Jannike K. Vikan, Marie I. Nilsson, Tamara Bushnik, Wanying Deng, Khamis Elessi, Yael Frost-Bareket, Elena Kovrigina, Jeries Shahwan, Hildegun Snekkevik, Elisabet Åkesson, Johan K. Stanghelle, Kerstin S. Fugl-Meyer
Research, Sunnaas Rehabilitation Hospital, 1450 Nesoddtangen, Norway. E-mail: jannikekathrine.vikan@sunnaas.no
DOI: 10.2340/16501977-2552

Objective: To identify and explore sexual health policies at specialized stroke rehabilitation centres in relation to the perspectives of healthcare personnel concerning sexual health.
Design: Cross-sectional study.
Subjects: Nine specialized rehabilitation centres representing 7 countries, and healthcare personnel (n = 323) working with stroke rehabilitation at the 9 centres were included in the study.
Methods: Two structured questionnaires were used: (i) an organizational-audit on sexual health policies; (ii) an anonymous web-questionnaire assessing the perspectives of healthcare personnel concerning sexual health.
Results: Of the 9 centres, 5 scored high on having sexual health policy in stroke rehabilitation and 4 scored low. Healthcare personnel working at centres with high scores reported higher levels of knowledge and comfort in working with sexual health, and looked more positively on the workplace sexual health policies, than personnel working at centres scoring low on these factors. Most personnel expressed a need for knowledge on the topic. Being comfortable about addressing sexuality was significantly associated with higher levels of knowledge about sexuality and working at centres having sexual health policies.
Conclusion: A lack of sexual health policy represents a barrier to evidence-based practice in stroke rehabilitation. Such protocols need to be implemented in standard care in order to meet the sexual rehabilitation needs of stroke patients and partners.

Stroke survivors and their partners have been found to have unmet sexual rehabilitation needs. Stroke guidelines recommend that sexual health should be part of standard care, but sexuality is not consistently addressed in stroke rehabilitation. This study explored sexual health policies at 9 specialized stroke rehabilitation centres around the world and the perspectives of health-care personnel on working with sexual health. Five centres had routines on sexual health, while 4 had few or none. Personnel working at centres with routines felt more knowledgeable and comfortable working with sexual health, and responded more positively to having routines at their workplace concerning sexual health than did personnel at centres having few or no such routines. Those who felt comfortable more often felt knowledge-able addressing sexuality and more often worked at a centre having routines on sexual health. Sexual health policies should be implemented in stroke care in order to meet the needs of patients and their partners.