Date Presented 04/05/19
Sexuality and intimacy are often meaningful activities for humans, yet OTs are hesitant to address these topics with their clients. Limited research is available that could inform and guide the profession in establishing curriculum and best practice. This case series is the first study to explore key factors of OT sex and intimacy intervention in enhancing performance in sexual activity and intimacy social participation.
Primary Author and Speaker: Kathryn Ellis
Contributing Authors: Michelle Nordstrom
PURPOSE: Sexuality encompasses both sex and intimacy (WHO, 2004).When evaluating quality of life for healthy individuals and those experiencing disability it is imperative to account for sex as an activity of daily living (ADL) and intimacy as an instrumental activity of daily living (IADL). However, Occupational Therapy (OT) has been reluctant to embrace treatment for sexuality with clients (Jones, Weerakoon, & Pynor, 2005; Lohman, Kobrin, & Wen-Pin Chang, 2017). While challenges managing intimate relationships and sexual activity following injury and illness continue to be documented, the development of a program-based intervention remains absent from the literature. Researchers aimed to measure the efficacy of the Occupational Therapy Sex and Intimacy (OTSI) intervention program for service recipients at Walter Reed National Military Medical Center (WRNMMCB).
DESIGN: This was a qualitative design. Purposeful sampling was used to recruit participants who differed from one another in age, diagnosis, and impact of symptoms on their engagement in sexual activity and intimate social participation. Researchers deliberately selected participants who could reflect the diverse caseload of the OTSI program.
METHODS: For this case series, participants of the OTSI intervention program consented to a retrospective chart review of their medical records and a semi-structured interview grounded in an interpretive phenomenological approach. A standardized score sheet was used to deconstruct the OTSI intervention into discrete categories of behavior that matched specific features of intimacy or sexual activity. Emerging themes were generated from the analysis.
RESULTS: Emerging themes highlighting the catalyst of OTSI as a mechanism to help clients enhance their sexuality and intimacy performance include (i) a change in understanding of definition for both sexual activity and intimacy social participation; (ii) adapting to pain and injury; (iii) importance of communication of sexual goals and desires; (iv) body image; (v) important of quality time with intimate partners; (vi) actualizing role identify; (vii) practicing emotional regulation.
CONCLUSION: Participation in OTSI reduced stress after both physical and/or psychological trauma, improved quality of life, and fostered healthy sexual and intimate practices for injured service members at WRNMMC. This case series raises awareness of the social, emotional, behavioral needs, and resources required for clients to reengage in sexual activity and intimate social participation. Emerging themes were noted to support specific components of the OTSI which helped clients enhance performance in sexual activity and intimate social participation.
IMPACT STATEMENT: This case series is the first study to explore key beneficial factors of OT sex and intimacy intervention. This information can guide intervention and influence future prospective studies on specific populations. Perhaps leveraging a widespread professional movement to prioritize sex and intimacy interventions in their practice and further improve the quality of life for our clients.
References
Jones, M. K., Weerakoon, P., & Pynor, R. A. (2005). Survey of occupational therapy students’ attitudes towards sexual issues in clinical practice. Occupational Therapy International, 12(2), 95–106.
Lohman, H. L., Kobrin, A., & Wen-Pin Chang. (2017). Exploring the activity of daily living of sexual activity: A Survey in occupational therapy education. Open Journal of Occupational Therapy (OJOT), 5(2), 1–11. https://doi.org/10.15453/2168-6408.1289
WHO (2004). What constitutes sexual health? Prog Reprod Health Res. 67: 2-8. http://www.who.int/reproductive-health/hrp/progress/67.pdf.
