Developing interventions to address sexuality after stroke: Findings from a four-panel modified Delphi study

Abstract

Although stroke often impacts on sexuality there are very limited programmes to provide sexual rehabilitation for stroke survivors or their partners. We asked stroke survivors, partners of stroke survivors, rehabilitation professionals and clinicians to identify what should be included in a sexual rehabilitation programme for stroke survivors, when this programme should be offered, what professionals should be involved in delivering the programme, and how they should provide the programme. The participants completed 2 online surveys and prioritized 18 core topics to be included in sexual rehabilitation following stroke. There was strong consensus among participants that sexual rehabilitation should be offered in person once the stroke survivor was medically stabilized and throughout rehabilitation. These results will be used to design an intervention to address sexuality after stroke. Background: Although stroke has a profound impact on sexuality there are limited evidence-based interventions to support rehabilitation professionals in this area. The aim of the current research was to prioritize content areas and approaches to sexual rehabilitation from the perspective of stroke survivors, their partners, stroke rehabilitation clinicians and researchers. Methods: A 2-step online Delphi method was used to prioritize the content of, and approaches to, sexual rehabilitation with stroke survivors, their partners, stroke rehabilitation clinicians and researchers. Results: Stroke survivors (n = 30), their partners (n = 18), clinicians and researchers in stroke rehabilitation (n = 45) completed at least 1 of 2 investigator-developed surveys. Participants prioritized 18 core content areas for inclusion in sexual rehabilitation following stroke with a high degree of consensus. Another 27 content areas were considered moderately important. There was strong consensus that sexual rehabilitation should be offered in the subacute and chronic phases of stroke recovery. Participants would prefer health professionals to deliver the intervention face-to-face. Conclusion: This study presents opinions from stroke survivors, partners of stroke survivors, clinicians and researchers. The information about content, timing and mode of delivery will be used to develop and evaluate a comprehensive sexuality rehabilitation programme.

Priorities and Needs Regarding Sexual Rehabilitation for Individuals in the Subacute Phase Post-stroke

“…support needs for hygiene or dressing). The Canadian Stroke Best Practice Recommendations suggest that sexuality be part of rehabilitation [5], especially in the subacute and chronic phases of recovery [6]. Considering the taboo related to sexuality [7], clinicians should initiate a conversation with stroke clients instead of waiting for them to raise the issue .…”

“…written), few data were collected concerning the type of information that the clients sought. To our knowledge, only a study by McGrath and collaborators [6] has addressed this issue. Using a Delphi method, they interviewed persons who had sustained a stroke (n = 30), their partners (n = 18), and clinicians and researchers in stroke rehabilitation (n = 45) to prioritize core concepts to be considered in sexual counseling in stroke rehabilitation.…”

Identifying sub-acute rehabilitation needs among individuals after transient ischaemic attack using rehab-compass as a simple screening tool in the outpatient clinic

“…Half of the participants in this study reported a high degree of problems with their sexual life. This problem has not been addressed previously among patients with TIA, although it is well-known among stroke survivors (30) with sexual rehabilitation needs (31). A cautious conclusion from the current study, due to limited sample size, is that this area needs further research and the problems should be addressed at follow-up with proper treatment and rehabilitation.…”

A Pilot Study of the Psychosocial Impact of Low-Cost Assistive Technology for Sexual Functioning in People with Acquired Brain Injury

“…The PIADS can be a useful tool for evaluating this type of AT, but more exhaustive research is needed to inform clinicians of the best intervention strategies for use with this group [53], as well as ways of continuing these interventions in outpatient settings [71] using AT among other measures.…”

“…Other authors such as McCluskey [52] show that one of the barriers to intervention in this group's sexual functioning is the lack of existing knowledge on the subject. There is no scientific evidence to justify the best intervention strategies for sexual functioning [53] or the use of AT among this group, although AT such as splints [54] is commonly used for mobility [13], including upper limb mobility [55]. However, no previous studies have used AT for sexual functioning as an intervention strategy.…”