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腹壁疝(AWH)对患者社交和性关系的影响:一项定性分析。

The impact of Abdominal Wall Hernia (AWH) on patients' social and sexual relationships: a Qualitative Analysis.

作者信息

Smith Olivia, Abbas Asim, Mierzwinski Mark, Oliver-Jenkins Veronica, Chitsabesan Praminthra, Chintapatla Srinivas

机构信息

York Abdominal Wall Unit, Department of General Surgery, York & Scarborough Teaching Hospitals NHS Foundation Trust, Wigginton Road, York, YO31 8HE, UK.

School of Science, Technology and Health, York St. John University, Lord Mayor's Walk, York, YO31 7EX, UK.

出版信息

Hernia. 2025 Jul 16;29(1):234. doi: 10.1007/s10029-025-03414-8.

Abstract

BACKGROUND

Abdominal Wall Hernia (AWH) impacts interpersonal relationships, which are vital to human wellbeing [1, 2], however social and sexual dimensions of AWH remain underexplored. This study investigates the impact of AWH on social disconnection and sexual intimacy challenges, and how this could be viably assessed in health related quality of life (HRQoL) assessment tools.

METHODS

A qualitative approach using Interpretative Phenomenological Analysis (IPA) was employed [3]. Fifteen participants (8 men and 7 women, aged 36-85 years) were purposively sampled. Data collected via semi-structured interviews was analysed iteratively until no new themes emerged [4].

RESULTS

AWH significantly impacted participants' interpersonal relationships, mainly through 'difficulties in connecting socially' and 'changes in sexual relationships'. Participants' social withdrawal was driven by physical limitations, altered self-perception, and stigma, leading to loneliness and reduced engagement. Changes in sexual relationships were shaped by pain, body image concerns, and perceived sexual pressure, often diminishing physical intimacy. Despite these challenges, emotional intimacy frequently persisted, largely due to empathetic and supportive partners. Postoperative improvements were highlighted as pivotal in restoring body confidence and intimacy.

CONCLUSIONS

This study illustrates the profound social and sexual disruptions AWH causes. These effects should be included in holistic and patient centred care, and incorporated into HRQoL assessment tools. Preoperative counselling should include issues of social connection and intimacy, whilst postoperative care should integrate structured support networks, psychoeducational interventions, and psychosexual counselling. Future research should pilot, revise and test the effectiveness of such measures.

摘要

背景

腹壁疝(AWH)会影响人际关系,而人际关系对人类福祉至关重要[1,2],然而AWH的社会和性方面仍未得到充分探索。本研究调查了AWH对社会脱节和性亲密关系挑战的影响,以及如何在健康相关生活质量(HRQoL)评估工具中对其进行有效评估。

方法

采用解释现象学分析(IPA)的定性方法[3]。目的抽样选取了15名参与者(8名男性和7名女性,年龄在36 - 85岁之间)。通过半结构化访谈收集的数据进行反复分析,直到没有新的主题出现[4]。

结果

AWH对参与者的人际关系产生了重大影响,主要通过“社交联系困难”和“性关系变化”体现。参与者的社交退缩是由身体限制、自我认知改变和耻辱感驱动的,导致孤独感增加和参与度降低。性关系的变化受到疼痛、身体形象问题和感知到的性压力的影响,常常减少身体亲密感。尽管存在这些挑战,但情感亲密关系往往仍然存在,这在很大程度上归功于善解人意和支持性的伴侣。术后改善被强调为恢复身体自信和亲密关系的关键。

结论

本研究表明AWH会造成严重的社会和性方面的干扰。这些影响应纳入整体的、以患者为中心的护理中,并纳入HRQoL评估工具。术前咨询应包括社会联系和亲密关系问题,而术后护理应整合结构化的支持网络、心理教育干预和性心理咨询。未来的研究应该试点、修订并测试这些措施的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/286f/12267305/40be7f6c8857/10029_2025_3414_Fig1_HTML.jpg

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