The utility of measuring sexual disability for predicting 1-year return to work.

OBJECTIVE: To explore sexual disability in injured workers undergoing rehabilitation. Specifically, we investigated (1) factors associated with high ratings of sexual disability, (2) factors associated with noncompletion of the sexual disability questionnaire, and (3) the association between sexual disability and future recovery. DESIGN: Historical cohort study with 1-year follow-up. SETTING: Workers' compensation rehabilitation facility. PARTICIPANTS: Workers' compensation claimants (N=1078) undergoing return-to-work assessment. Ratings of sexual disability were measured using the Sexual Behavior item of the Pain Disability Index. Other demographic, clinical, and occupational factors also were collected. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Outcomes included administrative indicators of timely and sustained recovery and return to work. RESULTS: Of subjects included in analysis, 18.5% did not complete the Sexual Behavior item. Claimants were less likely to complete if they were women, older, and single; had lower salaries, injury diagnoses other than sprain/strain, and fewer health visits before assessment; and reported lower recovery expectations. Higher levels of sexual disability were associated with higher levels of overall pain and disability, as well as being in a married/common law relationship. After adjusting for injury duration, the Sexual Behavior item was not associated significantly with any recovery measure or claims outcome. CONCLUSIONS: A response bias exists in Canadian injured workers asked to complete a sexual disability rating. In those completing the questionnaire, higher sexual disability was associated most closely with higher pain severity and higher disability. Perceptions of sexual disability did not contribute to predicting recovery, which supports replacement of this item for use within this and related contexts.

Attitudes and perceptions towards disability and sexuality.

PURPOSE: To describe current societal perceptions and attitudes towards sexuality and disability and how social stigma differs between individuals living with visible and invisible disabilities. METHOD: A qualitative approach was used to explore attitudes and perceptions towards sexuality and disability. Focus groups were conducted with the following groups: service providers, people with visible disabilities, people with invisible disabilities and the general public. The focus group participants viewed 'Sexability' a documentary film on sexuality and disability to stimulate discussion midway through the session. RESULTS: Findings suggest that individuals with disabilities are commonly viewed as asexual due to a predominant heteronormative idea of sex and what is considered natural. A lack of information and education on sexuality and disability was felt to be a major contributing factors towards the stigma attached to disability and sexuality. CONCLUSIONS: Stigma can lead individuals to internalise concepts of asexuality and may negatively impact confidence, desire and ability to find a partner while distorting one's overall sexual self-concept. Societal attitudes and perceptions are driven by education and knowledge, if there is no exposure to sexuality and disability, it follows suit that society would have a narrow understanding of these issues. Further research should focus on how best to educate and inform all members of society.

The use of complementary and alternative medicine (CAM) by Canadian occupational therapists.

The purpose of this study was to describe the proportion of occupational therapists currently using complementary and alternative medicine (CAM), or providing referrals to CAM practitioners, as well as the purposes of use/referral in one Canadian region. A questionnaire survey on CAM was sent through e-mail and post to 1123 Canadian occupational therapists. Content, construct and face validity, as well as response, desirability/social, and instrument bias were considered and controlled through study design. A response rate of 17.1% was achieved. Overall, 31.2% of respondents have used at least one form of CAM, with 5.5% using > 1 form of CAM. Purposes for use focused on the treatment of symptoms. Reasons preventing CAM's use included lack of training (82.4%), interest (23%) and/or supporting evidence (22.3%). Considerations of incorporating CAM into occupational therapy focused on a client-centred and holistic approach to treatment (43-63.3%), ranking above legal/employer-related aspects (43-43.6%). Elaborations of negative responses indicated that further supporting evidence on forms of CAM and related research may result in changes of opinion. Therefore, further research on the use of CAM is needed, allowing for evidence-based decisions to be made.