Talking about sex after traumatic brain injury: perceptions and experiences of multidisciplinary rehabilitation professionals

Abstract

Purpose: Research indicates that although 50–60% of people who have had a traumatic brain injury (TBI) experience changes in sexual functioning, sexuality issues remain largely unaddressed in rehabilitation. This study aimed to explore rehabilitation professionals’ perceptions and experiences of discussing sexuality with service-users who have had a TBI. Method: Purposeful sampling was used to recruit 24 participants from two local National Health Service trusts and from a national charity. Four focus groups were conducted with pre-existing groups of professionals, using a semi-structured interview schedule. Focus group data were transcribed verbatim and analysed using thematic analysis. Results: Six main themes were derived from the analysis: (1) sexuality after TBI is a specialist issue; (2) sexuality is a sensitive subject; (3) practicalities of discussing sexuality; (4) roles and responsibilities; (5) dilemmas about risk and vulnerabilities; and (6) organisational and structural issues. Conclusions: Our findings suggest that a more proactive approach to addressing sexuality issues be taken by incorporating sexuality into assessments and by having sexuality information available for service-users. Support for professionals is also needed in the form of the development of policy, on-going training and supervision.

Implications for Rehabilitation

• Rehabilitation professionals find it difficult to deal with issues of sexuality following TBI, and the reasons for this are complex and interrelated.

• To provide holistic care, a more proactive approach to addressing sexuality issues should be taken. Professionals do not need to be an expert in sexual issues to open dialogue.

• Sexuality discussions should be incorporated into assessments, and written information should be available for service-users. Further training for professionals and organisational policy change is sometimes required to effectively deal with sexuality issues.

• Rehabilitation
• sexuality
• traumatic brain injury

Acknowledgements

We would like to thank all the professionals who were involved in organising and participating in the focus groups and Dr Nigel Schofield for his professional help and advice in conducting this study.

Declarations of interest

The authors report no declarations of interest.

Notes

1. Full job titles not provided to preserve anonymity.

2. (.)   pause

-  participant stopped mid-sentence

[  overlapping speech

Italics laughter

Underline emphasis

((brackets)) additional researcher’s comments.

3. This code represents the participant ID. “P7” is the participant number, and “2” is the focus group number. “I” represents the interviewer.

4. Where appropriate, we have included the interaction between participants to show agreements, elaborations, endorsements and disagreements.

5. These refer to specific health campaigns promoted within many NHS settings.