Sexuality and Disability最新文献

To meta-synthesize the qualitative evidence on individuals’ subjective experiences of sexual health following a spinal cord injury (SCI). PubMed, EMBASE, CINAHL, and PsycInfo were searched from 1960 to 2021 for qualitative research articles that examined sexual health (i.e., sex, sexuality, reproductive health, etc.) in adults with SCI. Only studies published in English, including first-person accounts of living with a SCI were included. Using qualitative meta-synthesis methodology, data (reported results) from each selected study were coded line-by-line to develop descriptive and analytical themes by two investigators. A total of 22 studies met inclusion criteria. Some articles inquired about specific aspects of sexual health (e.g., how their sexual experiences are affected by urinary incontinence), and others inquired broadly about the experience of sexual relationships (e.g., how people engage in sexual relationships after their SCI). The themes identified in each study were positioned within the Sexual Rehabilitation Framework (Elliott 2017) composed of eight domains: sexual drive/interests, partnerships, self-image, bowel/bladder, sexual function, motor/sensory, fertility/contraception, and secondary complications. Sexual health was shown to be a significant priority for individuals after a SCI and they are impacted in a multitude of ways. Individuals report wanting education and knowledge on sexual health post SCI. Health care professionals were perceived to lack the ability to meet their needs and resources were inadequate. Further, providers’ approach, attitude, and insensitivity to patient needs were perceived barriers to adequate sexual health rehabilitation post SCI. The collective findings can inform (a) rehabilitation professionals’ awareness of patients’ sexual needs after SCI; (b) the development of SCI programming or services for sexual health rehabilitation; and (c) the design of future research studies (e.g., interventions for specific sexual issues).

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.

People with mild to borderline intellectual disabilities face many barriers toward their sexual health. To promote sexual health and overcome these barriers, they need individualized forms of sexuality support and education. To align sexuality support and education insight is needed on their understanding of sexual health. The current paper aims to provide greater insight in what sexual health consists of according to people with mild to borderline intellectual disabilities. Nine people with a mild to borderline intellectual disability participated in a concept mapping procedure, consisting of brainstorming, sorting, and ranking the statements. The resulting clusters and concept map were interpreted by an expert group. Analysis resulted in five clusters which participants considered important for their sexual health. According to people with mild to borderline intellectual disability cluster pertaining to romantic relationships and sexual socialization were the most important. These were followed by clusters on sexual health and lastly sexual selfhood. These results have implications for the development of sexuality support and education, as well as further research.

Supplementary information: The online version contains supplementary material available at 10.1007/s11195-023-09796-w.