Auger Louis-Pierre, Filiatrault Johanne, Allegue Dorra Rakia, Vachon Brigitte, Thomas Aliki, Morales Ernesto, Rochette Annie
Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, QC Canada.
Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363 Chem. Hudson, Montreal, QC H3S 1M9 Canada.
Sex Disabil. 2023 May 24:1-27. doi: 10.1007/s11195-023-09795-x.
This study aimed to better understand the factors influencing the provision of sexuality-related post-stroke rehabilitation services by clinicians on different sites and to explore strategies to improve post-stroke rehabilitation services with stakeholders. A qualitative study with co-design methods was conducted with 20 clinicians from five post-stroke rehabilitation centers in Canada, 1 manager and 1 patient-partner. Participants either took part in a focus group or in sessions of an adapted version of the LEGO Serious Play method to explore influencing factors and strategies of improvement in relation to post-stroke sexual rehabilitation services. Thematic analysis was conducted semi-deductively using the Theoretical Domains Framework (TDF), the Capability, Opportunity, Motivation and Behaviour (COM-B) system and the Behaviour Change Wheel (BCW). A total of twenty factors pertaining either to the categories of Capability (n = 8; e.g., Sexual rehabilitation procedural knowledge), Motivation (n = 4; e.g., Professional boundaries) or Opportunity (n = 8; e.g., Workload) were perceived as influencing provision of sexual rehabilitation services by participants. A theoretical model was conceptualized. Strategies (n = 10) were categorized in concordance with the BCW as Training (n = 1), Enablement (n = 5) or Environmental restructuring (n = 4). This study showed that factors influencing provision of post-stroke rehabilitation services were numerous and interrelated, and that various strategies aiming either clinicians or the rehabilitation environment would be relevant to improve services. This study will help guide the design and implementation of future interventions studies aiming at improving post-stroke sexual rehabilitation services.
本研究旨在更好地了解不同场所的临床医生提供中风后性康复服务的影响因素，并与利益相关者探索改善中风后康复服务的策略。采用联合设计方法对来自加拿大五个中风后康复中心的20名临床医生、1名管理人员和1名患者伴侣进行了定性研究。参与者要么参加焦点小组，要么参加乐高认真玩方法改编版的会议，以探讨中风后性康复服务的影响因素和改进策略。使用理论领域框架（TDF）、能力、机会、动机和行为（COM-B）系统以及行为改变轮（BCW）进行半归纳式主题分析。参与者认为共有20个因素与能力类别（n = 8；例如，性康复程序知识）、动机类别（n = 4；例如，专业界限）或机会类别（n = 8；例如，工作量）相关，这些因素影响性康复服务的提供。构建了一个理论模型。根据行为改变轮，将策略（n = 10）分为培训（n = 1）、赋能（n = 5）或环境重组（n = 4）。本研究表明，影响中风后康复服务提供的因素众多且相互关联，针对临床医生或康复环境的各种策略都与改善服务相关。本研究将有助于指导未来旨在改善中风后性康复服务的干预研究的设计和实施。
