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Anafy A, Cohen S, Matar M, Shouval DS, Shamir R, Weintraub Y. Sexual health in adolescents with inflammatory bowel disease - The paediatric gastroenterologists' point of view. Acta Paediatr 2024; 113:1965-1971. [PMID: 38850099 DOI: 10.1111/apa.17322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/04/2024] [Accepted: 05/30/2024] [Indexed: 06/09/2024]
Abstract
AIM Although sexual health (SH) impairment and sexually transmitted infections (STI) are occasionally encountered in patients with inflammatory bowel disease (IBD), paediatric gastroenterologists (PedGI) do not often discuss these issues. Literature about SH in the paediatric IBD population is limited. We aimed to assess PedGI knowledge and common practice related to sexual advice and STI workups in patients with IBD. METHODS A questionnaire comprising 25 questions addressing sexual activity in youth, SH, recommendations, and workup for STI in adolescents with IBD was sent to all registered PedGI in Israel. RESULTS Fifty-two physicians completed the questionnaire (27 males,52%). Only 50% correctly predicted the mean age that Israeli youth start practicing sex. Seventy-five per cent responded that providers should discuss sexual activity with their patients, but only 19% do so, most often in response to a patient's query. Ninety six percent answered that they do not have enough knowledge about SH in IBD. Finally, only 2% obtain rectal swabs for STI in patients with refractory proctitis. CONCLUSION Sexual issues and recommendations are not routinely discussed by the majority of PedGI in paediatric IBD clinics. Providers should obtain more knowledge in the field and initiate discussion of these issues with adolescent patients with IBD.
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Affiliation(s)
- Adi Anafy
- Pediatric Gastroenterology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Tel-Aviv Medical Center, Tel Aviv, Israel
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
| | - Shlomi Cohen
- Pediatric Gastroenterology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Tel-Aviv Medical Center, Tel Aviv, Israel
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
| | - Manar Matar
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Dror S Shouval
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Raanan Shamir
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Yael Weintraub
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
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Rague JT, Hirsch J, Rosoklija I, Meyer T, Streur C, Kielb S, Cheng EY, Bowen DK, Yerkes EB, Chu DI. Male perspectives on clinical communication about sexual health in spina bifida. Dev Med Child Neurol 2024; 66:389-397. [PMID: 37421342 PMCID: PMC10772204 DOI: 10.1111/dmcn.15709] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/17/2023] [Accepted: 06/20/2023] [Indexed: 07/10/2023]
Abstract
AIM To assess perspectives on clinical communication about sexual health in young adult males with spina bifida. METHOD Semi-structured interviews were conducted between February and May 2021 with males at least 18 years of age with spina bifida to assess their perspectives and experiences of sexual health communication with clinicians. Demographic and clinical characteristics were obtained from chart review and a survey of patients. Interviews were transcribed verbatim, and conventional content analysis was used for transcript coding. RESULTS Twenty individuals participated with a median age of 22 years 6 months (range 18-29 years). Sixteen had myelomeningocele. Most identified as heterosexual (n = 17) and not sexually active (n = 13). Barriers and facilitators of successful interactions were identified. Barriers for participants included general discomfort with talking about sex and variability in individual preferences for how conversations occur. Facilitators included participants' comfort with their urologist and discussing sex in relation to disability. Suggestions for improving discussions included (1) notifying individuals that discussion about sex will occur before clinic visits; (2) creating space for discussions; (3) respecting individuals' readiness to discuss; and (4) making discussions disability specific. INTERPRETATION Young adult males with spina bifida are interested in discussing sexual health with their clinicians. Great variability exists about conversation preferences, emphasizing the need to individualize clinical communication about sex. Current health guidelines for males may not be in line with individuals' wishes. WHAT THIS PAPER ADDS Great variability exists in individual preference around sexual health communication. Patient-level barriers hinder successful conversations about sex. Individuals have great insight into how conversations about sex can be improved.
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Affiliation(s)
- James T Rague
- Division of Urology, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Josephine Hirsch
- Division of Urology, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Ilina Rosoklija
- Division of Urology, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Theresa Meyer
- Division of Urology, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Courtney Streur
- Division of Urology, CS Mott Children’s Hospital, University of Michigan, Ann Arbor, MI, USA
| | - Stephanie Kielb
- Department of Urology, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Earl Y Cheng
- Division of Urology, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Diana K Bowen
- Division of Urology, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Elizabeth B Yerkes
- Division of Urology, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - David I Chu
- Division of Urology, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA
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3
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Ibrahim N, Hassler C, Jousselme C, Barry C, Lefèvre H, Falissard B, Bouyer J, Rouquette A. Chronic conditions, subjective wellbeing and risky sexual behaviour among adolescents and young adults. Eur J Pediatr 2023; 182:1163-1171. [PMID: 36602622 DOI: 10.1007/s00431-022-04784-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 01/06/2023]
Abstract
The purpose of this study is to clarify the relationship between having a chronic condition (CC) and several types of risky sexual behaviour (RSB) among adolescents and young adults. We used data from a multicentre cross-sectional study carried out on 14,431 adolescents from 137 French schools. Logistic regression was used to assess the association between several types of RSB and CCs among the 2680 participants aged 17 years or over who reported sexual intercourse. Survival analysis was conducted to assess the association between CCs and age at first sexual intercourse across the whole sample. Analyses were conducted separately by gender with and without adjustment for the parents' education level, early menarche and subjective wellbeing (relationship with mother and father, depression, perceived health status and liking school). Among boys, having a CC was associated with a higher risk of RSB in both univariate (OR: 1.58 [95% CI: 1.10-2.27]) and multivariate analyses (aOR: 1.62 [95% CI: 1.11-2.38]). Among girls, the association between chronic condition and RSB in univariate analysis was non-significant (OR: 1.30 [95% CI: 0.97-1.76]) and disappeared after adjustment on subjective wellbeing (aOR: 1.08 [95% CI: 0.78-1.49]). There was no association between CC and age at first sexual intercourse. Conclusion: There were major gender differences. Boys with a CC were more prone to engage in RSB independent of their subjective wellbeing, whereas in girls, subjective wellbeing seemed to mediate the relationship between CC and RSB. Clinicians should be aware of those gender differences in order to deliver preventive strategies regarding sexuality that target both genders. What is Known: • Young people with chronic conditions have a higher likelihood of engaging in risky sexual behaviour. • Engaging in such behaviours can be much more costly, as it can weaken their underlying state of health. What is New: • We found major gender differences. Boys were more prone to engage in risky behaviour independent of their subjective wellbeing, whereas in girls, it seemed to play an important role. • By understanding how risky sexual behaviour differs according to gender, clinicians can deliver prevention messages that target both genders.
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Affiliation(s)
- Nour Ibrahim
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France.
- French Research Group in Adolescent Health (GRMSA), Maison de Solenn, 97 Boulevard de Port Royal, Paris, France.
| | | | - Catherine Jousselme
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Fondation Vallée, Paris-Saclay University, Gentilly, France
| | - Caroline Barry
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
| | - Hervé Lefèvre
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- French Research Group in Adolescent Health (GRMSA), Maison de Solenn, 97 Boulevard de Port Royal, Paris, France
- AP-HP, Hôpital Cochin, Maison de Solenn, 97 Boulevard de Port-Royal, 75014, Paris, France
| | - Bruno Falissard
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Public Health and Epidemiology Department, AP-HP, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France
| | - Jean Bouyer
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Public Health and Epidemiology Department, AP-HP, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France
| | - Alexandra Rouquette
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Public Health and Epidemiology Department, AP-HP, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France
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4
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Ramlakhan KP, van der Zande JA, Roos-Hesselink JW, Franx A, Cornette J. Long-term quality of life after obstetric intensive care unit admission: A cross-sectional cohort study. BJOG 2023; 130:813-822. [PMID: 36655488 DOI: 10.1111/1471-0528.17400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/19/2022] [Accepted: 12/06/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To assess the long-term quality of life (QoL) after obstetric Intensive Care Unit (ICU) admission. DESIGN Cross-sectional survey study. SETTING Tertiary care centre. POPULATION Women admitted to the level 3 ICU during pregnancy or ≤6 weeks postpartum, between 2000 and 2015. METHODS Quality of life measures were compared with the population reference values. Associations with baseline ICU parameters were assessed with multivariable linear regression. Patient-reported outcome and experience measures (PROMs/PREMs) were described. MAIN OUTCOME MEASURES Quality of life according to the Linear Analogous Scale (LAS), the Satisfaction with Life Scale (SWLS) and the SF-36 questionnaire; PROMs/PREMs using the Pregnancy and Childbirth outcome set of the International Consortium for Health Outcomes Measurement. RESULTS Of all 265 obstetric ICU admissions, 230 were eligible and 94 (41%) were included (median follow-up time 14 years). The LAS (75.7 versus 78.7, p = 0.077) and SWLS (25.2 versus 26, p = 0.176) sum scores were not different from the population reference values. The SF-36 subdomains bodily pain (55.3 versus 73.9), general health (58.2 versus 73.9) and vitality (56.9 versus 69.1) were lower than the reference values (all p < 0.001). PROMs/PREMs were low in 46.2% for pain, 15.1% for depression, 11.8% for satisfaction with care and 52.7% for healthcare responsiveness. An indirect obstetric ICU admission diagnosis was independently associated with a reduced physical health score (B -1.7, 95% confidence interval [CI] -3.4 to -0.1) and severe neonatal morbidity with a reduced mental health score (B -6.6, 95% CI -11.3 to -1.8). CONCLUSION Obstetric ICU admission is associated with reductions in long-term physical health QoL and in some patients with mental health QoL. We suggest multidisciplinary rehabilitation and long-term psychosocial support.
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Affiliation(s)
- Karishma P Ramlakhan
- Department of Cardiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Obstetrics and Fetal Medicine, Erasmus MC - Sophia's Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Johanna A van der Zande
- Department of Cardiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Obstetrics and Fetal Medicine, Erasmus MC - Sophia's Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Jolien W Roos-Hesselink
- Department of Cardiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Arie Franx
- Department of Obstetrics and Fetal Medicine, Erasmus MC - Sophia's Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Jérôme Cornette
- Department of Obstetrics and Fetal Medicine, Erasmus MC - Sophia's Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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5
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Katz AJ, Lyon S, Farrell AG, Srivastava N, Wilkinson TA, Shew ML. Adolescent Women with Congenital Heart Disease: Self-Reported Reproductive Health Discussions with Health Care Providers. J Pediatr Adolesc Gynecol 2022; 35:299-304. [PMID: 34999230 PMCID: PMC9149112 DOI: 10.1016/j.jpag.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 12/14/2021] [Accepted: 12/29/2021] [Indexed: 10/19/2022]
Abstract
STUDY OBJECTIVE This study evaluated self-reported discussions with health care providers (HCPs) among adolescent and young adult (AYA) women with congenital heart disease (CHD). DESIGN Data were collected through a one-time survey of AYA women. SETTING Participants were recruited from pediatric cardiology clinics. PARTICIPANTS AYA women with CHD, ages 14-21 (N = 107) INTERVENTIONS: None MAIN OUTCOME MEASURES: Questionnaires assessed adolescent characteristics and specific HCP discussions regarding transmissibility of a cardiac condition to the infant, risk of pregnancy, and hormonal contraception. Outcome measures were self-reported discussions with HCPs about these reproductive health topics. RESULTS Mean age was 16.8 years (SD = 2.1). Self-reported reproductive health discussions were infrequent, including discussions on transmissibility of a heart condition to their offspring (37%), risk of pregnancy to their offspring (34%), risks of pregnancy to their health (46%), and risks of hormonal contraception given their heart condition (21%). Reported discussions were most commonly with a cardiologist. CONCLUSIONS AYA women with CHD reported limited discussions about reproductive health topics important to those with CHD. Lack of appropriate and timely counseling could lead to poor maternal and child health outcomes. Targeted interventions that improve reproductive health discussions between HCPs and AYA women with CHD are needed to close critical information and service gaps.
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Affiliation(s)
- Amy J Katz
- Division of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Shannon Lyon
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anne G Farrell
- Department of Pediatric Cardiology, Riley Hospital for Children, Indiana University Health, Indianapolis, Indiana
| | - Nayan Srivastava
- Department of Pediatric Cardiology, Riley Hospital for Children, Indiana University Health, Indianapolis, Indiana
| | - Tracey A Wilkinson
- Division of Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Marcia L Shew
- Division of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.
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6
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Patel CG, Tao G. STI/HIV Testing and Prevalence of Gonorrhea and Chlamydia Among Persons with Their Specified-Type Sex Partner. Am J Med 2022; 135:196-201. [PMID: 34655542 PMCID: PMC10186198 DOI: 10.1016/j.amjmed.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/15/2021] [Accepted: 09/15/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previous studies have shown that sexually transmitted infections (STI) and human immunodeficiency virus (HIV) testing has varied, but STI prevalence was not estimated among patients during their health care visits in which a high-risk sexual partnership was documented. This study estimated gonorrhea, chlamydia, syphilis, and HIV testing rates and chlamydia and gonorrhea prevalence. METHODS From the de-identified commercial claims data of OptumLabs Data Warehouse, we identified men and women aged 15-60 years classified as having high-risk sexual relationships as diagnosis codes: Z72.51 for opposite-sex, Z72.52 for same-sex, and Z72.53 for same-and-opposite-sex relationships, stratified by gender, age group, region, type of health plan, and HIV status. We estimated STI testing rate and prevalence for chlamydia and gonorrhea among patients with high-risk sexual relationships. HIV testing was assessed only in high-risk sexual relationship patients without HIV. RESULTS Among 8.2 million females and 7.3 million males aged 15-60 years in the database from 2016 to 2019, 115,884 patients (0.7% of female, 0.8% of male) including 3,535 patients with HIV were diagnosed with high-risk sexual relationships. The testing rates for gonorrhea, chlamydia, syphilis, and HIV were 69.4% (confidence interval [CI]: 69.1-69.7), 68.9% (CI: 68.6-69.2), 43.4% (CI: 43.1-43.7), and 41.7% (CI: 41.4-42.0), respectively. Among patients with valid chlamydia and gonorrhea tests, 7.2% (CI: 7.0-7.5) and 2.6% (CI: 2.4-2.8) had positive chlamydia and gonorrhea test results, respectively, and varied by type of high-risk sexual relationship. CONCLUSIONS Our study findings of suboptimal STI screening among patient in high-risk sexual relationships are consistent with previous studies. Administrative records confirmed by lab results indicate a need for STI counseling, testing, and treatment among patients who are diagnosed with high-risk sexual relationships with same-sex, opposite-sex, or same-and-opposite sex partners.
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Affiliation(s)
- Chirag G Patel
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Ga.
| | - Guoyu Tao
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Ga; OptumLabs Visiting Fellow, OptumLabs, Eden Prairie, Minn
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7
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Gerbild H, Areskoug Josefsson K, Marie Larsen C, Schantz Laursen B. Communication about physical activity to reduce vascular erectile dysfunction - A qualitative interview study among men in cardiac rehabilitation. Scand J Caring Sci 2021; 36:839-851. [PMID: 34288023 DOI: 10.1111/scs.13021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Physical activity, a core intervention in cardiac rehabilitation, can reduce vascular erectile dysfunction (ED). ED is a common sensitive problem for men with cardiac diseases, decreasing their quality of life. Cardiac health professionals rarely provide information about ED or its relation to physical activity. Developing health professionals' communicative component of the complex intervention 'Physical Activity to reduce Vascular Erectile Dysfunction' (PAVED) is important. Understanding the receiver needs is essential in designing a complex intervention. AIM To elucidate men's perspectives on cardiac health professionals' communication about PAVED. ETHICAL ISSUES An Institutional Data Protection Agency approved the study. METHODS An interpretive data-driven thematic analysis was applied to individual, qualitative semi-structured interviews with 20 Danish men attending cardiac rehabilitation. RESULTS The men wanted health professionals' communicating about ED, as it was perceived as a major problem diminishing masculinity and tabooed by health professionals. Men wanted help for self-help, which may be possible with the aid of competent health professionals' communication about how to prevent, reduce and cope with ED - including information about PAVED. The men wanted health professionals' communication about ED in various contexts: general information in groups, sexual counselling for individuals and couples and written material. STUDY LIMITATIONS Recruitment was done from a Danish municipality's cardiac rehabilitation, and the transferability of the results may be limited to similar contexts. CONCLUSION Erectile dysfunction was experienced as a major biopsychosocial problem for the men and their partners. The men had a need for health professionals' communication about sexuality, ED and information about PAVED as well as about prevention, reduction and management of ED. The men had a need for professional communication about sexual health.
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Affiliation(s)
- Helle Gerbild
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristina Areskoug Josefsson
- Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Sandnes, Norway.,School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Camilla Marie Larsen
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Birgitte Schantz Laursen
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Nursing Research Unit & Sexological Centre, Aalborg University Hospital, Aalborg, Denmark
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8
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Bonder R, Wincentak J, Gan C, Kingsnorth S, Provvidenza CF, McPherson AC. “They Assume That You’re Not Having Sex”: A Qualitative Exploration of How Paediatric Healthcare Providers Can Have Positive Sexuality-Related Conversations with Youth with Disabilities. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-021-09686-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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9
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Lindsay S. Healthcare providers' perspectives with addressing sex-related issues and sexual identity within pediatric rehabilitation: A qualitative study. Disabil Health J 2021; 14:101093. [PMID: 33775609 DOI: 10.1016/j.dhjo.2021.101093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/21/2021] [Accepted: 03/01/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although having a sexual and reproductive life is a fundamental human right, people with disabilities, especially youth, often have many unaddressed needs. Healthcare providers commonly report lacking knowledge and training in how to address sexual-related topics with youth. PURPOSE The purpose of this study was to explore the perspectives of pediatric rehabilitation care providers in addressing sex and sexuality among youth with disabilities. METHOD This qualitative study involved a secondary analysis of interviews with 21 participants (18 women, 2 men, 1 trans man) from a range of pediatric rehabilitation disciplines. An open-coding thematic analysis of the transcripts was performed. FINDINGS The results highlighted the following themes regarding healthcare providers' perspective of addressing sex-related issues within pediatric rehabilitation: (1) lack of attention to sex-related issues (i.e., taboo topic); (2) coping with clients disclosing sexual identity (i.e., unpreparedness, addressing discrimination and mental health issues, creating a safe space); and (3) navigating parental concerns (i.e., resistance to sex-related issues, privacy and confidentiality, youth's reliance on parents for managing menstruation). CONCLUSIONS Pediatric rehabilitation healthcare providers encounter challenges in providing health services and advice to youth with disabilities regarding sex-related issues and may need further training.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital & Department of Occupational Science & Occupational Therapy, University of Toronto, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada.
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10
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Morozowski M, Roughley RA. The journey of sexuality after spinal cord injury: Implications for allied health professionals. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2020. [DOI: 10.3138/cjhs.2020-0024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of this phenomenological study, which reflected the lived experiences of seven individuals living in Alberta with spinal cord injury (SCI), was to gain insights into how individuals with SCI (a) are ill-equipped after injury with respect to post-injury sexual function education, (b) explore their sexuality after injury, (c) learn about the importance of role models and friends living with similar injuries, and (d) explain barriers to access reasonable care surrounding sexual health and counselling reflective of intersectionality of sexuality and disability, among other factors. The intent is also to provide a basis for others living with SCI to be aware that they are not alone in their experiences as well as inform others, including professionals working in the area of SCI, of what some experiences of living with SCI are. This study uncovered real lived experiences of individuals with SCI and their experience of sexuality and relationships after injury. Recommendations are highlighted with the intention of informing professionals, including counselling psychologists and other health related professionals.
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Affiliation(s)
- Makrina Morozowski
- School of Arts and Sciences, City University of Seattle in Canada, Calgary, AB
| | - Robert A. Roughley
- School of Arts and Sciences, City University of Seattle in Canada, Calgary, AB
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