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Utilizing the Delphi Method to Assess Issues of Sexuality for Men Living with Spinal Cord Injury

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Abstract

This study investigated the physical and psychological issues of sexuality for men after spinal cord injury and identified areas of top concern. Using the Delphi Method, a panel of expert judges (twenty men with spinal cord injury [SCI], C3-T12, age 26–59) completed a series of three questionnaires in an attempt to reach a consensus on previously identified issues. It was agreed that SCI affects physical and psychosocial aspects of sexuality and that sexual support is limited for exploring sexuality post-SCI. Additionally, insight into the social constructs of masculinity, gender roles, body image and disability and their influence on the sexual experiences of this population is provided. Enhancing patient, healthcare provider and societal awareness of sexuality for men after spinal cord injury should be an immediate area of focus to improve sexual and overall quality of life for this population.

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References

  1. Gianotten, W.L., Bender, J.L., Post, M.W., Höing, M.: Training in sexology for medical and paramedical professionals: a model for the rehabilitation setting. Sex Relationsh. Ther 21, 303–317 (2006)

    Google Scholar 

  2. Reel, K., Davidson, S.: Sexuality in rehabilitation: supporting Canadian practitioners conceptually towards client enablement. Can. J. Bioeth. 1(3), 35–48 (2018)

    Google Scholar 

  3. Elliott, S., Jeyathevan, G., Hocaloski, S., O’connell, C., Gulasingam, S., Mills, S., Farahani, F., Kaiser, A., Alavinia, M., Omidvar, M., Craven, C.: Conception and development of sexual health indicators to advance the quality of spinal cord injury rehabilitation: SCI-High project. J. Spinal Cord Med. 42(1), 68–84 (2019)

    PubMed  PubMed Central  Google Scholar 

  4. Aikman, K., Oliffe, J.L., Kelly, M.T., McCuaig, F.: Sexual health in men with traumatic spinal cord injuries: a review and recommendations for primary health-care providers. Am. J. Men’s Health. 12(6), 2044–2054 (2018)

    Google Scholar 

  5. Kathnelson, J.D., Kurtz Landy, C.M., Ditor, D.S., Tamim, H., Gage, W.H.: Examining the psychological and emotional experience of sexuality for men after spinal cord injury. Cogent Psychol. 7(1), 1722355 (2020)

    Google Scholar 

  6. Stein, A., Saunder, S.K., Reale, J.: The role of physical therapy I sexual health in men and women: evaluation and treatment. Sex. Med. Rev. 7, 46–56 (2018)

    PubMed  Google Scholar 

  7. Siösteen, A., Lundqvist, C., Blomstrand, C., Sullivan, L., Sullivan, M.: Sexual ability, activity, attitudes and satisfaction as part of adjustment in spinal cord-injured subjects. Paraplegia. 28, 285–295 (1990)

    PubMed  Google Scholar 

  8. Shah, H., Kalaian, S.: Which is the best parametric statistic method for analyzing Delphi data? J. Mod. Appl. Stat. Methods. 8(20), 226–232 (2009)

    Google Scholar 

  9. Sklumoski, G.J., Hartman, F.T., Krahn, J.: The delphi method for graduate research. J. Inf. Technol. Inf. 6, 1–20 (2007)

    Google Scholar 

  10. Powell, C.: The Delphi technique: myths and realities. J. Adv. Nurs. 41(4), 376–382 (2002)

    Google Scholar 

  11. Thangaratinam, S., Redman, C.: The Delphi technique. Obstet Gynecol. 7, 120–125 (2005)

    Google Scholar 

  12. Witkin, B.R., Altschuld, J.W.: Planning and conducting needs assessment: A practical guide. Sage Publications Inc., Thousand Oaks (1995)

    Google Scholar 

  13. Ludwig, B.: Predicting the future: have you considered using the Delphi methodology? J. Ext. 35(5), 1–4 (1997)

    Google Scholar 

  14. Delbeq, A., Van de Ven, A., Gustafson, D.H.: Group techniques for program planning: a guide to nominal group and delphi processes. Scott, Foresman and Company, Glenview (1975)

    Google Scholar 

  15. Keeney, S., Hasson, F., McKenna, H.P.: A critical review of the Delphi technique as a research methodology for nursing. Int. J. Nurs. Stud. 38(2), 195–200 (2001)

    PubMed  Google Scholar 

  16. Sumsion, T.: The Delphi technique: an adaptive research tool. Br. J. Occup. Ther. 61(4), 153–156 (1998)

    Google Scholar 

  17. De Villiers, M.R., De Villiers, P.T., Kent, A.P.: The Delphi technique in health sciences education research. Med. Teach. 27(7), 639–643 (2005)

    PubMed  Google Scholar 

  18. Meshkat, B., Cowman, S., Gethin, G., Ryan, K., Wiley, M., Brick, A., Clarke, E., Mulligan, E.: Using an e-Delphi technique in achieving consensus across disciplines for developing best practice in day surgery in Ireland. J. Hosp. Adm. 3(4), 1–8 (2014)

    Google Scholar 

  19. Hasson, F., Keeney, S., McKenna, H.: Research guidelines for the Delphi survey. J. Adv. Nurs. 32(4), 1008–1015 (2000)

    PubMed  Google Scholar 

  20. Holey, E.A., Feeley, J.L., Dixon, J., Whittaker, V.J.: An exploration of the use of simple statistics to measure consensus and stability in Delphi studies. BMC Med. Res. Methodol. 7(52), 1–10 (2007)

    Google Scholar 

  21. Hsu, C.C., Sanford, B.: The Delphi technique: making sense of consensus. Pract Assess Res Eval. 12(10), 1–8 (2007)

    Google Scholar 

  22. Hsieh, H.F., Shannon, S.E.: Three approaches to qualitative content analysis. Qual. Health Res. 15, 1277–1288 (2005)

    PubMed  Google Scholar 

  23. Hohmann, G.W.: Considerations in management of psychosexual readjustment in the cord injured male. Rehabil. Psychol. 19(2), 50–58 (1972)

    Google Scholar 

  24. Hohmann, G.W.: Some effects of spinal cord lesions on experienced emotional feelings. Psychophysiology 3, 143–156 (1966)

    PubMed  Google Scholar 

  25. Tepper, M.S.: Letting go of restrictive notions of manhood: male sexuality, disability and chronic illness. Sex. Disabil. 17, 37–52 (1999)

    Google Scholar 

  26. Leibowitz, R.Q., Stanton, A.L.: Sexuality after spinal cord injury: a conceptual model based on women’s narratives. Rehabil. Psychol. 52(1), 44–55 (2007)

    Google Scholar 

  27. Talbot, H.S.: Psycho-social aspects of sexuality in spinal cord injury patients. Paraplegia. 9(1), 37–39 (1971)

    PubMed  Google Scholar 

  28. Willmuth, M.: Sexuality after spinal cord injury: a critical review. Clin. Psychol. Rev. 7, 389–412 (1987)

    Google Scholar 

  29. Romeo, A.J., Wanlass, R., Arenas, S.: A profile of psychosexual functioning in males following spinal cord injury. Sex. Disabil. 11, 269–276 (1993)

    Google Scholar 

  30. DeVivo, M.J., Fine, P.R.: Spinal cord injury: its short-term impact on marital status. Arch. Phys. Med. Rehabil. 66(8), 501–504 (1985)

    PubMed  Google Scholar 

  31. Kreuter, M.: Spinal cord injury and partner relationships. Spinal Cord. 38, 2–6 (2000)

    PubMed  Google Scholar 

  32. Kreuter, M., Sullivan, M., Dahllöf, A.G., Siösteen, A.: Partner relationships, functioning, mood and global quality of life in persons with spinal cord injury and traumatic brain injury. Spinal Cord. 36(4), 252 (1998)

    PubMed  Google Scholar 

  33. Lombardi, G., Macchiarella, A., Cecconi, F., Aito, S., Del Popolo, G.: Sexual life of males 50 years of age with spinal-cord lesions of at least 20 years. Spinal Cord. 46(10), 679–683 (2008)

    PubMed  Google Scholar 

  34. Burns, S.M., Hough, S., Boyd, B.L., Hill, J.: Sexual desire and depression following spinal cord injury: masculine sexual prowess as a moderator. Sex. Roles. 61, 120–129 (2009)

    Google Scholar 

  35. Consortium for Spinal Cord Medicine: Sexuality and reproductive health in adults with spinal cord injury: a clinical practice guideline for health-care professionals. J. Spinal Cord Med. 33, 281–336 (2010)

    Google Scholar 

  36. van der Meer, P., Post, M.W., van Leeuwen, C.M., van Kuppevelt, H.J., Smit, C.A., van Asbeck, F.W.: Impact of health problems secondary to SCI one and five years after first inpatient rehabilitation. Spinal Cord. 55(1), 98–104 (2017)

    PubMed  Google Scholar 

  37. Kathnelson, J.D., Kurtz Landy, C.M., Ditor, D.S., Tamim, H., Gage, W.H.: Supporting sexual adjustment from the perspective of men living with spinal cord injury. Spinal Cord (2020). https://doi.org/10.1038/s41393-020-0479-6

    Article  PubMed  Google Scholar 

  38. Pascual, A., Wighman, A., Littooij, E.C., Janssen, T.W.J.: Sexuality as part of rehabilitation? A qualitative study on the perceptions of rehabilitation nurses on discussing patient sexuality during clinical rehabilitation. Disabil. Rehabil. (2019). https://doi.org/10.1080/09638288.2019.1670271

    Article  PubMed  Google Scholar 

  39. Southard, N.Z., Keller, J.: The importance of addressing sexuality: a patient perspective. Clin. J. Oncol. Nursing. 13, 213–217 (2009)

    Google Scholar 

  40. Stead, M.L., Fallowfield, J., Brown, M., Selby, P.: Communication about sexual problems and sexual concerns in ovarian cancer: qualitative study. BMJ 323(7317), 836–837 (2001)

    PubMed  PubMed Central  Google Scholar 

  41. Elliott, S., Hocaloski, S., Carlson, M.: A multidisciplinary approach to sexuality and fertility rehabilitation: the sexual rehabilitation framework. Top. Spinal Cord Inj. Rehabil. 23(1), 49–56 (2017)

    PubMed  PubMed Central  Google Scholar 

  42. Pieters, R., Kedde, H., Bender, J.: Training rehabilitation teams in sexual health care: a description and evaluation of a multidisciplinary intervention. Disabil. Rehabil. 40(6), 732–739 (2018)

    PubMed  Google Scholar 

  43. Simpson, L.A., Eng, J.J., Hsieh, J.T., Wolfe, D.L.: Spinal cord injury rehabilitation evidence scire research team: the health and life priorities of individuals with spinal cord injury: a systematic review. J. Neurotrauma 29(8), 1548–1555 (2012)

    PubMed  PubMed Central  Google Scholar 

  44. McAlonan, S.: Improving sexual rehabilitation services: the patient’s perspective. Am. J. Occup. Ther. 50, 826–834 (1996)

    PubMed  Google Scholar 

  45. Aaby, A., Ravn, S.L., Kasch, H., Anderson, T.E.: The associations of acceptance with quality of life and mental health following spinal cord injury: a systematic review. Spinal Cord. 58, 130–148 (2020)

    PubMed  Google Scholar 

  46. Rutagumirwa, S., Bailey, A.: The heart desires but the body refuses: sexual scripts, older men’s perceptions of sexuality and implications for their mental and sexual health. Sex Roles. 78, 653–668 (2017)

    PubMed  PubMed Central  Google Scholar 

  47. Northcott, R., Chard, G.: Sexual aspects of rehabilitation: the client’s perspective. Br. J. Occup. Ther. 63(9), 412–418 (2000)

    Google Scholar 

  48. Walker, A.M., Selfe, J.: The Delphi technique: a useful tool for the allied health researcher. Br. J. Ther. Rehabil. 3, 677–680 (1996)

    Google Scholar 

  49. Anderson, K.D., Borisoff, J.F., Johnson, R.D., Steins, S.A., Elliott, S.L.: The impact of spinal cord injury on sexual function: concerns of the general population. Spinal Cord. 45, 328–337 (2007)

    PubMed  Google Scholar 

  50. Henzel, H., Berzins, K., Langford, J.P.: Provoked vestibulodynia: current perspectives. Int. J. Women’s Health 11, 631–642 (2017)

    Google Scholar 

  51. Sunilkumar, M.M., Boston, P., Rajagopal, M.R.: Sexual functioning in men living with a spinal cord injury- a narrative literature review. Indian J. Palliat. Care. 21(3), 274–281 (2015)

    PubMed  PubMed Central  Google Scholar 

  52. Post, M.W., van Leeuwen, C.M.: Psychosocial issues in spinal cord injury: a review. Spinal Cord. 50(5), 382–389 (2012)

    PubMed  Google Scholar 

  53. Fisher, W.A., Fisher, J.D.: Understanding and promoting sexual and reproductive health behavior: theory and method. Ann. Rev. Sex Res. 9, 39–76 (1998)

    Google Scholar 

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Acknowledgements

The authors would like to acknowledge Spinal Cord injury Ontario for their tremendous support with participant recruitment. We would like to acknowledge Lonnie Bissonnette for advocating for this study.

Funding

The authors received no direct funding for this research.

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Authors

Contributions

JDK was responsible for developing the protocol, collecting and analyzing data and writing the report. CMKL contributed to development of the protocol and provided feedback on the report. DSD contributed to protocol development and provided feedback on the report. HT contributed to protocol development and provided feedback on the report. WHG contributed to protocol development, data analysis and provided feedback on the report. All authors approved the version of the manuscript to be published.

Corresponding author

Correspondence to Jacqueline D. Kathnelson.

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Conflict of interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study. Participants provided consent regarding publishing their data.

Ethics Approval

This study was performed in line with the principals of the Declaration of Helsinki. Approval was granted by the York University Research Ethics Board (file number 2019-004) and the Brock University Research Ethics Board (file number 18-235).

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Kathnelson, J.D., Kurtz Landy, C.M., Tamim, H. et al. Utilizing the Delphi Method to Assess Issues of Sexuality for Men Living with Spinal Cord Injury. Sex Disabil 39, 33–54 (2021). https://doi.org/10.1007/s11195-020-09673-w

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