Identifying the Need for Student Education on the Scope of OT in Addressing Sexuality and Intimacy

PURPOSE: Sex and intimacy are meaningful activities that fall under the scope of occupational therapy (OT) because both consist of valued roles and occupations that contribute to a person’s identity as well as their overall health, well-being, and quality of life. Many OT practitioners agree that exploring sexuality is integral in providing holistic, person-centered care; however, this area is routinely overlooked because clinicians do not feel confident addressing and problem-solving the sexual concerns of their patients (Areskoug-Josefsson & Fristedt, 2019; McGrath & Sakellariou, 2016; Rose & Hughes, 2018; Young et al., 2019). This study aims to address the following questions: (1) How confident are OT students in addressing sexuality and intimacy with clients? (2) Do students perceive a need for integrating additional educational resources into OT curriculum on sexuality and intimacy? (3) If yes, what kinds of learning activities are preferred to improve student confidence on this topic?

DESIGN: The study design is a mixed methods approach. An anonymous and optional REDCap survey was distributed via email to 149 students in an entry-level occupational therapy doctorate (OTD) program and 20 students in an occupational therapy assistant (OTA) program to gather an intraprofessional perspective on addressing sexuality and intimacy.

METHOD: This study included quantitative (four-point Likert scale, select all that apply, multiple choice) and qualitative (open-ended) questions. Data were analyzed using descriptive statistics and thematic content analysis. Qualitative data were evaluated by the primary investigator and an outside reviewer, and thematic disagreements were resolved through discussion.

RESULTS: The survey response rate was 74% (n = 125). About 55% of participants feel comfortable talking to clients about sexuality and intimacy; however, 80% of students are not confident problem-solving specific sexual concerns of their patients. In addition, about 78% of students report that they have never addressed or witnessed an OT practitioner address sexuality and intimacy in a rehabilitative setting. In addition, about 81% of third-year OTD students surveyed assert that sexuality was insufficiently covered during their didactic coursework prior to Level II fieldwork. Students want more educational opportunities to practice communication, implement interventions, and normalize the topic of sexuality and intimacy through simulation or role play with peers. Finally, students want to learn from guest speakers, such as OT practitioners and former patients, who have unique experiences in this area.

CONCLUSION: Overall, students assert that there are curricular gaps and areas of improvement regarding student education on the scope of OT in addressing sexuality and intimacy. Students have little to no experience addressing or observing an OT practitioner address sexuality in practice and would like more opportunities to practice these skills in a safe environment through simulation or role play with peers. Expanding student education on the scope of OT in addressing sexuality and intimacy is vital in supporting and directing future clinicians in providing holistic, person-centered care.

References

Areskoug-Josefsson, K. & Fristedt, S. (2019). Occupational therapy students’ views on addressing sexual health. Scandinavian Journal of Occupational Therapy, 26(4), 306-314. https://doi.org/10.1080/11038128.2017.1418021

McGrath, M. & Sakellariou, D. (2016). Why has so little progress been made in the practice of occupational therapy in relation to sexuality? American Journal of Occupational Therapy, 70(1), 1-5. http://dx.doi.org/10.5014/ajot.2016.017707

Rose, N. & Hughes, C. (2018). Addressing sex in occupational therapy: A coconstructed autoethnography. American Journal of Occupational Therapy, 72(3), 7001360010. https://doi.org/10.5014/ajot.2018.026005

Young, K., Dodington, A., Smith, C., & Heck, C. S. (2019). Addressing client’s sexual health in occupational therapy practice. Canadian Journal of Occupational Therapy, 87(1), 52-62. https://doi.org/10.1177/0008417419855237