Sexual adjustment and quality of relationships in spinal paraplegia: A controlled study

Abstract

Objective: To identify determinants of sexual adjustment by persons with spinal cord injury (SCI) and quality of the relationship compared with persons in the general population Design: Controlled survey. Setting: Postdischarge community setting. Participants: A consecutive series of 252 persons admitted to our spinal unit between November 1982 and July 1991 with traumatic SCI were contacted, 85 of whom persons were excluded: 36 were dead, 37 had recovered, 5 could not be located, 4 were younger than 18 years, 2 had language difficulties, and 1 had a psychiatric illness. Of the remaining 167 persons with SCI, 85 had a stable partner relationship, 75 of whom (88%) completed and returned the questionnaires (median age, 33 years; range 19 to 76). An age- and sex-matched control group was randomly selected from the general population. Of the 264 respondents, 155 (59%) had a stable partner relationship. Main Outcome Measures: The 80-item questionnaire addressed experiences concerning sexual functioning, desire, and activity, sexual behavior, satisfaction with sex life, and aspects of the emotional quality of the relationship. Results: Sexual activity and satisfaction was lower among persons with SCI compared with the controls; the emotional quality of the relationship did not differ. The most important correlates for sexual fulfillment in both groups were found to be the use of a varied repertoire of sexual behaviors and the perception that the partner enjoys and is satisfied with the sexual part of the relationship. Conclusion: Psychosocial rather than physical factors were important for a satisfying sexual life and relationship. A qualitative study should be undertaken to further explore the complexity of sexual adjustment after SCI.