Looking Through a Biopsychosocial Lens: A Multimethod Examination of Sexuality and Disability in Inflammatory Bowel Disease
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Authors
Fretz, Katherine
Date
Type
thesis
Language
eng
Keyword
inflammatory bowel disease , sexuality , disability , healthcare , diversity
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Abstract
Inflammatory bowel disease (IBD) is a chronic health condition associated with impaired well-being and disability. Biopsychosocial research suggests that psychosocial impacts of IBD play an important role in patient well-being. Sexual well-being is poorly understood in IBD. Sexual difficulties in IBD relate to disability outcomes as well as biopsychosocial variables such as disease activity, depression, anxiety, and body image issues. Factors yet to be examined, such as sexual script flexibility and desire for emotional closeness, are important to consider because they may influence the relationship among IBD disease activity, sexual dysfunction, and disability. In addition to the literature limitations, sexuality is rarely addressed in IBD clinical care. The current dissertation aimed to address these gaps in a longitudinal, multimethod, online study. N = 470 adults with IBD participated. The study hypotheses were mostly supported. Greater levels of IBD disease activity, body image dissatisfaction, and lower sexual script flexibility predicted higher sexual dysfunction. Sexual dysfunction mediated the relationship between disease activity and disability, with this effect being stronger among those with higher levels of sexual script flexibility, as evidenced by a significant moderation effect. Longitudinally, the mediation effect remained significant, but the moderation did not. Desire for emotional closeness was not a significant moderator in any model. Thematic analysis identified themes in participants’ responses about the impacts of IBD on their sexual and intimate lives, and their experiences accessing information and help for such issues in the healthcare system. The impacts of IBD on participants’ sexual lives were complex and biopsychosocial in nature, highlighting that their concerns were beyond just sexual functioning, but included impacts on their relationships and sense of self. Participants’ reports of their healthcare experiences illuminated the nuanced personal and system level factors impacting their perceptions of support and desire to seek out information on sexual functioning from healthcare providers. Finally, sexual and gender minority participants reported worse sexual dysfunction and disability than sexual and gender majorities and were more likely to seek out and obtain information on these issues from healthcare providers. These findings may help to guide biopsychosocial, inclusive, and patient-oriented IBD research and clinical practice.
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Queen's University's Thesis/Dissertation Non-Exclusive License for Deposit to QSpace and Library and Archives Canada
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Attribution-NonCommercial-NoDerivs 3.0 United States
ProQuest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.
Attribution-NonCommercial-NoDerivs 3.0 United States