School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
School of Humanities and Social Sciences, La Trobe University, Melbourne, Victoria, Australia.
Aust Occup Ther J. 2023 Oct;70(5):581-598. doi: 10.1111/1440-1630.12888. Epub 2023 Jun 19.
Occupational therapists routinely report low levels of confidence in addressing needs related to sexuality and intimacy. These issues are compounded when supporting clients with intellectual disability, due to prevailing assumptions about capacity and few practical support resources. At a disciplinary level, there is ongoing discourse around how to best conceptualise and support sexual and gender identities generally, within models of human occupation. Leveraging interdisciplinarity, where sexuality overlaps as a sphere of interest, can aid the development of practical support resources. Engagement with sociology (focussed on relationality) and disability studies (focussed on embodiment) offers a generative path forward.
The deliberative dialogues framework was used to develop a co-designed resource by occupational therapists for occupational therapists. Six Australian occupational therapists with experience working with clients with intellectual disability and/or sexuality were purposively recruited to participate in co-design groups. Using the eight features of deliberative dialogue, data was collected and analysed by an interdisciplinary research team to collaboratively produce a practical support resource.
Participants agreed the greatest need was to develop a resource for clinicians, to support conversations with clients about sexuality. Five key themes emerged: (1) Theoretical explanations addressing why sexuality is important must be paired with practical advice; (2) make a conversational call to action from 'OTs' for 'OTs' by locating sexuality within the domain of occupational therapy; (3) make explicit that people with intellectual disability are sexual beings; (4) need for self-reflection; and (5) demonstrate how existing understandings of occupation apply to sexuality.
A resource in the form of a brochure was developed, intended to be used as a conversation primer. The process used to develop the resource demonstrated the value of interdisciplinary collaboration and the utility of deliberative dialogue as a co-design method.
职业治疗师在处理与性和亲密关系相关的需求时，经常报告自信心不足。当为智障客户提供支持时，由于对能力的普遍假设和很少的实际支持资源，这些问题更加复杂。在学科层面上，围绕如何在人类职业模型中最好地概念化和支持性和性别认同，存在持续的讨论。利用性作为兴趣领域重叠的跨学科性，可以帮助开发实用的支持资源。与社会学（关注关系性）和残疾研究（关注体现性）的接触为前进提供了一条富有成效的道路。
使用深思熟虑的对话框架，由职业治疗师为职业治疗师共同设计资源。六位具有与智障客户合作经验和/或性经验的澳大利亚职业治疗师被有目的地招募来参加共同设计小组。利用深思熟虑对话的八个特征，由跨学科研究团队收集和分析数据，共同制作实用的支持资源。
参与者一致认为，最大的需求是为临床医生开发一个资源，以支持与客户进行有关性的对话。出现了五个关键主题：（1）必须将解释为什么性很重要的理论解释与实用建议结合起来；（2）通过将性定位在职业治疗领域内，从“OTs”向“OTs”发出对话行动呼吁；（3）明确表示智障人士是有性别的人；（4）需要自我反思；（5）展示现有的职业理解如何适用于性。
以小册子的形式开发了一种资源，旨在用作对话入门。开发资源所使用的过程证明了跨学科合作的价值以及深思熟虑的对话作为共同设计方法的实用性。
