Sexuality in persons with severe physical disability: a guide to the physician (original) (raw)
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The Journal of Sexual Medicine
Introduction. Studies on sexual function in men with disabilities have mainly relied on clinical samples; population-based evidence on this topic is limited. Aim. We aimed to compare aspects of sexual function between disabled and non-disabled men using a representative sample. Methods. We used data from Ten to Men, a national cohort study of Australian men aged 18 to 55 years. We first compared the prevalence of 15 sexual function-related difficulties in disabled versus non-disabled men. Next, we used Poisson regression to examine associations between disability and sexual function. The main analytic sample had 8,496 men. Weights and adjustments appropriate to the sampling methodology were applied. Models adjusted for potential confounders. Results were reported as prevalence ratios (PRs). P-values of <0.05 were considered statistically significant. Outcomes. Outcomes were 15 individual items from the Natsal-SF, a validated measure of sexual function with items in 3 domains: physio-psychological aspect; relational aspect; and global selfrating (the 16 th item on help-seeking was excluded). These were coded as binary variables denoting past-year sexual problems. Results. Disabled men had higher prevalence of all outcomes than non-disabled men. 25.6% of men with disabilities and 15.1% of non-disabled men experienced at least 2 out of 15 difficulties. The most prevalent problems were 'orgasmed too early' (43.8% of disabled men, 37.1% of non-disabled men), imbalance of sexual desire between partners (47.6% of disabled men, 39.2% of non-disabled men), and overall sexual dissatisfaction (39.4% of disabled men, 26.7% of non-disabled men). All adjusted PRs were greater than 1.00 for disability; associations were statistically significant except 'partner experienced sexual difficulties' (PR 1.23; 95% CI 0.99, 1.53; p=0.058) and 'orgasmed too early' (PR 1.16; 95% CI 1.00, 1.35; p=0.050). 'Presence of discomfort/pain' had the largest adjusted PR for disability (PR 2.77, 95% CI 1.89, 4.06; p<0.001). Clinical Translation. This population-based comparative analysis helps contextualize evidence from clinical studies on the relationship between disability and sexual function, and may lead clinicians to new insights about sexual function in male patients with disabilities. Strengths & Limitations. Two major strengths of this study are that the sample included a nondisabled reference group and results are generalizable to Australian men. A key limitation is that disability and sexual function measures are self-reported. Conclusion. This study provides a broad foundation of population-based evidence about sexual function in men with disabilities, relative to men without, showing positive associations between disability and 13 of 15 sexual difficulties.
Sexual health problems in patients with motor disabilities in Poland
Journal of Health Inequalities
This article discusses the barriers to achieving a satisfactory sex life by patients with disabilities in Poland, and it compares the current situation with foreign literature on the subject. The most common causes of motor disabilitiy in Poland are injuries and diseases of the musculoskeletal system (59%) and neurological diseases (38%). According to the existing studies, the main areas on which sexual rehabilitation should be focused are as follows: breaking myths, fears, and stereotypes. The results of the surveys suggest that most people with disabilities did not come across information about their sexual abilities during rehabilitation. Healthcare facilities should be adjusted to the needs of persons with disabilities, and awareness should be raised among healthcare professionals to maintain high ethical standards of services. Despite huge demand, there is still a lack of available, high-quality sources of information on the sexual and reproductive health of people with disabilities in Poland, both for medical staff and for the patients themselves. Numerous studies show barriers to achieving a satisfactory sex life among people with disabilities: educational deficiencies both in the people with disabilities and the rest of society, difficulties in accessing affordable and suitable healthcare, and infrastructural, architectural, and economic barriers, which lead to inequalities in terms of sexual health. This paper highlights problems and barriers affecting people with disabilities and emphasizes the need for changes such as improving the adjustment of health centres to the needs of people with physical disabilities, as well as the need to incur additional costs related to receiving health services.
Sexuality and Physical Disability: Exploring the Barriers and Solutions in Healthcare
People with physical disability and/or chronic illness are more likely to seek medical help than their typical peers. Once pressing matters related to their condition are addressed clients may pay attention to how to incorporate the management of their health condition into other aspects of their lives (i.e., sexuality). This paper discusses inhibitory and facilitative experiences that people with physical disabilities may encounter in their interactions with healthcare workers and systems when adapting to changes in their sexuality. Sexual health models (i.e., PLISSIT, Kaplan, ALLOW and Bitzer et al.) for people with chronic illness or disability are summarized and analysed for their value in relation to contemporary health needs. This paper posits that healthcare providers and people with physical disabilities can learn from and teach each other in order to promote positive and agentic constructions of sexuality with significant disability.
ASSESSMENT OF SEXUALITY OF PERSONS WITH PHYSICAL DISABILITIES
Research in Education and Rehabilitation, 2019
The aim of the study was to assess the sexuality of persons with physical disabilities and to determine whether there were differences in relation to the respondents of typical development. The study included a sample of 60 respondents, over the age of 16. The total sample is divided into two sub-samples, of which the first sub-sample consists of persons with physical disabilities (N = 30) and the second sub-sample consists of persons of typical development (N = 30). For the purpose of the assessment of sexuality, the Sexuality Assessment Instrument was used. In order to verify the set study aim, a chi-square test for an independent sample of respondents was applied. Considering the results of the research, it can be concluded that people (of typical development) without disabilities experienced more French kissing but also regretted kissing. Persons (of typical development) without disabilities have experienced kissing against their will, while persons with physical disabilities have experienced the touching of the genitals of another person against their will. Key words: Sexuality, persons of typical development, persons with physical disabilities.
The experience of sexuality in adults with intellectual disability
Journal of Intellectual Disability Research
Background People with intellectual disability have the same sexual needs as those without any disability, yet their sexuality is often restricted by reluctant attitudes and/or fears based on irrational beliefs. The aim of this study is to describe and analyse different areas of sexuality in adults with mild or moderate intellectual disability. Method The sample consisted of 180 men and 180 women attending occupational centres. All the participants were administered a questionnaire about sexuality adapted to their characteristics. Results Results show that 84.2% have had sexual relationships with another person, this percentage being higher in females and in people aged between 38 and 55 years old. Condoms are used by 41.4%. The most frequently used contraceptive methods are the pill (39.6%), transdermal patch (30.2%) and intrauterine device (6.7%). 9.4% of the women and 2.8% of the men has experienced sexual abuse. Conclusion In conclusion, there is a need to draw up educational programmes, differentiated according to gender and adapted to their reality, which include contents related with sexual health, sexual abuse and condom use.
Sexuality: Experience of Women with Physical Disabilities
Open Journal of Nursing, 2014
It was aimed to describe the experiences at the practice of sexuality of women with physical disabilities. This study is part of a doctoral thesis entitled sexuality in women with acquired deficiency: nursing in health promotion and empowerment. It was conducted an exploratory descriptive study with qualitative approach, which was carried out from June to October, in the year of 2010. The survey participants were six women members of an association of people with physical disabilities. Data collection was based on focal group. Analysis and discussion by means of the classification of the speeches were performed according to the analysis of content and pertinent literature. In the results, the following categories and sub-categories were identified: concepts, covering self-image and sexuality; social actors, responsible for the promotion of sexuality, with highlight for men, family and health professionals; challenges experienced in the practice of sexuality, with highlight on prejudice and fear of sexual abuse due to the disability. We could state that the focus groups favored the discussion and the self-knowledge of the women with respect to sexuality.
The recognition that people living with impairments are sexual beings is a relatively new one. Historically, people living with a physical impairment including neuromuscular disorders (NMDs) have been perceived as asexual or potentially deviant. They can experience a lack of information as well as distress and anguish around their sexual and personal relationships. They often face obstacles to maximizing their sexual potential and may internalize negative societal assumptions and attitudes about their sexuality. The extent to which both sexual expression and interactions with healthcare providers influence the impact of physical impairment on the quality of life (QoL) of NMD patients has not previously been determined, providing the rationale for this study. The purpose of this study was (a) to determine if the levels of sexual expression and interactions with healthcare providers varied significantly between people with and without a NMD, and (b) to explore the extent to which sexual expression and interactions with healthcare providers significantly influenced the impact of NMDs on QoL. Responses were collected via an online survey using seven instruments: a demographic questionnaire; the Individualised Neuromuscular Quality of Life (INQoL); the Watts Sexual Function Questionnaire (WSFQ Male and Female); the Client Satisfaction Questionnaire (CSQ-8); WHO (five) Wellbeing Index; the Brief Burns Depression Checklist (BDC); and the Neuromuscular Patients and HCPS Sexuality Questionnaire. The participants included 144 people living with a NMD (termed the NMD group) and 134 people without a NMD (termed the control group). The scores for sexual expression were significantly lower in the NMD group. The impact on QoL was significantly higher in the NMD group. The frequency of sexual intercourse, the consistency of engagement in fulfilling sexual activity, and to a lesser extent, the facilitation of sexual expression by healthcare providers, was found to significantly reduce the deleterious impact of NMDs on QoL of the NMD group. The inhibition of sexual expression associated with the negative attitudes of healthcare providers was predicted to significantly increase the deleterious impact of physical impairment on the QoL of the NMD group. Sexual expression may help to diminish the deleterious impact of physical impairment on the QoL of people living with a NMD, and interactions with healthcare providers may moderate the strength of this impact. The clinical implications include healthcare providers being encouraged to facilitate sexual expression in all patients, irrespective of their level of physical impairment. Patients with a NMD are encouraged to understand their psychosexual health rights and to assert those rights when consulting with healthcare providers.
Journal of Intellectual Disability - Diagnosis and Treatment, 2024
Background: This article delves into the complex world of sexual dysfunctions in individuals with intellectual disabilities (ID), a topic that has been relatively underexplored in the realm of psychological research. Intending to shed light on the unique challenges faced by this population, the article meticulously examines the barriers to effective communication, cognitive differences, and the social dynamics that impact both the experiences and treatment outcomes for individuals with ID. Methods: The study utilized a blend of empirical methods, including questionnaires, psychodiagnostic tests, and graphical representations of data, and was conducted among a substantial sample of 1450 individuals with ID in Kyiv, Ukraine. It offers a comprehensive overview of the sexual health landscape within this community. Results: The research findings highlight a notable prevalence of sexual dysfunctions among the ID population, exacerbated by a lack of accessible sexual education, the prevalence of unsafe sexual practices, and a high rate of selfreported sexual abuse. Conclusions: The article emphasizes the importance of a nuanced understanding and approach to sexual health care and education for individuals with ID. It calls for policies, practices, and further research that honor the dignity, autonomy, and sexual rights of individuals with ID, aiming to bridge the current gaps in care and understanding. By doing so, it contributes significantly to the discourse on sexual health in the ID population, offering valuable insights and directions for future work in this vital area of study.
Health and Quality of Life Outcomes, 2015
Background: Despite the fact that the physically disabled have difficulties in many aspects of their lives, including sexuality, society often ignores these needs or assume that they have no such needs. This cross-sectional study therefore seeks to determine the prevalence of sexual dysfunction (SD) and its impact on the quality of life among persons with physical disability residing in the Kumasi metropolis, Ghana.