Effects of Chronic Neurological Conditions on Sexual Activity Participation, Satisfaction, and Quality of Life

PURPOSE: In the US, 795,000 people have a stroke every year and Parkinson’s disease (PD) is the second most commonly diagnosed neurodegenerative disorder, yet little is known about sexual health within these groups (Reich & Savitt, 2019; Seymour & Wolf, 2014). Occupational therapists must understand the impact that stroke and PD have on sexual activity participation, satisfaction, and quality of life to implement tailored sexual activity interventions into routine rehabilitative practice. The purpose of this study is to explore the impact of chronic neurological conditions (stroke and PD) on sexual activity participation, satisfaction, quality of life, and to better understand current practice regarding communication with healthcare providers.

DESIGN: A mixed-methods cross-sectional descriptive preliminary study was performed. Individuals who had a stroke or were diagnosed with PD were included. Current participants (n = 17) were recruited from prior studies at the Program in Occupational Therapy at Washington University in St. Louis. Inclusion criteria for all participants include the ability to participate in a telephone questionnaire for approximately 30 minutes, 50-80 years old, sexually active prior to having a condition, community-dwelling, and able to speak English. Participants who had a stroke were included if their stroke was at least 6 months prior to the study and excluded if they had a communication deficit or another chronic neurological condition. Participants with PD were included if they were diagnosed with PD at least 6 months prior to the study and excluded if they had another chronic neurological condition.

METHOD: This preliminary study consisted of a 30-minute telephone questionnaire regarding sexual participation, satisfaction, quality of life, and communication with healthcare providers. Modified Activity Card Sort-Social, PROMIS Item Bank v1.0 General Life Satisfaction, PROMIS v2.0 Brief Profile Sexual Function and Satisfaction (SexFS v2.0), World Health Organization’s Quality of Life-BREF (WHOQOL-BREF), 12-Item Short Form Health Survey (SF-12), Patient Health Questionnaire (PHQ-9), and additional questions were used. Groups were compared for group differences using independent samples t-tests. Correlational analyses were also performed. Themes were extracted from qualitative questions.

RESULTS: Preliminary results from this on-going study showed wide variability regarding sexual activity level of importance, frequency, and satisfaction with frequency and sexual education. Few participants reported receiving sexual education from a healthcare professional post stroke or PD diagnosis. Although no relationships between sexual satisfaction and the primary variables were found in this preliminary study, correlations among life satisfaction, social participation, and social quality of life were obtained. Results will be updated with additional participants currently being tested in the study.

CONCLUSION: Results from the completed study will inform occupational therapy practitioners about gaps in current rehabilitation practice with regard to sexual activity participation and sexual health education from healthcare professionals.

IMPACT STATEMENT: This study is exploring the relationships of sexual activity participation, life satisfaction, and quality of life in chronic neurological conditions (stroke and PD) to improve the rehabilitative process and communication about sexual health in occupational therapy.

References

Reich, S. G. & Savitt, J. M. (2019). Parkinson’s disease. Medical Clinic of North America, 103, 337-350. https://doi.org/10.1016/j.mcna.2018.10.014

Seymour, L. M. & Wolf, T. (2014). Participation changes in sexual functioning after mild stroke. OTJR: Occupation, Participation, and Health, 34(2), 72-80. https://doi.org/10.3928/15394492-20131217-01