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