Sexual health in Rheumatoid Arthritis - a physiotherapeutic approach
Summary, in English
The thesis has a mixed paradigm design in a fixed multiphase model, including qualitative, quantitative and psychometric methods, in order to respond to the research question and the aims of the thesis. The first study explored the views of persons living with RA concerning sexual health in relation to physiotherapy, and covered how the body and the total life situation affected sexual health. The impact of RA was experienced as multidimensional. The findings consisted of three themes: 1) Sexual health – physical and psychological dimensions, 2) Impacts of RA and 3) Possibilities of increasing sexual health – does physiotherapy make a difference? The findings from the first study were used as a base for the questionnaire used in the second study in order to further investigate views and experiences of the impact of RA on sexual health, experiences and needs of physiotherapy in this context, as well as communication between patients and health professionals concerning sexual health. The results of the second study clarified the need to improve communication and interaction between healthcare professionals and persons with RA concerning sexual health. This was investigated in the fourth study, where the question of whether decreased sexual health can be detected with a standard outcome measurement tool was explored. In order to perform the fourth study, the Multi Dimensional Health Assessment Questionnaire had to be validated and tested for reliability in a Swedish context, which was performed in the third psychometric study.
To conclude, sexual health is affected in different ways for persons with RA, and there is a lack of communication concerning sexual health between health professionals and persons with RA. Physiotherapists can play an active role in improving sexual health for persons with RA by being aware that pain, fatigue, decreased mobility, and level of physical capacity can affect sexual health negatively. Improvement of communication concerning sexual health between persons with RA and their partners, as well as with health professionals, may improve sexual health among persons with RA.
The Swedish version of the Multi Dimensional Health Assessment Questionnaire (MDHAQ-S) was found to have acceptable reliability and validity, and can be used as a base for sexual health communication since it correlates significantly with results of the Questionnaire of Sexual Health in persons with RA. The MDHAQ-S covers issues concerning sexual health in a multiple way to deepen the prerequisites for sexual health communication, but to uncover sexual health difficulties, an in-depth clinical interview or a more specific sexual health questionnaire is needed.
Lund University Faculty of Medicine Doctoral Dissertation Series
Division of Physiotherapy
- Sexual Health
- Rheumatoid Arthritis
- Physical therapy
- Human Movement: health and rehabilitation
- Gunvor Gard
- Charlotte Ekdahl
- ISSN: 1652-8220
- ISBN: 978-91-87449-44-4
13 September 2013
Health Science Centre, Lund
- Charlotte Löfgren-Mårtenson (Professor)