Perspectives of Portuguese People with Physical Disabilities Regarding Their Sexual Health: A Focus Group Study

The World Health Organization has considered sexual health as a major dimension of global health and a sexual right. However, the sexual health of people with physical disabilities is still poorly addressed by health and social care professionals, and it is very stigmatized by society. This study aimed to assess the perspectives of Portuguese people living with physical disabilities regarding issues affecting their sexual health. Nine women and 17 men with different physical disabilities participated in the study. Participants were recruited from a professional rehabilitation facility located in the North of Portugal and were assigned to four groups in one-hour sessions. Three main categories emerged from the content analysis: (1) meanings and beliefs regarding sexuality; (2) experiences of sexuality; (3) necessary changes. Despite the positive social changes towards sexuality, participants expressed that their sexual rights are still unfulfilled, as they live in a context that perpetuates their dependency. They pointed out low self-esteem, prejudice and social isolation, poor architectural accessibility and scarcity of financial support as some of the barriers to their lives and their sexual health. Finally, participants identified the main needs regarding their sexual health, such as: access to specialized information; training for health professionals. This study gives voice to people with physical disabilities and sheds light into both individual and contextual factors affecting their sexual health. Of utmost importance, this study draws attention to the need for reinforcing sexuality of people with disabilities in the social agenda and brings implications for future research and practice.This study was supported by a Grant attributed to the first author by the Portuguese Foundation for Science and Technology (SFRH/BD/112168/2015)info:eu-repo/semantics/publishedVersio

Embodying limb absence in the negotiation of sexual intimacy

Some people with physical disabilities experience difficulties in forming and maintaining intimate and sexual relationships (Taleporos and McCabe, 2001). Individuals with physical impairments may variously be seen as inferior, ‘not up to scratch’ and can be less valued than those thought to embody the cultural ideal of ‘normality’ (Edwards and Imrie, 2003). The loss of an anatomical part such as an arm or a leg can therefore set up a complex series of perceptual, emotional and psychological responses that can limit or prevent individuals from fully experiencing the kinds of intimate relationships that many of their ‘non-disabled’ counterparts can more freely enjoy (Oliver, 1990). Drawing on a series of semi-structured interviews and a group visual workshop with five men and two women with varying acquired and congenital limb absences, this study explores the variety of ways in which sexual relationships and intimacies are negotiated and managed. Certain participants reported a great deal of anxiety regarding their perceptions of sexual attractiveness, and experienced feelings of loss of desirability as a sexual partner. Others reported engaging in an ‘active management of visual information’ about the body, through methods of concealment and exposure. Compensatory strategies were also reported as a way to effectively maintain existing intimate relationships. Finally, hyper-masculine or hyper-feminine enactments of sexuality were described within a range of social and intimate contexts as a means to ‘normalise’ the disabled body. The findings of this study provide a richer and more contextualised understanding of the highly complex adjustment process faced by individuals with limb absence, who actively engage in sexual and intimate relationships

Developing mathematical fluency: comparing exercises and rich tasks

Achieving fluency in important mathematical procedures is fundamental to students’ mathematical development. The usual way to develop procedural fluency is to practise repetitive exercises, but is this the only effective way?This paper reports three quasi experimental studies carried out in a total of 11 secondary schools involving altogether 528 students aged 12–15. In each study, parallel classes were taught the same mathematical procedure before one class undertook traditional exercises while the other worked on a "mathematical etude" (Foster International Journal of Mathematical Education in Science and Technology, 44(5), 765–774, 2013b), designed to be a richer task involving extensive opportunities for practice of the relevant procedure. Bayesian t tests on the gain scores between pre- and post-tests in each study provided evidence of no difference between the two conditions. A Bayesian meta-analysis of the three studies gave a combined Bayes factor of 5.83, constituting Bsubstantial^ evidence (Jeffreys, 1961) in favour of the null hypothesis that etudes and exercises were equally effective, relative to the alternative hypothesis that they were not. These data support the conclusion that the mathematical etudes trialled are comparable to traditional exercises in their effects on procedural fluency. This could make etudes a viable alternative to exercises, since they offer the possibility of richer, more creative problem-solving activity, with comparable effectiveness in developing procedural fluency

A multiple timepoint pre-post evaluation of a ‘sexual respect’ dvd to improve competence in discussing sex with patients with disability

Sexual problems are common after chronic illnesses and disability, yet research indicates that this is a neglected area in healthcare services. Evaluation studies provide evidence of the effectiveness of education in enhancing professionals’ knowledge, skills, and comfort in addressing patients’ sexual concerns. However, there are limited evaluations aimed at improving ability to discuss sexuality when working with people with disabilities. The overall aim of this study was to evaluate a ‘Sexual Respect’ DVD as an intervention to improve competence in addressing ‘sexuality and disability’. A mixed methods design was used with both quantitative and qualitative components. Nursing students’ self-report ratings of knowledge, confidence, comfort and willingness (to discuss sexuality) levels were collected across four time points: baseline, pre-intervention, post-intervention, and follow-up. Data were analysed using one-way repeated measures ANOVAs with post hoc comparisons. Open-ended qualitative comments relating to the barriers and facilitators to discussing sexuality were analysed using content analysis and subsequent frequency analysis. Reported barriers included lack of knowledge about sex¬uality and disability issues, the patient’s level of disability, and waiting for the patient to raise sexuality issues first. Facilitators included education/training, written information, and if the patient raised it first. Overall, the DVD intervention had a significant and positive impact on nursing students’ self-reported knowledge, confidence, comfort and willingness levels. The findings are discussed in relation to the PLISSIT model, which emphasises the importance of a proactive approach to addressing sexuality issues

The sexual lives of people with disabilities within low- and middle-income countries: A scoping study of studies published in English

Although approximately 80% of the global population of people with disabilities reside in low- and middle-income countries, very little is known about their sexual lives due to a lack of empirical data. The purpose of this scoping review is to provide a data-driven overview of low- and middle-income countries concerning what topics in disability and sexuality have been investigated, where this research has been carried out, and how this research has been conducted. It is concluded that: a) disability and sexuality research in African countries focuses predominantly on contexts of vulnerability, b) the sexuality of people with disabilities within many low- and middle-income countries has received little or no empirical investigation, c) and there have been very few experimental studies on disability and sexuality conducted in low- and middle-income countries in general. Recommendations for future research are discussed