Assessment methods in sexual rehabilitation after stroke: a scoping review for rehabilitation professionals

Abstract

Purpose

The aim was to identify and describe the assessment methods used by rehabilitation professionals to evaluate sexuality for individuals post-stroke, as well as the domains of sexuality addressed.

Methods

Seven databases were selected for this scoping review. Articles needed to meet these inclusion criteria: published studies with a sample of ≥ 50% stroke clients and describing a quantitative or qualitative assessment method that could be used by rehabilitation professionals. This study was conducted following the PRISMA guidelines and domains of sexuality were categorized using the ICF core set for stroke.

Results

Of the 2447 articles reviewed, the 96 that met the selection criteria identified a total of 116 assessment methods classified as standardized assessment tools (n = 62), original questionnaires (n = 28), semi-structured interviews (n = 16) or structured interviews (n = 10). Sexual functions were predominantly assessed using standardized tools, while intimate relationships and partner’s perspective were generally addressed more by original questionnaires and qualitative methods. A stepwise approach combining relevant assessment methods is presented.

Conclusions

Individually, these diverse assessment methods addressed a limited scope of relevant domains. Future research should combine quantitative and qualitative methods to encompass most domains of sexuality of concern to post-stroke individuals.

IMPLICATIONS FOR REHABILITATION

• Most of the studies reviewed here used quantitative methods to assess sexuality, rather than qualitative methods, and mostly used standardized assessment tools.

• Few assessment methods covered all domains related to sexuality.

• Qualitative methods and standardized assessment tools were shown to be complementary, therefore emphasizing the added value of mixed methods in assessing sexuality after a stroke.

• Among the methods that were reviewed, certain would be more suitable for the identification of the need to address sexuality (e.g., Life Satisfaction Checklist-11) and others to assess more thoroughly sexuality (e.g., Change in Sexual Functioning Questionnaire (CSFQ-14)).

Keywords:

• Stroke
• sexuality
• clinicians
• assessment
• evaluation
• rehabilitation

Acknowledgments

The authors gratefully acknowledge that the first author was supported by doctoral scholarships from the Canadian Institutes for Health Research, the Fonds de recherche du Québec en santé (FRQS), the School of Rehabilitation of the Université de Montréal (UdeM) and the Ordre des ergothérapeutes du Québec. The fourth and last author were supported by a career award from the FRQS. Our sincere thanks to the bibliothèques/UdeM for enabling the participation of the third author in this research project. The authors would also like to thank Dr. Johanne Higgins, and Isabelle Quintal, MSc, for their insights on the manuscript.

Disclosure statement

The authors report no conflict of interest.