First-person narratives around sexuality in residential healthcare settings: a meta-ethnographic synthesis

ABSTRACT

The aim of this review is to identify, critically appraise, and synthesise the existing literature exploring adults' narratives around sexuality within residential healthcare settings from a first-person perspective. A systematic literature review was undertaken. Six databases were searched. A meta-ethnographic approach was used to synthesise studies' findings. Thirteen studies using qualitative methodology that met the inclusion criteria were identified. The synthesis revealed six key themes: how service users define sexuality, sexuality as something not to be discussed (“privates are private”), sexuality as a separate aspect of the self (“sectionality”), hopes and fears for the future, the impact of the environment (“physicality of being physical”), and adapted sexuality. The studies included were of varying quality. Sexuality remains an important aspect for many residents, yet is rarely noted or discussed with them by healthcare staff. The residential healthcare environment presents implicit and explicit barriers to sexuality expression, causing residents to adapt how they experience their sexuality. Findings from this review highlight the importance of considering service users' perspectives, and the need for open communication between residents and practitioners to facilitate care provision that acknowledges the barriers of the environment on sexuality and considers the person beyond the presenting illness.

KEYWORDS:

• Sexuality
• residential healthcare
• meta-synthesis
• meta-ethnography
• qualitative research

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. “Resident” and “patient” are used interchangeably, and refer to persons admitted to residential healthcare services for treatment, e.g. residents of nursing and care homes, in-patients of psychiatric hospitals, and patients admitted to general hospitals for assessment/treatment.

Additional information

Notes on contributors

Anna Hooper

Anna Hooper is a trainee clinical psychologist working in the NHS and undertaking doctoral studies at the University of Nottingham, UK. She is currently conducting research into the impact of residential care settings on sexuality, with a particular focus on the experiences of older adults and transitions into care home environments.

Danielle De Boos

Danielle De Boos is a clinical psychologist working in mental health services for older people in Nottinghamshire, UK. She also holds the position of clinical tutor and assistant professor in clinical psychology on the Trent doctoral programme at the University of Nottingham, UK.

Roshan das Nair

Roshan das Nair is a consultant clinical psychologist and honorary professor. He specialises in sexual health and neuropsychology, with a special interest in rehabilitation in neurological conditions. He is an experienced mixed-methods trialist and has authored several papers in peer-reviewed journals and books. His co-edited book, Intersectionality, Sexuality, & Psychological Therapies: Exploring Lesbian, Gay, and Bisexual Diversity was published in 2012 by BPS-Blackwell.

Nima Moghaddam

Nima Moghaddam is a research clinical psychologist. He works on the Trent doctoral programme in clinical psychology at the University of Lincoln, UK. He has an enduring interest in psychological aspects of physical health and healthcare.