title: Talking about sex after traumatic brain injury: perceptions and experiences of multidisciplinary rehabilitation professionals.
abstract: OBJECTIVE
  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. This study aimed to explore rehabilitation professionals' perceptions and experiences of discussing sexuality with service-users who have had a TBI.
  
  
  METHODS
  Purposeful sampling was used to recruit 24 participants from two local National Health Service trusts and from a national charity. Four focus groups were conducted with pre-existing groups 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 issues.
  
  
  CONCLUSIONS
  Our findings suggest that a more proactive approach to addressing sexuality issues be taken by incorporating sexuality into assessments and by having sexuality information available for service-users. Support for professionals is also needed in the form of the development of policy, on-going training and supervision. Implications for Rehabilitation Rehabilitation professionals find it difficult to deal with issues of sexuality following TBI, and the reasons for this are complex and interrelated. To provide holistic care, a more proactive approach to addressing sexuality issues should be taken. Professionals do not need to be an expert in sexual issues to open dialogue. Sexuality discussions should be incorporated into assessments, and written information should be available for service-users. Further training for professionals and organisational policy change is sometimes required to effectively deal with sexuality issues.
authors.affiliation: Institute of Health, Life and Social Sciences, University of Lincoln , Lincoln , UK .
authors.forename: Kerry
authors.initials: K
authors.lastname: Dyer
authors.forename: Roshan
authors.initials: R
authors.lastname: das Nair
mesh_terms: D001930:Brain Injuries / Q000534:rehabilitation*; D003376:Counseling; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006694:Holistic Health; D006801:Humans; D036301:Qualitative Research; D012725:Sexual Behavior; D019529:Sexuality
keywords: Rehabilitation; sexuality; traumatic brain injury