Sexual Health Education for SCI Clinicians
SCI can have consequences on many different domains, including sexual health. A variety of health professionals (e.g., psychologists, physical therapists, nurses, physicians, sexual health clinicians) may be involved in treating these domains, as well as discussing the impact of SCI on aspects of sexual function. In fact, research shows that patients expect their health care professionals to bring up sexuality and sexual health, but health care professionals can be reluctant to do so because of their lack of knowledge, fear of offending the patient, or discomfort in asking questions that address sexual concerns (Althof et al. 2013).
People with disabilities often express their sexual health concerns to the people they feel most comfortable with, so it is recommended that all persons working with people with spinal cord injury understand the effects of SCI on sexual function (Biering-Sorenson et al. 2013, p. 613). Education and support to health professionals is critical to ensure that these professionals are able to comfortably and knowledgably address relevant patient concerns about sexual health.
Discussion
One randomized controlled trial demonstrated that one-day workshops could improve clinician knowledge, comfort, approach, and attitude towards sexual health counselling (Fronek et al. 2005, 2011). Another RCT (Sawyer et al. 1983) found that an interactive session on microcounselling would improve clinician’s ability to respond appropriately to sexual concerns of patients. One prospective controlled trial and multiple pre-post studies have shown that Sexual Health workshop participants show significant increases in knowledge, skills and comfort after workshops, and a number of these gains are maintained at three-month, six-month, and two year follow-up (Simpson et al. 2006; Giannoten et al. 2006; Tepper 1997; Chubon 1981; Mims et al. 1974; Cohen et al. 1994, 1996; Fronek et al. 2011).
Conclusion
There is level 1b evidence from 1 RCT (Fronek et al. 2005), level 2 evidence (Simpson et al. 2006) and level 4 evidence (Giannoten et al. 2006; Tepper 1997; Chubon 1981; Mims et al. 1974; Cohen et al. 1994, 1996) that educational workshops can improve clinician knowledge, comfort and attitudes towards sexual health counselling.
There is level 2 (Simpson et al. 2006) and level 4 evidence (Fronek et al. 2011; Giannoten et al. 2006) that gains can be in knowledge, attitudes, and comfort in addressing sexual health issues are maintained at six-month follow-up.
There is level 2 evidence from 1 poor quality RCT (Sawyer et al. 1983) that microcounselling sessions can improve clinician’s ability to respond appropriately to sexual concerns of patients.
