Neglected sexual needs: A qualitative study in Iranian patients with severe mental illness

BACKGROUND This paper has attempted to explore views of patients with severe mental illness and their care providers about sharing sexual problems with care providers in these patients within the context of Iran. METHOD A total of 17 in-depth semi-structured interviews were conducted in one of the psychiatric hospital in Tehran: 4 with patients, 2 with patient's family, and 11 with health providers who had been employed for 5 years in psychiatric wards at least. All participants were selected by purposive sampling. Using conventional qualitative content analysis data reduction was done. FINDINGS A total of 89 codes about the reasons for lack of communication between clinician and patients, about sexuality were extracted. These are classified in two categories. The first is "Clinicians avoidance from addressing sexual issues" and second is "Patients avoidance from expressing their sexual problems." CONCLUSION Despite having sexual needs, severe mental illnesses patients do not disclose it due to poor communication between clinician and patients, about sexuality. So, physician had to be pioneer in communicating with them. Therefore, to enhance clinicians' sexual knowledge and effective communication skills with patients, especially those with severe mental illnesses, training is completely necessary.

[1]  Fazlollah Ghofranipour,et al.  Sexual Knowledge and Attitudes Among Premarital Couples: A Need for Future Educational Programs , 2016 .

[2]  T. J. Persson,et al.  Sex Education Groups in a Psychiatric Day Hospital: Clinical Observations , 2016, Journal of sex & marital therapy.

[3]  G. Ahmadzadeh,et al.  Sexual dysfunctions in the patients hospitalized in psychiatric wards compared to other specialized wards in Isfahan, Iran, in 2012 , 2015, Advanced biomedical research.

[4]  A. Ebadi,et al.  What are Iranian married women's rewards? Using interpersonal exchange model of sexual satisfaction: a qualitative study , 2015 .

[5]  R. das Nair,et al.  Why don't healthcare professionals talk about sex? A systematic review of recent qualitative studies conducted in the United kingdom. , 2013, The journal of sexual medicine.

[6]  B. Happell,et al.  Talking or avoiding? Mental health nurses' views about discussing sexual health with consumers. , 2011, International journal of mental health nursing.

[7]  A. Pourreza,et al.  A Qualitative Assessment of the Sex Education Needs of Married Iranian Women , 2008 .

[8]  L. Krebs Sexual assessment: research and clinical. , 2007, The Nursing clinics of North America.

[9]  K. Mohammad,et al.  Developing and testing a sex education program for the female clients of health centers in Iran , 2007 .

[10]  S. Noohi,et al.  Relationship between female sexual difficulties and mental health in patients referred to two public and private settings in Tehran, Iran. , 2007, The journal of sexual medicine.

[11]  E. Wright,et al.  HIV Prevention Services for Adults with Serious Mental Illness in Public Mental Health Care Programs , 2007, Journal of prevention & intervention in the community.

[12]  C. Begley,et al.  Sexual health education for people with mental health problems: what can we learn from the literature? , 2006, Journal of psychiatric and mental health nursing.

[13]  E. Susser,et al.  A randomized trial of a brief HIV risk reduction intervention for men with severe mental illness. , 2006, Psychiatric services.

[14]  Hsiu-Fang Hsieh,et al.  Three Approaches to Qualitative Content Analysis , 2005, Qualitative health research.

[15]  M. Tavakol,et al.  A quantitative survey of intern's knowledge of communication skills: an Iranian exploration , 2005, BMC medical education.

[16]  P. Tajik,et al.  Knowledge and attitude towards HIV/AIDS among Iranian students , 2004 .

[17]  Kerstin E. E. Schroder,et al.  Reducing HIV-risk behavior among adults receiving outpatient psychiatric treatment: results from a randomized controlled trial. , 2004, Journal of consulting and clinical psychology.

[18]  E. McCann Exploring sexual and relationship possibilities for people with psychosis--a review of the literature. , 2003, Journal of psychiatric and mental health nursing.

[19]  Sue Penna, Kieron Sheehy Sex Education and Schizophrenia: Should Occupational Therapists Offer Sex Education to People with Schizophrenia? , 2000 .

[20]  K. Carey,et al.  Increasing assertiveness skills to reduce HIV risk among women living with a severe and persistent mental illness. , 1998, Journal of consulting and clinical psychology.

[21]  J. Morse,et al.  Qualitative Research Methods for Health Professionals , 1995 .

[22]  S. Kalichman,et al.  Use of a brief behavioral skills intervention to prevent HIV infection among chronic mentally ill adults. , 1995, Psychiatric services.

[23]  A. Aron,et al.  Shared Activities and Marital Satisfaction: Causal Direction and Self-Expansion versus Boredom , 1993 .

[24]  J. Waterhouse,et al.  Attitudes toward nurses discussing sexual concerns with patients. , 1991, Journal of advanced nursing.

[25]  D. Kautz,et al.  Using research to identify why nurses do not meet established sexuality nursing care standards , 1990, Journal of nursing quality assurance.

[26]  Seyyed-Abdolhamid Mirhosseini,et al.  Designing Qualitative Studies , 2020 .

[27]  E. Kaltenthaler,et al.  The effectiveness of sexual health interventions for people with severe mental illness: a systematic review. , 2014, Health technology assessment.

[28]  F. Tehrani,et al.  Sexual Behavior of Married Iranian Women, Attending Taleghani Public Health Center , 2013, Journal of reproduction & infertility.

[29]  M. Mohammadi,et al.  Reproductive knowledge, attitudes and behavior among adolescent males in Tehran, Iran. , 2006, International family planning perspectives.