Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
Top Stroke Rehabil. 2010 May-Jun;17(3):204-13. doi: 10.1310/tsr1703-204.
To study the perspectives and experiences of stroke survivors and partners of stroke survivors regarding sexual issues and perceived rehabilitation needs.
Using semi-structured interviews, 15 stroke survivors and 14 partners of stroke survivors (median age of 65 years, range 29 to 85) provided information about sexual issues experienced after stroke and their perspectives on how to address sexual concerns in a rehabilitation setting. A qualitative thematic analysis was applied to transcribed interviews to identify and describe common themes within the data relevant to the aim of the study. A quantitative analysis was utilized to elucidate the frequency of themes by demographic characteristics that were not readily apparent using a qualitative method alone.
Seven themes were identified. Two related to the effects of stroke on sexual life: physical/functional changes and relationship changes. Five related to addressing sexual issues in the process of rehabilitation: (1) difficulty in patients and providers talking about sexual matters, (2) little to no discussion of poststroke sexuality, (3) need for tailoring education to an individual or couple's unique needs, (4) provider rapport and competence, and (5) timing of poststroke sexual education.
Poststroke sexual issues are complex and suggest the need for the development of a biopsychosocial model of education and treatment intervention. Rehabilitation programs need to evaluate the level of training and services provided to address poststroke sexual issues. Development of clinically useful poststroke sexual adjustment assessment tools and interventions is warranted.
研究脑卒中幸存者及其伴侣对性问题的看法和体验，以及他们对康复中涉及性问题的需求的看法。
采用半结构式访谈，对 15 名脑卒中幸存者及其 14 名脑卒中幸存者的伴侣（中位年龄 65 岁，范围 29 至 85 岁）进行调查，了解他们在脑卒中后经历的性问题，以及他们对在康复环境中解决性问题的看法。对转录后的访谈进行定性主题分析，以识别和描述与研究目的相关的、数据中常见的主题。利用定量分析阐明了在不单独使用定性方法时，通过人口统计学特征出现的主题频率。
确定了 7 个主题。其中两个与脑卒中对性生活的影响有关：身体/功能变化和关系变化。另外 5 个主题与康复过程中解决性问题有关：（1）患者和提供者难以谈论性问题，（2）很少或根本没有讨论脑卒中后的性行为，（3）需要根据个人或夫妻的独特需求定制教育，（4）提供者的亲和力和能力，以及（5）脑卒中后性教育的时机。
脑卒中后的性问题很复杂，这表明需要制定一种生物心理社会模式的教育和治疗干预措施。康复计划需要评估提供的培训和服务水平，以解决脑卒中后的性问题。有必要开发临床有用的脑卒中后性调整评估工具和干预措施。
