Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.
Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia.
Disabil Rehabil. 2022 Dec;44(26):8294-8302. doi: 10.1080/09638288.2021.2012605. Epub 2021 Dec 24.
Studies indicate that up to 50% of survivors of acquired brain injury (ABI) experience persistent changes in sexuality. However, research on clinicians' perspectives in addressing sexuality issues post-ABI is limited. This study explored the attitudes and approaches, barriers and facilitators, and training preferences of Australian clinicians in addressing sexuality in individuals post-ABI.
Purposive sampling was used to recruit 20 Australian multi-disciplinary clinicians from a related survey study. Semi-structured interviews were conducted and qualitatively analysed using thematic analysis.
Three broad themes were identified: ABI results in multi-faceted changes in sexuality; there is a fundamental discomfort in talking about sexuality; and, strategies proposed by clinicians may help to improve sexuality support. Participants also provided suggestions for sexuality training, which they believed should start at university.
Most clinicians are aware of sexuality issues post-ABI but fail to adequately address sexuality in individuals post-ABI due to personal levels of discomfort, perpetuated by institutional factors. Therefore, participants believe that changes made at individual and institutional levels may increase sexuality support for individuals with ABI. However, further research on the causes and treatment of sexual problems and patient perspectives is required to provide the evidence-based guidelines and training programs that clinicians require.Implications for rehabilitationUp to half of individuals experience changes in sexuality after ABI that restrict quality of life and relationships.The consequences of ABI and their impacts on sexuality are understood by Australian clinicians but remain largely unaddressed due to individual discomfort, perpetuated by institutional factors.This study suggests that professional training targeted towards understanding, assessing and treating sexuality issues post-ABI may help to reduce the discomfort.Adjustments should also be made at individual, policy and procedural levels to ensure that sexuality is addressed within rehabilitation post-ABI.
研究表明，多达 50%的后天性脑损伤（ABI）幸存者经历持续性的性功能改变。然而，针对 ABI 后临床医生处理性功能问题的观点的研究有限。本研究探讨了澳大利亚临床医生在处理 ABI 后个体性功能问题方面的态度和方法、障碍和促进因素，以及培训偏好。
采用目的抽样法，从一项相关的调查研究中招募了 20 名澳大利亚多学科临床医生。进行了半结构化访谈，并使用主题分析进行定性分析。
确定了三个广泛的主题：ABI 导致性功能多方面改变；谈论性话题存在根本不适；临床医生提出的策略可能有助于改善性功能支持。参与者还为性功能培训提供了建议，他们认为培训应在大学开始。
大多数临床医生都意识到 ABI 后存在性功能问题，但由于个人不适程度，加上机构因素的影响，未能充分解决 ABI 后个体的性功能问题。因此，参与者认为，在个人和机构层面做出改变可能会增加对 ABI 个体的性功能支持。然而，需要进一步研究性问题的原因和治疗方法以及患者观点，为临床医生提供所需的基于证据的指导方针和培训计划。
多达一半的 ABI 患者经历性功能改变，限制了生活质量和人际关系。澳大利亚临床医生理解 ABI 的后果及其对性功能的影响，但由于个人不适，加上机构因素，这些问题在很大程度上仍未得到解决。本研究表明，针对理解、评估和治疗 ABI 后性功能问题的专业培训可能有助于减少不适。还应在个人、政策和程序层面做出调整，以确保在 ABI 后康复期间解决性功能问题。
