Sexuality and Disability最新文献

To prepare future nurses in their providing of holistic care to patients, creative drama activities involving hands-on learning and experiential exercises are important in developing requisite skills. The aim of this study is to determine the effectiveness of education based on creative drama among nursing students, specifically in relation to facilitating discussions as to the expression of sexuality—an important aspect of patient care. A qualitative descriptive research design was employed in this study, therein utilizing semi-structured interviews as the data collection method. The dataset is comprised of field notes from interviews conducted with 16 students. Thematic analysis was employed to analyze the data and MAXQDA analysis software was used for data organization purposes. Five themes and twenty-one codes were identified. The themes which emerged from the data are; (1) the difficulties faced in questioning expressions of sexuality, (2) the factors which affect sexual care, (3) the feelings experienced by student nurses when taking patient histories, (4) the inclusion of creative drama in nursing education and (5) the perceptions held among student nurses towards the creative drama method. The 21 codes which emerged included cultural and social structures, the perception of sexuality as a private matter, gender discrimination, societal knowledge gaps, age-related concerns, patient hesitation, personal comfort when discussing sexuality, the encountering of negative reactions from patients, the ability to communicate comfortably, the comprehensive fulfilment of the caregiving role and the students' feelings of shame or boredom. Providing education as to the expression of sexuality, accompanied by creative drama activities, shall enable students to address and explore this challenging area and to provide holistic care.

Sexual disability is an emerging topic in the management of low back pain (LBP); nevertheless, sexual counseling skills are not widespread amongst professionals. The clinical behavior of physiotherapists in this field was not studied thoroughly; therefore, it is not clear if and how physiotherapists collect information related to sexual disability and how they manage it. This survey aimed to investigate knowledge, beliefs and attitudes of Italian physiotherapists in managing this disability. An online survey with 28 questions was distributed from February 2nd to July 10th 2023 via the newsletter of the Italian Association of Physiotherapy, email and social media. The questionnaire queried on participant demographics, assessment and treatment procedures, beliefs and potential barriers, sex, expertise, previous educational background, and geographical area. 448 physiotherapists completed the survey, with 69.87% not investigating LBP-related sexual disability routinely. 85% of physiotherapists diagnosed sexual disability in 0–10% of patients treated for LBP. Sexual disability is reported by physiotherapists at random in 54.91% of patients. When it is diagnosed, 90.41% of physiotherapists would choose evidence-based procedures, but only 19.96% of them would directly involve the patient’s partner. Postgraduate education and professional expertise positively influence beliefs and attitudes. Main barriers and difficulties in the field are the perceived lack of expertise, other therapeutic priorities, cultural attitudes of patients, and fear of violating patients’ privacy. The beliefs and attitudes of Italian physiotherapists in the management of sexual disability are characterized by scarce attention and feeling of inadequacy, but they show the potential to adequately treat this disability.

Parents of autistic youth often express uncertainty in addressing topics related to sexual health and puberty with their children. The purpose of this pilot study was to assess the feasibility, acceptability, and preliminary efficacy of the Birds and Bees program, a novel, group-based sexual and reproductive health education (SRE) program for parents of autistic youth. Parents (n = 10) completed measures of their knowledge about SRE topics, self-efficacy, outcome expectations for discussing these topics with their children, and child daily living skills pre- and post-intervention. Of the ten parents enrolled in the intervention, six completed the program. Treatment completers attended 77% of sessions (an average of 6 of the 8 sessions). Parent acceptability of the program was high. There was support for increased parent knowledge (Hedge’s g = 0.79), self-efficacy (Hedge’s g = 0.75), and outcome expectations (Hedge’s g = 0.51) from pre- to post-intervention. No meaningful changes in parent report of their child’s personal daily living skills were reported (Hedge’s g = 0.15). Implications of these results illustrate the positive impact of an innovative parent-led SRE program for caregivers of autistic youth.

Disabled communities’ sexualities have been historically oppressed. Currently in the U.S., public school curricula do not include inclusive sexual education and students with disabilities are often left out of classrooms that discuss any amount of personal health and sexual education (PHSE). Research on the disabled population is filled with samples of non-disabled individuals imposing their opinions on a population that they do not belong to. The purpose of this study was to capture lived experiences of ways emerging adults with disabilities learned about PHSE. Individuals with varied disabilities were intentionally included to add breadth to the research field. The final sample consisted of eight individuals (75% female, 87% White, mean age of 21.5). After conducting narrative interviews and analyses, four story types were generated: (1) “The Self-Guided Journey”, (2) “Experience is the Best Teacher”, (3) “Personal Health Matters More”, and (4) “Two Ears, One Mouth”. Our findings highlighted the lack of formal support and access to adequate, relevant information about sexuality for disabled communities. Informal sources, like families and media, sometimes served as helpful resources for PHSE and disabilities. Individuals’ disability symptoms and personal characteristics need to be considered when crafting universally applicable personal health and sexuality education.

Rheumatoid arthritis (RA) is an autoimmune-associated pathology with an articular inflammatory basis. RA is diagnosed by severe pain, movement restriction, fatigue, anxiety, depression, and sexual disorder (SD). This pathology can potentially reduce the quality of life and cause many problems. The electronic databases of PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar search engine were systematically searched for the papers reporting the prevalence of SD in patients with RA (by August 2023). Following paper collection and data extraction, the Random Effects model was used to perform the data analysis (CMA, v.2). The heterogeneity of studies was assessed using I² index. Following the assessment of 53 eligible studies with a sample size of 9,174 cases, the overall prevalence of SD in RA patients was 32.4% (95% CI:24.4–41.6). Also, the prevalence of SD in RA females and males was 36.5% (95% CI: 26.4–48) and 23.5% (95% CI:12.6–39.4), respectively. Based on the findings, the prevalence of SD among RA individuals was found relatively high; thus, the application of measures seems necessary to prevent sexual disorders in RA cases. These strategies are useful for health policymakers.

Sexual dysfunction is a common and significant issue for patients with multiple sclerosis (MS), adversely affecting their overall quality of life. Proper sexual counseling can be beneficial for these women. This study aimed to evaluate the impact of a counseling intervention based on the PLISSIT model on family functioning and sexual quality of life in women with MS. This interventional study was conducted in 2020 at the largest center for special diseases in southeast Iran. Sixty women with MS were selected through convenience sampling and randomly assigned to either an intervention group or a control group. The intervention group participated in four 90-minute individual counseling sessions based on the PLISSIT model over four weeks, while the control group received routine training. Data were collected using a demographic information form and questionnaires on family functioning and sexual quality of life, both before and after the intervention. Results showed no significant differences between the two groups in terms of family functioning and sexual quality of life scores before the intervention (p > 0.05). However, after the intervention, the intervention group exhibited significant improvements in both family functioning and sexual quality of life scores (P < 0.0001). Specifically, there was a notable increase in the mean scores for family functioning and sexual quality of life in the intervention group post-intervention (P = 0.001 and P = 0.0001, respectively). In contrast, the control group showed no significant change in family functioning (P = 0.79) and a significant decrease in sexual quality of life (P = 0.014) during the second assessment. The results suggest that sexual counseling based on the PLISSIT model can effectively enhance family functioning and sexual quality of life in women with multiple sclerosis.

Female infertility is a major public health concern, and viral infections have been suggested as a potential cause. The recent emergence of coronaviruses, such as SARS-CoV-2, has raised concerns about their potential impact on female fertility. This systematic review aimed to evaluate the existing literature on the relationship between female infertility and viral diseases, with a particular focus on coronaviruses. A systematic review was conducted using relevant databases, including PubMed, Scopus, Web of Science, and Google Scholar. Studies published between 2009 and 2023 were included. The Critical Appraisal Skills Program (CASP) tool was used to assess the quality of the studies. Data extraction and synthesis was carried out to summarize the findings. 13 studies met the inclusion criteria and were included in the review. The review demonstrated that many type viruses including human papillomavirus (HPV), human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and coronaviruses van affect female reproductive system. Moreover, findings revealed that some viral infections such as HPV and HIV may be associated with female infertility. However, evidence on the effect of coronaviruses on female infertility was limited and inconclusive.

Sexual wellness can be a difficult topic for people who have both bipolar disorder (BD) and bisexual identities, despite the essential role sexuality plays as a core feature of health and human behavior. In the United States, bi+ (bisexual, pansexual, sexually fluid) persons with BD can experience discrimination and face barriers by living in a society where misinformation and ableist ideals remain unchallenged. Examples of this include persistent stereotyping of hypersexuality and risky sexual behaviors, stigmatization, erasure, and biases against both groups. These groups need to be examined free from ableist tendencies and generalizations. In this conceptual paper, we introduce varied experiences of bi + and bipolar individuals, with a focus on their ability to engage freely with their sexuality despite societal judgments and conventions that refuse to acknowledge their sexuality in literature, academic research, and public spaces. By assessing this specific population, we have identified patterns and correlations that can start conversations to create a better understanding and acceptance of fluid sexualities and marginalized populations. We ultimately aim to guide further research for both bi + and bipolar populations that will advance cultural acceptance and facilitate sexual empowerment. This, in turn, may help in developing best practices, expanding knowledge, improving sexual health education, and ultimately reducing stigma.

Pelvic Floor Muscle Training (PFMT) is the first primary solution to improve urinary incontinence (UI) symptoms, but many challenges stems from certain PFMT-related practices. Exploring PFMT experience will help to increase treatment satisfaction, enjoyment, and empowerment. Hence, the aim of this study was to investigate the experience of pelvic floor muscle training (PFMT) in Italian people with UI. A qualitative semi-structured interview study was conducted. The interviews’ transcriptions were analysed using a constructionist epistemology lens and adopting the “Reflexive Thematic Analysis”. Sixteen Italian participants (Women N = 10, Men = 6) with UI who experienced PFMT were interviewed. Four themes were generated: (1) ‘Learn to Control the Unconscious Consciously’ as participants learned to control continence through active exercises; (2) ‘Starting PFMT, Changing Mind’ as they realised they can have an active role in managing their condition; (3) ‘Into the unknown intimacy’, as they bridged the gap in their (mis)understanding of the pelvic floor area, overcoming the discomfort linked to intimacy; (4) The Importance of Not Being Alone in this Process’, as the participants emphasised the paramount role of the physiotherapists in the healing process. To conclude, in people with UI, PFMT enhanced pelvic floor knowledge and understanding, fostering awareness, positive mindset, and symptom relief. The physiotherapist's pivotal role as an educator and empathetic guide in exercise programs, along with a preference for active exercises. Overall, our results proved that PFMT has positive consequences in people’s beliefs and mindset about and in the management of UI.

The study aims to assess the factors determining the access and utilization of sexual and reproductive health (SRH) services among people with disabilities residing in the Kathmandu Valley of Nepal. A cross-sectional study was conducted among randomly selected 422 people with disabilities in Kathmandu Valley. Data were collected through face-to-face interviews using structured questionnaires. Bivariate and multivariate logistic regression analyses were conducted. Among a total of 422 participants, 32.7% had utilized SRH-related education, information, and counselling services. Contraceptive-related services were utilized by 47.6% of participants, pregnancy-related services by 27.7%, safe abortion-related services by 13.0%, and HIV testing and treatment services by 3.6%. Likewise, 16.8% of participants utilized STI screening, diagnosis, and management services. Males were 2.5 times more likely to utilize SRH services compared to females (AOR = 2.5, 95% CI = 1.4-4.2), whereas unmarried participants were less likely to utilize SRH services as compared to single/separated/divorced (AOR = 0.2, 95% CI = 0.0-0.5). Similarly, participants who were living with their families compared to those living alone (AOR = 3.4, 95% CI = 1.4-7.7), and participants who were unemployed compared to employed (AOR = 1.8, 95% CI = 1.0-3.5) had higher odds for utilization of SRH services. There are significant variations depending on the intersections of various characteristics affecting the utilization rate across different SRH services among people with disabilities. Contraceptive-related services were the most utilized service, whereas safe abortion, pregnancy related services, STI screening and management services and HIV testing and treatment services were less utilized services.