Addressing The Sexual Health Concerns Of People With Acquired Brain Injury: A Framework For Action

Background Adults sustaining diverse types of acquired brain injury (ABI) such as stroke or traumatic brain injury often experience characteristic motorsensory, cognitive and behavioural impairments. These impairments can be profoundly disabling in key life domains such as occupation, relationships and independent living. Research shows that up to 60% of people with ABI experience disruption to their sexual functioning, sexual relationships or broader psychosexual development. Despite the widespread nature of such changes, staff in ABI rehabilitation or disability services rarely address these problems. Objective To present a framework for action that provides ABI services with a structured approach to enhancing their capacity to meet patient/client sexual health concerns (SHCs). The Model The tripartite framework consists of an underlying philosophy, service provision modalities and supporting organisational structures. The underlying philosophy identifies four conditions that are important in enabling services to address client SHCs, namely (i) a broad definition of sexual concerns, (ii) the primary goal of enhancing the quality of client\'s sexual lives, (iii) the incorporation of several service principles (e.g. choices, values, responsibility), and (iv) the affirmation that all staff can play a role. Within this context, there are five modalities of service intervention that can be provided, namely information, education, assessment, treatment, and referral. At the third level, the provision of these service modalities are influenced and/or supported by organisational structures including (i) agency policy and procedures, (ii) the broader legislative context, (iii) staff training, (iv) the development of inter-service networks and (v) resource and knowledge development. Implementation Strategies for implementing the model can include conducting need surveys, staff training, establishing a service sexuality committee, or holding staff planning days. Final The framework constitutes a comprehensive yet parsimonious model providing clear guidelines for agencies interested in developing options to address the SHCs of people with ABI.

Conflict of Interest: None disclosed
Financial Support/Funding: None disclosed
Sydney, Australia, April 2007