Internet-based sexual health resources for those living with spinal cord injury: A content analysis.

CONTEXT: Spinal cord injuries (SCIs) disrupt physiological functioning which can significantly impact sexuality. Those with SCI may rely heavily on Internet sexual health resources for many reasons. Evaluation of current internet health resources is warranted to identify the gaps in the literature. OBJECTIVES: The aim of this study was to conduct a purposive review of available Internet sexual health resources for those with SCI. METHODS: A Google search was completed with search terms such as: "SCI and sexual functioning", "SCI and sexuality", "SCI and pregnancy" and "SCI and sexual pleasure". Resources were selected if they: (1) provided sexual health education to those with SCI; (2) were designed to increase skills-based learning or influence attitudes and beliefs; and (3) in English language. All identified resources were imported to NVivo 1.5.1 where a thematic content analysis was conducted. RESULTS: The search resulted in 123 resources meeting the criteria. The most common themes included: Sexual functioning (in 83.7% of resources), Reproductive health (67.5%) and Impact of Secondary Complications (61.8%). The least common themes were Psychosocial (24.4%), Stigma (13.8%), and Quality of Life (12.2%). No information was coded for LGBTQ+. DISCUSSION: Sexual health and SCI information focuses primarily on heterosexual males and specifically on sexual functioning. Resources addressing female sexuality were extremely limited and focused largely on reproduction. There was a complete absence of resource aimed to address LGBTQ+ people. CONCLUSION: The results demonstrate a need for Internet-based sexual health education resources to meet the needs of diverse individuals including women and gender non-conforming people.

Couples' experiences with sexuality after spinal cord injury.

PURPOSE: To explore sexuality after spinal cord injury (SCI) from the perspectives of individuals with SCI and their romantic partners. METHODS: A sample of 8 Canadian adults with SCI (6 men, 2 women) and their partners participated in this study (N = 16). Semi-structured dyadic and individual interviews were conducted, discussions surrounding sexuality and intimacy were extracted, and a qualitative description of the interview data was performed using thematic analysis. RESULTS: Three major themes were identified: the changing definition of sex; emotions; and practical support. Couples' conversations around the changing definition of sex after SCI addressed the taboo topic of sexuality and the importance of communication between couples, peers, and healthcare providers. Emotions included fears of losing intimacy, embarrassment in managing bladder and bowel interference, and acceptance in balancing being a romantic partner and a caregiver. Finally, couples reported challenges accessing practical support including medical interventions and sexual health nurses, but saw value in peer mentorship programs. CONCLUSION: Couples explored a changing definition of sex following SCI that was complicated by the taboo nature of discussing sexuality, experienced a range of emotions throughout the recovery process, and had difficulties navigating the healthcare system for appropriate support.IMPLICATIONS FOR REHABILITATIONHealthcare professionals should promote discussion and provide support for sexuality following SCI, but during initial rehabilitation may be too early.Healthcare providers should prepare people with SCI and their partners for the inevitable trial-and-error process involved in sexual rehabilitation.Rehabilitation professionals could direct couples to SCI peer mentorship programs to help normalize the experiences and emotions of sexual rehabilitation.

Feasibility of a virtual service delivery model to support physical activity engagement during the COVID-19 pandemic for those with spinal cord injury.

BACKGROUND: The current pandemic has reduced access to safe, monitored physical activity (PA) programs for persons with spinal cord injury (SCI). The use of telerehabilitation has the potential for continuing activity engagement without risking virus exposure. The present study evaluates the feasibility and efficacy of an online group-based PA program for persons with SCI. METHODS: This preliminary pre-post study delivered an online group-based PA program to persons with SCI. The program consisted of 1-hour sessions twice weekly for six weeks. Online PA satisfaction questionnaires were assessed at post-treatment. Psychosocial subscales from the NeuroQOL-SF were assessed. RESULTS: Participants were adult females between 3 and 32 years post-injury, 1 tetraplegic and 3 paraplegics (n = 4). All participants were highly satisfied with the online instruction, overall content, and videoconferencing platform. Participants stated that the online program was beneficial for their overall physical and psychosocial wellbeing. The program resulted in improvement in anxiety and satisfaction with social roles and activities. CONCLUSION: The current pilot study demonstrates the acceptability and limited efficacy of an online PA program for those with SCI. The program resulted in improved overall perceived wellbeing and satisfaction with social roles and activities. These results have important implications for the clinical implementation of online PA programs in a hospital and community setting.