Open Access Dissertation
Date of Award
Merry A. Stewart
PERCEPTIONS OF SEXUALITY BY AFRICAN AMERCIAN PATIENTS ON HEMODIALYSIS
Advisor: Dr. Ramona Benkert
Degree: Doctor of Philosophy
Sexuality is central to who we are as sentient beings and transcends physical sex acts. Sexuality concerns are reported as common for individuals receiving hemodialysis; yet, sexuality-related research for this population has been limited to a focus on altered physical sexuality. Little is known about the effects of hemodialysis on perceptions of personal identity, family-social roles as men or women, and intimate relationships. African Americans make up a disproportionate percentage of chronic hemodialysis patients and may be at greater risk for altered sexuality. The purpose of this qualitative descriptive study was to explore African Americans' perceptions of sexuality since being on dialysis. A middle-range model, the Sexuality Adaptation Model (SAM), derived from Roy's Adaptation Model provided a guiding theoretical framework. Semi-structured interviews were conducted with 19 African American men (n = 12) and women (n = 7) who were receiving hemodialysis treatment (mean age = 49.95 years). Eight participants (seven men, one woman) were married, or in steady relationships. The range of dialysis years for the participants ranged from 1 to 10 years (M = 4.16, SD = 3.08). For male participants, a strong endorsement of traditional masculinity ideology was found to promote adaptive behaviors that minimized an altered sense of "who I am" as a man. In contrast, female participants' perceptions of sexuality were found to be influenced by multiple meanings of their identity as Black women. Most partnered men expressed greater concerns regarding the effects of hemodialysis on diminished physical sexuality and altered partner relationships, whereas women participants were primarily concerned about their altered personal sexuality identities and roles as a mother. The rollercoaster effects of loss of time, energy, independence, and negative dialysis center environment was suggested to erode perceptions of sexuality among the majority of study participants. Informal mutual support groups were reported to contribute to positive perceptions of sexuality. The application of the SAM facilitated relevant descriptions of participants' perceptions of sexuality and supported the investigator's assertion that a holistic approach is needed to guide research and clinical interventions related to sexuality concerns.
Stewart, Merry Ann, "Perceptions Of Sexuality By African American Patients On Hemodialysis" (2010). Wayne State University Dissertations. 52.