Development of a Sexual Needs Rehabilitation Framework in Women Post–Spinal Cord Injury: A Study From Iran

Abstract

ObjectiveTo develop a sexual needs rehabilitation framework in women after spinal cord injury (SCI). DesignMixed-methods study. The study consisted of 3 steps: (1) a primary needs assessment with quantitative and qualitative methods; (2) prioritization of identified needs by expert panels; and (3) development of a framework. SettingMulti-dimensional clinical referral center. ParticipantsMarried women (N=31) with an SCI that occurred at least 1 year ago. InterventionsNot applicable. Main Outcome MeasuresDevelopment of sexual needs rehabilitation framework. ResultsThe quantitative phase in the first phase showed that the total mean ± SD score of the Sexual Quality of Life–Female questionnaire was 60.47±1.53, and the total mean ± SD score of the Female Sexual Function Index was 50.54±11.35. Moreover, women's sexual understanding post-SCI in the qualitative assessment revealed the following 3 main themes: (1) “dilemma leading to limited sexual activity”; (2) “seeking positive sexual adjustment”; and (3) “lack of client-based sexual and reproductive education/counseling in the rehabilitation process.” Results from prioritizing identified needs in the second step indicated that the most important needs related to sexual aspects of life. In the final step, the framework for Iranian woman with post-SCI sexual rehabilitative needs developed with focus on sexual behavior complication post-SCI as a main need. ConclusionsIt is important to assess probable unmet needs before designing, planning, and implementing an interventional rehabilitative health care program, especially when focusing on issues of sexuality. A developed framework can be applied by the rehabilitation team during initial caregiving and can be continued as long as needed.