Let's talk about sex: A pilot randomised controlled trial of a structured sexual rehabilitation programme in an Australian stroke cohort

Abstract

Background: Sexual dysfunction is a common problem after stroke. Sexual rehabilitation is recommended but little is known about the types or effectiveness of this intervention. Aim: To assess the effectiveness of a structured sexual rehabilitation programme alongside the use of written material in comparison with the use of written material alone, and to evaluate the impact of both interventions on sexual and psychological function in an Australian stroke cohort. Methods: Twelve participants (patients n=10; partners n=2) were randomly assigned to an intervention (n=4) or control (n=6) group. Standardised measurements were used to assess: sexual functioning (Changes in Sexual Function Questionnaire Short-Form) (CSFQ-14) (primary outcome); psychological functioning (Depression, Anxiety and Stress Scale) (DASS); physical functioning (Functional Independence Measure); and quality of life (Stroke and Aphasia Quality of Life scale–39-item generic version) (SAQOL-39g). All measures were assessed at baseline (T1) and six weeks after the programme (T2). Results: There was no significant difference between the intervention and control groups at T2 in sexual functioning (CSFQ-14), psychological functioning (DASS) and quality of life (SAQOL-39g); however, there was a trend in both groups toward improvement in all outcome measures at T2 compared with T1. Conclusion: This preliminary study demonstrates the feasibility and importance of providing sexual rehabilitation following stroke, and that sexual rehabilitation may improve sexual and psychological functioning and quality of life. Further studies are needed to confirm these findings for stroke survivors and their partners to address sexual issues that may arise and perceived rehabilitation needs.

Determinants of sexual function and dysfunction in men and women with stroke: A systematic review

“…Of the 19 studies reviewed, the global rating of quality resulted in five studies rated as moderate and 14 studies that were weak . There were no studies meeting the criteria for a strong rating.…”

“…In regards to gender, there were no studies exclusively focusing on sexual function or dysfunction in women. There were seven studies that focused on men exclusively, twelve studies that included both men and women, and two studies that included patients and spouses . In regards to design, there were 13 descriptive studies, all with a weak global quality rating.…”

“…In regards to design, there were 13 descriptive studies, all with a weak global quality rating. There were three case‐control studies, all rated as moderate; one cohort analytic intervention study rated as moderate; and two randomised controlled trials (RCT), with one rated as weak and one as moderate in quality . The most common reasons for weak ratings were in the individual component ratings for study design (13 studies), blinding (18 studies), confounders (six studies), data collection method (three studies) and selection bias (four studies).…”

“…The three intervention studies are described in Table , with one cohort analytic study and two RCTs . Of note, sample sizes were small in all studies, ranging from 10 to 30 stroke patients.…”

Relationship between community integration and life satisfaction among stroke survivors dwelling in rural communities of southwest, Nigeria

“…An interesting result from this study is that the satisfaction expressed by the stroke survivors with partner relationship did not translate to satisfaction with sexual life. This suggests that spousal relationship and sexual life can be interpreted as different constructs that need robust attention/intervention during rehabilitation [27,28]. The findings from this study further showed that the stroke survivors' age, gender, marital status, stroke type, post stroke duration and episodes of stroke were not associated with reintegration to normal living after stroke affectation.…”