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Evaluating a co-design and implementation project to improve sexuality support following traumatic brain injury in a
Jill H A Hwang1, Marina G Downing1, Jennie L Ponsford1,2
1Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, VIC, Australia.
Purpose:
Despite sexuality changes occurring in up to half of individuals with traumatic brain injury (TBI), sexuality is frequently not addressed in Australian rehabilitation settings. This study evaluated an implementation project aimed at improving sexuality support in an Australian TBI rehabilitation unit.
Method:
Through a mixed-method design, 81 individuals with TBI (48 pre-implementation and 33 post-implementation) completed surveys, 26 clinicians completed a repeated survey and 15 clinicians participated in semi-structured interviews.
Results:
Post-implementation individuals with TBI experienced significantly higher frequency of sexuality support (χ2(1, n = 81) = 11.2, p < .001), and were more likely to seek help (t(67.9) = -2.08, p = .04). Significant reductions in clinician Sexuality Attitudes and Beliefs Scale scores indicated improved attitudes and beliefs towards addressing sexuality (t(25) = 7.0, p < 001). Qualitatively, clinicians indicated growth in attitudes, comfort and skills, and that sexuality was more normalised. However, clinicians still rely on champions to address sexuality, which may be limiting individual behavioural changes.
Conclusion:
This study highlights the use of co-design and implementation approaches to improve sexuality support attitudes and behaviours in a rehabilitation setting. Ongoing efforts will be essential to sustain these positive changes and normalise clinical discussions on sexuality.
Trial Registration:
Australian New Zealand Clinical Trials Registry (ACTRN12622001033730) registered on 25/07/2022.
