Sexual Rehabilitation After a Stroke: A Multi-site Qualitative Study About Influencing Factors and Strategies to Improve Services.

IF 1.1 4区 医学 Q3 REHABILITATION Sexuality and Disability Pub Date : 2023-05-24 DOI:10.1007/s11195-023-09795-x
Louis-Pierre Auger, Johanne Filiatrault, Dorra Rakia Allegue, Brigitte Vachon, Aliki Thomas, Ernesto Morales, Annie Rochette
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Abstract

This study aimed to better understand the factors influencing the provision of sexuality-related post-stroke rehabilitation services by clinicians on different sites and to explore strategies to improve post-stroke rehabilitation services with stakeholders. A qualitative study with co-design methods was conducted with 20 clinicians from five post-stroke rehabilitation centers in Canada, 1 manager and 1 patient-partner. Participants either took part in a focus group or in sessions of an adapted version of the LEGO Serious Play method to explore influencing factors and strategies of improvement in relation to post-stroke sexual rehabilitation services. Thematic analysis was conducted semi-deductively using the Theoretical Domains Framework (TDF), the Capability, Opportunity, Motivation and Behaviour (COM-B) system and the Behaviour Change Wheel (BCW). A total of twenty factors pertaining either to the categories of Capability (n = 8; e.g., Sexual rehabilitation procedural knowledge), Motivation (n = 4; e.g., Professional boundaries) or Opportunity (n = 8; e.g., Workload) were perceived as influencing provision of sexual rehabilitation services by participants. A theoretical model was conceptualized. Strategies (n = 10) were categorized in concordance with the BCW as Training (n = 1), Enablement (n = 5) or Environmental restructuring (n = 4). This study showed that factors influencing provision of post-stroke rehabilitation services were numerous and interrelated, and that various strategies aiming either clinicians or the rehabilitation environment would be relevant to improve services. This study will help guide the design and implementation of future interventions studies aiming at improving post-stroke sexual rehabilitation services.

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中风后性康复:一项关于影响因素和改善服务策略的多站点定性研究。
本研究旨在更好地了解影响不同地点临床医生提供性相关脑卒中后康复服务的因素,并与利益相关者探讨改善脑卒中后恢复服务的策略。一项采用联合设计方法的定性研究由来自加拿大五个卒中后康复中心的20名临床医生、1名管理人员和1名患者合作伙伴进行。参与者要么参加了一个焦点小组,要么参加了乐高严肃游戏方法的改编版本,以探索影响因素和改善中风后性康复服务的策略。主题分析采用理论领域框架(TDF)、能力、机会、动机和行为(COM-B)系统和行为改变轮(BCW)进行半演绎。与能力类别(n = 8.例如,性康复程序知识),动机(n = 4.例如专业界限)或机遇(n = 8.工作量)被认为影响了参与者提供性康复服务。一个理论模型被概念化了。策略(n = 10) 与BCW一致地被归类为训练(n = 1) ,启用(n = 5) 或环境重组(n = 4) 。这项研究表明,影响卒中后康复服务提供的因素是多方面且相互关联的,针对临床医生或康复环境的各种策略都与改善服务有关。这项研究将有助于指导未来旨在改善脑卒中后性康复服务的干预研究的设计和实施。
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来源期刊
Sexuality and Disability
Sexuality and Disability REHABILITATION-
CiteScore
2.70
自引率
20.00%
发文量
47
期刊介绍: Sexuality and Disability is an international forum for the publication of peer-reviewed original interdisciplinary scholarly papers that address the psychological and medical aspects of sexuality in relation to rehabilitation. Publishing timely research articles, review articles, case studies, clinical practice reports, brief research reports, survey data reports, and book and film reviews, the journal offers the latest developments in the area of sexuality as it relates to a wide range of disabilities and conditions. Contributions address: clinical and research progress; community programs; independent-living programs; guidelines for clinical practice; special grand-rounds topics; consumer issues; and contemporary developments in special programs in sex education and counseling for people with disabilities. The journal features special issues with internationally renowned guest editors focusing on current topics in sexual health. By publishing research, best-practice, evidence-based, and educational articles, the journal seeks to contribute to the field''s knowledge base and advancement. Sexuality and Disability is an essential resource for the exchange of new knowledge, issues, techniques, and available modalities for researchers and other professionals addressing the psychological and medical aspects of sexuality in rehabilitation, medical, academic, and community settings.
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