Sexual professional boundaries: physiotherapy students' experiences and opinions

Headnote

ABSTRACT

A high rate of inappropriate patient sexual behaviour (IPSB) has been reported to occur towards healthcare professionals and is associated with adverse consequences. This study aimed to: (i) determine the incidence and nature of IPSB experienced by physiotherapy students; (ii) compare students' responses to vignettes pertaining to sexual professional boundaries with responses from qualified physiotherapists; (iii) identify how prepared students felt to manage IPSB and strategies they used, and, (iv) determine if a need existed for more education on sexual professional boundaries within the undergraduate physiotherapy curriculum.

A cross-sectional design with data collected via a self-complete questionnaire was used. Participants were from the BSc (Physiotherapy) final year student cohort at a West Australian university. Sixty-seven responses (48 female) were received from 109 questionnaires representing a response rate of 62%. Seventy-eight percent of respondents had experienced at least one form of IPSB and 50% had discussed the incident. Seventy-nine percent of respondents reported feeling unprepared to manage IPSB. Students were inconsistent in their attitudes regarding sexual professional boundaries in keeping with published data from physiotherapists. These findings highlight the need for education regarding IPSB and sexual professional boundaries in the undergraduate curriculum. Ang AY, Cooper I, Jenkins S. (2010): Sexual professional boundaries: physiotherapy students' experiences and opinions. New Zealand Journal of Physiotherapy 38(3) 106-1 12.

Key words: Patient sexual behaviour, physiotherapists, students

INTRODUCTION

Sexual harassment in healthcare settings has been reported to occur at a high rate in the form of inappropriate patient sexual behaviour (IPSB) towards healthcare professionals (McComas et al 1993). Inappropriate patient sexual behaviour has been defined as "a verbal or physical act of an explicit or perceived sexual nature which is unacceptable within the social context in which it is carried out" (Johnson et al 2006). These acts can vary from forced physical advances to innuendos and sexist remarks (McComas et 1993). Specific to the physiotherapy profession, the close physical proximity, partial disrobing of patients and interpersonal relationships established over a course of treatment places physiotherapists at risk of experiencing IPSB.

Inappropriate patient sexual behaviour can lead to the development of significant physical and psychological symptoms (Fitzgerald et al 1988, Hotelling 1991, McComas et al 1993). These consequences can negatively impact on a physiotherapist's work in the form of absenteeism,...