Sexual Function after Burn Injury: “The Bystander Effect” and Other Results from a Survey of Active Medical Providers from the Canadian Burn Association

Abstract

ABSTRACT Introduction The prevalence of new onset sexual dysfunction amongst burn survivors may be as high as 53%. Unsurprisingly, patients consistently report intimacy and sexual function in romantic relationships as something that lowers their quality of life. Other groups have reported that the topic of sexual health and new onset erectile difficulties was not adequately addressed in 83% of responding patients cared for at major US burn centers. It is unknown how well healthcare providers themselves feel they address the topic of sexual health in patients who survive major burn injuries. Objective The goal of this project was to survey current practice patterns, views and beliefs on sexual function of burn survivors in a population of medical providers providing direct care to patients. Ideally, the goal of this study was to describe existing biases and communication barriers that prevent discussions of sexual function during recovery. The results of this survey will identify blind-spots in the care of burn victims as it pertains to improving their quality of life. Methods A 24-item survey; modified from a survey created by Rimmer et al, 2010, was distributed to active members of the Canadian Burn Association (nurses, physicians and nurse practitioners) across 23 centers. The Survey was divided into 3 sections, aiming to collect information on participant demographics, on how participants’ burn centers address the topic of intimacy and sexuality with burn survivors, and on how individual participants address this important topic. Participation was voluntary, and no personal identifiers were collected. Results 32 health care providers participated in our survey. When asked “Who on your burn team is primarily responsible for discussing sexuality and intimacy with burn survivors and/or partners”, 47% (n=15) and 36% (n=11) of participants indicated that “it is not anyone's responsibility” in respective inpatient and outpatient units. Furthermore, when asked “In your opinion, does your burn team do a good job of addressing sexuality and intimacy with your burn survivors?”, 84% (n=26) participants responded “no”. Conclusions Health care providers are often not addressing sexuality and intimacy in the care of survivors of burn injuries. Multiple barriers work together to inhibit health care providers from initiating these important conversations with patients. This includes a high prevalence of the well-described “bystander effect”, where no single person is responsible for addressing the issue of sexual health. Cultural, gender, and sexual orientation-sensitive education programs and incorporation of sexual health discussions into standardized admission discharge processes should be explored further. Finally, specification of which provider is responsible to initiate and follow-up on discussions of sexuality/intimacy is a specific intervention that can improve the care provided to burn survivors moving forward. Disclosure No