Abstract

Background: Research indicates that although 50-60% of people who have had a traumatic brain injury (TBI) experience changes in sexual functioning, sexuality issues remain largely unaddressed in rehabilitation. Studies have
investigated professionals’ perspectives about communicating about sexual issues with service-users2 post-TBI, with a number of barriers being identified. However, as studies have tended to use quantitative methodologies, it was felt
that qualitative research would provide a richer understanding.
Aim: This study aimed to explore professionals’ perceptions and experiences of discussing sexuality with service-users who have had a TBI.
Method: This study employed a qualitative design. Purposeful sampling was used to recruit 24 participants from two local National Health Service (NHS) trusts, and from a national charity. Four focus groups were carried out with pre-existing teams of professionals, using a semi-structured interview schedule. Focus group data were transcribed verbatim and analysed using thematic analysis.
Results: Six main themes were derived from the analysis: 1) Sexuality after TBI is a specialist issue; 2) Sexuality is a sensitive subject; 3) Practicalities of discussing sexuality; 4) Roles and responsibilities; 5) Dilemmas about risk and
vulnerabilities, and 6) Organisational and structural factors. Each of these themes have between two and five subthemes.
Conclusions and recommendations: In order that sexuality becomes accepted as an integral part of holistic rehabilitation, it is recommended that a more proactive approach is taken. It is recommended that sexuality is
incorporated into assessments, and that written information is available for service-users. Support for professionals is also needed in the form of the development of policy, on-going training, and supervision.