Background
Although people who sustain a stroke can experience sexual difficulties, few address them during rehabilitation.
Objectives
Explore
the feasibility of implementing a Sexuality Interview Guide (SIG) in
stroke rehabilitation and describe the factors perceived as influencing
its implementation.
Materials and Methods
Using
a mixed research design, the SIG was implemented for four months in a
rehabilitation hospital. The frequency with which clinicians addressed
sexuality and their level of comfort pre-post implementation was
measured. Perceived factors influencing implementation were determined
through individual interviews and focus groups with five stroke clients,
15 clinicians and a coordinator. A paired-specimen Wilcoxon test was
used to explore differences in pre- post-level of comfort. Qualitative
data was analyzed by two independent evaluators using thematic analysis.
Results
The SIG was used 28 times and clinicians' level of comfort in addressing sexuality improved significantly (p = 0.001).
The factors perceived as influencing implementation were: the
acceptability of the SIG, the individual characteristics, the context of
the rehabilitation hospital and the implementation process.
Conclusion
This
study showed that the SIG can be used in stroke rehabilitation and
that, with sufficient financial and human resources, and training for
clinicians, it would be feasible to implement it in usual care.
Implications for rehabilitation
-
The
Sexuality Interview Guide (SIG) can be used in stroke rehabilitation
and helps clinicians to target stroke clients who want to include
sexuality in their rehabilitation.
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The best time to approach sexuality using the SIG, according to all participants, was in outpatient rehabilitation.
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For inpatient clients, it was more appropriate to use the SIG as they approach a weekend home trial or rehabilitation discharge.
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Training
for clinicians working in post-stroke sexual rehabilitation,
administrative policies and procedures and access to a sexual health
specialist for consultation or referral purpose, would be important
facilitators in integrating sexuality into clinical practices.
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