Supporting sexual adjustment from the perspective of men living with spinal cord injury (original) (raw)
Related papers
| (2020) Examining the psychological and emotional experience of sexuality for men after spinal cord injury, Cogent Psychology, 7:1, 1722355 To link to this article: https://doi. Abstract: Sexual rehabilitation for men after spinal cord injury (SCI) has focused on physical challenges and has neglected psychosocial factors. Utilizing a descriptive phenomenological approach, the lived psychological experience of sexuality was described for six men (age 24-49) with complete or incomplete SCI (C4-T12; <1 year to 29 years post-injury) who participated in one in-depth, standardized, open-ended interview (68-101 minutes). Participants described the emergence of a new perspective of sexuality placing less emphasis on any one physical act and more importance on emotional factors. Understanding the evolving meaning of sexuality for men after SCI is imperative for delivering effective sexual health information.
Spinal Cord, 2022
STUDY DESIGN: A qualitative, semi-structured interview design. OBJECTIVES: This study aimed to identify, from the perspective of people living with a Spinal Cord Injury (SCI), the primary psychosocial barriers and facilitators that impact on their sexual function and sexual satisfaction post-injury. SETTING: Community-dwelling sample of people with SCI in England, United Kingdom METHODS: Semi-structured interviews with twenty people with SCI (15 males; 5 females) were conducted using an 8-item interview schedule. Inductive thematic analysis was undertaken of verbatim transcripts coded using Braun and Clarke's (2021) six phases of thematic analysis. RESULTS: Six inductive themes were generated, collectively describing the psychosocial barriers and facilitators impacting on sexual function and satisfaction post-SCI: (1) Internalising societal views and stigmatisation; (2) Diminished sexual confidence; (3) Navigating communication; (4) Managing relationship dynamics; (5) Lack of sexual support provision; and (6) Intervention development recommendations. CONCLUSION: Sexual function and satisfaction are highly challenging areas of rehabilitation for males and females living with SCI. Increased efforts are needed to educate others in society to overcome the negative stereotypical attitudes obstructing acceptance of sex despite disability. Countering sexual stigmatisation for people with SCI would facilitate growth in sexual confidence. Techniques to enhance interpersonal sexual communication and involve the partner/spouse in regaining mutual sexual satisfaction are foundational. The current study highlighted key outpatient-based recommendations for intervention development, clarifying primary targets for future SCI-focused sexual therapeutic work.
Sexuality of People with Spinal Cord Injury: Knowledge, Difficulties and Adaptation
Expressing sexuality is an important part of life, whether the person has a spinal cord injury (SCI) or not. This study investigated the sexual activity before and after SCI, the difficulties, and adjustments made by these people in relation to their sexuality. This is a qualitative study conducted with 14 people with SCI through semi-structured interviews, which we analyzed in light of pertinent literature and organized into three themes: sexual activity before and after SCI; difficulties in performing sexual activities; and adjustments in sexual activity after SCI. We conclude that, although there may be many difficulties, with the partner’s support they can get sexual satisfaction and adapt to the new reality. Nonetheless, it is necessary and essential that the patient receive guidance about the possible changes and adaptive methods, and nurses can play a critical role in this process.
Journal of Rehabilitation Medicine
Objective: To explore healthcare professionals’ perspectives on the barriers and facilitators impacting provision of support for sexual functioning/satisfaction during spinal cord injury rehabilitation.Design: Qualitative, semi-structured interview design.Methods: Sixteen healthcare professionals working in spinal cord injury rehabilitation settings were recruited (14 females, 2 males). Semi-structured interviews were conducted using a 9-item interview guide. Interviews were transcribed verbatim and inductively analysed following Braun and Clarke’s (2006) 6 phases of thematic analysis.Results: Five inductive themes were generated describing healthcare professional-perceived barriers and facilitators impacting upon care delivery postspinal cord injury: (1) Integrating sexual wellbeing in rehabilitation; (2) Sex-informed multi-disciplinary teams; (3) Acknowledging awkwardness; (4) Enhancing approachability; and (5) Recognizing the partner.Conclusion: Sexual functioning and satisfactio...
Sexuality and Disability, 2008
Recent epidemiological statistics suggest approximately 250,000 people in the United States live with a spinal cord injury. Men constitute roughly 82% of these individuals. Following spinal cord injury, men frequently experience significant changes in their sexual functioning. As a result, men with spinal cord injuries are at an increased risk for experiencing adjustment difficulties. Unfortunately, relatively little is known about factors that promote or impede men's adjustment to these changes. In the present article, the authors highlight how men's adherence to gender scripts for sexual potency may contribute to their adjustment following a spinal cord injury. To organize the discussion, the authors review related literature and, through case examples, illustrate how men's adherence to this gender norm may influence their post-injury mental health. Directions for gender-sensitive interventions and future clinical research are provided.
Sexuality and Disability, 2017
Sexuality is an important priority for people following spinal cord damage (SCD), due to the impact on sensory and motor function, including paralysis and associated mobility restrictions. Men living with SCD report difficulty in achieving and maintaining erection, impaired capacity for orgasm (with or without ejaculation), and increased likelihood of retrograde ejaculation as significant challenges for sexuality. The implications of these issues for men following non-traumatic SCD (spinal cord dysfunction or SCDys) has not been examined. Drawing on interviews with eight heterosexual men following SCDys, this paper seeks to examine the factors that impact sexual satisfaction. Due to a focus on coitus and the significance of erectile function in this, most participants reported dissatisfaction with their sexuality post-SCD. However, this could be overcome through expanding their sexual repertoires. Through providing information and education about non-coitus focused expressions of sexuality, there is scope for sexual rehabilitation services to significantly increase the quality of life of men after SCDys.
A Primary Care Provider’s Guide to Sexual Health for Individuals With Spinal Cord Injury
Topics in Spinal Cord Injury Rehabilitation
The collaboration with individuals regarding their sexual health is an important component of patient-centered health care. However, talking about sexual health in primary care settings is an area not fully addressed as a result of time limitations, medical task prioritization, awareness or knowledge deficit, and discomfort with the topic of sexuality. A critical shift in professional focus from disease and medical illness to the promotion of health and wellness is a prerequisite to address sexual health in the primary care setting. This article provides guidance for practitioners in primary care settings who are caring for persons with spinal cord injury. Clinicians should seize the opportunity during the encounter to reframe the experience of disability as a social construct status, moving away from the narrow view of medical condition and “find it, fix it” to a broader understanding that provides increased access to care for sexual health and sexual pleasure.
Spinal Cord, 2016
Study design: Mixed-methods study using comprehensive survey and semi-structured interviews. Objectives: Compare the experiences of sexual education during rehabilitation for people with non-traumatic spinal cord dysfunction (SCDys) and traumatic spinal cord injury (SCI), determine preferences for the delivery of this information and provide recommendations for spinal rehabilitation professionals. Setting: Community, Australia. Methods: Adults completed survey (traumatic SCI n = 115; SCDys = 39) or were interviewed (SCDys: n = 21). Survey included questions regarding sexual education during rehabilitation, participant satisfaction with this and preferred modes for receiving such information. These themes were also explored during interviews. Results: No difference between SCI and SCDys regarding satisfaction or preferred modes of presentation (all P40.05). People with SCDys were less likely to report receiving sexuality education during rehabilitation (SCDys n = 11, 30%; SCI n = 61, 53%; P = 0.03). Interviews suggested that this may be gendered, as only two women recalled receiving sexual education, whereas men often received this as part of continence management. Overall, only 18% were satisfied or very satisfied with sexual education and information received, and 36% were dissatisfied or very dissatisfied. Preferred modes for receiving sexuality information included sexuality counsellor (n = 97), recommended internet sites (n = 77), peer support workers (n = 76), staff discussion (n = 67), written information (n = 67) and DVD (n = 58). These preferences were confirmed during interviews, although women expressed a strong preference for written information sheets. Conclusion: There was very low satisfaction with sexuality education during rehabilitation. Our findings highlight the scope and directions for improving the sexual education and information given to people with both SCDys and SCI during rehabilitation.
The training needs of rehabilitation professionals in the area of sexuality and sexual function, particularly following spinal cord injury (SCI) has received little attention in the literature. Specifically, there is negligible theoretical discussion related to staff training needs, as well as a paucity of standardised scales to measure these needs. A conceptual model was developed encompassing staff knowledge, comfort, and attitudes towards sexuality following SCI. Using this model, a scale was developed, evaluated, and refined. Factor analysis supported the construct validity of the scale in measuring the existing conceptual model outlined but highlighted the existence of a separate construct related to personal approaches from clients. The subsequently named Knowledge, Comfort, Approach and Attitudes towards Sexuality Scale (KCAASS) demonstrated high levels of internal consistency across the four conceptual domains. The KCAASS has utility for rehabilitation facilities interested in identifying and targeting training initiatives related to addressing client sexuality needs following SCI. sex, training, rehabilitation, spinal cord injury, interprofessional, measurement