Implementation of a sexuality interview guide in stroke rehabilitation: a feasibility study

Abstract

Background

Although people who sustain a stroke can experience sexual difficulties, few address them during rehabilitation.

Objectives

Explore the feasibility of implementing a Sexuality Interview Guide (SIG) in stroke rehabilitation and describe the factors perceived as influencing its implementation.

Materials and Methods

Using a mixed research design, the SIG was implemented for four months in a rehabilitation hospital. The frequency with which clinicians addressed sexuality and their level of comfort pre-post implementation was measured. Perceived factors influencing implementation were determined through individual interviews and focus groups with five stroke clients, 15 clinicians and a coordinator. A paired-specimen Wilcoxon test was used to explore differences in pre- post-level of comfort. Qualitative data was analyzed by two independent evaluators using thematic analysis.

Results

The SIG was used 28 times and clinicians' level of comfort in addressing sexuality improved significantly (p = 0.001). The factors perceived as influencing implementation were: the acceptability of the SIG, the individual characteristics, the context of the rehabilitation hospital and the implementation process.

Conclusion

This study showed that the SIG can be used in stroke rehabilitation and that, with sufficient financial and human resources, and training for clinicians, it would be feasible to implement it in usual care.

Implications for rehabilitation

• The Sexuality Interview Guide (SIG) can be used in stroke rehabilitation and helps clinicians to target stroke clients who want to include sexuality in their rehabilitation.

• The best time to approach sexuality using the SIG, according to all participants, was in outpatient rehabilitation.

• For inpatient clients, it was more appropriate to use the SIG as they approach a weekend home trial or rehabilitation discharge.

• Training for clinicians working in post-stroke sexual rehabilitation, administrative policies and procedures and access to a sexual health specialist for consultation or referral purpose, would be important facilitators in integrating sexuality into clinical practices.

Keywords:

• Sexuality
• stroke
• knowledge translation
• implementation
• mixed methods
• rehabilitation

Acknowledgements

The authors would like to thank the clients, clinicians and coordinators who participated in the study. The first author was supported by a Graduate Scholarship-Master’s Program from the Canadian Institutes of Health Research (CIHR) and by scholarships from the School of Rehabilitation at the Université de Montréal, the Center for Interdisciplinary Research in Rehabilitation of Greater Montreal and the Ordre des ergothérapeutes du Québec. The second author was supported by doctoral scholarships from the CIHR and the Fonds de recherche du Québec en santé (FRQS). The last author was supported by a senior career award from the FRQS.

Disclosure statement

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

Additional information

Funding

The first author was supported by a Graduate Scholarship-Master’s Program from the Canadian Institutes of Health Research (CIHR) and by scholarships from the School of Rehabilitation at the Université de Montréal, the Center for Interdisciplinary Research in Rehabilitation of Greater Montreal and the Ordre des ergothérapeutes du Québec. The second author was supported by doctoral scholarships from the CIHR and the Fonds de recherche du Québec en santé (FRQS). The last author was supported by a senior career award from the FRQS.