Abstract

Background: Touch and physical proximity are essential in various healthcare procedures. Despite their necessity, some procedures can evoke feelings of shame, embarrassment, humiliation, fear, and anger in patients (Brennan et al., 2023; Harriel-Hidlebaugh, 2023). Such negative experiences can lead to psychological harm, such as post-traumatic stress disorder, and may cause patients to avoid or refuse further care (Flynn et al., 2020; Harriel-Hidlebaugh, 2023).

Objective: This study aimed to develop and define the concept of “patient’s sexual dignity discomfort.”

Design: This study utilized a hybrid model of concept development, comprising three phases: theoretical, fieldwork, and analytical phases (Schwartz-Barcott & Kim, 2000).

Methods: In the theoretical phase, a scoping review was conducted to establish a working definition of patient’s sexual dignity discomfort. This definition was refined and validated using qualitative data collected from 18 participants during the fieldwork phase. All interviews were recorded and transcribed and were analyzed using directed content analysis (Hsieh & Shannon, 2005). In the analytical phase, a final conceptual model of patient’s sexual dignity discomfort was proposed by integrating findings from both the theoretical and fieldwork phases.

Results: Four themes describing attributes of patient’s sexual dignity discomfort were explored and confirmed: 1) experiencing shame and embarrassment, 2) vulnerability-induced loss of control, 3) dehumanization and objectification, and 4) uncertain sexual autonomy. Despite varying contextual factors, patient’s sexual dignity discomfort occurs when patients perceive care procedures as sexually inappropriate or as involving unnecessary sexual activity, particularly when healthcare providers display unprofessional attitudes or when patients lack consent or are not mentally prepared for the procedure because of insufficient information. Consequently, this discomfort leads patients to refuse or avoid healthcare treatments and prioritize finding better healthcare services over their health. It can also prompt providers to avoid patients, resulting in a compromised quality of care and poor health outcomes.

Conclusions: A patient’s sexual dignity discomfort poses a significant threat to the quality of patient care and preservation of dignity. Nurses can trigger this intentionally or unintentionally, highlighting the need for comprehensive education and training to prevent it.

Notes

References: Brennan, M. E., Bell, K., Hamid, G., Gilchrist, J., & Gillingham, J. (2023). Consumer experiences of shame in clinical encounters for breast cancer treatment. “Who do you think you are– Angelina Jolie?” Breast, 72, 103587. https://doi.org/10.1016/j.breast.2023.103587

Flynn, P. M., Betancourt, H., Emerson, N. D., Nunez, E. I., & Nance, C. M. (2020). Health professional cultural competence reduces the psychological and behavioral impact of negative healthcare encounters. Cultural Diversity & Ethnic Minority Psychology, 26(3), 271–279. https://doi.org/10.1037/cdp0000295

Harriel-Hidlebaugh, S. (2023). Not just non-consensual pelvic exams: The need for expressed consent for all intimate tasks for elective procedures. Voices In Bioethics, 9. https://doi.org/10.52214/vib.v9i.11927

Hsieh, H.-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Nordic Journal of Digital Literacy, 15(1), 29–42. https://doi.org/10.1177/1049732305276687

Schwartz-Barcott, D., & Kim, H. S. (2000). An expansion and elaboration of the hybrid model of concept development. In E. Thomas (Ed.), Concept Development in Nursing: Foundations, Techniques, and Applications (2nd ed., pp. 129–159). Saunders.

Description

Some healthcare procedures involve physical touch and close proximity, potentially leading to negative emotions in patients. This study developed and defined the concept of ‘patient’s sexual dignity discomfort (SDD).’ SDD encompasses feelings of shame, embarrassment, vulnerability, dehumanization, and uncertain sexual autonomy. These issues can cause patients to avoid healthcare and distrust providers, ultimately reducing the quality of care and health outcomes.

Author Details

Sihyun Park, PhD

Sigma Membership

Lambda Alpha at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Ethics, Theory, Patient Dignity

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the poster.

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Patient’s Sexual Dignity Discomfort in Healthcare Setting: A Concept Development

Seattle, Washington, USA

Background: Touch and physical proximity are essential in various healthcare procedures. Despite their necessity, some procedures can evoke feelings of shame, embarrassment, humiliation, fear, and anger in patients (Brennan et al., 2023; Harriel-Hidlebaugh, 2023). Such negative experiences can lead to psychological harm, such as post-traumatic stress disorder, and may cause patients to avoid or refuse further care (Flynn et al., 2020; Harriel-Hidlebaugh, 2023).

Objective: This study aimed to develop and define the concept of “patient’s sexual dignity discomfort.”

Design: This study utilized a hybrid model of concept development, comprising three phases: theoretical, fieldwork, and analytical phases (Schwartz-Barcott & Kim, 2000).

Methods: In the theoretical phase, a scoping review was conducted to establish a working definition of patient’s sexual dignity discomfort. This definition was refined and validated using qualitative data collected from 18 participants during the fieldwork phase. All interviews were recorded and transcribed and were analyzed using directed content analysis (Hsieh & Shannon, 2005). In the analytical phase, a final conceptual model of patient’s sexual dignity discomfort was proposed by integrating findings from both the theoretical and fieldwork phases.

Results: Four themes describing attributes of patient’s sexual dignity discomfort were explored and confirmed: 1) experiencing shame and embarrassment, 2) vulnerability-induced loss of control, 3) dehumanization and objectification, and 4) uncertain sexual autonomy. Despite varying contextual factors, patient’s sexual dignity discomfort occurs when patients perceive care procedures as sexually inappropriate or as involving unnecessary sexual activity, particularly when healthcare providers display unprofessional attitudes or when patients lack consent or are not mentally prepared for the procedure because of insufficient information. Consequently, this discomfort leads patients to refuse or avoid healthcare treatments and prioritize finding better healthcare services over their health. It can also prompt providers to avoid patients, resulting in a compromised quality of care and poor health outcomes.

Conclusions: A patient’s sexual dignity discomfort poses a significant threat to the quality of patient care and preservation of dignity. Nurses can trigger this intentionally or unintentionally, highlighting the need for comprehensive education and training to prevent it.