Canadian healthcare provider perspectives and practices in the provision of sexual health support for people with chronic kidney disease: a mixed methods study

People with non-dialysis-dependent chronic kidney disease (CKD) have identified sexual health as an important aspect of kidney care and a research priority, yet limited information is available on how sexual health is provided within multidisciplinary clinics. We aimed to explore the perceptions, needs, and practices of healthcare providers in Canadian multidisciplinary CKD clinics related to sexual health support for individuals with non-dialysis-dependent CKD. We used a convergent mixed methods design involving a self-administered online survey and semi-structured interviews to collect information from healthcare providers working in CKD clinics. The survey included questions related to providers’ understanding of sexual health, current practices, and perceived gaps in how sexual health is addressed in routine CKD care, and was analyzed using descriptive statistics. We undertook follow-up interviews with a subset of survey respondents to elaborate on perspectives about sexual health support, which we analyzed using inductive, content analysis. Thirty-three nurses, 23 nephrologists, 9 allied health professionals, and 8 administrators completed the survey between September and December 2023. Five survey respondents participated in an interview. Quantitative and qualitative results were integrated and summarized in four themes describing current perceptions and practices in the provision of sexual health support for patients with non-dialysis-dependent CKD: (1) Mismatch between perceived value and ability to respond; (2) Roles and processes for integrating sexual health into CKD care; (3) Insufficient knowledge and competence in sexual health provider practices; (4) Influence of patient and provider characteristics in sexual health discussions. Key barriers to integrating sexual health into routine care were lack of knowledge, experience, and training; insufficient time and competing priorities; lack of resources; need for clarity in scope of practice; and concern for patient discomfort. Providers suggested access to credible, appropriate resources and clear expectations and guidelines around sexual health care provision for providers working in CKD clinics and other specialty areas (e.g., primary care) to support sexual health care for those with non-dialysis-dependent CKD. We identified variability in care practices among healthcare providers from multidisciplinary CKD clinics. Identified barriers will inform strategies to enhance sexual health supports for individuals with non-dialysis-dependent CKD.