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Wright H, Walker-Clarke A, Drummond A, Kidd L, Yeates G, Williams D, McWilliams D, Clyne W, Clark CCT, Kimani P, Turner A. Self-directed versus peer-supported digital self-management programmes for mental and sexual wellbeing after acquired brain injury (HOPE4ABI): protocol for a feasibility randomised controlled trial. Pilot Feasibility Stud 2023; 9:194. [PMID: 38031132 PMCID: PMC10685616 DOI: 10.1186/s40814-023-01421-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/21/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Acquired brain injury (ABI) can lead to biopsychosocial changes such as depression, low self-esteem and fatigue. These changes can cause, and be caused by, sexual issues affecting relationships and wellbeing. Given the relationship between sexual wellbeing and mental health, it is feasible that supporting sexual wellbeing will benefit psychological wellbeing. However, neurorehabilitation is inconsistent and often fragmented across the UK, and psychological, sexual and social support are lacking. Research shows that self-management and peer-support programmes can improve quality of life, self-efficacy and psychological wellbeing after brain injury. This protocol describes a feasibility randomised controlled trial (RCT) of a digital self-management programme to support mental and sexual wellbeing (known as HOPE4ABI), co-designed with and for people with ABI. METHODS This mixed-methods feasibility RCT has two parallel trial arms of the 8-week digital HOPE4ABI self-management programme. Eligibility criteria include age > 18 years, diagnosed or suspected ABI > 3 months prior to trial entry, access to an Internet-enabled device and ability to engage with the intervention. Referrals to the study website will be made via the National Health Service (NHS), social media and partnering organisations. Sixty eligible participants will be randomised at a ratio of 1:1 to peer-supported (n = 30) or self-directed (n = 30) HOPE4ABI programmes. Primary feasibility outcomes include recruitment and retention rates, engagement, adherence and usage. Secondary outcomes related to standardised measures of quality of life, sexual wellbeing and mental wellbeing. Participants and peer facilitators will be interviewed after the course to assess acceptability across both trial arms. DISCUSSION This feasibility trial data is not sufficiently powered for inferential statistical analyses but will provide evidence of the feasibility of a full RCT. Quantitative trial data will be analysed descriptively, and participant screening data representing age, ethnicity and gender will be presented as proportions at the group level. These data may indicate trends in reach to particular demographic groups that can inform future recruitment strategies to widen participation. Progression to a definitive trial will be justified if predetermined criteria are met, relating to recruitment, retention, engagement and acceptability. TRIAL REGISTRATION ISRCTN46988394 registered on March 1, 2023.
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Affiliation(s)
- Hayley Wright
- Centre for Intelligent Healthcare, Coventry University, CV1 5FB, Coventry, England.
| | - Aimee Walker-Clarke
- Centre for Intelligent Healthcare, Coventry University, CV1 5FB, Coventry, England
| | - Avril Drummond
- Queen's Medical Centre, University of Nottingham, NG7 2UH, Nottingham, England
| | - Lisa Kidd
- School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, Scotland
| | | | - Deborah Williams
- Centre for Intelligent Healthcare, Coventry University, CV1 5FB, Coventry, England
| | - David McWilliams
- Centre for Intelligent Healthcare, Coventry University, CV1 5FB, Coventry, England
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, CV2 2DX, England
| | - Wendy Clyne
- Peninsula Medical School, University of Plymouth, PL4 8AA, Plymouth, England
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, CV1 5FB, Coventry, England
| | - Peter Kimani
- Warwick Medical School, University of Warwick, CV4 7AL, Coventry, England
| | - Andy Turner
- Centre for Intelligent Healthcare, Coventry University, CV1 5FB, Coventry, England
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Ek AS, Holmström C, Elmerstig E. Sexuality >1 year after brain injury rehabilitation: A cross-sectional study in Sweden. Brain Inj 2023; 37:34-46. [PMID: 36408962 DOI: 10.1080/02699052.2022.2145358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE This study investigates whether Acquired Brain Injury (ABI) is associated with changes in sexual function and satisfaction and how such changes are experienced, focusing on invisible impairments after ABI. MATERIALS AND METHODS A study-specific questionnaire was distributed in 2018-2019. The sample included individuals aged 20-90 years diagnosed with ABI due to subarachnoid hemorrhage (SAH), trauma, infection, or anoxia (ischemic stroke and intracerebral hemorrhage excluded), who participated in brain injury rehabilitation in Sweden, 2014-2016. Chi-square and Logistic regression analyses were used. RESULTS The study consists of 250 participants (response rate was 40%). Among participants 78% (194/250) had resumed sexual life. Participants reporting sexual changes also experienced more consequences related to ABI. Those with decreased sexual desire (63%, 148/234) reported more ABI consequences, including decreased memory (86% vs 65%, p = 0.000), decreased concentration ability (82% vs 65%, p = 0.003), and increased tiredness (91% vs 70%, p = 0.000) compared to those with intact desire. Such consequences can be invisible to others. CONCLUSION Visible impairments are known to impact sexual functions and satisfaction after ABI. Our results show how invisible impairments also have a great impact. From a biopsychosocial perspective, these results imply that individuals should receive sexual rehabilitation, irrespective of ABI impairment.
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Affiliation(s)
- Ann-Sofie Ek
- Centre for Sexology and Sexuality Studies, Faculty of Health and Society, Malmö University, Malmö, Sweden.,Department of Neurology, Rehabilitation Medicine, Memory Disorders, and Geriatrics, Skåne University Hospital, Malmö-Lund, Sweden
| | - Charlotta Holmström
- Centre for Sexology and Sexuality Studies, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Eva Elmerstig
- Centre for Sexology and Sexuality Studies, Faculty of Health and Society, Malmö University, Malmö, Sweden
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Marital Satisfaction and Sexual Quality of Life of Patients with Amyotrophic Lateral Sclerosis (ALS). SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-022-09755-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Fraser EE, Downing MG, Haines K, Bennett L, Olver J, Ponsford JL. Evaluating a Novel Treatment Adapting a Cognitive Behaviour Therapy Approach for Sexuality Problems after Traumatic Brain Injury: A Single Case Design with Nonconcurrent Multiple Baselines. J Clin Med 2022; 11:jcm11123525. [PMID: 35743597 PMCID: PMC9225377 DOI: 10.3390/jcm11123525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023] Open
Abstract
There has been little progress in development of evidence-based interventions to improve sexuality outcomes for individuals with traumatic brain injury (TBI). This study aimed to evaluate the preliminary efficacy of an individualised intervention using a cognitive behaviour therapy (CBT) framework to treat sexuality problems after TBI. A nonconcurrent multiple baseline single-case design with 8-week follow-up and randomisation to multiple baseline lengths (3, 4, or 6 weeks) was repeated across nine participants (five female) with complicated mild–severe TBI (mean age = 46.44 years (SD = 12.67), mean post-traumatic amnesia = 29.14 days (SD = 29.76), mean time post-injury = 6.56 years (median = 2.50 years, SD = 10.11)). Treatment comprised eight weekly, individual sessions, combining behavioural, cognitive, and educational strategies to address diverse sexuality problems. Clinical psychologists adopted a flexible, patient-centred, and goal-orientated approach whilst following a treatment guide and accommodating TBI-related impairments. Target behaviour was subjective ratings of satisfaction with sexuality, measured three times weekly. Secondary outcomes included measures of sexuality, mood, self-esteem, and participation. Goal attainment scaling (GAS) was used to measure personally meaningful goals. Preliminary support was shown for intervention effectiveness, with most cases demonstrating sustained improvements in subjective sexuality satisfaction and GAS goal attainment. Based on the current findings, larger clinical trials are warranted.
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Affiliation(s)
- Elinor E. Fraser
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (M.G.D.); (K.H.); (L.B.); (J.L.P.)
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, VIC 3121, Australia
- Correspondence:
| | - Marina G. Downing
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (M.G.D.); (K.H.); (L.B.); (J.L.P.)
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, VIC 3121, Australia
| | - Kerrie Haines
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (M.G.D.); (K.H.); (L.B.); (J.L.P.)
| | - Linda Bennett
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (M.G.D.); (K.H.); (L.B.); (J.L.P.)
| | - John Olver
- Rehabilitation Medicine, Epworth HealthCare, Richmond, VIC 3121, Australia;
| | - Jennie L. Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (M.G.D.); (K.H.); (L.B.); (J.L.P.)
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, VIC 3121, Australia
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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.
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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
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Anto-Ocrah M, Oktapodas Feiler M, Pukall C, Pacos-Martinez A. Resilience and Sexuality After Concussion in Women. Sex Med 2021; 9:100297. [PMID: 33482610 PMCID: PMC7930863 DOI: 10.1016/j.esxm.2020.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 12/02/2022] Open
Abstract
Background Previous findings from our group show that in the acute (ie, 6–10 weeks) post-injury period, women with concussions have a 70% greater risk of sexual dysfunction than those with extremity injuries. There are currently limited treatment options for the clinical management of concussions. Resilience is a protective, modifiable psychological construct that has been shown to improve concussion-related sequelae. To date, however, no research has evaluated how resilience impacts sexuality outcomes after concussion in women. Aim Evaluate if resilience offers protection against negative sexuality outcomes in a cohort of reproductive, aged women with a concussion, seeking care in the Emergency Department of a Level-1 Trauma Center. We hypothesized that women with low resilience will be more likely to experience negative impacts on sexuality and that increasing levels of resilience will be associated with more positive sexuality outcomes. Methods Secondary data analyses. Measures Resilience was evaluated with the Resilience Scale (RS), and the Brain Injury Questionnaire for Sexuality (BIQS) was used for sexuality. Results Of the 299 participants recruited for the parent study, 80 with concussion had complete follow-up data and were included in these secondary analyses. Less than half (42.5%; n = 34) had low resilience (score≤130 on the RS), and the remaining 46 (57.5%) had high resilience (score>130 on the RS). In crude linear regression models, 1-unit increase in resilience was associated with a 4% increase in sexuality outcomes (β = 0.04, 95% CI:0.01, 0.05; P = .008). The effect estimate remained similar in post-concussion-symptom-adjusted models (β = 0.03, 95% CI:0.002, 0.06; P = .03). Mood-adjusted models showed a statistically significant interaction term (P < .0001). After stratifying by mood, findings showed that unit increases in resilience were associated with a 6% increase in sexuality outcomes for women in the high risk mood group (HADS score ≥11; PCS-adjusted β = 0.06, 95% CI:0.02, 0.11; P = .009). Conclusion Longitudinal studies are needed to evaluate how these improvements in resilience translate to patient recovery measures following concussion. Anto-Ocrah M, Oktapodas Feiler M, Pukall C, et al. Resilience and Sexuality After Concussion in Women. Sex Med 2021;9:100297.
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Affiliation(s)
- Martina Anto-Ocrah
- Department of Emergency Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY; Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, NY; Department of Neurology, School of Medicine and Dentistry, University of Rochester, Rochester, NY.
| | - Marina Oktapodas Feiler
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY
| | - Caroline Pukall
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Amy Pacos-Martinez
- Department of Physical Medicine & Rehabilitation, School of Medicine and Dentistry, University of Rochester, Rochester, NY
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Auger LP, Grondin M, Aubertin M, Marois A, Filiatrault J, Rochette A. Interventions used by allied health professionals in sexual rehabilitation after stroke: A systematic review. Top Stroke Rehabil 2020; 28:557-572. [DOI: 10.1080/10749357.2020.1845014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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
| | - Myrian Grondin
- Marguerite-d’Youville Library, Université de Montréal, Montreal, QC, Canada
| | - Mélanie Aubertin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Audrey Marois
- Centre intégré de santé et de services sociaux des Laurentides, Saint-Jérôme, QC, Canada
| | - Johanne Filiatrault
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- Marguerite-d’Youville Library, Université de Montréal, Montreal, QC, Canada
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre intégré de santé et de services sociaux des Laurentides, Saint-Jérôme, 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
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Baguley IJ, Barden HL, Nott MT. Altered sexual function after central neurological system trauma is reflective of region of injury; brain vs spinal cord. Brain Inj 2020; 34:1732-1740. [PMID: 33190566 DOI: 10.1080/02699052.2020.1832258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare and contrast the contributory effects of traumatic brain injury (TBI) and spinal cord injury (SCI) on sexual function and social relationship opportunities, hypothesizing that patterns of change in sexual function would follow etiology. DESIGN Cross-sectional, case-matched survey of community living individuals with TBI, SCI or both (termed dual diagnosis). PARTICIPANTS Consecutive sample of participants with TBI (n = 25), SCI (n = 24) and dual diagnosis (n = 28), an average 3.6 years post-rehabilitation discharge. METHODS Participants were interviewed using a modified version of the 'Sexuality after Spinal Injury Questionnaire.' RESULTS Almost all respondents (97%) perceived adverse post-injury change in their experience of neurosexual function and/or social relationships. Physiological aspects of sexual function (e.g., erection, orgasm) were most affected by SCI whereas social relationships appeared more affected by TBI. People with dual diagnoses exhibited a combination of features. Participants with SCI (with or without TBI) were significantly more likely to have their concerns about sexual function discussed during rehabilitation than the TBI group. CONCLUSION TBI and SCI produce predictable impacts upon sexual function following injury, the impact of which were less frequently addressed during inpatient rehabilitation for those with TBI.
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Affiliation(s)
- Ian J Baguley
- Brain Injury Rehabilitation Service, Westmead Hospital , Sydney, Australia.,Sydney Medical School, The University of Sydney , Sydney, Australia
| | - Hannah L Barden
- Brain Injury Rehabilitation Service, Westmead Hospital , Sydney, Australia.,School of Community Health, Charles Sturt University , Albury, Australia
| | - Melissa T Nott
- Brain Injury Rehabilitation Service, Westmead Hospital , Sydney, Australia.,School of Community Health, Charles Sturt University , Albury, Australia
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Understanding the Multidimensional Nature of Sexuality After Traumatic Brain Injury. Arch Phys Med Rehabil 2020; 101:2080-2086. [DOI: 10.1016/j.apmr.2020.06.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/24/2020] [Accepted: 06/30/2020] [Indexed: 01/11/2023]
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10
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Priorities and Needs Regarding Sexual Rehabilitation for Individuals in the Subacute Phase Post-stroke. SEXUALITY AND DISABILITY 2020. [DOI: 10.1007/s11195-020-09664-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Anto-Ocrah M, Tiffany K, Hasman L, van Wijngaarden E. Mild traumatic brain injury/concussion and female sexuality, a scoping review of the literature. Inj Epidemiol 2020; 7:7. [PMID: 32127044 PMCID: PMC7050144 DOI: 10.1186/s40621-020-0232-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/14/2020] [Indexed: 12/28/2022] Open
Abstract
Background The American Congress of Rehabilitation Medicine (ACRM) in 2010 called for more head injury research on gender disparities to bridge the gender gap for the short-and long-term effects of TBI, including sexual and reproductive outcomes. In this paper, we review the state of the literature before and after the ACRM announcement, and evaluate how research teams have considered females and mildly injured TBI(mTBI)/concussion groups in post-TBI-related changes in sexual functioning. Methods The research question for this scoping review was “what is the state of the literature in the evaluation of post-TBI sexual changes for women, and individuals with mTBI?” Using the 2010 ACRM call for action as a line of demarcation, we compared our findings before and after the 2010 announcement. Results We identified 9 research studies that addressed sexual functioning changes in females and mTBI/concussion groups. Four of the nine were published before the 2010 ACRM announcement, and five were published after. The representation of female research participants increased steadily over the 28-year timespan. The proportion of individuals with mTBI included in the post-2010 era was higher than the earlier time period. Consistently, women with mTBI reported more adverse sexual outcomes compared to male cohorts, orthopaedic, and non-injured comparison groups. This observation persisted regardless of recruitment site (rehabilitation center/Emergency Department (ED)/Community) or time of outcome assessment (acute versus chronic). The findings also remained despite the heterogeneity of survey questionnaires used to evaluate sexual functioning outcomes. Excluding the most recent 2019 study, none of the research groups compared the findings by TBI severity, making it difficult to fully understand how concussion-related sexual changes compare to more severe forms of the head injury. The long term impacts of the sexual changes, such as infertility and relationship discord were also absent across all studies; even though most evaluated outcomes chronically (some as far out as 20 years post injury). Conclusion The number of publications in the era before the ACRM call for action and afterwards were almost identical. In order to tailor interventions for the appropriate groups of TBI patients, more neurosexuality research is needed to increase awareness of the importance of sexuality as a health outcome for individuals with neurodisabilities.
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Affiliation(s)
- Martina Anto-Ocrah
- Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. .,Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. .,Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
| | | | - Linda Hasman
- Miner Library, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
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O’Shea A, Frawley P, Leahy JW, Nguyen HD. A Critical Appraisal of Sexuality and Relationships Programs for People with Acquired Brain Injury. SEXUALITY AND DISABILITY 2020. [DOI: 10.1007/s11195-020-09616-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Poletti B, Carelli L, Solca F, Pezzati R, Faini A, Ticozzi N, Mitsumoto H, Silani V. Sexuality and intimacy in ALS: systematic literature review and future perspectives. J Neurol Neurosurg Psychiatry 2019; 90:712-719. [PMID: 30538137 DOI: 10.1136/jnnp-2018-319684] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/05/2018] [Accepted: 11/05/2018] [Indexed: 12/12/2022]
Abstract
Several features of amyotrophic lateral sclerosis (ALS) impact on sexuality and intimate relationship; however, the issue has received poor attention so far. We performed a systematic literature review in order to provide an up-to-date account of sexuality in ALS. References were identified by searches of PubMed, Web of Science, Scopus and PsycINFO (1970-2017, English literature). The following were the key terms: 'sexual' OR 'sexuality' OR 'intimacy' OR 'marital' AND 'ALS' OR 'Amyotrophic Lateral Sclerosis' OR 'Motor Neuron Disease' OR 'MND'. Titles and abstracts were screened for relevance and a full-text analysis was performed on the selected articles. Studies were included if they referred to sexual well-being/activities/functions or intimate relationship between patients and their partners and management of such topic by clinicians. Eligibility assessment was performed independently by two reviewers. A thematic and level of evidence classification of studies was performed. Studies' design, objectives, measurements and outcomes were summarised. Thirty articles were included and four topics were identified: intimacy in the dyads; sexual activities in patients and with their partners; sexual function disturbances; and sexuality and cognitive-behavioural alterations. The quality of the studies varies, with globally poor level of evidence. Some sexuality issues have been only sparsely addressed, such as gender-related differences, same-sex relationships and sexual activities other than intercourse. Sexuality in ALS is still not adequately considered by clinicians and researchers. We present preliminary recommendations for improving sexuality and intimacy at any ALS multidisciplinary clinics.
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Affiliation(s)
- Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Laura Carelli
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Federica Solca
- Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, Milan, Italy
| | - Rita Pezzati
- University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.,Centro Terapia Cognitiva, Como, Italy
| | - Andrea Faini
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, IRCCS, Milan, Italy.,Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, Milan, Italy
| | - Hiroshi Mitsumoto
- Eleanor and Lou Gehrig ALS Center, Department of Neurology, Columbia University Medical Center, New York City, New York, USA
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, IRCCS, Milan, Italy .,Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, Milan, Italy
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