Addressing Sexuality as Standard Care in People with an Upper Limb Deficiency: Taboo or Necessary Topic?

Abstract

The purpose of this paper is to analyze whether professionals who work with people with an upper limb deficiency (ULD) received questions about sexuality from their patients and whether they addressed sexuality themselves, and to analyze their knowledge and comfort level, approach and attitudes towards sexuality. An online questionnaire, including questions on self-perceived sexological competence and the Knowledge, Comfort, Approach and Attitudes towards Sexuality Scale (KCAASS) was used to asses these aspects. One out of three professionals had received a question about sexuality from their patients. Nearly one out of five professionals had addressed sexuality themselves. Professionals who received a question about sexuality from patients or addressed this issue themselves had significantly higher scores on self-perceived knowledge about sexuality and on self-perceived conversation skills compared to professionals who did not. The scores on the KCAASS Knowledge and Comfort of professionals who received a question about sexuality or addressed the issue of sexuality were significantly higher than those of professionals who did not. Sexuality is thus only scantly discussed by professionals working with patients with an ULD. Professionals indicated they do not feel confident nor comfortable enough to address this issue. They also experience a lack of appropriate knowledge to address sexuality with patients. Professionals reported a need for courses and training on both knowledge and conversation skills concerning sexuality. In addition, a 123Sex Disabil (2013) 31:167-177 DOI 10.1007 protocol and necessary facilities need to be provided for the team working with people with an ULD in order to be able to address sexuality systematically.

People with lower limb amputation and their sexual functioning and sexual well-being

“…However, most participants indicated that sexuality was not discussed with them at all during the rehabilitation process, let alone with the partners. This was also in line with what was found in other studies [12,[36][37][38]. Nonetheless, most participants would have liked more information about sexuality and amputation.…”

The Pelvic Health Curricular Exposure Scale (PHCES): A Survey of Physical Therapy Students’ Comfort Discussing Sexual Health

“…Sex is a topic that is both taboo and critical to one's self-identity. [1][2][3][4][5][6][7][8] Discussing sexual issues in a health care setting may seem like a profound idea, yet is a common desire vocalized by an abundance of patient populations seeking to improve all aspects of their health. [9][10][11] While a variety of factors contribute to the presence of sexual dysfunction, chronic disease is a frequent component.…”

“…11,13,14,16 Many studies emphasize the importance of discussing patients' sexual health concerns, with benefits ranging from improved mental and physical health, improved quality of life, and relationship success. [1][2][3][4][5][6][7][8] Physical therapists are one of many health care providers who must be capable of actively engaging with every system of the body in clinical practice. Thus, sexual dysfunction may be a common complaint among the patients with whom physical therapists will interact.…”

“…20 Although rehabilitation providers are well equipped to treat neuromuscular impairments and associated functional mobility deficits of these patients, they often report difficulty engaging in conversation about sexuality with patients despite its close connection to overall well-being. [1][2][3][4][5][6][7][8]21 Despite the fact that health care professionals must engage in discussion about sexual health with patients to provide holistic care, studies suggest that providers are not comfortable with this skill. 3,[22][23][24][25][26] A variety of provider-related reasons why sexual health goes unaddressed, including embarrassment, lack of training, lack of experience, time constraints, differences in gender or sexual orientation, issues related to culture and religion, perception that it is someone else's responsibility, and fear of offending the patient, are identified in the literature.…”

“…Sex is a topic that is both taboo and critical to one’s self-identity 1–8. Discussing sexual issues in a health care setting may seem like a profound idea, yet is a common desire vocalized by an abundance of patient populations seeking to improve all aspects of their health 9–11.…”