Experiences of sexual health in persons with hip and knee osteoarthritis: a qualitative study

Abstract

Background: Osteoarthritis (OA) is the world's most common form of arthritis and a common cause of musculoskeletal pain and disability. Persons living with chronic diseases often have affected sexual health because of pain and limited function. Osteoarthritis is a chronic disease but there is scarce knowledge about how sexual health is experienced. The aim of this study was to explore the experience of sexual health in persons who have seen a physiotherapist for their hip and/or knee OA. Methods: This study has a qualitative design. Participants were recruited from the Swedish Quality Register Better Management of Patients with Osteoarthritis (BOA). To reach a variety of experiences and strengthen credibility, a purposeful sampling strategy based on age, sex and hip and knee OA was used. Semi-structured telephone interviews were held with 20 persons with hip and/or knee OA. Data were analysed with qualitative content analysis and inductive category development was applied. Results: The analysis resulted in two main categories. The first category, Individual differences in how sexual health is affected by hip and knee OA, comprises of two sub categories: Pain limits sexual health; and Strategies for sexual health in the relationship. The second main category, Varying needs for communication about sexual health, is supported by the sub categories: Physiotherapists do not ask about sexual health; and Relevance of communicating about sexual health. Conclusions: Painful hip and knee OA limit sexual health to varying degrees, and individuals make adjustments or develop strategies to maintain sexual life. Sexual health is not talked about during consultations with physiotherapists or other health care professionals, indicating that patients with OA may have unmet needs regarding their sexual health. Further research is needed on how to provide support and information about sexual health in OA.

It is not just about sex: viewpoints of men with inflammatory arthritis on the overall impact of the disease on their sexual health

“…This has also been reported for similar chronic musculoskeletal conditions affecting sexual health. 27 They were open to discuss sexual health with their healthcare professionals, but this issue was hardly ever raised by healthcare professionals.…”

Qualitative evidence synthesis using meta-ethnography to understand the experience of living with osteoarthritis pain

“…Perhaps it's because many of us who have osteoarthritis are elderly and then maybe society de-emphasizes sexuality for the elderly, without asking, so to speak. 109…”

Sexual well‐being needs of patients with chronic illness expressed in health care: A scoping review

“…Themes References Traumer et al, 2019;Zhang et al, 2020Nurse Cuenca-Barrales & Molina-Leyva, 2020Grondhuis Palacios et al, 2018;Holmes et al, 2019;Josefsson & Gard, 2012;den Ouden et al, 2019;Reese et al, 2020;Savel et al, 2020;van Driel et al, 2014Physiotherapist Josefsson & Gard, 2012LePage & Selk, 2016;Nilsing Strid & Ekelius-Hamping, 2020;Petit-Steeghs et al, 2020 Psychosocial/psychological/mental support/ psychologist Almont et al, 2018;Coimbra & Teixeira, 2015;Cuenca-Barrales & Molina-Leyva, 2020;Leonardi-Warren et al, 2016;LePage & Selk, 2016;Rutte et al, 2016;Savel et al, 2020;Stewart, 2013;Traa et al, 2014 Source of information Different types of information Albers et al, 2020;Fourie et al, 2021 Written information/brochures Josefsson & Gard, 2012;Leonardi-Warren et al, 2016;McCallum et al, 2012;Nilsing Strid & Ekelius-Hamping, 2020;den Ouden et al, 2019;Savel et al, 2020;van Driel et al, 2014 Online information/consultation Leonardi-Warren et al, 2016;den Ouden et al, 2019;Petit-Steeghs et al, 2020;van Driel et al, 2014;Zysman et al, 2020 In-person discussion with HCPs…”

“…Additional offers/ referrals Sexologist Albers et al, 2020;Cuenca-Barrales & Molina-Leyva, 2020;Grondhuis Palacios et al, 2018;Petit-Steeghs et al, 2020;Zysman et al, 2020 Appropriate support/experienced expert Egerod et al, 2018;Fourie et al, 2021;den Ouden et al, 2019;Petit-Steeghs et al, 2020;Sandfort et al, 2013;Savel et al, 2020 Exchange with other patients or support groups Almont et al, 2018;Nilsing Strid & Ekelius-Hamping, 2020;Savel et al, 2020;Winch et al, 2015 Counsellor or couple counselling Almont et al, 2018;Josefsson & Gard, 2012;Reese et al, 2020 physiotherapists and gynaecologists in particular. In general, patients expect their HCPs to be self-assured secure, educated and capable of such discussions.…”

“…the choice with or without partnersLeonardi-Warren et al, 2016; den Ouden et al., 2013;Nilsing Strid & Ekelius-Hamping, 2020 Body imageEgerod et al, 2018;Savel et al, 2020 …”