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O'Mullan C, O'Reilly M, Meredith P. Bringing sexuality out of the closet: What can we learn from occupational therapists who successfully address the area of sexuality in everyday practice? Aust Occup Ther J 2021; 68:272-281. [PMID: 33598988 DOI: 10.1111/1440-1630.12723] [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: 08/06/2020] [Revised: 12/01/2020] [Accepted: 01/28/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Sex has been recognised as an activity of daily living, and sexuality as an important part of our identity, with implications for our self-esteem and quality of life. Although this brings sex and sexuality within the scope of occupational therapy practice, empirical and anecdotal information suggests that neither are routinely included in therapy. The aim of this study was to investigate the experiences of therapists who are comfortable addressing sex and sexuality in practice, with a view to influencing future research and practice. The research question posed was as follows: "What can we learn from occupational therapists who successfully address the area of sexuality in everyday practice?" METHODS Interpretative Phenomenological Analysis (IPA) was used to explore the research question. Semi-structured interviews were conducted with 11 Australian occupational therapists who were purposively recruited. Interviews were audio-recorded, transcribed verbatim, and analysed following the guidelines for IPA data analysis. RESULTS Four master themes and five sub-themes emerged from the analysis and are discussed under the following headings: sexuality matters; know your boundaries; just do it; and seek support and mentoring. The themes provide insight into how occupational therapists successfully integrate sexuality into everyday practice. CONCLUSION According to the participants in this study, addressing sex and sexuality during therapy is part of providing holistic client-centred care. With clear personal and professional boundaries, occupational therapists can address sexuality within routine practice utilising core occupational therapy skills, such as communication, collaborative problem solving, pacing, positioning, and adaptive equipment. Furthermore, participants demonstrated that this can be done within a range of settings. It starts with a commitment and the motivation to find a way.
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Affiliation(s)
- Cathy O'Mullan
- Central Queensland University, Bundaberg, Qld, Australia
| | - Maria O'Reilly
- Central Queensland University, Bundaberg, Qld, Australia
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Young K, Dodington A, Smith C, Heck CS. Addressing clients' sexual health in occupational therapy practice. The Canadian Journal of Occupational Therapy 2019; 87:52-62. [PMID: 31220932 DOI: 10.1177/0008417419855237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND. Sexuality is an important dimension of one's health and well-being. Studies show that occupational therapists regard clients' sexual health as a legitimate domain of practice but do not adequately address it in their clinical work. PURPOSE. This study aims to describe occupational therapists' perspectives regarding clients' sexual health. METHOD. This exploratory study surveyed Canadian occupational therapists using an online questionnaire that collected information on beliefs, knowledge, comfort, barriers, and facilitators with regard to addressing sexuality. Descriptive analysis was conducted on questionnaire data, and content analysis was used to organize respondents' comments. FINDINGS. While most respondents believed that addressing sexuality was within their scope, few actually did so in practice. Participants reported comfort with sexuality but identified lack of knowledge as a barrier to addressing clients' sexual health. IMPLICATIONS. This study provided a greater understanding of factors that require consideration for occupational therapists to effectively meet clients' sexual health needs.
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Rose N, Hughes C. Addressing Sex in Occupational Therapy: A Coconstructed Autoethnography. Am J Occup Ther 2018; 72:7203205070p1-7203205070p6. [DOI: 10.5014/ajot.2018.026005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Occupational therapy practitioners generally agree that sex is a meaningful occupation and should be part of the rehabilitation process; however, there has been reluctance to include clients’ sexual concerns in practice. To explore how occupational therapy is addressing clients’ sexual concerns, we (one author with a professional background in occupational therapy and the other who is a consumer of occupational therapy services) used a coconstructed autoethnographic approach that involved shared reflection between us. We discuss insights discovered through the coconstructed process, including the potential health risks involved in sexual activity, the importance of sexuality as a core aspect of identity, the ways that rehabilitation currently excludes sexuality, and the potential role of occupational therapy in addressing sexuality.
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Affiliation(s)
- Natalie Rose
- Natalie Rose, MSc(OT), BA, is PhD Candidate, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada;
| | - Claire Hughes
- Claire Hughes is Undergraduate Student, York University, Toronto, Ontario, Canada
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Callaway L, Barclay L, McDonald R, Farnworth L, Casey J. Secondary health conditions experienced by people with spinal cord injury within community living: implications for a National Disability Insurance Scheme. Aust Occup Ther J 2016; 62:246-54. [PMID: 26256853 DOI: 10.1111/1440-1630.12206] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Australia's National Disability Insurance Scheme (NDIS) provides supports for individuals, delivered through a personalised participant planning process, to influence choice and goal attainment. AIM This study aimed to use both quantitative and qualitative methods to examine the impact of secondary health conditions on the experiences of people with spinal cord injury (SCI) who have returned to community living, in the context of Australia's National Disability Strategy and recently launched NDIS. Exploration of lived experience of health conditions following SCI utilising this mixed methods approach may offer important insights for effective planning within an NDIS. METHODS A cross-sectional survey using the Spinal Cord Injury Secondary Conditions Scale (SCISCS), demographic questionnaire and in-depth interview was undertaken with 33 people with SCI living in the community. Demographic and SCISCS data were reported using descriptive statistics. Interviews were audio-taped, transcribed and analysed thematically. RESULTS Participants were on average 58.5 years of age and 20 years post-injury. Five key themes emerged relating to (i) spasm and pain; (ii) sexual dysfunction; (iii) pressure areas; (iv) fatigue; and (v) the impact of secondary health conditions on life role participation and choice of supports and equipment. CONCLUSION Secondary health conditions can significantly impact occupational participation following SCI. Appropriate intervention, including customised equipment and direct support, if delivered as part of an effective NDIS, may prevent or reduce the severity of these conditions and offer the potential to influence health and participation outcomes of people who have returned to community living.
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Affiliation(s)
- Libby Callaway
- Occupational Therapy Department, Monash University, Frankston, Victoria, Australia
| | - Linda Barclay
- Occupational Therapy Department, Monash University, Frankston, Victoria, Australia
| | - Rachael McDonald
- Occupational Therapy Department, Monash University, Frankston, Victoria, Australia
| | - Louise Farnworth
- Occupational Therapy Department, Monash University, Frankston, Victoria, Australia
| | - Jackie Casey
- Occupational Therapy Department, University of Ulster, Antrim, UK
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Bushby K, Chan J, Druif S, Ho K, Kinsella EA. Ethical tensions in occupational therapy practice: A scoping review. Br J Occup Ther 2015. [DOI: 10.1177/0308022614564770] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Ethical tensions are an unavoidable part of occupational therapy practice. Given the significance of this, and the divergent nature of the literature, a need was identified for a systematic examination of the published literature on this topic. The purpose of this scoping review therefore was to identify, summarize, and describe existing literature on ethical tensions in occupational therapy practice. Method A comprehensive scoping review was conducted. In the initial search, 459 articles, spanning a 13-year time frame, were retrieved from six databases; 32 articles met the criteria for full review. Results Seven themes were identified that highlighted ethical tensions related to: (a) resource and systemic issues; (b) upholding ethical principles and values; (c) client safety; (d) working with vulnerable clients; (e) interpersonal conflicts; (f) upholding professional standards and (g) practice management. Conclusion This scoping review highlights a breadth of ethical tensions that have implications for practice, education, policy and research. It represents an important first step in mapping knowledge about ethical tensions in occupational therapy practice, and lays a foundation for future research directions.
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Affiliation(s)
| | - Jody Chan
- Occupational Therapist, Western University, Canada
| | - Shawna Druif
- Occupational Therapist, Western University, Canada
| | - Kim Ho
- Occupational Therapist, Western University, Canada
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Fritz HA, Dillaway H, Lysack CL. "Don't Think Paralysis Takes Away Your Womanhood": Sexual Intimacy After Spinal Cord Injury. Am J Occup Ther 2015; 69:6902260030p1-10. [PMID: 26122683 PMCID: PMC4480055 DOI: 10.5014/ajot.2015.015040] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Sexuality and intimacy are important components of health and well-being. Issues surrounding sexuality and intimacy are equally important for men and women living with physical disabilities, including spinal cord injury (SCI). Yet, women's sexuality after SCI remains largely unexamined. This article presents the findings from an in-depth qualitative investigation of the sexual and reproductive health experiences of 20 women with SCI in or around Detroit, MI. Findings echo existing literature documenting the sexual consequences of life after SCI and suggest new areas of inquiry important for better addressing sexual concerns across the lifespan. Specifically, findings suggest a need to consider the variable effects of SCI on sexual intimacy in relation to a person's developmental trajectory, the appropriate timing of sexual education, the need to expand conceptualizations of sexual intimacy, and the ways SCI may affect sexuality in later life.
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Affiliation(s)
- Heather A Fritz
- Heather A. Fritz, PhD, OTR/L, is Postdoctoral Fellow, Institute of Gerontology, Wayne State University, Detroit, MI;
| | - Heather Dillaway
- Heather Dillaway, PhD, is Associate Dean of Master's Programs, The Graduate School, and Associate Professor, Department of Sociology, Wayne State University, Detroit, MI
| | - Cathy L Lysack
- Cathy L. Lysack, PhD, OT(C), is Acting Dean, Eugene Applebaum College of Pharmacy and Health Sciences; Professor, Occupational Therapy Program, Department of Health Care Sciences; and Professor and Deputy Director, Institute of Gerontology, Wayne State University, Detroit, MI
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Abstract
Introduction: Sexuality is a holistic concept that involves more than the sexual act. Despite being a quality of life domain that promotes meaningful existence, it is an aspect of life that is often avoided by health care practitioners. Method: In this Heideggerian phenomenological study, conversational interviews were conducted with 13 people with motor neurone disease, and 10 of their partners, in order to understand their experiences of sexuality and intimacy. Findings: The findings provide evidence for the value of touch in people's lives and shed light upon the impact that assistive equipment has on intimacy, sexual expression and maintaining emotional and physical connection between couples. None of the people interviewed had previously been given the opportunity to discuss these issues with their occupational therapist. Conclusion: There is a place in occupational therapy practice for discussing the value of emotional and physical connection for individuals in the context of any equipment provided.
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Liedberg G, Hensing G. Occupational Therapy Students' Choice of Client Activities: Does Patients' Gender Matter? Br J Occup Ther 2011. [DOI: 10.4276/030802211x13074383957904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Aim: In order to achieve a fairer system of health care, it is important that the research and education of health professionals, as well as the organisation of health care, takes into account the gender perspective. The gender order influences women's and men's lifestyles and living conditions and, through this, their health, quality of life and daily activities. The aim of the present study was to explore the perceptions of gender in occupational therapy students in their choice of activities: do students choose activities according to traditional roles? Method: The method was a fictional case study containing 16 activities. Each student was given a copy of one of the versions of the case, Eric or Erica. The students were told to underline the three activities regarded as being of most benefit for the actual patient. Eight male and 99 female students participated. Results: The most chosen activities were cooking, visits to cafeterias and gardening, and the least chosen were spinning, laundry and computer work. The results showed that the students made choices based on traditional gender roles. Conclusion: Extended knowledge is needed about how gender is constructed in occupational therapy, and about whether gendered choices contribute to a prolonged period of treatment or rehabilitation, or the opposite.
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Affiliation(s)
- Gunilla Liedberg
- Senior Lecturer, Occupational Therapy Programme, Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden
| | - Gunnel Hensing
- Professor, Unit of Social Medicine, The Sahlgrenska Academy of Göteborg University, Göteborg, Sweden
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Sexuality and health care: are we training physical therapy professionals to address their clients' sexuality needs? Phys Ther 2009; 89:101-2. [PMID: 19119145 DOI: 10.2522/ptj.2009.89.1.101] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Affiliation(s)
- Subhajit Sengupta
- The Royal Orthopaedic Hospital, Birmingham
- Postgraduate Trainee in Rehabilitation, Oxford Brookes University
| | - Brendon Stubbs
- St Andrew's Healthcare, Northampton
- Postgraduate Trainee in Rehabilitation, Oxford Brookes University
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Sengupta S, Davis S, Stubbs B. Let's talk about sexuality: Whose responsibility is it? INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2008. [DOI: 10.12968/ijtr.2008.15.7.30406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Subhajit Sengupta
- Oxford Brookes University; Specialist Occupational Therapist, The Royal Orthopaedic Hospital, Birmingham
| | - Sally Davis
- Primary Care and Rehabilitation, Oxford Brookes University, Oxford
| | - Brendon Stubbs
- Oxford Brookes University, Clinical Specialist and Lead Physiotherapist, St Andrews Healthcare, Billing Road, Northampton, United Kingdom
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