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

This is so fucking simple, get survivors 100% recovered. Then you don't have to work on this secondary problem. 

My recreational therapist just said sex was ok to do. Nothing on how to accomplish. Missionary style sex just doesn't work anymore, or the Queens's throne, or the Mare, or the Swing(Look up Kama Sutra). Problems:

1.  Fingers and thumb will not stay flat.
2. Wrist collapses.
3. Elbow collapses.
4. Bicep spasticity pulls everything out of line.

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

Margaret McGrath, Sandra Lever, Annie McCluskey, Emma Power
Faculty of Health Sciences , The University of Sydney, 2141 Sydney, Australia: E-mail: margaret.mcgrath@sydney.edu.au

DOI: 10.2340/16501977-2548

Abstract

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.

Lay 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.

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