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Let's talk about sex: lower limb amputation, sexual functioning and sexual well-being: a qualitative study of the partner's perspective

Authors

  • Jesse EA Verschuren MSc,

    PhD Student, Corresponding author
    1. Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
    • Correspondence: Jesse EA Verschuren, PhD Student, Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. Telephone: +31 50 3611348.

      E-mail: j.e.a.verschuren@umcg.nl

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  • Mariya A Zhdanova MD,

    Resident
    1. Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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  • Jan HB Geertzen MD, PhD,

    Professor
    1. Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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  • Paul Enzlin PhD,

    Professor
    1. Department of Development and Regeneration, Institute for Family and Sexuality Studies, KU Leuven, Belgium
    2. Department of Psychiatry, Context – Center for Couple, Family and Sex Therapy, UPC KU Leuven, Belgium
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  • Pieter U Dijkstra PT, MT, PhD,

    Professor
    1. Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
    2. Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, The Netherlands
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  • Rienk Dekker MD, PhD

    Associate Professor
    1. Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Abstract

Aims and objectives

To describe the impact of patients’ lower limb amputations on their partners’ sexual functioning and well-being.

Background

Annually, about 3300 major lower limb amputations are performed in the Netherlands. An amputation may induce limitations in performing marital activities, including expression of sexual feelings between partners. However, up until now, little attention has been paid towards this aspect in both research and clinical practice. The lack of studies on sexual activities and lower limb amputation is even more apparent with respect to partners of patients with such an amputation. Previous studies have shown, however, that the presence of a disease or disability may have a large impact not only on the patient's but also on the partner's sexual activities.

Design

Qualitative thematic analysis.

Methods

Semi-structured interviews. The questions used in the interview were inspired by a generic framework about chronic disease and sexual functioning and well-being. In total, 16 partners of patients with a lower limb amputation who were at least 18 years old were recruited in different rehabilitation centres.

Results

Seven major themes (i.e. importance of sexuality, thoughts about sexuality before the amputation, changes in sexual functioning and sexual well-being, amputation as the main cause of these changes, acceptance of the amputation, role confusion and communication about sexuality) were derived from the interviews. Minor changes in sexual functioning and sexual well-being were reported by the participants. Problems participants did encounter were solved by the couples themselves. For some participants, their sexual well-being improved after the amputation.

Conclusion and relevance to clinical practice

Participants in our study reported minor changes in their sexual well-being. Most of them indicated that communication about the changes expected and how to cope with these would have been helpful. It is therefore important that professionals address sexuality during the rehabilitation process with patients and partners.

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