 Subjects -> DISABILITY (Total: 103 journals)
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- Perceived Barriers to patient-healthcare Professional Communication on
Sexual Health Information in Patients with Gynecological cancer-
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Abstract: Abstract Gynecological cancer treatment may cause dysfunction and cessation of sexual activity, adversely impacting patients’ psychological health, relationship adjustment, and overall quality of life (QoL). Gynecological oncologists can significantly enhance survivors’ QoL by addressing sexual concerns. However, these remain unaddressed among many cancer survivors. Hence, this qualitative study explored healthcare professionals’ perceived barriers to providing sexual information to gynecological cancer patients and examined their gender blindness. We collected data through in-depth, semi-structured interviews with 14 participants recruited from the gynecological cancer ward and radiotherapy department of a northern Taiwan medical center. Using the Miles and Huberman method, the analysis yielded four themes: (1) the service system is unsupportive; (2) providers’ sexual health literacy is often inadequate; (3) providers often make their own decisions about the criterion for addressing sexual health; (4) certain situations can be unfavorable for initiating a conversation about sexual health. Gender blindness was identified as a significant barrier to sexual healthcare among healthcare professionals. This highlights the need for gender sensitivity in cancer care and the awareness of gender blindness in sexual healthcare. This can help professionals identify sex and sexual health conversation barriers, promoting discussions that enhance the sexual health of patients with gynecological cancer.
PubDate: 2023-09-26
- From the Editor of Sexuality and Disability
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PubDate: 2023-09-01
- Validating the Teacher Sexuality Education Questionnaire Scales to Assess
Educators’ Preparedness to Deliver CSE to Young People with Disabilities
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Abstract: Abstract Comprehensive sexuality education (CSE) is instrumental in ensuring that young people have the knowledge and skills to make informed decisions and practice safer sex. Worryingly, CSE is often not available to adolescents and young with disabilities. The Breaking the Silence (BtS) approach to CSE was developed to address this gap and help equip educators to teach CSE to adolescents and young people with disabilities. The TSE-Q was designed to evaluate the effectiveness of the BtS approach and monitor changes in educators’ knowledge, skills, attitudes, self-confidence, and preparedness to teach CSE to young people with disabilities. The TSE-Q is aligned with an adapted version of the theory of planned behavior. This is a second validation study of the TSE-Q embedded within a feasibility study for the BtS approach. Fifty educators and support staff from two South African special schools for people with disability participated in a BtS training workshop and completed the TSE-Q before and after the workshop. Additionally, participants were asked to complete an adapted version of Rowe, Oxman, and O’Brien’s validity questionnaire probing content validity, face validity, and ease of use. Baseline data from the TSE-Q was evaluated for reliability, while the validity questionnaire and verbal feedback were used to assess validity. Most scales show good reliability, but knowledge-based scales have lower reliability due to their multidimensionality. The TSE-Q shows good face validity, content validity, and ease of use, but should be done on different days to any intervention/training. Overall, the TSE-Q is a robust questionnaire with good content coverage.
PubDate: 2023-09-01
- ASD and Gender Dysphoria: A Review of Challenges and Facilitators for
Health Professionals-
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Abstract: Abstract Although the literature highlights a growing number of diagnoses of autism spectrum disorder (ASD) and the rise in the number of referrals for gender dysphoria in specialized clinics, there is little data currently available on how to intervene with this clientele in health care settings having a comorbidity for these two diagnoses. The objective of this systematic review was to define the challenges encountered by various health professionals when intervening with individuals who present a comorbidity of ASD and gender dysphoria in comparison with neurotypical individuals with similar developmental gender characteristics. Four databases [Sociological Abstracts, EMBASE, PsycInfo (OVID), Academic Search Premier] were consulted with keywords such as "autism spectrum disorder", "neurotypical" and "gender dysphoria". From 5639 studies screened, 184 full-text studies were assessed for eligibility. A total of 25 articles were retained. The results show that individuals with gender dysphoria are at risk of developing psychological distress and that family and friends play a fundamental role in the support offered to them. Health professionals must adapt their approach according to the individual's unique profile, which is even more evident when intervening with individuals with an ASD because of their particularities. Health care professionals need to expand their knowledge on gender dysphoria in order to have a better understanding of the various challenges faced by these individuals, such as discrimination. By the same token, these results will help to shed some light on clinical interventions focusing on the unique profile of these patient in order to better address their particular needs.
PubDate: 2023-09-01
- The Effect of Sex Education Intervention on Sexual Knowledge of Female
Adolescents with Intellectual Disabilities-
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Abstract: Abstract The present study sought to evaluate the effectiveness of a Sex Education Intervention on sexual knowledge in a group of female adolescents with intellectual disabilities. This research was conducted in a pretest-posttest design with a control group. The sample included 30 female adolescents with intellectual disabilities that were selected through convenience sampling and randomly divided into two groups: an experimental group and a control group (15 participants in each group). The experimental group received 18 sessions of a Sex Education Intervention while the control group did not receive this intervention. Assessment of Sexual Knowledge in Adolescents (ASKA) was used to measure sexual knowledge of the adolescents. The results showed that Sex Education Intervention improved general sexual knowledge and subscales like parts of the body, public and private parts and places, puberty, relationships, social sexual boundaries, safe sex practices, and sex and the law in the experimental group. However, no effect of the intervention was observed in subscales of masturbation and sexuality. The present research emphasizes the importance of Sex Education Intervention in increasing sexual knowledge in female adolescents with intellectual disabilities.
PubDate: 2023-09-01
- Using Concept Mapping to Explore the Perspectives of People with Mild to
Borderline Intellectual Disabilities Toward Sexual Health-
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Abstract: Abstract People with mild to borderline intellectual disabilities face many barriers toward their sexual health. To promote sexual health and overcome these barriers, they need individualized forms of sexuality support and education. To align sexuality support and education insight is needed on their understanding of sexual health. The current paper aims to provide greater insight in what sexual health consists of according to people with mild to borderline intellectual disabilities. Nine people with a mild to borderline intellectual disability participated in a concept mapping procedure, consisting of brainstorming, sorting, and ranking the statements. The resulting clusters and concept map were interpreted by an expert group. Analysis resulted in five clusters which participants considered important for their sexual health. According to people with mild to borderline intellectual disability cluster pertaining to romantic relationships and sexual socialization were the most important. These were followed by clusters on sexual health and lastly sexual selfhood. These results have implications for the development of sexuality support and education, as well as further research.
PubDate: 2023-09-01
- Increasing Opportunities for Healthy Sexual Socialization in
LGBTQ+ People with IDD: The Role of LGBTQ+ Organizations and Community
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Abstract: Abstract In the current intersectionality-focused discourse within sexuality research, individuals existing at the convergence of intellectual and developmental disabilities (IDD) and lesbian, gay, bisexual, transgender, and queer+ (LGBTQ+) are often overlooked. Individuals with IDD face difficulties acquiring sexual knowledge and skills due to limited opportunities for sexual socialization, misconceptions concerning sexuality and IDD, lack of comprehensive sexual education, restricted support from staff and caregivers, and a lack of community experiences that facilitate the development of healthy sexuality. When an individual with IDD identifies as LGBTQ+, these disability-related barriers can exacerbate the stigma and discrimination some LGBTQ+ people experience. Using the intimate justice framework, we explore avenues to support and foster inclusivity within the LGBTQ+ community for members with IDD. Several recommendations were identified from the literature search, including logistical considerations and using accessible language for outreach events, presentations, workshops, training, and other activities and opportunities for sexuality education while challenging disability-related stigma in LGBTQ+ spaces.
PubDate: 2023-09-01
- Sex.Ed.Agram: Co-created Inclusive Sex Education on Instagram
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Abstract: Abstract Most sex education programs for adults with intellectual disabilities are led by non-disabled sexual health experts. This approach may be less effective and appropriate for adult learners. Using community-based participatory research (CBPR), we explored a program that uses an inquiry-based learning process so that members can create reliable information about sex and disseminate it on Instagram. Through thematic analysis of interviews with group participants, we identified three themes about how the program brought everyone’s different ideas about sex and sex ed together into content for Instagram: Blurring the Lines Between the Educated and Educating; Learning is Dependent on the Strengths and Weaknesses of Our Connections; and Committed to Inclusivity but Wrestling with Ableism.
PubDate: 2023-09-01
- Racial and Ethnic Differences in the Severity of Sexual Dysfunction
Symptoms in Patients with Multiple Sclerosis-
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Abstract: Abstract Sexual dysfunction (SD) is a common symptom for many with multiple sclerosis (MS). However, most studies researching this topic have predominantly White samples. While this matches epidemiological estimates, research has shown that those of other ethnic groups, such as African Americans/Blacks and Hispanics/Latinos, tend to exhibit more symptomology. This study aimed to determine if this greater symptomology in other ethnic groups with MS holds for SD. Study participants were recruited from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry. Participants completed the MSISQ-19 and the PDDS and provided demographic information. Study participants were 5445 respondents (Mage = 51 years, SD = 9.56, 75% female, 93% White). White, African American/Black, and Hispanic/Latino groups were compared on sexual dysfunction. Linear mixed effects modeling revealed that the MSISQ-19 subscale scores were significantly different for the African American/Black group (t = − 2.48, p < 0.013) and all female participants (t = − 2.58, p < 0.010). African American/Black participants had the least amount of primary SD (M = 10.56, 95% CI [9.09, 12.03]). African American/Black participants had the highest amount of secondary SD (M = 18.62, 95% CI [17.15, 20.09]), though the result was not statistically significant. Additionally, African American/Black females scored higher in all subscale scores when compared to African American/Black males, with a 3-point and 2-point difference in primary and tertiary symptoms. Our study has highlighted the importance of clinicians assessing for SD within their patients and to consider potential differences in symptom presentations of racial groups.
PubDate: 2023-09-01
- Life Experiences of Married Women with Visual and Orthopedic Disabilities
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Abstract: Abstract The study aims to determine the life experiences of married women with visual and orthopedicdisabilities concerning sexuality and sexual health with the grounded theory method and develop a theory revealing the concepts and processes that affect these experiences with an explanatory framework. The study was implemented with a constructivist grounded theory design and method. The data were collected and analyzed by performing profound interviews with 12 visually disabled women and 13 orthopedically disabled women and recording the data, taking notes with observation, taking analytic notes (mnemonic notes), using secondary data sources and continuous comparison method until attaining satisfaction and using analysis stages (open, axial and selective coding) of the grounded theory synchronously with analysis stage of the data. Focus categories defining the life experiences of married women with visual and orthopedic disabilities concerning sexuality and sexual health were determined as; “Social Perception”, “Immediate Environmental Perception”, “Familial Perception”, “Partner Perception” and “Disabled Individual’s Perception”, “Coping Mechanisms” and “Solution Offers”. Focus categories were under the influence of the categories of; disability, sexuality, disabled sexuality, marriage and starting a family, the intention of having a child and were explained accordingly. Every stage of the grounded theory is affected by the characteristics of married women with visual and orthopedic disabilities, the relationship of their life experiences concerning sexuality and sexual health with each other, contextual and comparative factors, as well as a complex structure that varies according to time and experience.
PubDate: 2023-09-01
- Parental Knowledge and Attitudes Towards Sexuality and Sex-Education of
Their Children with Developmental Disabilities-
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Abstract: Abstract This study examined parents’ knowledge and attitudes about sexuality and sex education of their children with developmental disabilities (DD) in the Accra Metropolis of Ghana. Using a descriptive cross-sectional design, 46 conveniently sampled parents of children with DD responded to an online survey on knowledge of their children’s sexuality and their attitudes towards sex education. Findings from univariate analysis revealed that about 67% of parents have not given any form of sexual education to their children. However, 65% of parents in this study had good general knowledge about the sexuality of their children except for experiential topics (i.e., sexual feelings and experiences, including their sexual orientation (heterosexual/ gays and lesbians), and masturbation, but were generally positive about views of sex education for their children. Majority of the parents (82.6%) had not received any training on how to educate their children on sexuality matters to support and empower themselves and their children. These findings indicate that Ghanaian families rarely provide sex education for their children with DD, however, they perceive sex education as a positive and protective strategy for the reproductive and sexual health of their children with DD. Implications for the development of training programs that provides appropriate knowledge and skills related to sexual health are discussed.
PubDate: 2023-09-01
- Sexual Rehabilitation After a Stroke: A Multi-site Qualitative Study About
Influencing Factors and Strategies to Improve Services-
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Abstract: 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.
PubDate: 2023-09-01
- Sexuality Perceptions and Sexual Care Needs of Patients with Type 1
Diabetes Mellitus: A Mixed Methods Study-
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Abstract: Abstract This study was to evaluate the sexual functions of individuals with type 1 diabetes mellitus (T1DM) and determine their sexuality perceptions and sexual care needs. This convergent parallel design mixed methods study was conducted with eight volunteer participants with T1DM aged 25–47 years. Data were collected using Personal Information Form, Female Sexual Function Index Scale, Erection Function International Evaluation Form and semi-structured interview form. 50% of the participants are male. Erectile dysfunction was found in all men, and sexual dysfunction was found in 25% of women. As a result of the in-depth interviews, the sexuality perceptions and sexual care needs of the participants were gathered in five categories. These were (1) Meaning, (2) Difficulties in Relationship, (3) Barriers to Getting Professional Support, (4) Help Seeking Behavior, (5) Sexual Care Recommendations. In addition, participants produced metaphors to describe their sexuality before and after T1DM. Participants produced negative metaphors after being diagnosed with T1DM. It has been observed that participants with T1DM experience physiological and psychological difficulties in their sexual lives, and they often find solutions on their own rather than seeking professional support to cope with these difficulties. As a result, individuals with T1DM need training and sexual counseling on the effects of T1DM on sexuality, how they can cope with their sexual problems, and which institutions they can apply to for solutions to their problems.
PubDate: 2023-08-29
- Associations Between Weight and Sexual Behavior and Function in Chinese
Men and Women: Role of Body Image and Physical Factors-
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Abstract: Abstract Obesity is associated with increased risk of a number of physical and psychological problems, including heart disease, depression, and sexual dysfunction. We investigated the relationship between Body Mass Index categories, body image, and sexual function using more detailed assessment of potential weight related sexual problems than previous research. We recruited 251 Chinese participants (124 men) aged 18–57 to fill out an online questionnaire regarding sexual function, general body image, body image related to sexuality, and weight-related physical problems during sexual activity. The created body weight category groups with equal age controlling for its potential confounding effect on the association between obesity and sexual function. Participants’ and their partners’ height and weight as well as the International Index of Erectile Function-5 (IIEF-5), Checklist for Early Ejaculation Symptoms (CHEES), Female Sexual Function Index (FSFI), Body Image States Scales (BISS), sexual body image questions, and a series of questions regarding weight-related physical problems during sex were used. Obese and overweight men had worse erectile and ejaculatory function than normal weight men whereas in women no association with sexual dysfunction was found. Obese and overweight men and women had worse general and sexual body image than normal weight individuals of their gender. For men, Body Mass Index was associated with erectile and ejaculatory function through sexual body acceptance and sexual body shame. In addition, Body Mass Index was associated with ejaculatory function via body image and physical problems related to exhaustion and fat tissue during the sex. For women, Body Mass Index was associated with female sexual function through body image and sexual body acceptance. Finally, we also found that participants’ own Body Mass Index was positively associated with their partners’ Body Mass Index. The resulted indicate that obesity and overweight have complex relationships with sexual function that clinicians should be aware of. This study is first to investigate the potential mediation psychological and physical factors on the relationship between obesity and sexual function both for men and women. However, the sample size is limited and the cross-sectional design does not allow causal conclusions. Body Mass Index is associated with individuals’ sexual functioning via satisfaction with their own body, body satisfaction specifically related to sexual activity as well as physical problems during sexual activity.
PubDate: 2023-08-23
- Evaluation of the Effect of Sociodemographic Characteristics of Patients
with Prostate Cancer on Their Sexual Experiences and Self-Efficacy-
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Abstract: Abstract The study was planned as a descriptive study to evaluate the effects of sociodemographic characteristics of prostate cancer patients on their sexual experiences and self-efficacy. The sample of the study consisted of 69 patients with prostate cancer who were followed up for treatment in the outpatient clinic of an oncology hospital between December 2020 and March 2021 and met the inclusion criteria of the stud. Research data were collected by using the Patient Information Form, Arizona Sexual Experiences Scale (ASEX)-Male, and Sexual Self-Efficacy Scale (SSES). The mean age of prostate cancer patients was 67.1 ± 11.74 years, 95.7% (n = 66) were married, 37.7% (n = 66) were university graduates, and 75.4% (n = 52) were unemployed. Patients’ mean scores were 19.29 ± 7.66 on the total Sexual Self-Efficacy Scale and 22.08 ± 4.92 on the total Arizona Sexual Experiences Scale. In the study, it was determined that the sexual experiences and sexual self-efficacy of prostate cancer patients differed according to their education level, employment status, and duration of treatment. In the study, it was determined that patients with prostate cancer experienced sexual dysfunction and had low self-efficacy. In line with these results, our recommendations are for health professionals to evaluate the sexual functions of patients with prostate cancer and their sexual self-efficacy, which is an important determinant of sexual life, during the diagnosis, treatment, and care process. In addition, the sociodemographic characteristics of the patients should be considered when planning interventions that increase sexual self-efficacy in the management of sexual problems.
PubDate: 2023-08-22
- Professional Educational Opportunities
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PubDate: 2023-07-25
- Sexual Health Among Individuals with Spinal Cord Injury: A Meta-Synthesis
of Qualitative Evidence-
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Abstract: Abstract To meta-synthesize the qualitative evidence on individuals’ subjective experiences of sexual health following a spinal cord injury (SCI). PubMed, EMBASE, CINAHL, and PsycInfo were searched from 1960 to 2021 for qualitative research articles that examined sexual health (i.e., sex, sexuality, reproductive health, etc.) in adults with SCI. Only studies published in English, including first-person accounts of living with a SCI were included. Using qualitative meta-synthesis methodology, data (reported results) from each selected study were coded line-by-line to develop descriptive and analytical themes by two investigators. A total of 22 studies met inclusion criteria. Some articles inquired about specific aspects of sexual health (e.g., how their sexual experiences are affected by urinary incontinence), and others inquired broadly about the experience of sexual relationships (e.g., how people engage in sexual relationships after their SCI). The themes identified in each study were positioned within the Sexual Rehabilitation Framework (Elliott 2017) composed of eight domains: sexual drive/interests, partnerships, self-image, bowel/bladder, sexual function, motor/sensory, fertility/contraception, and secondary complications. Sexual health was shown to be a significant priority for individuals after a SCI and they are impacted in a multitude of ways. Individuals report wanting education and knowledge on sexual health post SCI. Health care professionals were perceived to lack the ability to meet their needs and resources were inadequate. Further, providers’ approach, attitude, and insensitivity to patient needs were perceived barriers to adequate sexual health rehabilitation post SCI. The collective findings can inform (a) rehabilitation professionals’ awareness of patients’ sexual needs after SCI; (b) the development of SCI programming or services for sexual health rehabilitation; and (c) the design of future research studies (e.g., interventions for specific sexual issues).
PubDate: 2023-07-23
- Youth and Parent Perspectives on Sexual Health Education for People with
Intellectual Disabilities-
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Abstract: Abstract Youth with intellectual disabilities face barriers to receiving sex education including the lack of educational tools accessible for multiple cognitive and emotional learning styles. We conducted exploratory research to gather input from a diverse group of youth with disabilities and their guardians about needed learning modalities and sexual health content areas. Three focus groups were conducted with youth ages 17–28 years (n = 14) and three with parents (n = 16). An applied thematic analysis of the transcripts resulted in three structural codes related to topics of greatest interest for youth sexuality education, teaching tools and methods, and needs for ancillary parent education and support to help youth access information and health care. We identified a total of ten themes associated with the three structural codes. Next steps will be to create educational resource prototypes that are responsive to focus group input for testing in further research.
PubDate: 2023-07-18
DOI: 10.1007/s11195-023-09805-y
- Youtube as a Source of Information on Sexual Dysfunction, Neurogenic
bladder and Neurogenic bowel after Spinal Cord Injury-
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Abstract: Abstract Spinal cord injury (SCI) is a serious medical condition which can lead to many complications, resulting in significant disability and morbidity in individuals. YouTube is one of the largest online platforms and also a potential source of information for patients. We aimed to analyze Youtube videos in terms of the reliability and quality levels on sexual dysfunction (SD), “neurogenic bladder (NBL)” and “neurogenic bowel (NBW)” in this study. YouTube search was performed on April 24th, 2022, about SCI and sexual dysfunction, neurogenic bladder and neurogenic bowel. DISCERN and Global Quality Score (GQS) were used to evaluate the quality and reliability of the videos. The characteristics of each video such as the number of likes and views, upload date, duration, popularity index were recorded. A total of 50 videos were analyzed. When the videos were evaluated according to their DISCERN scores, they were mostly categorized as “poor” quality and they were classified as medium-low quality due to their GQS scores. The rate of videos based on “patient experience” was 40%. The quality of the videos about “Sexual dysfunction” was significantly higher than the videos about “neurogenic bladder” and “neurogenic bowel”. Neurogenic bowel videos were mostly uploaded by non-professional sources and had the lowest DISCERN scores. Most of the Youtube videos about sexual dysfunction, neurogenic bladder and neurogenic bowel after spinal cord injury, are helpful but low-to-medium quality videos. Although the videos included some basic topics, they did not provide enough information and were “limited use” videos for patients’ use.
PubDate: 2023-07-12
DOI: 10.1007/s11195-023-09802-1
- Professional Educational Opportunities
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PubDate: 2023-04-24
DOI: 10.1007/s11195-023-09801-2
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