Toward a Sex-positive View of Sexuality After Spinal Cord Injury: A Qualitative Metasynthesis 0416

Objective(s)

To explore facilitators of sexuality for people with spinal cord injury (SCI) using a strengths-based and sex-positive approach, we conducted a systematic review and qualitative metasynthesis of qualitative studies.

Data Sources

A systematic search of 6 online databases (Web of Science, Scopus, PubMed, PsycINFO, MEDLINE, Embase) was conducted by 5 authors. Search terms were organized using the PICo Framework and were developed with the support of an academic librarian. Search terms included: Population: “spinal cord injur*” OR “spinal injur*” OR “spinal cord” OR “spinal cord trauma” OR “spinal cord lesion” OR quadriplegi* OR paraplegi* OR tetraplegi*; Interest: sex* OR sexual* OR sensual* OR intimate OR intimacy; Context: qualitative OR “focus group” OR “grounded theory” OR interview* OR ethnography OR phenomenology OR phenomenological OR experience. Papers were included if they: focused on sexuality/intimacy, included participants with SCI, were qualitative (including interviews and focus groups), were in English, were peer-reviewed, and their qualitative findings were clearly articulated. They were excluded if they were quantitative or mixed methods, if the researchers were unable to parse out the voice of the participants with SCI, full text was not available, or were thesis or gray literature.

Study Selection

Studies were imported into Covidence Systematic Review Software for screening and each paper was screened at every point by at least 2 authors. A systematic search of 6 databases found 3655 articles about sexuality and SCI. Title and abstract screening narrowed these down to 144 for full-text screening, further narrowed to 33 articles to be analyzed using thematic synthesis.

Data Extraction

Data were extracted into NVIVO for coding and thematic synthesis. All papers were comparatively coded by at least 2 authors. Paper quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research.

Data Synthesis

Codes were then grouped into descriptive themes by 4 authors. Themes were iteratively discussed and reassessed by the entire research team, to develop analytical themes.

Conclusions

The 6 analytical themes addressing facilitators for sexuality post-SCI included: an evolving understanding of sexuality, new and other ways of sexual expression, being sexually active, access to appropriate resources, having the right partner, and establishing a sexual self. These will be discussed in-depth in our presentation and published in an upcoming journal article. The results of this study use a novel lens of sex-positivity to analyze the results of 33 qualitative papers on sexuality and SCI. Results can be used to inform clinical practice and future sex-positive research.

Disclosures

none.