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

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.