How is sexuality after stroke experienced by stroke survivors and partners of stroke survivors? A systematic review of qualitative studies

McGrath, Margaret; Lever, Susan Z.; McCluskey, Annie; Power, Emma

doi:10.1177/0269215518793483

Cited by 49 publications

(64 citation statements)

References 51 publications

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“…In a qualitative study Martinsen et al (26) have shown the vulnerable situation for persons with stroke, in particular singles. In light of the present results, and in accordance with McGrath et al (15), it seems important to include spouses when addressing post-stroke recovery, as the spouses are at risk of a life in an unsatisfying partner relationship.…”

Section: Discussionsupporting

confidence: 89%

“…Negative changes in family roles and partner roles are commonly reported both among those who have had a stroke and their spouses (12,15,(25)(26)(27)(28)(29)(30) and can be an important explanation for the low levels of satisfaction with "Family life" and "Partner relationship" 6 years after stroke. Unwanted role changes within a partner relationship, e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Unwanted role changes within a partner relationship, e.g. going from being a partner to being a care-giver (3,12,15,25,29) may create ambivalence, or avoidance of a mutual sexual life. Thus, not surprisingly "Sexual life" was reported as the least satisfying in all 3 groups of participants.…”

Section: Discussionmentioning

confidence: 99%

“…However, in a prospective study, Wise et al (14) found marital status to be the strongest predictor of social integration following mild stroke, thus leaving the single person more vulnerable. Furthermore, in a review study McGrath et al (15) have stressed the importance of including singles in future studies.…”

mentioning

confidence: 99%

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Closeness and life satisfaction after six years for persons with stroke and spouses

Fugl-Meyer

Nilsson²,

Koch³

et al. 2019

J Rehabil Med

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The aim of this study was to explore long-term experiences of satisfaction with life in persons with stroke and spouses. Data were collected 1 and 6 years after stroke; focusing on "Life as a whole" and the domain "Closeness" ("Family life", "Partner relationship", "Sexual life"). A total of 72 persons with stroke (24 singles, 48 married) and 24 spouses participated. Most of the stroke participants were men. All groups (singles/married stroke participants, spouses) experienced changes in satisfaction regarding "Closeness" and most of these perceived as negative. "Sexual life" had the lowest proportion of satisfied participants. After 6 years, 58% of singles, 78% of married stroke participants and 41% of spouses were satisfied with "Life as a whole". In conclusion, for the majority of people with stroke and their spouses, long-term satisfaction with aspects of "Closeness" declines. The results suggest a need to develop, evaluate and implement programmes that support satisfaction with the different aspects of "Closeness". Objective: To explore long-term experiences of satisfaction with life in persons with stroke and spouses. Design: This prospective cohort-study collected data on life satisfaction 1 and 6 years after stroke using the Life Satisfaction Checklist; focusing on "Life as a whole" and the domain "Closeness" ("Family life", "Partner relationship", "Sexual life"). Open-ended questions were added to illustrate changes in daily life. Subjects: A total of 72 stroke participants (24 singles, 48 married) and 24 spouses. Most of the stroke participants were men with a mild stroke. Median age for persons with stroke and spouses was 65 years. Results: All groups (singles/married stroke participants, spouses) experienced changes in satisfaction regarding "Closeness", and most often these changes were perceived as negative. The item "Sexual life" had the lowest proportion of satisfied participants. After 6 years, 58% of singles and 78% of married stroke participants were satisfied with "Life as a whole". The proportion of satisfied spouses was 41%. Conclusion: For the vast majority of people who have had a stroke and their spouses, long-term satisfaction with aspects of "Closeness" decline. The results suggest a need to develop, evaluate and implement programmes that support satisfaction with the different aspects of "Closeness".

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Closeness and life satisfaction after six years for persons with stroke and spouses

Fugl-Meyer

Nilsson²,

Koch³

et al. 2019

J Rehabil Med

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“…S troke has a profound impact on the ways in which sexuality is experienced and expressed by stroke survivors and their partners. A recent thematic synthesis found that, while sexuality is largely silenced by stroke, it nonetheless remains important to stroke survivors and their partners (1). International clinical guidelines for stroke rehabilitation propose that sexuality should be included as a core component of comprehensive rehabilitation (2)(3)(4).…”

mentioning

confidence: 99%

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

McGrath¹,

Lever²,

McCluskey³

et al. 2019

J Rehabil Med

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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.

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Sexual Function and Quality of Life in Individuals Post Stroke

Schneider,

Comley‐White

2024

Physiotherapy Res Intl

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BackgroundSexual function is commonly affected post stroke and impacts an individual's quality of life. This study aimed to determine the factors associated with sexual function in an individual post stroke and the association with quality of life.MethodThis cross‐sectional study included 56 participants who had a stroke between three and 24 months prior. The participants were assessed for: level of disability with the Modified Rankin Scale (MRS); quality of life with the Stroke Specific Quality of Life scale (SSQOL); and sexual function with the Changes in Sexual Functioning Questionnaire (CSFQ‐14), and an open‐ended questionnaire was administered.ResultsThe average age of the participants was 51.32 (SD = ±13.24) years, with 32 (57.1%) males and 24 (42.9%) females. According to the CSFQ‐14, the majority of the study participants (n = 35, 62.5%) had sexual dysfunction after their stroke. The factors associated with sexual dysfunction post stroke included age, disability, comorbidities, psychosocial factors such as self‐esteem, role changes, and depression. Those with sexual dysfunction were found to have a lower mean SSQOL score (139.94 ± 33.89) than those without sexual dysfunction (149.76 ± 33.77), however, there was no significant difference (p = 0.298) between the groups. Majority of the participants (n = 37; 66.1%) did not know that healthcare professionals can assist with sexual dysfunction.ConclusionThe majority of participants experienced sexual dysfunction after their stroke. Factors such as pain, difficulty with positioning, self‐esteem issues, lack of motivation, and change in desire, are important considerations for the multidisciplinary team in the rehabilitation of a patient's sexual function post stroke.Trial RegistrationThis cross‐sectional study did not require study registration.

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How is sexuality after stroke experienced by stroke survivors and partners of stroke survivors? A systematic review of qualitative studies

Cited by 49 publications

References 51 publications

Closeness and life satisfaction after six years for persons with stroke and spouses

Closeness and life satisfaction after six years for persons with stroke and spouses

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

Sexual Function and Quality of Life in Individuals Post Stroke

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