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Sexual health and quality of life among male veterans with intestinal ostomies.
Clin Nurse Spec. 2008 Jan-Feb; 22(1):30-40.CN

Abstract

PURPOSE

This secondary analysis was conducted to expand our understanding of the challenges men with ostomies face regarding intimate relationships and sexual functioning. We examined quantitative and qualitative data to examine sexual functioning, intimate relationships, and health-related quality of life (HR-QOL) among military veterans who are living with an intestinal stoma.

SETTING

Three Veterans Health Administration sites.

SAMPLE

Four hundred eighty-one male veterans.

METHODS

Case-control, mixed-methods design; cases were those who had ostomies for at least 2 months, and controls had a similar major intestinal surgical procedure that did not result in an ostomy. Quantitative and qualitative data on sexual functioning, relationships, and other dimensions of HR-QOL were collected using the modified City of Hope Quality of Life-Ostomy questionnaire.

RESULTS

The overall response rate was 49%. Prevalence of erectile dysfunction was significantly higher among ostomates compared with controls (P < .001). Although a greater proportion of veterans with ostomies reported being sexually active before surgery compared with controls (P < .001), the proportion of men who had resumed sexual activity after surgery is significantly lower among the ostomy group (P = .015). Compared with veterans with ostomies who did not resume sexual activity after surgery, those who were sexually active reported a higher total HR-QOL score and higher scores on all 4 modified City of Hope Quality of Life-Ostomy dimensions (psychological, social, physical, and spiritual well-being). Veterans with ostomies who had resumed sexual activity after their ostomy also reported that their ostomy had caused significantly less interference with social activities, less isolation, less interference with their personal relationships, and less interference with their ability to be intimate. These men also reported less difficulty adjusting to the ostomy. Results of qualitative analyses showed that problems with intimacy and sexual function are among the greatest challenges faced by ostomates.

CONCLUSION

Presence of an ostomy was associated with lower rates of sexual activity and higher erectile dysfunction. The lower rates of sexual activity and sexual satisfaction were related to the social and psychological dimensions of HR-QOL among men with ostomies. Interventions to address sexual concerns of male ostomates and their partners may prevent decrements to HR-QOL for these patients.

IMPLICATIONS FOR PRACTICE

Results of the study have implications for the clinical nurse specialist role in supporting and educating patients with ostomies to minimize the negative impact of an intestinal ostomy on sexual health and HR-QOL. Implications also relate to the need to educate current and future nurses about the importance of assessing sexual health.

Authors+Show Affiliations

Indiana University, Division of Gastroenterology/Hepatology, Indianapolis, IN 46202, USA. msymms@iupui.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

18091126

Citation

Symms, Michelle R., et al. "Sexual Health and Quality of Life Among Male Veterans With Intestinal Ostomies." Clinical Nurse Specialist CNS, vol. 22, no. 1, 2008, pp. 30-40.
Symms MR, Rawl SM, Grant M, et al. Sexual health and quality of life among male veterans with intestinal ostomies. Clin Nurse Spec. 2008;22(1):30-40.
Symms, M. R., Rawl, S. M., Grant, M., Wendel, C. S., Coons, S. J., Hickey, S., Baldwin, C. M., & Krouse, R. S. (2008). Sexual health and quality of life among male veterans with intestinal ostomies. Clinical Nurse Specialist CNS, 22(1), 30-40.
Symms MR, et al. Sexual Health and Quality of Life Among Male Veterans With Intestinal Ostomies. Clin Nurse Spec. 2008 Jan-Feb;22(1):30-40. PubMed PMID: 18091126.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sexual health and quality of life among male veterans with intestinal ostomies. AU - Symms,Michelle R, AU - Rawl,Susan M, AU - Grant,Marcia, AU - Wendel,Christopher S, AU - Coons,Stephen Joel, AU - Hickey,Sara, AU - Baldwin,Carol M, AU - Krouse,Robert S, PY - 2007/12/20/pubmed PY - 2008/3/14/medline PY - 2007/12/20/entrez SP - 30 EP - 40 JF - Clinical nurse specialist CNS JO - Clin Nurse Spec VL - 22 IS - 1 N2 - PURPOSE: This secondary analysis was conducted to expand our understanding of the challenges men with ostomies face regarding intimate relationships and sexual functioning. We examined quantitative and qualitative data to examine sexual functioning, intimate relationships, and health-related quality of life (HR-QOL) among military veterans who are living with an intestinal stoma. SETTING: Three Veterans Health Administration sites. SAMPLE: Four hundred eighty-one male veterans. METHODS: Case-control, mixed-methods design; cases were those who had ostomies for at least 2 months, and controls had a similar major intestinal surgical procedure that did not result in an ostomy. Quantitative and qualitative data on sexual functioning, relationships, and other dimensions of HR-QOL were collected using the modified City of Hope Quality of Life-Ostomy questionnaire. RESULTS: The overall response rate was 49%. Prevalence of erectile dysfunction was significantly higher among ostomates compared with controls (P < .001). Although a greater proportion of veterans with ostomies reported being sexually active before surgery compared with controls (P < .001), the proportion of men who had resumed sexual activity after surgery is significantly lower among the ostomy group (P = .015). Compared with veterans with ostomies who did not resume sexual activity after surgery, those who were sexually active reported a higher total HR-QOL score and higher scores on all 4 modified City of Hope Quality of Life-Ostomy dimensions (psychological, social, physical, and spiritual well-being). Veterans with ostomies who had resumed sexual activity after their ostomy also reported that their ostomy had caused significantly less interference with social activities, less isolation, less interference with their personal relationships, and less interference with their ability to be intimate. These men also reported less difficulty adjusting to the ostomy. Results of qualitative analyses showed that problems with intimacy and sexual function are among the greatest challenges faced by ostomates. CONCLUSION: Presence of an ostomy was associated with lower rates of sexual activity and higher erectile dysfunction. The lower rates of sexual activity and sexual satisfaction were related to the social and psychological dimensions of HR-QOL among men with ostomies. Interventions to address sexual concerns of male ostomates and their partners may prevent decrements to HR-QOL for these patients. IMPLICATIONS FOR PRACTICE: Results of the study have implications for the clinical nurse specialist role in supporting and educating patients with ostomies to minimize the negative impact of an intestinal ostomy on sexual health and HR-QOL. Implications also relate to the need to educate current and future nurses about the importance of assessing sexual health. SN - 0887-6274 UR - https://www.unboundmedicine.com/medline/citation/18091126/Sexual_health_and_quality_of_life_among_male_veterans_with_intestinal_ostomies_ L2 - https://doi.org/10.1097/01.NUR.0000304181.36568.a7 DB - PRIME DP - Unbound Medicine ER -