SUPPORTING SEXUAL FUNCTIONING AND SATISFACTION DURING REHABILITATION AFTER SPINAL CORD INJURY: BARRIERS AND FACILITATORS IDENTIFIED BY HEALTHCARE PROFESSIONALS

Journal of Rehabilitation Medicine, 2022 · DOI: 10.2340/jrm.v54.1413 · Published: July 7, 2022

Spinal Cord Injury Urology Rehabilitation

Simple Explanation

Spinal cord injury can affect sexual functioning and satisfaction. However, support for sex is often overlooked in spinal injury rehabilitation. Healthcare professionals can feel uncomfortable, and lack confidence and training to address this with patients. Programmes are needed that provide education and psychological support for people with spinal cord injury who want to maintain sexual engagement and, critically, this requires improvements in knowledge and skills for the healthcare professionals who are providing spinal cord injury rehabilitation.

Study Duration

Not specified

Participants

16 healthcare professionals (14 females, 2 males)

Evidence Level

Qualitative study

Key Findings

1
Healthcare professionals recognized the importance of sexual functioning/satisfaction, intimacy, and personal relationships as a vital part of a person’s rehabilitation, impacting on overall quality of life.
2
Participants felt there was no need to be an expert in the subject of sexual wellbeing and, that instead, all HCPs should open-up a dialogue with patients
3
All HCPs highlighted the impact of SCI on the partner(s)/spouse in relation to sexual functioning and intimacy. Participants felt that the partner without SCI was often ignored or unrecognized by HCPs

Research Summary

This study aimed to identify the barriers and facilitators to sexual rehabilitation for people with SCI, as perceived by HCPs. The findings demonstrate that the lack of coherent MDTs in which all members were trained and equipped with the knowledge and skills to address sexual wellbeing within SCI rehabilitation, combined with HCP feelings of awkwardness in broaching sexual functioning/satisfaction and broader failure to recognize the importance of the partner, all act as barriers. By contrast, facilitators were thought to be equipping HCPs with further tailored sexual education/training and enhancing conversational approachability by fostering an atmosphere of “permissive discussion”, triggered by sex-focused resources and materials.

Practical Implications

Improved Training Programs

Develop and implement comprehensive training programs for healthcare professionals to enhance their knowledge, skills, and confidence in addressing sexual health with SCI patients.

MDT Collaboration

Promote the creation of well-coordinated multidisciplinary teams where all members are equipped to support sexual wellbeing, ensuring a holistic approach to care.

Resource Development

Create and disseminate sex-focused resources and materials for patients to increase approachability and normalize discussions around sexual functioning and satisfaction.

Study Limitations

1
Facilitators emerged to be more salient than barriers.
2
Participants who took part worked within SCI inpatient and community-based rehabilitation settings across England and, therefore, their experiences may not replicate the experiences of those working in SCI rehabilitation settings elsewhere.
3
Medical consultants’ who were specialist in SCI did not volunteer to participate.

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