of healthcare professionals do not proactively discuss sexuality issues with service users, and this warrants further attention. An understanding of the perceived barriers and facilitators indicates that interventions to improve the extent to which sexuality issues are addressed need to take organizational, structural, and personal factors into consideration. Dyer K and das Nair R.

A Multiple Timepoint Pre-post Evaluation of a ‘Sexual Respect’ DVD to Improve Competence in Discussing Sex with Patients with Disability

“…This perceived topic sensitivity has been identified by previous research [28,29,37,59,60]. However, research indicates that most patients are not offended by discussions of sexuality [40,61], and do expect professionals to make inquiries about sexuality issues [21].…”

“…Research indicates that professionals are reluctant to address sexuality because of: Perceived lack of knowledge and skills; lack of resources, time and policy; fear of causing offence; personal embarrassment and discomfort; believing it is not their responsibility and perceiving that patients are too ill or unwilling to discuss sexual issues [22][23][24][25][26][27][28][29].…”

“…It was not clear what beliefs underpinned these comments, but is could represent the categorisation of these patients as "asexual". Indeed this viewpoint has been highlighted in the literature [28,55]. This is concerning given that sexuality is identified as a fundamental and natural need within everyone's life [6], along with the known importance of sexuality for overall quality of life [56,57,58], and the professional and clinical responsibility of nurses to address sexual issues [7].…”

“…Clinicians and researchers have highlighted the need for education in the area of sexuality and disability [22,28,[36][37][38][39][40][41]. Furthermore, it has been argued that education should be provided early in the clinicians' career, before negative attitudes and stereotypes have been developed [42][43][44].…”

Translating knowledge into practice: content analysis of online resources about sexual difficulties for individuals with traumatic brain injury

“…lack of time and institutional policies), and healthcare practitioners' personal aspects (e.g. lack of training and religion), among others (Dyer & das Nair, 2013). When individuals with TBI are unable to gain information related to sexuality within the healthcare system, or if they feel they cannot address these issues with healthcare professionals, they often turn to other resources, including close friends, partners, films, books, and the Internet.…”