Sexuality Re-education Program Logic Model for People with Traumatic Brain Injury (TBI): Synthesis via Scoping Literature Review

Khajeei, Dahlia; Smith, Donna; Kachur, Brittany; Abdul, Najwa

doi:10.1007/s11195-018-09556-1

Cited by 6 publications

(4 citation statements)

References 75 publications

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“…Despite sexuality resources having been available for decades, participants expressed a lack of knowledge of post-TBI sexuality issues, and existing management approaches, resources, and external referral pathways. A resource that is often highlighted as a possible model to assess sexuality in brain injury rehabilitation is the Permission, Limited information, Specific suggestions, and Intensive therapy (PLISSIT) sexual counselling model by Annon (1976) (Khajeei et al 2019;Marier Deschênes et al 2019;Auger et al 2020). There is also the 'You and Me' program by Simpson (1999), a 15-module education program designed for staff to educate clients and families on sex and sexuality after a TBI.…”

Section: Discussionmentioning

confidence: 99%

Co-designing for behavioural change: understanding barriers and enablers to addressing sexuality after traumatic brain injury and mapping intervention strategies in a multi-disciplinary rehabilitation unit

Hwang,

Downing,

Specht

et al. 2024

Brain I.

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Background Persistent changes in sexuality often follow traumatic brain injury (TBI). However, health professionals remain reticent about discussing sexuality and have reported barriers including uncertainties around whose role it is and limited educational and institutional support. This study employed a co-design and implementation process, aiming to promote team-wide behavioural change, whereby health professionals at a TBI rehabilitation unit would attempt to address sexuality with patients routinely. Methods Focus group sessions with multidisciplinary health professionals were conducted to identify barriers and enablers to behavioural change, identify areas for development, and co-design intervention options. Implementation deliverables were then finalised and provided to the team. The Theoretical Domains Framework was used to map factors influencing behaviours and the Behaviour Change Wheel was used to map interventions. Thematic analysis was used to further analyse barrier themes. Results Thirty-five barriers and eight enablers falling within 12 theoretical domains to behavioural change were identified. Thematic analysis revealed highly correlated barriers in initiating and sustaining change. Nine co-designed intervention options aligned with five intervention functions of the Behaviour Change Wheel, resulting in six final implementation deliverables. Conclusions Barriers were highly interrelated, influencing the approach to implementation deliverables. Simultaneously addressing multiple barriers could potentially alleviate discomfort associated with discussing sexuality. Concerns around initiating change were related to confidence in achieving sustainable changes. Achieving change requires organisational and team-level environmental restructuring and enablement. The next step involves evaluating the effectiveness of the co-design and implementation process in driving behavioural change and potential impacts on patient satisfaction and sexuality outcomes.

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Section: Discussionmentioning

confidence: 99%

Co-designing for behavioural change: understanding barriers and enablers to addressing sexuality after traumatic brain injury and mapping intervention strategies in a multi-disciplinary rehabilitation unit

Hwang,

Downing,

Specht

et al. 2024

Brain I.

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“…Some researchers have suggested methods for professionals to address sexuality matters in rehabilitation after ABI. According to Khajeei et al's [32] scoping review on sexual reeducation after TBI, such rehabilitation programs should involve, for example, knowledge about bodily functions and vocabulary regarding sexuality. In addition, sexual rehabilitation should include themes such as sexuality after disability, sexual identity, relationships, coping, and training in social skills and communication [32].…”

Section: Assessing Sexuality At Rehabilitationmentioning

confidence: 99%

“…According to Khajeei et al's [32] scoping review on sexual reeducation after TBI, such rehabilitation programs should involve, for example, knowledge about bodily functions and vocabulary regarding sexuality. In addition, sexual rehabilitation should include themes such as sexuality after disability, sexual identity, relationships, coping, and training in social skills and communication [32]. In a review of articles and programs concerning sexuality and relationships programs after ABI, it was found that ABI survivors and relatives were generally positive to sexual rehabilitation, but there was a lack of LGBTQIA + 1 perspectives [1].…”

Section: Assessing Sexuality At Rehabilitationmentioning

confidence: 99%

Unmet Need for Sexual Rehabilitation after Acquired Brain Injury (ABI): A Cross-Sectional Study Concerning Sexual Activity, Sexual Relationships, and Sexual Rehabilitation after ABI

Holmström

Elmerstig

2023

Sex Disabil

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In relation to brain injury rehabilitation, research has stressed the importance of including sexuality issues due to increased risk for sexual dysfunctions after Acquired Brain Injury (ABI). This study aims to explore experiences after non-stroke ABI concerning individual and relational aspects of sexuality, received information about sexuality at rehabilitation, and gender differences. A postal nationwide survey was conducted in Sweden, 2018–2019. The sample included individuals who had participated in brain injury rehabilitation 2014–2016, response rate 40% (250/624). Among all participants 78% had resumed sexual activity, and there was a significant difference between males (84%, 118/140) and females (69%, 76/110, p = 0.004). Among all participants, 95% reported physical intimacy as important, 80% considered sex as important on an individual level, and 91% stated sexuality as important for the relationship (no gender differences). Significantly more females (52%) than males (22%) reported that they had tried sexual aids (p = 0.000), and more males (29%) than females (16%) reported that professionals addressed sexuality issues during brain injury rehabilitation (p = 0.024). However, only a few participants were offered specific sexual counseling during brain injury rehabilitation, such as individual counseling (3%), couples counseling (2%), and group counseling (3%). To conclude, the vast majority valued both individual and relational aspects of sex and sexuality highly, and more males than females had resumed sexual activity. Few had received information about sexuality after ABI, and even fewer females compared to males reported that the issue was raised during rehabilitation. Clinical implications are discussed in relation to sexual rehabilitation.

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“…Taylor and Davis [ 31 ] later published the extended PLISSIT (Ex-PLISSIT) model which proposes that all levels begin with explicit giving of permission. In previous TBI sexuality research, more emphasis has been placed on addressing the first two levels through the development and evaluation of handouts, booklets, and information resources [ 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. As a result, there is little information on interventions for persistent and complex post-TBI sexuality problems at the Specific Suggestions and Intensive Therapy levels.…”

Section: Introductionmentioning

confidence: 99%

Evaluating a Novel Treatment Adapting a Cognitive Behaviour Therapy Approach for Sexuality Problems after Traumatic Brain Injury: A Single Case Design with Nonconcurrent Multiple Baselines

Fraser

Downing

Haines

et al. 2022

JCM

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There has been little progress in development of evidence-based interventions to improve sexuality outcomes for individuals with traumatic brain injury (TBI). This study aimed to evaluate the preliminary efficacy of an individualised intervention using a cognitive behaviour therapy (CBT) framework to treat sexuality problems after TBI. A nonconcurrent multiple baseline single-case design with 8-week follow-up and randomisation to multiple baseline lengths (3, 4, or 6 weeks) was repeated across nine participants (five female) with complicated mild–severe TBI (mean age = 46.44 years (SD = 12.67), mean post-traumatic amnesia = 29.14 days (SD = 29.76), mean time post-injury = 6.56 years (median = 2.50 years, SD = 10.11)). Treatment comprised eight weekly, individual sessions, combining behavioural, cognitive, and educational strategies to address diverse sexuality problems. Clinical psychologists adopted a flexible, patient-centred, and goal-orientated approach whilst following a treatment guide and accommodating TBI-related impairments. Target behaviour was subjective ratings of satisfaction with sexuality, measured three times weekly. Secondary outcomes included measures of sexuality, mood, self-esteem, and participation. Goal attainment scaling (GAS) was used to measure personally meaningful goals. Preliminary support was shown for intervention effectiveness, with most cases demonstrating sustained improvements in subjective sexuality satisfaction and GAS goal attainment. Based on the current findings, larger clinical trials are warranted.

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Sexuality Re-education Program Logic Model for People with Traumatic Brain Injury (TBI): Synthesis via Scoping Literature Review

Cited by 6 publications

References 75 publications

Co-designing for behavioural change: understanding barriers and enablers to addressing sexuality after traumatic brain injury and mapping intervention strategies in a multi-disciplinary rehabilitation unit

Co-designing for behavioural change: understanding barriers and enablers to addressing sexuality after traumatic brain injury and mapping intervention strategies in a multi-disciplinary rehabilitation unit

Unmet Need for Sexual Rehabilitation after Acquired Brain Injury (ABI): A Cross-Sectional Study Concerning Sexual Activity, Sexual Relationships, and Sexual Rehabilitation after ABI

Evaluating a Novel Treatment Adapting a Cognitive Behaviour Therapy Approach for Sexuality Problems after Traumatic Brain Injury: A Single Case Design with Nonconcurrent Multiple Baselines

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