Date Presented 04/05/19
Primary Author and Speaker: Beth Ann Walker
Additional Authors and Speakers: Kasey Otte, Kelsey Lemond, Tori Faulkner, Pamela Hess, Kandyse Kaizer, Davis Christy
BACKGROUND: Sexuality is incorporated in every human being’s daily life (Lohman et al., 2017) regardless of the presence of a disability (Isler et al., 2009). Unfortunately, many healthcare practitioners are hesitant to initiate the subject of sexuality due to personal embarrassment and belief that they would embarrass the client and clients do not bring the topic up because they do not want to embarrass the professional (Nilsson et al., 2017). The lack of education, experience, and comfort in addressing sexual concerns has been associated with brief discussions or a complete disregard of the issue in practice (Areskoug-Josefsson et al., 2016). There is a desperate need for a screen and thorough performance measure of the complex occupational nature of sexuality and intimacy incorporating aspects of the Sexual Assessment Framework (SAF): sexual knowledge, sexual self-view, sexual behavior, sexual interest, sexual activity, sexual response and sexual health and family planning (Kokesh, 2016; McBride & Rines, 2000). Such tools would serve as effective means for occupational therapists to adequately introduce, assess, and address the complex nature of sexuality and intimacy.
PURPOSE: The purpose of this study was to create a theoretical and occupation-based screen and performance measure to adequately measure the complex occupational nature of sexuality and intimacy.
DESIGN: The screen and performance measure were developed following DeVellis’s guidelines for scale development (2017). The following steps taken thus far include: mapping the construct, generating an item pool, determining the format for measurement, and having the initial item pool reviewed by a small panel of experts.
METHOD: The first step in this process was to map the construct by defining the occupational nature of sexuality and intimacy. Step two involved generating an item pool of existing items that address sexuality and intimacy. This process began with using a deductive approach to generate items based on an exhaustive search of the literature and pre-existing scales of sexuality and sexual health (Hinkin, 1995) and assembly of an item pool through collecting and categorizing individual items for the domains of the SAF. The next step involved a thorough theoretical analysis of the OTPF and our conceptual model to determine occupation-based elements necessary for inclusion within each construct. Items were generated for each construct until theoretical saturation was achieved. An inductive approach was applied to generate items based on qualitative information obtained from interviews with couples from the target population. The next step involved determining the format for measurement and a checklist format with an indicator for level of item importance to the client was chosen. The initial item pool has been reviewed thus far by six occupational therapists, a physical therapist, and a physician, George Szasz, who is a renowned pioneer in sexual medicine and developed the SAF in the 1970’s.
RESULTS: A screening tool and accompanying performance measure of sexuality and intimacy was created based on the core tenets of the SAF as they intertwine with aspects of the domain of occupational therapy. The screening tool (14 item) provides an introduction to the topic of sexuality and intimacy, the role of OT, and items relevant to sexual knowledge. There is a separate in-depth checklist associated with the following constructs of the SAF: sexual self-view (15), sexual behavior (19), sexual interest (21), sexual activity (23), sexual response (11), and sexual health and family planning (9).
CONCLUSION: There is a need for formal validation of the OPISI in order to get this much needed screen and performance measure into the the hands of occupational therapists.
References
Lohman, H. L., Kobrin, A., & Chang, W. P. (2017). Exploring the activity of daily living of sexual activity: A survey in occupational therapy education. The Open Journal of Occupational Therapy, 5(2), 1-11. doi: 10.15453/2168-6408.1289
Isler, A., Beytut, D., Tas, F., & Conk, Z. (2009). A study on sexuality with the parents of adolescents with intellectual disability. Sexuality And Disability, 27(4), 229-237. doi:10.1007/s11195-009-9130-3
McBride, K. E., & Rines, B. (2000). Sexuality and spinal cord injury: a road map for nurses. SCI nursing: a publication of the American Association of Spinal Cord Injury Nurses, 17(1), 8-13.
DeVellis, R. F. (2017). Scale development: Theory and applications. Thousand Oaks, CA: SAGE Publications, Inc.
