Addressing the elephant in the room: integrating sexual health practice in spinal cord injury rehabilitation

Giurleo, Charlie; McIntyre, Amanda; Kras‐Dupuis, Anna; Wolfe, Dalton

doi:10.1080/09638288.2020.1856949

Cited by 8 publications

(6 citation statements)

References 23 publications

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“…Using materials developed at other sites expedited changes. 25 Comprehensive team composition (persons with SCI/D, nursing, physicians, pharmacy) provided multiple perspectives to contribute to consensus building, understanding root causes, and maximizing engagement on an issue with diverse baseline practices. Documentation differed across SCI/D units and did not always reflect the comprehensive care being provided.…”

Section: Resultsmentioning

confidence: 99%

“… 10 As networks provide a platform for idea and resource sharing, QICs may augment the cost-effectiveness of implementation initiatives by reducing individual sites’ development burden; for instance, SCI IEQCC sites with robust resources on sexual health shared their expertise as well as staff training and patient-level resources with other sites. 25 Nonetheless, most of the initial six key domains addressed by this QIC are unlikely to yield cost savings adequate to support self-sufficiency at this early stage of implementation. Robust implementation of best practices in additional domains, including patient safety domains and those prioritized for later implementation efforts, may offer opportunities for cost-savings that lead towards self-sufficiency, even though this was not a criterion for their selection.…”

Section: Discussionmentioning

confidence: 99%

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Improving practice through collaboration: Early experiences from the multi-site Spinal Cord Injury Implementation and Evaluation Quality Care Consortium

Bateman

Sreenivasan

Farahani

et al. 2021

The Journal of Spinal Cord Medicine

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Context Dedicated implementation efforts are critical to bridging the gaps between current practices and best practices. A quality improvement collaborative (QIC), the Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI IEQCC), was established to meet this need, bringing together a network of clinicians and administrators to systematically improve the quality and equity of tertiary spinal cord injury or disease (SCI/D) rehabilitation care in Ontario, Canada. Methods Clinicians and leaders from five tertiary SCI/D rehabilitation centers and two not-for-profit SCI/D advocacy groups comprised a network dedicated to supporting implementation of the SCI-High quality indicators in prioritized domains of SCI rehabilitation and related best practices by: (1) building capacity through implementation science education of frontline clinicians; (2) providing resources and support to empower frontline clinicians to lead quality improvement efforts within their institutions; (3) promoting wider learning through a network for sharing ideas, efforts, and experiences; and (4) collecting indicator data to facilitate provincial evaluation of goal attainment. Results Network members and sites collaborated to implement best practices within six priority domains; in 18 months, significant progress has been made in emotional wellbeing, sexual health, walking, and wheeled mobility despite disruptions due to the COVID-19 pandemic. These efforts encompass heterogeneous challenges and strategies, ranging from developing clinical skills programs, to streamlining processes, to manipulating physical space. Conclusion A QIC targeting SCI/D rehabilitation demonstrates promise for advancing the implementation of best practices, building implementation science capacity across multiple sites, and for promoting collaboration amongst SCI/D rehabilitation centers and organizational partners.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Improving practice through collaboration: Early experiences from the multi-site Spinal Cord Injury Implementation and Evaluation Quality Care Consortium

Bateman

Sreenivasan

Farahani

et al. 2021

The Journal of Spinal Cord Medicine

Self Cite

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“…Pregnancy is still possible for female patients with SCI, but they may face specific complications during pregnancy, including autonomic dysreflexia [ 22 ]. It is important to highlight that there is growing evidence of an inadequate level of sexual counseling and rehabilitative programs for patients with SCI, despite the crucial importance of sexual function for the patient’s and partner’s health and quality of life [ 23 , 24 ].…”

Section: Genitourinary and Gastroenteric Impairments And Priority Of ...mentioning

confidence: 99%

Prediction of Lower Urinary Tract, Sexual, and Bowel Function, and Autonomic Dysreflexia after Spinal Cord Injury

Pavese

Kessler

2023

Biomedicines

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Spinal cord injury (SCI) produces damage to the somatic and autonomic pathways that regulate lower urinary tract, sexual, and bowel function, and increases the risk of autonomic dysreflexia. The recovery of these functions has a high impact on health, functioning, and quality of life and is set as the utmost priority by patients. The application of reliable models to predict lower urinary tract, sexual, and bowel function, and autonomic dysreflexia is important for guiding counseling, rehabilitation, and social reintegration. Moreover, a reliable prediction is essential for designing future clinical trials to optimize patients’ allocation to different treatment groups. To date, reliable and simple algorithms are available to predict lower urinary tract and bowel outcomes after traumatic and ischemic SCI. Previous studies identified a few risk factors to develop autonomic dysreflexia, albeit a model for prediction still lacks. On the other hand, there is an urgent need for a model to predict the evolution of sexual function. The aim of this review is to examine the available knowledge and models for the prediction of lower urinary tract, sexual, and bowel function, and autonomic dysreflexia after SCI, and critically discuss the research priorities in these fields.

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“…Sexual health can be negatively impacted by a spinal cord injury and research has shown that improving sexual functioning can improve the quality of life of people living with SCI [ 76 – 79 ]. There are many ways sexual dysfunction and fertility issues can be successfully managed so we recommend that at a minimum, annual assessments should occur.…”

Section: Introductionmentioning

confidence: 99%

Primary Care in the Spinal Cord Injury Population: Things to Consider in the Ongoing Discussion

Gibson-Gill

Mingo

2023

Curr Phys Med Rehabil Rep

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Purpose of Review Spinal cord injury (SCI) creates unique needs that if not recognized and addressed timely can have detrimental effects on the health and quality of life (QOL) of people living with a SCI. Primary preventive health care is shown to decrease morbidity and mortality, yet the SCI population reportedly faces challenges getting access to this care. This area in SCI health care is still largely understudied with no consensus on the ideal way or which health care provider is best to provide primary care for this population. Findings Preventive care is generally provided by general primary care providers, but not all primary care providers are trained in recognizing and addressing spinal cord injury-specific needs. SCI providers generally are not trained in addressing all aspects of preventive care. Knowing the recommended preventive care screenings, recognizing and managing specific conditions seen after a SCI, and seamless coordination of care between general practitioners and SCI specialists are some of the interventions to help prevent health complications, decrease morbidity and mortality, improve health outcomes, and promote QOL in this patient population. Summary Prioritized focus on preventive care is necessary for a positive impact on the overall health and QOL in this population. Addressing the knowledge gap reported by primary care providers and SCI providers may help increase the probability of SCI patients getting their preventive and specialty care needs addressed. We present a “cheat sheet” of recommendations for the preventive care evaluation of a person living with a SCI.

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Addressing the elephant in the room: integrating sexual health practice in spinal cord injury rehabilitation

Cited by 8 publications

References 23 publications

Improving practice through collaboration: Early experiences from the multi-site Spinal Cord Injury Implementation and Evaluation Quality Care Consortium

Improving practice through collaboration: Early experiences from the multi-site Spinal Cord Injury Implementation and Evaluation Quality Care Consortium

Prediction of Lower Urinary Tract, Sexual, and Bowel Function, and Autonomic Dysreflexia after Spinal Cord Injury

Primary Care in the Spinal Cord Injury Population: Things to Consider in the Ongoing Discussion

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