Abstract
IntroductionThe consequences of stroke on sexual life in stroke patients in need of specialized cognitive rehabilitation have been limited explored. A biopsychosocial perspective in post-stroke sexuality studies is warranted to capture the complex picture of stroke consequences and sexual life after stroke and sexual satisfaction is an important outcome measure when exploring such multifactorial associations.AimTo explore sexual satisfaction and associated biopsychosocial factors in stroke patients admitted to specialized cognitive rehabilitation.MethodsA cross-sectional study was performed including 91 consecutive stroke patients admitted to specialized cognitive rehabilitation. Data were collected from medical records and by face-to-face interviews using a structured interview guide and questionnaires. Descriptive and inferential statistics were applied.Main outcome measuresA wide range of biopsychosocial variables including medical and sociodemographic characteristics, social support, sexual complaints, aspects of sexual life, psychological distress and life satisfaction were analyzed in relation to the main outcome “Satisfaction with sexual life.”ResultsOnly 33 % were satisfied with sexual life. Prevalence of sexual complaints was high, more frequent in women (84%) than in men (64%). Three-quarters were less sexually active than before stroke. Multivariable analyses showed that anxiety, sleep problems, manifested sexual complaint, decrease in sexual activity and fear of partner rejection were significantly associated with low odds of sexual satisfaction, while affectionate support and partnership satisfaction were significant for sexual satisfaction. When combined in a biopsychosocial multivariable model only fear of partner rejection (OR 0.07; 95 % CI: 0.01–0.42) and decrease in sexual activity (OR 0.11; 95 % CI: 0.02–0.58) showed significant contribution to sexual satisfaction.ConclusionThe variety of predictors for sexual satisfaction indicates that therapeutic actions need to be individualized and points towards a broad assessment and interventional approach to meet the sexual rehabilitation needs of stroke patients with cognitive impairments in need of specialized rehabilitation.Vikan JK, Snekkevik H, Nilsson MI, et al. Sexual Satisfaction and Associated Biopsychosocial Factors in Stroke Patients Admitted to Specialized Cognitive Rehabilitation. Sex Med 2021;9:100424.
Highlights
The consequences of stroke on sexual life in stroke patients in need of specialized cognitive rehabilitation have been limited explored
Only 33 % were satisfied with sexual life
Multivariable analyses showed that anxiety, sleep problems, manifested sexual complaint, decrease in sexual activity and fear of partner rejection were significantly associated with low odds of sexual satisfaction, while affectionate support and partnership satisfaction were significant for sexual satisfaction
Summary
The consequences of stroke on sexual life in stroke patients in need of specialized cognitive rehabilitation have been limited explored. Previous research on post-stroke sexuality have overlooked patients with poststroke cognitive impairments (PSCI)[5] in need of cognitive rehabilitation. PSCI, such as problems with attention, concentration, memory, language, visuospatial abilities and executive functions are common poststroke, and frequent in patients with good physical recovery, with extensive impact on functional outcome, activity and participation and quality of life.[5,6,7,8] a large group of stroke patients with long-term disabilities is left with unknown sexual concerns and sexual rehabilitation needs. Evidence-based studies to guide clinical practice after stroke from a biopsychosocial perspective are called for to meet the diverse sexual rehabilitation needs,[12,13,14,15] in stroke patients with cognitive impairments
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