1
|
Auger LP, Filiatrault J, Allegue DR, Vachon B, Thomas A, Morales E, Rochette A. Sexual Rehabilitation After a Stroke: A Multi-site Qualitative Study About Influencing Factors and Strategies to Improve Services. SEXUALITY AND DISABILITY 2023; 41:1-27. [PMID: 37362801 PMCID: PMC10206562 DOI: 10.1007/s11195-023-09795-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 06/28/2023]
Abstract
This study aimed to better understand the factors influencing the provision of sexuality-related post-stroke rehabilitation services by clinicians on different sites and to explore strategies to improve post-stroke rehabilitation services with stakeholders. A qualitative study with co-design methods was conducted with 20 clinicians from five post-stroke rehabilitation centers in Canada, 1 manager and 1 patient-partner. Participants either took part in a focus group or in sessions of an adapted version of the LEGO Serious Play method to explore influencing factors and strategies of improvement in relation to post-stroke sexual rehabilitation services. Thematic analysis was conducted semi-deductively using the Theoretical Domains Framework (TDF), the Capability, Opportunity, Motivation and Behaviour (COM-B) system and the Behaviour Change Wheel (BCW). A total of twenty factors pertaining either to the categories of Capability (n = 8; e.g., Sexual rehabilitation procedural knowledge), Motivation (n = 4; e.g., Professional boundaries) or Opportunity (n = 8; e.g., Workload) were perceived as influencing provision of sexual rehabilitation services by participants. A theoretical model was conceptualized. Strategies (n = 10) were categorized in concordance with the BCW as Training (n = 1), Enablement (n = 5) or Environmental restructuring (n = 4). This study showed that factors influencing provision of post-stroke rehabilitation services were numerous and interrelated, and that various strategies aiming either clinicians or the rehabilitation environment would be relevant to improve services. This study will help guide the design and implementation of future interventions studies aiming at improving post-stroke sexual rehabilitation services.
Collapse
Affiliation(s)
- Louis-Pierre Auger
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, QC Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363 Chem. Hudson, Montreal, QC H3S 1M9 Canada
| | - Johanne Filiatrault
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, QC Canada
- Montreal Geriatric University Institute Research Center, Montreal, QC Canada
| | - Dorra Rakia Allegue
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363 Chem. Hudson, Montreal, QC H3S 1M9 Canada
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC Canada
| | - Brigitte Vachon
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, QC Canada
- Montreal University Institute of Mental Health, Montreal, QC Canada
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363 Chem. Hudson, Montreal, QC H3S 1M9 Canada
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC Canada
| | - Ernesto Morales
- Department of Rehabilitation, Université Laval, Quebec City, QC Canada
- Interdisciplinary Research Centre in Rehabilitation and Social Inclusion (CIRRIS), Quebec City, QC Canada
| | - Annie Rochette
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, QC Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363 Chem. Hudson, Montreal, QC H3S 1M9 Canada
| |
Collapse
|
2
|
Auger LP, Allegue DR, Morales E, Thomas A, Filiatrault J, Vachon B, Rochette A. Co-designing a Program to Improve Post-stroke Sexual Rehabilitation: The Promise of Innovative Methods. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:777897. [PMID: 36188972 PMCID: PMC9397714 DOI: 10.3389/fresc.2022.777897] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 04/15/2022] [Indexed: 12/05/2022]
Abstract
Introduction Most people who sustain a stroke are likely to experience sexual difficulties during their recovery. However, few people get the opportunity to address sexuality during their rehabilitation because of factors related to the organization (e.g., culture), managers (e.g., lack of resources), clinicians (e.g., perceived lack of knowledge, skills, and comfort), and clients (e.g., taboo). A multifactorial program tailored to stakeholders' needs with various complementary interventions is needed to lead to a change of practice in post-stroke sexual rehabilitation. Objective To co-design with stakeholders (i.e., people with stroke, partners, clinicians, managers and researchers) a theory-driven multifactorial program to improve post-stroke sexual rehabilitation services. Methods This qualitative study will be conducted in four steps using an Intervention Mapping approach and a co-design methodology divided into four phases: (1) exploration; (2) co-design; (3) validation; and (4) development. Persons with stroke, partners, clinicians and managers from five distinct stroke rehabilitation centres in the province of Quebec (Canada), and researchers will be recruited to either participate in an advisory committee or working groups throughout the study. A combination of contributions from three different types of groups (advisory group, Lego® groups, work groups) will be used for data collection. Qualitative data analysis will first be realized by two independent reviewers using the Theoretical Domains Framework, and preliminary results of analysis will be validated with the advisory and working groups. Conclusion This study will lead to the co-design of the first theory-driven program intended to optimize post-stroke sexual rehabilitation services.
Collapse
Affiliation(s)
- Louis-Pierre Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- *Correspondence: Louis-Pierre Auger
| | - Dorra Rakia Allegue
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| | - Ernesto Morales
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
- Interdisciplinary Research Centre in Rehabilitation and Social Inclusion (CIRRIS), Quebec City, QC, Canada
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Johanne Filiatrault
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Montreal Geriatric University Institute Research Center, Montreal, QC, Canada
| | - Brigitte Vachon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Montreal University Institute of Mental Health, Montreal, QC, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| |
Collapse
|