Hartshorn Carly, D'Castro Emma, Adams Jillian
Spinal Urology, Royal Perth Hospital, Perth, WA, Australia.
J Clin Nurs. 2013 Dec;22(23-24):3541-8. doi: 10.1111/jocn.12449.
To maximise involvement of the multidisciplinary team using a model of sexual health management for spinal cord-injured persons.
Regaining sexual function is a priority following spinal cord injury, with the majority of people remaining sexually active with a satisfying sex life. Nevertheless, rehabilitation programmes often focus on activities related to mobility and elimination, with sexual health relegated to a secondary under-resourced position.
Model creation and audit of current and desired status to identify required education.
A four-tier model for sexual health management identified phases of management, increasing in complexity, from tier 1 to tier 4. The model was used to audit the current and desired status of the multidisciplinary team on a spinal injuries unit, identifying knowledge levels, barriers to involvement and education requirements.
Fifty-nine questionnaires were completed (85%) by nurses and allied health professionals. Knowledge deficits and discomfort with the topic were the primary reasons prohibiting involvement with sexual health rehabilitation. Two thirds were willing to be involved with sexual health activities, mainly at an introductory level rather than providing education or problem-solving. However, following relevant education, the level of involvement changed: 90% (n = 53) desired involvement at more complex levels, and 10% (n = 6) were unwilling to be involved.
Developing the necessary skills and knowledge creates potential to increase the resources available to participate in sexual health rehabilitation following a spinal cord injury and ensure that it is a core rehabilitation activity.
The progressive model portrayed discrete phases of sexual health management, which collectively portray the whole. Team members identified a level of involvement to compliment their skills and knowledge. The audit demonstrated that the primary barriers to involvement were not culture, language or attitude as hypothesised, but inadequate knowledge, addressable through education.
采用脊髓损伤患者性健康管理模式，使多学科团队的参与度最大化。
恢复性功能是脊髓损伤后的首要任务，大多数人仍保持性活跃且拥有满意的性生活。然而，康复计划往往侧重于与行动能力和排泄相关的活动，性健康被置于资源不足的次要位置。
创建模型并审核当前和期望状态，以确定所需教育内容。
一个四层的性健康管理模型确定了管理阶段，从第1层到第4层，复杂性逐渐增加。该模型用于审核脊髓损伤科室多学科团队的当前和期望状态，确定知识水平、参与障碍和教育需求。
护士和专职医疗专业人员共完成了59份问卷（85%）。知识不足和对该主题的不适感是禁止参与性健康康复的主要原因。三分之二的人愿意参与性健康活动，主要是在入门层面，而非提供教育或解决问题。然而，经过相关教育后，参与程度发生了变化：90%（n = 53）希望在更复杂的层面参与，10%（n = 6）不愿意参与。
培养必要的技能和知识有可能增加脊髓损伤后参与性健康康复的可用资源，并确保其成为核心康复活动。
渐进式模型描绘了性健康管理的不同阶段，共同构成了整体。团队成员确定了与其技能和知识相匹配的参与水平。审核表明，参与的主要障碍并非如假设的文化、语言或态度，而是知识不足，可通过教育解决。
