Occupational therapists' perspectives on addressing sexual concerns of older adults in the context of rehabilitation
ABSTRACT To explore occupational therapists’ perspectives on addressing sexuality in the context of rehabilitation services for older people. Method: A qualitative exploratory design was used. Data were collected using a series of focus groups (n = 5) among occupational therapists (n = 22) working with older people. Data were analysed using content analysis. Results: Occupational therapists in this study rarely addressed sexuality in the context of rehabilitation services for older people. Three major categories emerged in relation to barriers which influence therapists’ practice in this area: (i) the influence of culture on decisions regarding whether or not to address sexuality, (ii) perceived competence and confidence to address sexuality and (iii) the impact of resources regarding the inclusion or exclusion of sexuality from rehabilitation. Conclusions: Although sexuality is increasingly considered an important and relevant aspect of successful ageing the extent to which healthcare professionals are prepared to address sexual concerns identified by older people is less clear. If new expectations of healthy ageing are to be met, healthcare professionals must acknowledge the importance of sexuality and be prepared to be involved in sexual health management.Implications for Rehabilitation
Healthcare professionals continue to be reluctant to respond to older peoples’ concerns relating to sexuality.
Occupational therapists in Ireland identified socio-cultural norms relating to sexuality, perceived professional competence and confidence and prioritization of resources as key barriers.
Education is needed to improve therapists’ perceived competence and confidence in addressing sexuality with older adults.
Policy change is required to consider the underlying assumptions about sexuality, ageing and disability.
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ABSTRACT: Abstract Aim/objectives. This paper explores how a particular form of reflection - critical reflexivity - can support clinicians in developing a more nuanced understanding of therapeutic relationships, and work to advance the goal of client-centred practice. Methods. A critical autobiographical narrative was written, and critical reflexivity adopted, as methods to critically examine the therapeutic relationship. Findings. Critically reflexive stories have the potential to advance client-centred therapeutic relationships by inspiring the (re-)consideration of practices, and by interrogating interpretive systems. Discussion. Understandings and practices that potentially limit the extent to which therapeutic relationships are client centred include (i) Dichotomous thinking, (ii) Objectification, (iii) The economic imperative, and (iv) Knowledge generation. Conclusion. The critical autobiographical account points to ways in which critical reflexivity on the therapeutic relationship has the potential to foster critical questioning, interrogate interpretive systems, attune to subjectivities, contribute to practice-based knowledge, resist violation, foster compassionate practice, and develop new understandings of relevance to client-centred practice. Significance. This critical examination of the therapeutic relationship supports occupational therapists in more fully realizing the profession's core value of client-centred practice.Scandinavian Journal of Occupational Therapy 02/2015; 22(4):1-7. DOI:10.3109/11038128.2015.1018319 · 1.13 Impact Factor
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ABSTRACT: The role of sexual health has been historically underaddressed in the assessment and treatment of people with disabilities. This is due to several factors, including provider discomfort and lack of competence in discussing sexual health, and few assessment tools or treatment strategies designed specifically for people with disabilities. However, the literature suggests that people with disabilities desire opportunities for sexual expression and are engaging in sexual activity. The research shows that sexual health is an important component of overall quality of life. We aim to update readers to ongoing and new discourse about the complex factors associated with sexual health for people with disabilities, review available assessments and interventions and make suggestions for how to integrate these into a disability-affirmative framework that is relevant for a range of health-care providers in varied settings, and make recommendations for future inquiry and practice. We emphasize that providers working with people with disabilities need to be educated in the social model of disability and aware of the biopsychosocial factors affecting sexual health, as well as encouraged to develop insight into their own disability biases. People with disabilities represent the largest minority population in the USA, and the health-care system is now challenged to grow and adapt to the needs of this traditionally underserved population. Through the lens of a health-care system, we recommend incorporating discussions about sexual health into an integrative primary care model that promotes accessibility and patient-centered care for people with disabilities.Current Sexual Health Reports 03/2015; 7(1). DOI:10.1007/s11930-014-0037-3