Sexuality after stroke
355
Table I. Participants’ characteristics
Characteristic
Age, years, mean (SD)
Years since first stroke/partner’s
first stroke, mean (SD)
Received advice about sexuality
during stroke rehabilitation, n (%)
Yes
No
Don’t recall
Disciplinary background, n (%)
Rehabilitation medicine
Nursing
Occupational therapy
Physiotherapy
Psychology
Speech pathology
Social work
Sexology
Sexual counselling
Other
Gender, n (%)
Male
Female
Sexual orientation, n (%)
Heterosexual
Gay
Lesbian
Bisexual
Prefer not to say
Religious preference, n (%)
Christian
Judaism
Buddhism
Hinduism
Atheism
Missing
Stroke survivors
(R1) n = 30 Stroke survivors Partners
Partners
(R2) n = 19
(R1) n = 18 (R2) n = 8
Clinicians
(R1) n = 35
Clinicians Researchers
(R2) n = 17 (R1) n = 19 Researchers
(R2) n = 6
53.4 (15.4) 55.7 (17.6) 52.5 (15.6) 51.9 (14.6) 47.7 (12.3)
43.6 (11.3) 48 (10.3) 46.3 (12.5)
6.1 (4.2) 5.6 (3.3) 6.2 (3.2)
5.4 (3.3)
4 (13.3)
24 (80.0)
2 (6.6) 3 (15.7)
16 (84.2) 1 (5.5)
16 (88.8)
1 (4.5)
7 (87.5)
1 (12.5)
5 (14.2)
4 (11.4)
12 (34.2)
1 (2.8)
3 (8.5)
2 (5.7)
2 (5.7)
4 (11.4)
1 (2.8)
1 (2.8) 3
3
6
1
1
1
1
1
1 (16.6)
1 (16.6)
2 (33.3)
(17.6)
(17.6)
(35.3)
(5.8)
(5.8)
(5.8)
(5.8)
(5.8)
2
4
3
2
3
1
2
1
(10.5)
(21)
(15.7)
(10.5)
(15.7)
(5.2)
(10.5)
(5.2)
1 (16.6)
1 (16.6)
1 (5.2)
16 (53.3)
14 (46.6) 9 (47.4)
10 (52.6) 13 (72.2)
6 (33.3) 5 (62.5)
3 (37.5) 3 (8.5)
32 (91.4) 1 (5.8)
16 (94.1) 12 (63.1)
7 (36.8) 4 (66.6)
2 (33.3)
27 (90.0)
3 (10.0)
17 (89.5)
2 (10.5)
18 (100.0) 8 (100.0) 32 (92.0)
1 (2.8)
1 (2.8) 15 (88.2)
1 (5.9)
1 (5.9) 16 (84.2) 5 (83.3)
2 (10.6) 1 (16.6)
15 (43)
3 (8.6) 2 (11.8)
1 (5.9) 7 (36.8) 6 (100.0)
13 (37.1)
4 (11.4) 12 (70.5)
2 (11.8) 8 (42.1)
4 (21) 10 (33.3)
1 (3.3)
2 (6.7) 9 (47.4)
1 (5.3)
1 (5.3)
13 (43.3)
4 (13.3) 8 (42)
13 (59) 3 (37.5)
1 (4.5)
1 (4.5) 1 (12.5)
1 (12.5)
3 (13.7) 3 (37.5)
tion following stroke. No further content was identified
through open-ended questions in rounds 1 or 2. Table
SI 1 shows the final 47 content areas, with consensus sco-
res and both priority scores. Table II presents the final
47 questions in a matrix categorized by consensus and
priority tier. None of the original 47 content areas were
excluded by participants. Eighteen content areas were
identified as being of high priority with a high level of
consensus. A further 27 content areas were identified as
having intermediate priority, again with a high level of
consensus. One content area “What is sexuality?” was
given a low priority with moderate level of consensus,
while the content area “Why is it important to talk about
sexuality?” was given an intermediate priority with
high consensus. Analysis of responses between rounds
1 and 2 indicated no changes in priority or consensus
relating to content areas.
Analysis of responses to open-ended questions indi-
cated that stroke survivors and partners were conscious
of the individual nature of sexuality and the stroke re-
covery experience, and thus, were reluctant to exclude
content areas based on their own personal experience:
‘I feel these would be relevant to all stroke survivors and
the partners. Additional information should be chosen on an
individual basis depending on the personal situation’ and
1 (5.3)
‘I have no physical problems and my partner’s very sup-
portive therefore I have many neutral answers. I could expect
that there are many others have real problems.’
Clinicians and researchers had similar concerns, noting
that discriminating between content areas was often
difficult, with practice typically led by the needs of
individual stroke survivors and their partner.
‘All are extremely relevant, and each has a specific function
regarding one’s sexuality and disability and their approach
with this as an individual and as a couple.’
Clinicians and researchers tended to rank content
related to psychological, cognitive and behavioural
changes after stroke higher because in their experience,
professionals were more able to respond to sexual pro-
blems caused by stroke-related physical impairments:
‘I have focused more on the social and psychological
aspects for suggested topics as, in my experience, doctors
and allied health are already reasonably comfortable in dis-
cussing changes to physical functioning related to sexuality
following stroke.’
Similarly, some respondents suggested that focusing
on communication about sexuality following stroke
could be a useful starting point as this would support
stroke survivors and their partners to identify other
areas of concern:
J Rehabil Med 51, 2019