Abstract
Sexual dysfunction is a common concern among individuals with physical disabilities but often unaddressed by health care professionals, with many reporting lack of sufficient training and perceived lack of competence. The present study sought to examine educational factors and how they relate to health professions students’ attitudes around the sexual health needs of individuals with physical disabilities. This was part of a larger study of 479 health professions students from training programs in the Southeast who completed a survey of attitudes and beliefs about sexual health topics. Significant differences were found across student field on the main outcome measure (attitudes related to sexual health of patients with disability). Differences were also found in quantity and quality of sexual health education across student field, with psychology students reporting the lowest quantity and quality of education. Item analysis of the main outcome measure revealed significant differences across student field on most items, with dentistry students generally reporting the most negative attitudes. Implications for health care providers working with patients with physical disabilities are discussed, and suggestions for implementing sexual health curriculum in training programs are provided.
Similar content being viewed by others
Referencess
Esmail, S., Knox, H., Scott, H.: Sexuality and the role of the rehabilitation professional. Center for International Rehabilitation Research Information and Exchange (CIRRIE). http://cirrie.buffalo.edu/encyclopedia/en/article/29 (2008–2013). Accessed 15 October 2012
Lewis, R.W., Fugl-Meyer, K.S., Bosch, R., Fugl-Meyer, A.R., Laumann, E.O., Lizza, E., Martin-Morales, A.: Epidemiology/risk factors of sexual dysfunction. J. Sex. Med. 1, 35–39 (2004)
Kedde, H., Van de Wiel, H.B., Schultz, W.C., Vanwesenbeek, W.M., Bender, J.L.: Efficacy of sexological healthcare for people with chronic diseases and physical disabilities. J. Sex. Marital Ther. 36, 282–294 (2010)
McCabe, M.P., Taleporos, G., Dip, G.: Sexual esteem, sexual satisfaction, and sexual behavior among people with physical disability. Arch. Sex. Behav. 32, 359–369 (2003)
Trost, L.W., McCaslin, R., Linder, B., Hellstrom, W.J.: Long-term outcomes of penile prostheses for the treatment of erectile dysfunction. Expert Rev. Med. Devices 10, 353–366 (2013)
Fruhauf, S., Gerger, H., Schmidt, H. M., Munder, T., Barth, J.: Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Arch. Sex. Behav. 1–19 (2013)
Hackett, G., Cole, N., Bhartia, M., Kennedy, D., Raju, J., Wilkinson, P.: Testosterone replacement therapy with long-acting testosterone undecanoate improves sexual function and quality-of-life parameters vs. placebo in a population of men with Type 2 diabetes. J. Sex. Med. (2013). doi:10.1111/jsm.12146
Brison, D., Seftel, A., Sadeghi-Nejad, H.: The resurgence of the vacuum erection device (VED) for treatment of erectile dysfunction. J. Sex. Med. 10, 1124–1135 (2013)
Berner, M., Gunzler, C.: Efficacy of psychosocial interventions in men and women with sexual dysfunctions—a systematic review of controlled clinical trials: part 1-the efficacy of psychosocial interventions for male sexual dysfunction. J. Sex. Med. 9, 3089–3107 (2012)
Foley, F. W.: Intimacy and sexuality with multiple sclerosis. Multiple Sclerosis Foundation. http://www.msfocus.org/article-details.aspx?articleID=37 (2009). Accessed 24 May 2013
Phillips, N.A.: Female sexual dysfunction: evaluation and treatment. Am. Fam. Physician 62, 127–136 (2000)
Gianotten, W.L., Bender, J.L., Post, M.W., Hoing, M.: Training in sexology for medical and paramedical professionals: a model for the rehabilitation setting. Sex. Relat. Ther. 21, 303–317 (2006)
Solursh, D.S., Ernst, J.L., Lewis, R.W.: The human sexuality education of physicians in North American medical schools. Int. J. Impot. Res. 15, S41–S45 (2003)
Berman, L., Berman, J., Felder, S., Pollets, D., Chhabra, S., Miles, M., Powell, J.A.: Seeking help for sexual function complaints: What gynecologists need to know about the female patient’s experience. Fertil. Steril. 79, 572–576 (2003)
Montejo-Gonzalez, A.L., Llorca, G., Izquierdo, J.A., Ledesma, A., Bousono, M., Calcedo, A., Carrasco, J.L., Ciudad, J., Daniel, E., De la Gandara, J., Derecho, J., Franco, M., Gomez, M.J., Macias, J.A., Martin, T., Perez, V., Sanchez, J.M., Sanchez, S., Vicens, E.: SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J. Sex. Marital Ther. 23, 176–194 (1997)
Leiblum, S., Wiegel, M., Brickle, F.: Sexual attitudes of US and Canadian medical students: the role of ethnicity, gender, religion and acculturation. Sex. Relat. Ther. 18, 1468–1479 (2003). doi:10.1080/14681990310001609813
Papaharitou, S., Nakopoulou, E., Moraitou, M., Tsimtsiou, Z., Konstantinidou, E., Hatzichristou, D.: Exploring sexual attitudes of students in health professions. J. Sex. Med. 5, 1308–1316 (2008)
Talley A., Ritzdorf K., Muma, R.D.: Attitudes of US physician assistants toward persons with HIV/AIDS. JAAPA. 23, 41–42, 44–46, 48 (2010) First published on 2011/01/15
Malhotra, S., Khurshid, A., Hendricks, K.A., Mann, J.R.: Medical school sexual health curriculum and training in the United States. J. Natl. Med. Assoc. 100, 1097–1106 (2008)
World Health Organization: Education and treatment in human sexuality: the training of health professionals. Report of a WHO meeting. World Health Organization. http://whqlibdoc.who.int.trs/WHO_TRS_572.pdf (1975). Accessed 7 March 2013
National Institutes of Health Consensus Conference.: NIH consensus statement: Impotence. The National Institutes of Health. http://consensus.nih.gov/1992/1992Impotence091PDF.pdf (1992). Accessed 5 March 2013
Shindel, A.W., Parish, S.J.: Sexual education in North American medical schools: current status and future directions (CME). J. Sex. Med. 10, 3–18 (2013)
Galletly, C., Lechuga, J., Layde, J.B., Pinkerton, S.: Sexual health curricula in U.S. medical schools: current educational objectives. Acad. Psychiatry 34, 333–338 (2010)
Tervo, R.C., Azuma, S., Palmer, G., Redinius, P.: Medical students’ attitudes toward persons with disability: a comparative study. Arch. Phys. Med. Rehabil. 83, 1537–1542 (2002)
Satchidanand, N., Gunukula, S.K., Lam, W.Y., McGuigan, D., New, I., Symons, A.B., Withiam-Leitch, M., Akl, E.A.: Attitudes of healthcare students and professionals toward patients with physical disability: A systematic review. Am. J. Phys. Med. Rehabil. 91, 533–545 (2012)
Hahn, H.: The social component of sexuality and disability: Some problems and proposals. Sex. Disabil. 4, 220–233 (1981)
GR Facts: Georgia Regents University. gru.edu/facts/index.php. (2013). Accessed 29 January 2014
State and County QuickFacts: U.S. Census Bureau. quickfacts.census.gov/qfd/states/13/1304204.html (2014). Accessed 29 January 2014
Carroll, R.A.: Psychological aspects of erectile dysfunction. In: McVary, K.T. (ed.) Contemporary treatment of erectile dysfunction: A clinical guide, pp. 23–37. Springer, New York (2010)
Molloy, G.L., Herold, E.S.: Sexual counseling for the physically disabled: A comparison of health care professionals’ attitudes and practices. Can. Fam. Physician 31, 2277–2285 (1985)
Cohen, J.: Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Erlbaum Associates, Hillsdale, NJ (1988)
Reissing, E.D., Giulio, G.D.: Practicing clinical psychologists’ provision of sexual health care services. Prof. Psychol-Res. Pr. 41, 57–63 (2010)
Herrero, R., Castellsaque, X., Pawlita, M., Lissowska, J., Kee, F., Balaram, P., Rajkumar, T., Sridhar, H., Rose, B., Pintos, J., Fernandez, L., Idris, A., Sanchez, M.J., Nieto, A., Talamini, R., Tavani, A., Bosch, F.X., Reidel, U., Snijders, P.J., Meijer, C.J., Viscidi, R., Munoz, N., Franceschi, S.: Human papillomavirus and oral cancer: The international agency for research on cancer multicenter study. J. Natl. Cancer Inst. 95, 1772–1783 (2003)
Reed, B.D., Zazove, P., Pierson, C.L., Gorenflo, D.W., Horrocks, J.: Candida transmission and sexual behaviors as risks for a repeat episode of Candida vulvovaginitis. J. Womens Health 12, 979–989 (2003)
Garcia, J.R., Kruger, D.J.: Unbuckling in the Bible belt: Conservative sexual norms lower age at marriage. J. Soc. Evol. Cult. Psychol. 4, 206–214 (2010)
Olson, L.R., Green, J.C.: Introduction—gapology and the presidential vote. PS. Polit. Sci. Polit. 39, 443–446 (2006)
Humes, K. R., Jones, N. A., Ramirez, R. R.: Overview of race and Hispanic origin: 2010. 2010 Census Briefs. United States Census Bureau. http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf (2011). Accessed 27 January 2014
Hall, P.: Interprofessional teamwork: Professional cultures as barriers. J. Interprof. Care 19, 188–196 (2005)
Bitzer, J., Platano, G., Tschudin, S., Alder, J.: Sexual counseling for women in the context of physical diseases—a teaching model for physicians. J. Sex. Med. 29–37 (2007)
Dune, T.: Sexuality and physical disability: Exploring the barriers and solutions in healthcare. Sex. Disabil. 247–255 (2012)
Couldrick, L., Sadlo, G., Cross, V.: Proposing a new sexual health model of practice for disability. Int. J. Ther. Rehabil. 17, 290–299 (2010)
Annon, J.S.: The behavioural treatment of sexual problems: Brief therapy, 1st edn. Kapiolani Health Services, Honolulu (1974)
Simpson, G., Samir, A., Wilson, J., Bertapelle, T.: Improving the rehabilitative management of client sexual health concerns after neurological disability: Evaluation of a staff sexuality training programme in New Zealand. Clin. Rehabil. 20, 847–859 (2006)
Lane, C., Rollnick, S.: The use of simulated patients and role-play in communication skills training: A review of the literature to August 2005. Patient Educ. Couns. 67, 13–20 (2005)
Leiblum, S.R.: An established medical school human sexuality curriculum: Description and evaluation. Sex. Relat. Ther. 16, 59–70 (2001)
Tucker, P., Candler, C., Hamm, R.M., Smith, E.M., Hudson, J.C.: Assessing changes in medical student attitudes toward non-traditional human sexual behaviors using a confidential audience response system. Sex. Educ. 10, 37–45 (2010)
Ozan, S., Timbil, S., Aras, S., Bilgin, A.C., Orcin, E., Semin, S.: Sexual attitudes, behavior changes and opinions of interns in Izmir, Turkey. Eur J Contracept Reprod. Healthc. 15, 367–375 (2010)
Gott, M., Hinchliff, S., Galena, E.: General practitioner attitudes to discussing sexual health issues with older people. Soc. Sci. Med. 58, 2093–2103 (2004)
Parchomiuk, M.: Specialists and sexuality of individuals with disability. Sex. Disabil. 30, 407–419 (2012)
Appel, J.M.: Sex rights for the disabled? J. Med. Ethics 36, 152–154 (2010)
Acknowledgments
We would like to acknowledge Brittany Ange, M.S., Margo Villarosa, M.S., Jeff Campbell, M.S., and Matthew Decker, Ph.D. for their contributions to this project. We would also like to acknowledge the Educational Innovation Institute at Georgia Regents University as our funding source.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Valvano, A.K., West, L.M., Wilson, C.K. et al. Health Professions Students’ Perceptions of Sexuality in Patients with Physical Disability. Sex Disabil 32, 413–427 (2014). https://doi.org/10.1007/s11195-014-9347-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11195-014-9347-7