O36 Let’s talk about sex: an occupational therapy clinical evaluation about the importance of sexual intimacy issues in the treatment of patients with persistent pain

  • Ewer-Smith C
  • Trent A
  • Lewis J
N/ACitations
Citations of this article
14Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

Background: Sexuality is described as an essential part of selfidentity crucial to wellbeing. This evaluation considers physical and psychological aspects of sexual intimacy. Seventy percent of rheumatology patients report dissatisfaction with sexual intimacy, yet only 12% of consultations include sexual activity screening. This suggests that health care professionals are reluctant to raise this issue with patients. The complex regional pain syndrome [CRPS] programme at the Royal National Hospital for Rheumatic Diseases provides specialist rehabilitation to patients managing the impact of musculoskeletal pain disorder in daily life. The CRPS OT team recognise sexual intimacy as an important aspect of personal care which patients raise when clinicians provide the opportunity. OT intervention normalises challenges to sexual intimacy, facilitating shared problem solving. Therapy includes psychological work on body image, self-esteem, sense of sexual-self, anxiety management and communication. Physical issues of allodynia, limited movement, fatigue, positioning, aids and modifications are addressed. Methods: A retrospective evaluation of the Canadian Occupational Performance Measure [COPM] within OT clinical notes was undertaken. Using COPM in the rehabilitation process enables identification and measurement of changes in patient perception of occupational performance. Changes in patients' occupational performance and satisfaction within sexual intimacy following OT intervention through use of this standardised outcome measure were calculated. Patients use a 10-point scale to rate the five most important occupations they are unable to accomplish. A 10-point scale rates performance and satisfaction for each problem pre- and post-programme. Change scores are calculated, with a score of 2 and above being clinically important. Results: Between July 2016 and July 2017 87% of patients attending OT raised concerns regarding sexual intimacy. 10 patients (10.5%) allocated it highest priority with 90% scoring it 10. Of these 10, nine were female and one male, aged 27-59. All were in established sexual relationships that commenced prior to CRPS. Six identified problems with physical intimacy; three with communication about the physical and emotional aspects of sexual intimacy; and one with sense of sexual-self. Two were unable to provide post-programme scores. Of the eight that rated the programme's impact on their management of sexual intimacy 87.5% demonstrated increased performance, of which 75% were clinically important outcomes; 87.5% reported increased satisfaction, all clinically important. Average change scores were +2.6 in performance and +5.1 in satisfaction. Conclusion: The results demonstrate that exploring the impact of persistent pain on sexual intimacy is important to patients. Patients viewed sexual intimacy as encompassing communication, emotional and physical intimacy, and the sense of sexual self. OT intervention has a clinically important impact on patients' abilities to re-engage in this domain.

Cite

CITATION STYLE

APA

Ewer-Smith, C., Trent, A., & Lewis, J. (2018). O36 Let’s talk about sex: an occupational therapy clinical evaluation about the importance of sexual intimacy issues in the treatment of patients with persistent pain. Rheumatology, 57(suppl_3). https://doi.org/10.1093/rheumatology/key075.218

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free