Supporting sexuality after spinal cord injury: a scoping review of non-medical approaches

Bryant, Chloe; Gustafsson, Louise; Aplin, Tammy; Setchell, Jenny

doi:10.1080/09638288.2021.1937339

Cited by 12 publications

(33 citation statements)

References 52 publications

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“…Physiological and psychosocial changes after SCI can significantly impact sexuality and sexual function ( 52 , 53 ). Sexual function recovery was consistently rated as the least important among the 7 priority areas in all the 3 groups (tetraplegics, paraplegics, and caregivers) of participants in our study.…”

Section: Discussionmentioning

confidence: 99%

Functional recovery priorities and community rehabilitation service preferences of spinal cord injury individuals and caregivers of Chinese ethnicity and cultural background

Koljonen

Yip

Su³

et al. 2022

Front. Neurol.

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IntroductionSpinal cord injury (SCI) causes significant and permanent disability affecting motor, sensory and autonomic functions. We conducted a survey on the priorities of functional recovery and preferences for community rehabilitation services in a cohort of Chinese individuals with SCI as well as the primary caregivers. The study also investigated their views on advanced technology and research.MethodsAn online platform with a self-administered questionnaire was used to collect the opinions of clients that received services from an SCI follow-up clinic, a self-help association, or a non-government organization from 1 September−31 December 2021.ResultsEighty-seven subjects (74 individuals with SCI−48 tetraplegic, 26 paraplegic, and 13 caregivers) responded to the survey. Recovery of arm/hand function was given the highest priority among tetraplegics, followed by upper trunk/body strength and balance, and bladder/bowel function. Sexual function had a significant lower ranking than all priority areas except normal sensation (p < 0.05). Paraplegics viewed bladder/bowel function as the most important area of functional recovery, followed by walking movement, upper trunk/body strength and balance, elimination of chronic pain, and regaining normal sensation. There was no statistically significant difference among the top priority areas (p > 0.05). In contrast to previous studies done in Western populations, the study revealed that sexual function was ranked as the lowest by all 3 groups of respondents (tetraplegics, paraplegics, and caregivers). The majority of participants thought community rehabilitation services were inadequate. Most of the respondents were interested to try advanced technology which would facilitate their daily life and rehabilitation. About half of the individuals with SCI thought advance in technology and research could bring significant improvement in their quality of life in the coming 10 years.ConclusionThis survey is the first study specifically looking into the recovery and rehabilitation priorities of a Chinese population of individuals with SCI. This is also the first study to investigate the priorities of the primary caregivers of SCI individuals. The findings are useful as a reference for planning of future research and provision of rehabilitation services for the SCI community locally and in other parts of China.

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Section: Discussionmentioning

confidence: 99%

Functional recovery priorities and community rehabilitation service preferences of spinal cord injury individuals and caregivers of Chinese ethnicity and cultural background

Koljonen

Yip

Su³

et al. 2022

Front. Neurol.

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“…Support for sexuality has previously largely focused on highly medicalized areas of sexuality, such as prescribing Viagra to achieve erections [ 1 ]. This study’s findings support this as the most frequently provided interventions were for medical treatments by doctors.…”

Section: Discussionmentioning

confidence: 99%

“…Although research points to the value of using of a range of sexuality interventions as part of a comprehensive approach [ 1 ], in the Australian context, it was found that few interventions are routinely provided in practice. Our findings also indicate, as depicted in Table 4 , that some management strategies, such as ‘peer support sessions’ (15%) were less utilized than others, for example, sexual education (74%).…”

Section: Discussionmentioning

confidence: 99%

“…There is increasing attention in healthcare research on sexuality after spinal cord injury (SCI) [ 1 ]. However, sex-related topics are often avoided in healthcare, particularly in the context of disability and as such, are often neglected by healthcare professionals (HCP) [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, sex-related topics are often avoided in healthcare, particularly in the context of disability and as such, are often neglected by healthcare professionals (HCP) [ 2 ]. Sexuality support has traditionally been outcome-oriented and medically driven, with a focus on fertility, erections, and/or ejaculation [ 1 , 3 ]. Qualitative research, however, points to the need for a broader focus, with people with SCI reporting that HCP undervalue the importance and scope of sexuality, and that the resources they receive are provided are outdated and/or limited [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Sexuality Support After Spinal Cord Injury: What is Provided in Australian Practice Settings?

2022

Self Cite

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This study sought to understand what sexuality support Australian health professionals currently provide to people with spinal cord injury (SCI) and their perspectives on what changes may better support the sexuality needs of people with SCI. Australian Health professionals who had worked with people with SCI within the last 10 years were invited to participate in an online survey. Results were analyzed using content analysis and descriptive statistics. The 39 participants were from a range of health professions including medical, allied health, nursing, and peer support. Participants worked in various service settings, with the highest frequency in the community (33%) or inpatient rehabilitation (28%). Analysis indicated 85% of participants had provided sexuality support, however this provision was rarely routine. Discussing sexuality education topics were reported to be routinely provided for less than 16% of participants. Overall, 32% of participants felt sexuality was addressed ‘not well at all’ in their workplace. Qualitative analysis of open-ended responses produced five themes: barriers to supporting sexuality, health professionals require training, utilizing a team approach, responsibility to initiate conversation, and involving others in support. Barriers to provision included stigma and lack of education. Commonly suggested strategies to improve practice included: increasing sexuality training, utilizing a team approach, initiating the conversation of sexuality early, and consensual inclusion of significant others in sexuality support. The results therefore indicate sexuality support is not routinely provided to people with SCI and findings suggest a need for sexuality training, utilizing a team approach, initiating the conversation, and including significant others.

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“It’s Not, Can You Do This? It’s… How Do You Feel About Doing This?” A Critical Discourse Analysis of Sexuality Support After Spinal Cord Injury

Bryant,

Aplin,

Piantedosi

et al. 2024

Sex Disabil

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Previous research has indicated that healthcare support for sexuality after spinal cord injury appears to be neglected or inadequately provided. The perspectives of people living with spinal cord injuries regarding what is lacking and what support they would like to be provided, and why, has yet to be explored. This paper uses critical theory to explore how societal constructs of sexuality and disability shape how sexuality is supported after a spinal cord injury. To do this, we conducted in-depth semi-structured interviews with 11 people with a spinal cord injury from Australia, the United Kingdom, and the United States. We drew from the works of various critical disability theorists to analyze what discourses underpinned the experiences people with spinal cord injuries had when receiving sexuality support. Analysis suggested that the following discourses were apparent: (1) broken bodies require repair, (2) sex is penetration, ejaculation then reproduction, and (3) sexual autonomy is required. Findings indicated healthcare professionals need to recognize people with spinal cord injuries as sexual beings with a diverse range of desires, lives, relations, and bodies. Provision of individualized comprehensive high-quality sexuality support is therefore warranted. To achieve this, healthcare professionals should aim to be aware of, and mitigate, ableist and normative assumptions.

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Supporting sexuality after spinal cord injury: a scoping review of non-medical approaches

Cited by 12 publications

References 52 publications

Functional recovery priorities and community rehabilitation service preferences of spinal cord injury individuals and caregivers of Chinese ethnicity and cultural background

Functional recovery priorities and community rehabilitation service preferences of spinal cord injury individuals and caregivers of Chinese ethnicity and cultural background

Sexuality Support After Spinal Cord Injury: What is Provided in Australian Practice Settings?

“It’s Not, Can You Do This? It’s… How Do You Feel About Doing This?” A Critical Discourse Analysis of Sexuality Support After Spinal Cord Injury

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