Abstract
The aim of the project was to explore and describe the views of physiotherapy students concerning sexual health as a part of physiotherapy education, and to enable them in their future profession as physiotherapists to be able to discuss sexual health matters with patients in an informed, sensitive and relaxed way. A qualitative interview study with data collection through focus group interviews was performed and analyzed with thematic content analysis. There was a strong consensus among the physiotherapy students in believing that sexual health should be acknowledged by physiotherapists. The theme that emerged from the data was: Sexual health—a professional challenge. The interviews resulted in the following categories: professional challenge, personal life experiences, communication, perceptive patient understanding, environmental factors and need for competence development. Students are positive towards working with sexual health. They believe that sexual health is an important aspect of quality of life, and therefore should be a part of physiotherapy education. Sexual health needs to be more addressed in the physiotherapy education. Students lack knowledge of lesbian, gay, bisexual, transgender and queer, sexual health and communication about sensitive issues. Perceived barriers towards working with sexual health could probably be lessened with increased education, but further research is needed. Personal development, knowledge, experience and environmental factors facilitate communication about sexual health.
Similar content being viewed by others
References
Nicholls, D.A., Gibson, B.E.: Physiotherapy as a complex assemblage of concepts, ideas and practices. Physiother. Theory Pract. 28(6), 418–419 (2012). doi:10.3109/09593985.2012.692557
Ratner, E.S., Erekson, E.A., Minkin, M.J., Foran-Tuller, K.A.: Sexual satisfaction in the elderly female population: a special focus on women with gynecologic pathology. Maturitas 70(3), 210–215 (2011). doi:10.1016/j.maturitas.2011.07.015
Lindau, S.T., Gavrilova, N.: Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing. BMJ 340, c810 (2010)
Field, N., Mercer, C.H., Sonnenberg, P., Tanton, C., Clifton, S., Mitchell, K.R., Erens, B., Macdowall, W., Wu, F., Datta, J., Jones, K.G., Stevens, A., Prah, P., Copas, A.J., Phelps, A., Wellings, K., Johnson, A.M.: Associations between health and sexual lifestyles in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet 382(9907), 1830–1844 (2013). doi:10.1016/S0140-6736(13)62222-9
WorldHealthOrganization: Defining sexual health. Report of a technical consultation on sexual health, 28–31 January 2002, Geneva. In: WorldHealthOrganization (ed.) Sexual Health Document Series. p. 35. Geneva, (2006)
Giami, A.: Sexual health: the emergence, development, and diversity of a concept. Ann. Rev. Sex Res. 13, 1–35 (2002)
Areskoug-Josefsson, K., Oberg, U.: A literature review of the sexual health of women with rheumatoid arthritis. Musculoskelet. Care 7(4), 219–226 (2009). doi:10.1002/msc.152
Josefsson, K.A., Gard, G.: Sexual health in patients with rheumatoid arthritis: experiences, needs and communication with health care professionals. Musculoskelet. Care 10(2), 76–89 (2012). doi:10.1002/msc.1002
Egan, M.Y., McEwen, S., Sikora, L., Chasen, M., Fitch, M., Eldred, S.: Rehabilitation following cancer treatment. Disabil. Rehabil. 35(26), 2245–2258 (2013). doi:10.3109/09638288.2013.774441
Rosenbaum, T.: The role of physiotherapy in sexual health: Is it evidence-based? J. Assoc. Chart. Physiother. Women’s Health 99, 1–5 (2006)
Rosenbaum, T.Y.: Pelvic floor physiotherapy for women with urogenital dysfunction: indications and methods. Minerva Urol. Nefrol. 63(1), 101–107 (2011)
Rosenbaum, T.: Addressing anxiety in vivo in physiotherapy treatment of women with severe vaginismus: a clinical approach. J. Sex Marital Ther. 37(2), 89–93 (2011). doi:10.1080/0092623X.2011.547340
Starr, J.A., Drobnis, E.Z., Lenger, S., Parrot, J., Barrier, B., Foster, R.: Outcomes of a comprehensive nonsurgical approach to pelvic floor rehabilitation for urinary symptoms, defecatory dysfunction, and pelvic pain. Female Pelvic Med. Reconstr. Surg. 19(5), 260–265 (2013). doi:10.1097/SPV.0b013e31829cbb9b
Reissing, E.D., Armstrong, H.L., Allen, C.: Pelvic floor physical therapy for lifelong vaginismus: a retrospective chart review and interview study. J. Sex Marital Ther. 39(4), 306–320 (2013). doi:10.1080/0092623X.2012.697535
Bo, K.: Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction. World J. Urol. 30(4), 437–443 (2012). doi:10.1007/s00345-011-0779-8
Esmail, S., Darry, K., Walter, A., Knupp, H.: Attitudes and perceptions towards disability and sexuality. Disabil. Rehabil. 32(14), 1148–1155 (2010). doi:10.3109/09638280903419277
Low, W.Y., Zubir, T.N.: Sexual issues of the disabled: implications for public health education. Asia Pac. J. Public Health 12(Suppl), S78–S83 (2000)
Valvano, A.K., West, L.M., Wilson, C.K., Macapagal, K.R., Penwell-Waines, L.M., Waller, J.L., Stepleman, L.M.: Health professions students’ perceptions of sexuality in patients with physical disability. Sex. Disabil. 32(3), 413–427 (2014)
Haboubi, N.H., Lincoln, N.: Views of health professionals on discussing sexual issues with patients. Disabil. Rehabil. 25(6), 291–296 (2003)
Coleman, E., Elders, J., Satcher, D., Shindel, A., Parish, S., Kenagy, G., Bayer, C.R., Knudson, G., Kingsberg, S., Clayton, A., Lunn, M.R., Goldsmith, E., Tsai, P., Light, A.: Summit on medical school education in sexual health: report of an expert consultation. J. Sex. Med. 10(4), 924–938 (2013). doi:10.1111/jsm.12142
Ussher, J.M., Perz, J., Gilbert, E., Wong, W.K., Mason, C., Hobbs, K., Kirsten, L.: Talking about sex after cancer: a discourse analytic study of health care professional accounts of sexual communication with patients. Psychol. Health 28(12), 1370–1390 (2013). doi:10.1080/08870446.2013.811242
Wittenberg, A., Gerber, J.: Recommendations for improving sexual health curricula in medical schools: results from a two-arm study collecting data from patients and medical students. J. Sex. Med. 6(2), 362–368 (2009). doi:10.1111/j.1743-6109.2008.01046.x
Taylor, B., Davis, S.: Using the extended PLISSIT model to address sexual healthcare needs. Nurs. Stand. 21(11), 35–40 (2006)
Post, M.W.M., Gianotten, W.L., Heijnen, L., Lambers, E.J.H.R., Willems, M.: Sexological competence of different rehabilitation disciplines and effects of a discipline-specific sexological training. Sex. Disabil. 26(1), 3–14 (2008)
Shakespeare, T., Iezzoni, L.I., Groce, N.E.: Disability and the training of health professionals. Lancet 374(9704), 1815–1816 (2009)
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. Relatsh. Ther. 21(3), 303–317 (2006)
Weerakoon, P., Jones, M.K., Pynor, R., Kilburn-Watt, E.: Allied health professional students’ perceived level of comfort in clinical situations that have sexual connotations. J. Allied Health 33(3), 189–193 (2004)
Penwell-Waines, L., Wilson, C.K., Macapagal, K.R., Valvano, A.K., Waller, J.L., West, L.M., Stepleman, L.M.: Student perspectives on sexual health: implications for interprofessional education. J. Interprof. Care (2014). doi:10.3109/13561820.2014.884553
Helland, Y., Garratt, A., Kjeken, I., Kvien, T., Dagfinrud, H.: Current practice and barriers to the management of sexual issues in rheumatology: results of a survey of health professionals. Scand. J. Rheumatol. 42(1), 20–26 (2013). doi:10.3109/03009742.2012.709274
Kong, S.K., Wu, L.H., Loke, A.Y.: Nursing students’ knowledge, attitude and readiness to work for clients with sexual health concerns. J. Clin. Nurs. 18(16), 2372–2382 (2009). doi:10.1111/j.1365-2702.2008.02756.x
Rondahl, G.: Heteronormativity in health care education programs. Nurse Educ. Today 31(4), 345–349 (2011). doi:10.1016/j.nedt.2010.07.003
Massey, O.T.: A proposed model for the analysis and interpretation of focus groups in evaluation research. Eval. Progr. Plann. 34(1), 21–28 (2011). doi:10.1016/j.evalprogplan.2010.06.003
Jayasekara, R.S.: Focus groups in nursing research: methodological perspectives. Nurs. Outlook 60(6), 411–416 (2012). doi:10.1016/j.outlook.2012.02.001
Hyde, A., Howlett, E., Brady, D., Drennan, J.: The focus group method: insights from focus group interviews on sexual health with adolescents. Soc. Sci. Med. 61(12), 2588–2599 (2005). doi:10.1016/j.socscimed.2005.04.040
Graneheim, U.H., Lundman, B.: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ. Today 24(2), 105–112 (2004). doi:10.1016/j.nedt.2003.10.001
Kidd, P.S., Parshall, M.B.: Getting the focus and the group: enhancing analytical rigor in focus group research. Qual. Health Res. 10(3), 293–308 (2000)
Gott, M., Galena, E., Hinchliff, S., Elford, H.: “Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care. Fam. Pract. 21(5), 528–536 (2004)
McGuire, B.E., Bayley, A.A.: Relationships, sexuality and decision-making capacity in people with an intellectual disability. Curr. Opin. Psychiatry 24(5), 398–402 (2011). doi:10.1097/YCO.0b013e328349bbcb
Palmer, D., El Miedany, Y.: Sexual dysfunction in rheumatoid arthritis: a hot but sensitive issue. Br. J. Nurs. 20(17), 1134–1137 (2011)
Couldrick, L., Gaynor, S., Cross, V.: Proposing a new sexual health model of practice for disability teams: the recognition model. Int. J. Ther. Rehabil. 17(6), 290–298 (2010)
Stausmire, J.M.: Sexuality at the end of life. Am. J. Hosp. Palliat. Care 21(1), 33–39 (2004)
Ryan, S., Wylie, E.: An exploratory survey of the practice of rheumatology nurses addressing the sexuality of patients with rheumatoid arthritis. Musculoskelet. Care 3(1), 44–53 (2005). doi:10.1002/msc.25
Bitzer, J., Platano, G., Tschudin, S., Alder, J.: Sexual counseling for women in the context of physical diseases: a teaching model for physicians. J. Sex. Med. 4(1), 29–37 (2007). doi:10.1111/j.1743-6109.2006.00395.x
McInnes, R.A.: Chronic illness and sexuality. Med. J. Aust. 179(5), 263–266 (2003)
Rowen, T.S.: Sexual health for people with disabilities. J. Sex. Med. 10(6), 1667–1668 (2013). doi:10.1111/jsm.12206
Papaharitou, S., Nakopoulou, E., Moraitou, M., Tsimtsiou, Z., Konstantinidou, E., Hatzichristou, D.: Exploring sexual attitudes of students in health professions. J. Sex. Med. 5(6), 1308–1316 (2008). doi:10.1111/j.1743-6109.2008.00826.x
Mollon, L.: The forgotten minorities: health disparities of the lesbian, gay, bisexual, and transgendered communities. J. Health Care Poor Underserved 23(1), 1–6 (2012). doi:10.1353/hpu.2012.0009
Hyland, A., Mc Grath, M.: Sexuality and occupational therapy in Ireland–a case of ambivalence? Disabil. Rehabil. 35(1), 73–80 (2013). doi:10.3109/09638288.2012.688920
Praestegaard, J., Gard, G.: Ethical issues in physiotherapy–reflected from the perspective of physiotherapists in private practice. Physiother. Theory Pract. 29(2), 96–112 (2013). doi:10.3109/09593985.2012.700388
Hudon, A., Laliberte, M., Hunt, M., Sonier, V., Williams-Jones, B., Mazer, B., Badro, V., Ehrmann Feldman, D.: What place for ethics? An overview of ethics teaching in occupational therapy and physiotherapy programs in Canada. Disabil. Rehabil. 36(9), 775–780 (2014). doi:10.3109/09638288.2013.813082
Saunamaki, N., Engstrom, M.: Registered nurses’ reflections on discussing sexuality with patients: responsibilities, doubts and fears. J. Clin. Nurs. 23(3–4), 531–540 (2014). doi:10.1111/jocn.12155
Saunamaki, N., Andersson, M., Engstrom, M.: Discussing sexuality with patients: nurses’ attitudes and beliefs. J. Adv. Nurs. 66(6), 1308–1316 (2010). doi:10.1111/j.1365-2648.2010.05260.x
Britto, M.T., Rosenthal, S.L., Taylor, J., Passo, M.H.: Improving rheumatologists’ screening for alcohol use and sexual activity. Arch. Pediatr. Adolesc. Med. 154(5), 478–483 (2000)
Nicolai, M.P., Both, S., Liem, S.S., Pelger, R.C., Putter, H., Schalij, M.J., Elzevier, H.W.: Discussing sexual function in the cardiology practice. Clin. Res. Cardiol. 102(5), 329–336 (2013). doi:10.1007/s00392-013-0549-2
Morrison-Beedy, D., Cote-Arsenault, D., Feinstein, N.F.: Maximizing results with focus groups: moderator and analysis issues. Appl. Nurs. Res. 14(1), 48–53 (2001). doi:10.1053/apnr.2001.21081
Tong, A., Sainsbury, P., Craig, J.: Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int. J. Qual. Health Care 19(6), 349–357 (2007). doi:10.1093/intqhc/mzm042
Rosenbaum, T.Y.: Musculoskeletal pain and sexual function in women. J. Sex. Med. 7(2 Pt 1), 645–653 (2010). doi:10.1111/j.1743-6109.2009.01490.x
Rosenbaum, T.Y.: Physiotherapy treatment of sexual pain disorders. J. Sex Marital Ther. 31(4), 329–340 (2005). doi:10.1080/00926230590950235
Josefsson, K.A., Gard, G.: Women’s experiences of sexual health when living with Rheumatoid Arthritis - an explorative qualitative study. BMC Musculoskelet. Disorders 11, 240 (2010). doi:10.1186/1471-2474-11-240
Acknowledgments
Futurum – Academy for Healthcare, County of Jönköping, Jönköping, Sweden funded the research project.
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical standard
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Areskoug-Josefsson, K., Gard, G. Sexual Health as a Part of Physiotherapy: The Voices of Physiotherapy Students. Sex Disabil 33, 513–532 (2015). https://doi.org/10.1007/s11195-015-9403-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11195-015-9403-y