Supporting sexual adjustment from the perspective of men living with spinal cord injury

Abstract

Study design

Descriptive phenomenological approach.

Objectives

This study explored the lived experience of sexuality for men after spinal cord injury (SCI) and described the current state of tools and resources available to assist with sexual adjustment from the perspective of men living with SCI.

Setting

Men living in the community in Ontario, Canada.

Methods

Six men (age 24–49 years) with complete or incomplete SCI (C4-T12; <1–29 years post injury) participated in one individual, in-depth, standardized, open-ended interview (68–101 min). Analysis was conducted using Giorgi’s method, and involved within case analysis followed by cross-case analysis.

Results

All participants reported that resources available to support sexual adjustment after SCI were inadequate, and the majority of men felt their healthcare providers lacked knowledge regarding, and comfort discussing sexuality after SCI. Men reported sexuality was not a priority of the rehabilitation centers and felt that healthcare providers did not understand the importance of addressing sexuality. Existing resources were described as too clinical and not necessarily relevant given changes in sensation and mobility post injury. Participants provided recommendations for the effective delivery of relevant sexual education information.

Conclusions

To improve quality of life for men after SCI, suitable resources must be available to support sexual rehabilitation post injury. Future research should focus on developing strategies to facilitate discussions about sexuality between individuals with SCI and healthcare providers, and on developing resources that are effective and relevant for these men.

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Data availability

The datasets generated and analyzed during the current study are not publicly available due to the possibility of identifying information occurring in the in-depth qualitative data, but are available from the corresponding author on reasonable request.

References

  1. 1.

    Noonan VK, Fingas M, Farry A, Baxter D, Singh A, Fehlings MG, et al. Incidence and prevalence of spinal cord injury in Canada: a national perspective. Neuroepidemiology. 2012;38:219–26.

    Article  Google Scholar 

  2. 2.

    Jim, et al. Press kit—get the facts. Spinal Cord Injury Ontario. sciontario.org/information-news/news-media/press-kit/.

  3. 3.

    Sharma SC, Singh R, Dogra R, Gupta SS. Assessment of sexual functions after spinal cord injury in Indian patients. Int J Rehabil Res. 2006;29:17–25.

    Article  Google Scholar 

  4. 4.

    Siösteen A, Lundqvist C, Blomstrand C, Sullivan L, Sullivan M. Sexual ability, activity, attitudes and satisfaction as part of adjustment in spinal cord-injured subjects. Paraplegia. 1990;28:285–95.

    PubMed  Google Scholar 

  5. 5.

    Pieters R, Kedde H, Bender J. Training rehabilitation teams in sexual health care: a description and evaluation of a multidisciplinary intervention. Disabil Rehabil. 2018;40:732–9.

    Article  Google Scholar 

  6. 6.

    Anderson KD, Borisoff JF, Johnson RD, Steins SA, Elliott SL. The impact of spinal cord injury on sexual function: concerns of the general population. Spinal Cord. 2007;45:328–37.

    CAS  Article  Google Scholar 

  7. 7.

    Low WY, Tunku NTTZ. Sexual issues of the disabled: implications for public health education. Asia Pac J Public Health. 2000;12:78–83.

    Google Scholar 

  8. 8.

    Sunilkumar MM, Boston P, Rajagopal MR. Sexual functioning in men living with a spinal cord injury- a narrative literature review. Indian J Palliat Care. 2015;21:274–81.

    CAS  Article  Google Scholar 

  9. 9.

    Basson PJ, Walter S, Stuart AD. A phenomenological study into the experience of their sexuality by males with spinal cord injury. Health SA Gesondheid. 2003;8:3–11.

    Article  Google Scholar 

  10. 10.

    Herson L, Hart KA, Gordon MJ, Rintala DH. Identifying and overcoming barriers to providing sexuality information in the clinical setting. Rehabil Nurs. 1999;24:148–51.

    CAS  Article  Google Scholar 

  11. 11.

    Elliott. S, Jeyathevan G, Hocaloski S, O’connell C, Gulasingam S, Mills S, et al. Conception and development of sexual health indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project. J Spinal Cord Med. 2019;42:68–84.

    Article  Google Scholar 

  12. 12.

    Kathnelson JD, Kurtz Landy CM, Ditor DS, Tamim H, Gage WH. Examining the psychological and emotional experience of sexuality for men after spinal cord injury. Cogent Psychol. 2020;7:1722355 .https://doi.org/10.1080/23311908.2020.1722355.

    Article  Google Scholar 

  13. 13.

    Patton MQ, editor. Qualitative research & evaluation methods. Thousand Oaks, CA: Sage; 2002.

  14. 14.

    Polit DF, Hungler BP. Nursing research: principles and methods. Philadelphia, PA: Lippincott; 1995.

  15. 15.

    Smith JA, Osborn M. Interpretive phenomenological analysis. Qualitative psychology: a practical guide to methods. 2nd ed. London: Sage; 2008.

  16. 16.

    Creswell J, editor. Qualitative inquiry and research design: choosing among five approaches. 2nd ed. Thousand Oaks, CA: Sage; 2007.

  17. 17.

    Giorgi A, editor. The descriptive phenomenological method in psychology: a modified husserlian approach. Pittsburgh, PA: Duquesne University Press; 2009.

  18. 18.

    Liamputtong P, editor. Qualitative research methods. 3rd ed. Victoria: Oxford University Press; 2009.

  19. 19.

    Carpenter C, Suto M, editors. Qualitative research for occupational and physical therapists: a practical guide. Oxford: Blackwell Publishing Ltd; 2008.

  20. 20.

    Ortlipp M. Keeping and using reflective journals in the qualitative research process. Qualitative Rep. 2008;13:695–705.

    Google Scholar 

  21. 21.

    Cohen MZ, Omery A. Schools of phenomenology: implications for research. In: Morse JM, editor. Critical issues in qualitative methods. Thousand Oaks, CA: Sage; 1994.

  22. 22.

    Gianotten WL, Bender JL, Post MW, Höing M. Training in sexology for medical and paramedical professionals: a model for the rehabilitation setting. Sex Relatsh Ther. 2006;21:303–17.

    Article  Google Scholar 

  23. 23.

    Consortium for Spinal Cord Medicine. Sexuality and reproductive health in adults with spinal cord injury: a clinical practice guideline for health-care professionals. J Spinal Cord Med. 2010;33:281–336.

    Article  Google Scholar 

  24. 24.

    Aikman K, Oliffe JL, Kelly MT, McCuaig F. Sexual health in men with traumatic spinal cord injuries: a review and recommendations for primary health-care providers. Am J Men’s Health. 2018;12:2044–54.

    Article  Google Scholar 

  25. 25.

    Elliott S, Hocaloski S, Carlson M. A multidisciplinary approach to sexual and fertility rehabilitation: the sexual rehabilitation framework. Top Spinal Cord Inj Rehabil. 2017;23:49–56.

    Article  Google Scholar 

  26. 26.

    McAlonan S. Improving sexual rehabilitation services: the patient’s perspective. Am J Occup Ther. 1996;50:826–34.

    CAS  Article  Google Scholar 

  27. 27.

    Eisenberg NW, Andreski S, Mona LR. Sexuality and physical disability: a disability-affirmative approach to assessment and intervention within health care. Curr Sex Health Rep. 2015;7:19–29.

    Article  Google Scholar 

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Acknowledgements

We thank Merna Seliman who assisted with data analysis.

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Authors

Contributions

JDK was responsible for developing the protocol, collecting and analyzing data, interpreting results and writing the report. JDK has had full access to the data in the study and has final responsibility for the decision to submit for publication. CMKL contributed to development of the protocol, interpretation of results and provided feedback on the report. DSD contributed to protocol development and provided feedback on the report. HT contributed to protocol development and provided feedback on the report. WHG was responsible for development of the protocol, interpretation of results and provided.

Corresponding author

Correspondence to Jacqueline D. Kathnelson.

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Ethics statement

This file has been reviewed and received ethics clearance from the York University Research Ethics Board (file number 2019–004) and the Brock University Research Ethics Board (file number 18–235). We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.

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The authors declare that they have no conflict of interest.

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Kathnelson, J.D., Kurtz Landy, C.M., Ditor, D.S. et al. Supporting sexual adjustment from the perspective of men living with spinal cord injury. Spinal Cord (2020). https://doi.org/10.1038/s41393-020-0479-6

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