N20 Sexual health in IBD can be brought up with help from tools

Abstract

Abstract Background Sexual topics can be tabooed; both for patients with IBD and for the health care professionals (HCPs). Patients with IBD have more sexual problems than the background population. A considerable number of patients with IBD have other autoimmune diseases (Ads), which may exacerbate sexual problems. Based on patient reported data, we aimed to develop communication tools and models for talks about patients' sexual health. Furthermore, we aimed to generate informative patient leaflets for different ADs including one specific for patients with IBD. Methods A cross-sectional e-survey on sexual health among patients with IBD, dermatological- and/or rheumatologically diseases (both solely and in combination). Patients were invited consecutively as they tuned up in the out-patient clinics at our university hospital. Participation were anonymous and access were possible by using a QR-code. The questions were ad hoc designed and focused on 1) disease-related sexual problems, 2) partner-related sexual problems, and 3) the need (and current practise) for talks with HCPs about sexual health. In addition, the participants could add qualitative descriptions. Quantitative data were analysed using descriptive statistics. NVivo™ were used to code the qualitative data. Based on the survey results we developed and implemented communication tools in daily practise. Results 170 patients scanned the QR-code. 142 responded (61% females, 44% had IBD, 49% had a dermatologically disease, 40% had a rheumatologically disease, 33% had ≥ 2 AD). 51% of participants with only 1 AD reported disease-related sexual problems vs 71% for participants with ≥ 2 ADs. In IBD, the main reasons for impaired sexual health were: pain, fatigue, fistulas, incontinence and mental reasons. 86% responded that they didn't talk to HCPs about sexual issues (38% wish the HCPs to bring up the topic, 34% felt the topic to be a taboo, and 25% found it difficult to address problems). Based on the findings, specialist nurses with knowledge of all 3 ADs developed communication tools. The tools were tested and evaluated by both patients and reviewed by Clinic for Sexual Health and include: i) communication aid for nurses; ii) action card for nurses; iii) leaflets to patients with IBD. Conclusion Disease-related sexual problems are common for patients with IBD and ADs. Even more prevalent for patients with more than one AD. Sexual health is seldom a topic between patients and HCPs. Based on patient reported data, simple tools are developed and implemented. Figure 1: Typical levels of topics for the HCPs talks with patients about sexual health. HCPs will most often be able to help patients by focusing on the 2 lower levels.