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Perspectives of Portuguese People with Physical Disabilities Regarding Their Sexual Health: A Focus Group Study

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Abstract

The World Health Organization has considered sexual health as a major dimension of global health and a sexual right. However, the sexual health of people with physical disabilities is still poorly addressed by health and social care professionals, and it is very stigmatized by society. This study aimed to assess the perspectives of Portuguese people living with physical disabilities regarding issues affecting their sexual health. Nine women and 17 men with different physical disabilities participated in the study. Participants were recruited from a professional rehabilitation facility located in the North of Portugal and were assigned to four groups in one-hour sessions. Three main categories emerged from the content analysis: (1) meanings and beliefs regarding sexuality; (2) experiences of sexuality; (3) necessary changes. Despite the positive social changes towards sexuality, participants expressed that their sexual rights are still unfulfilled, as they live in a context that perpetuates their dependency. They pointed out low self-esteem, prejudice and social isolation, poor architectural accessibility and scarcity of financial support as some of the barriers to their lives and their sexual health. Finally, participants identified the main needs regarding their sexual health, such as: access to specialized information; training for health professionals. This study gives voice to people with physical disabilities and sheds light into both individual and contextual factors affecting their sexual health. Of utmost importance, this study draws attention to the need for reinforcing sexuality of people with disabilities in the social agenda and brings implications for future research and practice.

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Notes

  1. One of the participants was 51 years old. However, we decided to include him in the focus group session since he manifested a strong will to participate and we considered that his age was not significantly different from the maximum range.

  2. M = male; F = female; FG = focus group.

References

  1. Lottes, I.: Sexual rights: meanings, controversies, and sexual health promotion. J. Sex Res. 50, 367–391 (2013)

    Article  Google Scholar 

  2. Tiefer, L.: The emerging global discourse of sexual rights. J. Sex Marital Ther. 28, 439–444 (2002)

    Article  Google Scholar 

  3. World Health Organization: Defining sexual health: report of a technical consultation on sexual health. Special Programme of Research, Development and Research Training in Human Reproduction, Geneva (2002)

  4. Bahner, J.: Legal rights or simply wishes? The struggle for sexual recognition of people with physical disabilities using personal assistance in Sweden. J. Sex. Disabil. 30, 337–356 (2012)

    Article  Google Scholar 

  5. Brodwin, M., Frederick, P.: Sexuality and societal beliefs regarding persons living with disabilities. J. Rehabil. 76, 37–41 (2010)

    Google Scholar 

  6. Esmail, S., Darry, K., Walter, A., Knupp, H.: Attitudes and perceptions towards disability and sexuality. Disabil. Rehabil. 32, 1148–1155 (2010)

    Article  Google Scholar 

  7. Fontes, F., Martins, B., Hespanha, P.: The emancipation of disability studies in Portugal. J. Disabil. Soc. 29, 849–862 (2014)

    Article  Google Scholar 

  8. International Classification of Functioning Disability and Health (ICF): World Health Organization, Geneva (2001)

  9. Thomas, C.: How is disability understood? An examination of sociological approaches. J. Disabil. Soc. 19, 569–583 (2004)

    Article  Google Scholar 

  10. Kennedy, P.: Introduction, context and overview. In: Kennedy, P. (ed.) Psychological Management of Physical Disabilities: A Practitioner’s Guide, pp. 3–13. Routledge, London and New York (2007)

    Chapter  Google Scholar 

  11. Loja, E.: Impacto da incapacitação e do ableísmo nas pessoas incapacitadas em Portugal: Fado, cidadania e o eu corporizado (2012)

  12. Shakespeare, T.: Disability Rights and Wrongs. Routledge, London (2006)

    Book  Google Scholar 

  13. Cardoso, J.: Sexualidade na doença crónica e na deficiência física. Rev. Port. 20, 385–394 (2004)

    Google Scholar 

  14. Cole, T.: Sexuality and physical disabilities. Arch. Sex. Behav. 4, 389–403 (1975)

    Article  Google Scholar 

  15. Higgins, G.: Sexual response in spinal cord injured adults: a review of the literature. Arch. Sex. Behav. 8, 173–196 (1979)

    Article  Google Scholar 

  16. Amidu, N., Owiredu, W., Woode, E., Addai-Mensah, O., Gyasi-Sarpong, K., Alhassan, A.: Prevalence of male sexual dysfunction among Ghanaian populace: myth or reality? Int. J. Impot. Res. 22, 337–342 (2010)

    Article  Google Scholar 

  17. Owiredu, W., Owusu, A., Amidu, N., Quaye, L., Gyasi-Sarpong, C., Dapare, P., Alidu, H.: Sexual dysfunction and sexual quality of life among the physically challenged in the Kumasi metropolis, Ghana. Health Qual. Life Outcomes 13, 3 (2015)

    Article  Google Scholar 

  18. Sellwood, D., Raghavendra, P., Jewell, P.: Sexuality and intimacy for people with congenital physical and communication disabilities: barriers and facilitators: a systematic review. J. Sex. Disabil. 35, 227–244 (2017)

    Article  Google Scholar 

  19. DiGiulio, G.: Sexuality and people living with physical or developmental disabilities: a review of key issues. Can. J. Hum. Sex. 12, 53–68 (2003)

    Google Scholar 

  20. Garret, A., Martins, F., Teixeira, Z.: A actividade sexual após lesão medular – meios terapêuticos [review article]. Acta Méd. Port. 22, 821–826 (2009)

    Google Scholar 

  21. McCabe, M., Taleporos, G.: Sexual esteem, sexual satisfaction, and sexual behavior among people with physical disability. Arch. Sex. Behav. 32, 359–369 (2003)

    Article  Google Scholar 

  22. Lawrance, K., Byers, E.: Sexual satisfaction in long-term heterosexual relationships: the interpersonal exchange model of sexual satisfaction. Pers. Relatsh. 2, 267–285 (1995)

    Article  Google Scholar 

  23. Taleporos, G., McCabe, M.: The impact of sexual esteem, body esteem and sexual satisfaction on psychological well-being in people with physical disability. J. Sex. Disabil. 20, 177–183 (2002)

    Article  Google Scholar 

  24. Taleporos, G., McCabe, M.: Relationships, sexuality and adjustment among people with physical disability. Sex. Relatsh Ther. 18, 25–43 (2003)

    Article  Google Scholar 

  25. Sadoughi, W., Leshner, M., Fine, H.: Sexual adjustment in a chronically ill and physically disabled population: a pilot study. Arch. Phys. Méd. Rehabil. 52, 311–317 (1971)

    PubMed  Google Scholar 

  26. Sahay, R., Haynes, E., Rao, M., Pirko, I.: Assessment of sexual satisfaction in relation to potential sexual problems in women with multiple sclerosis: a pilot study. J. Sex. Disabil. 30, 227–236 (2011)

    Article  Google Scholar 

  27. Crewe, N., Krause, J.: Marital relationships and spinal cord injury. Arch. Phys. Méd. Rehabil. 69, 435–438 (1988)

    PubMed  Google Scholar 

  28. Ahumuza, S., Matovu, J., Ddamulira, J., Muhanguzi, F.: Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda. J. Reprod. Health. (2014). https://doi.org/10.1186/1742-4755-11-59

    Article  Google Scholar 

  29. García, A., Álvarez, C.: Sexuality and functional diversity: an analysis from a gender perspective. Procedia Soc. Behav. Sci. 161, 299–305 (2014)

    Article  Google Scholar 

  30. Vaughn, M., Silver, K., Murphy, S., Ashbaugh, R., Hoffman, A.: Women with disabilities discuss sexuality in San Francisco focus groups. J. Sex. Disabil. 33, 19–46 (2014)

    Article  Google Scholar 

  31. Cole, S., Cole, T.: Sexuality, disability, and reproductive issues through the lifespan. J. Sex. Disabil. 11, 189–205 (1993)

    Article  Google Scholar 

  32. Helmius, G.: Disability, sexuality and sociosexual relationships in women’s everyday life. Scand. J. Disabil. Res. 1, 50–63 (1999)

    Article  Google Scholar 

  33. Williams, T.: Understanding internalized oppression: a theoretical conceptualization of internalized subordination (2012)

  34. Reeve, D.: Psycho-emotional dimensions of disability and the social model. In: Barnes, C., Mercer, G. (eds.) Implementing the Social Model of Disability: Theory and Research, pp. 83–100. The Disability Press, Leeds (2004)

    Google Scholar 

  35. Reeve, D.: Towards a psychology of disability: the emotional effects of living in a disabling society. In: Goodley, D., Lawthom, R. (eds.) Disability and Psychology: Critical Introductions and Reflections, pp. 94–107. Palgrave, London (2006)

    Chapter  Google Scholar 

  36. Nguyen, T., Liamputtong, P., Monfries, M.: Reproductive and sexual health of people with physical disabilities: a metasynthesis. J. Sex. Disabil. 34, 3–26 (2015)

    Article  Google Scholar 

  37. Alarcão, V., Machado, F., Giami, A.: Traditions and contradictions of sexual function definitions for Portuguese heterosexual men and women: medicalization and socially constructed gender effects. Sex. Relatsh Ther. 1–18 (2015)

  38. Rowen, T., Stein, S., Tepper, M.: Sexual health care for people with physical disabilities. J. Sex. Méd. 12, 584–589 (2015)

    Article  Google Scholar 

  39. Couldrick, L., Sadlo, G., Cross, V.: Proposing a new sexual health model of practice for disability teams: the recognition model. Int. J. Ther. Rehabil. 17, 290–299 (2010)

    Article  Google Scholar 

  40. Linton, K., Rueda, H., Williams, L., Sandoval, A., Bolin, S.: Reproductive and sexual healthcare needs among adults with disabilities as perceived by social workers. J. Sex. Disabil. 34, 145–156 (2015)

    Article  Google Scholar 

  41. Tugut, N., Golbasi, Z., Erenel, A., Koc, G., Ucar, T.: A multicenter study of nursing students’ perspectives on the sexuality of people with disabilities. J. Sex. Disabil. 34, 433–442 (2016)

    Article  Google Scholar 

  42. Kazukauskas, K., Lam, C.: Disability and sexuality: knowledge, attitudes, and level of comfort among certified rehabilitation counselors. Rehabil. Couns. Bull. 54, 15–25 (2009)

    Article  Google Scholar 

  43. Pinto, P.: Between the lines: a critical discourse analysis of disability policy in Portugal. Disabil. Stud. Q. 31 (2011)

  44. Pinto, P.: At the crossroads: human rights and the politics of disability and gender in Portugal. Eur. J. Disabil. Res. 5, 116–128 (2011)

    Article  Google Scholar 

  45. Venkatesh, V., Brown, S., Bala, H.: Bridging the qualitative-quantitative divide: guidelines for conducting mixed methods research in information systems. MIS Q. 37, 21–54 (2013)

    Article  Google Scholar 

  46. Shannon-Baker, P.: Making paradigms meaningful in mixed methods research. J. Mix. Methods Res. 10, 319–334 (2016)

    Article  Google Scholar 

  47. Braun, V., Clarke, V.: Interactive data collection 2: focus groups. In: Braun, V., Clarke, V. (eds.) Successful Qualitative Research: A Pratical Guide for Beginners. Sage, London (2013)

    Google Scholar 

  48. Freeman, T.: ‘Best practice’ in focus group research: making sense of different views. J. Adv. Nurs. 56, 491–497 (2006)

    Article  Google Scholar 

  49. APA: Diagnostic and Statistical Manual of Mental Disorders—DSM-5. American Psychiatric Publishing, Washington, DC (2013)

    Google Scholar 

  50. Bogart, K.: The role of disability self-concept in adaptation to congenital or acquired disability. Rehabil. Psychol. 59, 107–115 (2014)

    Article  Google Scholar 

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

    Article  Google Scholar 

  52. Leonard, M., Cano, A., Johansen, A.: Chronic pain in a couples context: a review and integration of theoretical models and empirical evidence. J. Pain. 7, 377–390 (2006)

    Article  Google Scholar 

  53. Qaderi, K., Merghati Khoei, E.: Sexual problems and quality of life in women with multiple sclerosis. J. Sex. Disabil. 32, 35–43 (2013)

    Article  Google Scholar 

  54. Schairer, L., Foley, F., Zemon, V., Tyry, T., Campagnolo, D., Marrie, R., Gromisch, E., Schairer, D.: The impact of sexual dysfunction on health-related quality of life in people with multiple sclerosis. J. Multiple Scler. 20, 610–616 (2013)

    Article  Google Scholar 

  55. McCracken, L., Vowles, K.: Acceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress. Am. Psychol. 69, 178–187 (2014)

    Article  Google Scholar 

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Acknowledgements

This study was supported by a Grant attributed to the first author by the Portuguese Foundation for Science and Technology (SFRH/BD/112168/2015). The authors would like to thank Centro de Reabilitação Profissional de Gaia (Professional Rehabilitation Centre of Gaia), namely Dr.ª Ana Correia Barros, Dr. Ivo Adrião, Dr.ª Andreia Mota, Dr.ª Sandra Guerreiro and Dr.ª Isabel Almeida, for their help in the recruitment procedures. We would also like to thank José Fernandes for proofreading the manuscript. Finally, a special thank you to all the participants and their willingness in sharing their opinions for this research.

Funding

This work was funded by the Portuguese Scientific Foundation (CPUP UID/PSI/00050/2013; FEDER/COMPETE2020 POCI-01-0145-FEDER; SFRH/BD/112168/2015).

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Authors and Affiliations

  1. Research Group in Human Sexuality, Center of Psychology, Faculty of Psychology and Educational Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal

    Raquel Pereira & Pedro J. Nobre

  2. Life and Health Sciences Research Institute ICVS/3B’s PT Government Associate Laboratory, School of Medicine, University of Minho, Braga/Guimarães, Portugal

    Pedro M. Teixeira

Authors
  1. Raquel Pereira
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  2. Pedro M. Teixeira
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  3. Pedro J. Nobre
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Correspondence to Raquel Pereira.

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The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the Ethics Committee of the Faculty of Psychology and Educational Sciences of University of Porto (Refª 3-07/2016) and by the National Commission for Data Protection (nº 15445/2016, N/ref.ª 30187).

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Pereira, R., Teixeira, P.M. & Nobre, P.J. Perspectives of Portuguese People with Physical Disabilities Regarding Their Sexual Health: A Focus Group Study. Sex Disabil 36, 389–406 (2018). https://doi.org/10.1007/s11195-018-9538-8

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