Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan.
Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan.
Womens Health Issues. 2022 Jul-Aug;32(4):376-387. doi: 10.1016/j.whi.2022.02.003. Epub 2022 Mar 23.
Women with physical disability (WWPD) experience more sexual dysfunction, are typically less sexually active, and engage in fewer intimate relationships than women without physical disability. Although patient-reported outcome measures can help researchers and providers to meet the needs of this population, current measures fail to reflect the relevant experiences of WWPD. The purposes of this study were to 1) understand the experiences of WWPD related to sexual wellness, 2) identify the gaps in the current Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction, and 3) develop a conceptual framework for the measurement of sexual well-being on which a new supplemental measure will be built.
WWPD (n = 59) were recruited from an online health registry through a large academic medical center and took part in semistructured focus groups and interviews exploring experiences with sexuality, intimate relationships, sexual function, and sexual and reproductive health care. Interviews were transcribed and coded using an inductive approach to thematic analysis.
Participants expressed that their sexual well-being extends beyond simply physical function and includes aspects of their environment, society, and intrapersonal and interpersonal factors. From themes that emerged from the qualitative data, we developed a conceptual framework of sexual well-being, which includes sexual health and sexual self-efficacy. The framework is composed of five constructs that impact sexual health and sexual self-efficacy: physical factors, intrapersonal factors, environmental factors, relationships and partner opportunity, and stigma.
This conceptual framework can be used to develop patient-reported outcome measures items relevant to the experiences of WWPD, facilitate conversations between providers and patients, and identify areas to target for sexual wellness interventions.
身体残疾的女性（WWPD）比身体健全的女性经历更多的性功能障碍，性活动通常较少，亲密关系也较少。尽管患者报告的结果测量可以帮助研究人员和提供者满足这一人群的需求，但目前的测量方法未能反映 WWPD 的相关体验。本研究的目的是：1）了解 WWPD 与性健康相关的体验，2）确定当前患者报告的结果测量信息系统性功能和满意度的差距，3）为性幸福感的测量建立一个概念框架，在此基础上构建一个新的补充测量工具。
通过一家大型学术医疗中心的在线健康登记处招募了 59 名 WWPD，并参加了半结构化焦点小组和访谈，探讨了她们的性体验、亲密关系、性功能以及性和生殖保健。使用归纳法对访谈进行了转录和编码分析。
参与者表示，她们的性健康不仅仅局限于身体功能，还包括环境、社会以及个人和人际关系等方面。从定性数据中出现的主题中，我们开发了一个性健康的概念框架，其中包括性健康和性自我效能。该框架由五个影响性健康和性自我效能的结构组成：身体因素、个人因素、环境因素、关系和伴侣机会以及污名化。
这个概念框架可以用于开发与 WWPD 经历相关的患者报告结果测量工具，促进提供者和患者之间的对话，并确定性健康干预的目标领域。
