Addressing the elephant in the room: integrating sexual health practice in spinal cord injury rehabilitation

Abstract

Purpose

Sexual health, a basic human right, maybe disrupted after a spinal cord injury (SCI) and is often not addressed in rehabilitation. This quality improvement initiative embedded sexual health education and support for patients with SCI into clinical practice.

Materials and methods

In 2017–2018 a team of clinicians, researchers and persons with SCI developed and implemented a new sexual health practice in SCI rehabilitation. A systematic process was undertaken which included implementation science principles; the PLISSIT model and Sexual Rehabilitation Framework were foundational to the new practice.

Results

Adult inpatients with SCI began receiving the sexual health practice in June 2018. After 6 months, patient and health care provider surveys were conducted. Patients reported increased awareness of sexual health resources and increased satisfaction with sexual health concerns being addressed. Clinicians reported increased comfort in addressing patients’ sexual health concerns and increased awareness of sexual health resources.

Conclusions

Embedding the new sexual health practice facilitates the reintegration of sexual health into the daily lives of SCI patients and supports a more comprehensive and holistic rehabilitation. It normalizes sexual health concerns and questions in an SCI rehabilitation facility.

IMPLICATIONS FOR REHABILITATION

• Sexual health is noted to be a top priority among persons with spinal cord injury, however, this area of care is often overlooked by healthcare providers across the rehabilitation continuum.

• A team of clinicians, researchers, and persons with SCI used a systematic process to address this gap by developing and implementing a new sexual health practice in the SCI rehabilitation program.

• This quality improvement initiative resulted in increased clinician knowledge and confidence in this domain of practice and greater patient satisfaction in having their sexual health needs to be addressed during rehabilitation.

Keywords:

• Implementation science
• quality improvement
• rehabilitation
• sex education
• sexual health
• spinal cord injuries

Acknowledgments

As a Vanier Scholar, Amanda McIntyre is supported by the Government of Canada, Vanier Canada Graduate Scholarships. In addition, the foundation for this work involved the embedding of implementation science principles by the R2P team at Parkwood Institute, originally facilitated through the SCI Knowledge Mobilization Network and more recently the Ontario SCI Implementation & Evaluation Quality Care Consortium funded by the Ontario Neurotrauma Foundation and Praxis Institute. Dalton Wolfe and Charlie Giurleo are currently partially supported through the Consortium. We would like to gratefully acknowledge Madison Cockery for her contribution to data collection. As well as the hard work of the Parkwood Institute SCI Rehabilitation staff whose participation and dedication made this initiative possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).