Journal of Rehabilitation Medicine 51-5 | Page 48

364 J. K. Vikan et al. Table II. Classification of 9 specialized stroke rehabilitation centres as High or Low policy score centre; number (%) of healthcare personnel (HCP) responding and response rate on web survey Country, Specialized stroke rehabilitation centre HCP Category a n (%) Palestine: Alamal Rehabilitation Centre and Islamic University – Faculty of Medicine and Health Sciences, Gaza Palestine: Bethlehem Arab Society for Rehabilitation, Bethlehem Israel: Sheba Medical Center, Tel Aviv China: Bayi Rehabilitation Center, Chengdu Russia: Polyclinica nr.2; Petrozavodsk; Respublikanskaja Bol’nica imeni Baranova United States: Rusk Rehabilitation, NYU Lagone Health, New York Sweden: Sahlgrenska University Hospital, Gothenburg Sweden: Stockholm’s Sjukhem, Stockholm Norway: Sunnaas Rehabilitation Hospital, Oslo Total High High High Low Low Low High Low High – Response rate %, HCP 19 (6) 29 28 (9) 56 80 (25) 83 72 (22) 100 20 (6) 80 19 (6) 54 12 (4) 26 43 (13) 72 30 (9) 48 323 (100) 64 a A positive score for 5 or more statements on the “Organizational Audit” was categorized as “High policy score” and less than 5 as “Low policy score”. high-scoring centres had significantly (p < 0.001) more years of work experience (mean 10.6, SD 9.7 years) than at low-scoring centres (mean 6.6, SD 6.0 years). Among HCPs having lectures in sexual medicine/ sexology in their professional education (46%) a ma- jority had 1–2 h of lectures and 5% had more than 10 h, most of the latter being physicians. A need for education or training within sexual health issues was expressed by 90%, with “stroke and sexuality” (68%), “medication and side-effects” (48%) and “sexual dys- function” (44%) reported most frequently. Preferred models for sexological education and training were interdisciplinary (46%), intradisciplinary (36%) and “e-learning” (29%) courses, with no significant dif- ferences between centres with high and low scores. However, 10% of HCPs in both high- and low-scoring centres explicitly reported that they did not want to work with sexuality-related issues. Table III. Characteristics of respondents, healthcare personnel Characteristics n (%) Gender (n  = 323) Male Female Other gender identity Age (n  =321) < 30 years 30–49 years ≥50 years Profession (n  =323) Physicians Nurses Nurses (23%) Assistant nurses (5%) Allied professionals Physiotherapists (18%) Occupational therapists (17%) Speech therapists (8%) Psychologists (5%) Social workers (3%) Others (3%) Years of work experience in rehabilitation (n  =316) median (range) Lectures in sexual medicine/sexology during professional training (n  =314) Attended continuing education in sexual medicine/sexology (n  =314) www.medicaljournals.se/jrm 86 (26) 235 (73) 2 (1) 95 (30) 168 (52) 58 (18) 59 (18) 89 (28) 175 (54) 6 (1–50) 136 (46) 13 (4) Workplace routines and practices Fig. 1 shows that significantly more HCPs working at high rather than low policy score centres reported that their workplace prioritized giving information about sexuality to patients (p = 0.009), offered education in sexual medicine/sexology (p < 0.001) and that they had access to guidelines or procedures on sexual health (p < 0.001). In total, 24% of respondents reported that they did not know who was responsible for addressing sexuality in current practice at their workplace, with significantly (p < 0.001) more at low- than at high- scoring centres. HCPs at low-scoring centres also more frequently reported that patients did not initiate talking about sexuality (p < 0.001) than those at high- scoring centres. In total, 8% of respondents reported that all profes- sionals have a shared responsibility for communica- tion on sexual health in current practice, while 19% believed that this should be a shared responsibility among HCPs, with no significant differences between centres scoring high and low on sexual health policy. Level of knowledge and comfort HCPs at centres scoring high on sexual health policy rated both their level of knowledge (p < 0.001) and com- fort (p < 0.001) working with sexual health significantly higher than those at low-scoring centres (Table IV). HCPs were asked if the age, gender or marital status of the patients or their partners affected their comfort with addressing sexuality. A higher patient age (> 50 years) was found to negatively affect the feeling of comfort in 38% of HCPs, with more discomfort (p < 0.001) at low- than high-scoring centres. The gender of stroke patients affected 45% of HCPs, with both female and male personnel being most comfort­ able with patients of the same gender as themselves; no significant differences were identified between high- and low-scoring centres. Nor were there any significant differences regarding patients’ marital status, although