INTIMASY-TBI Guideline: Optimization of INTIMAcy, SexualitY, and Relationships Among Adults With Traumatic Brain Injury.

Autor:	Patsakos EM; Author Affiliations: Rehabilitation Sciences, Institute, University of Toronto, Toronto, Ontario (Ms Patsakos and Dr Bayley); KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario (Ms Patsakos and Dr Bayley); Physical Medicine & Rehabilitation, School of Medicine, Indiana University, Indianapolis, Indiana (Drs Backhaus and Neumann); Shepherd Center, Atlanta, Georgia (Ms Farris); Kessler Institute for Rehabilitation, West Orange, New Jersey (Dr King); Faculty of Medicine, McGill University, Montreal, Quebec (Dr Moreno); and Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (Dr Sander)., Backhaus S, Farris K, King M, Moreno JA, Neumann D, Sander A, Bayley MT
Jazyk:	angličtina
Zdroj:	The Journal of head trauma rehabilitation [J Head Trauma Rehabil] 2024 Sep-Oct 01; Vol. 39 (5), pp. 395-407. Date of Electronic Publication: 2024 Sep 10.
DOI:	10.1097/HTR.0000000000000981
Abstrakt:	Introduction: Traumatic brain injury (TBI) can negatively impact intimacy, relationships, and sexual functioning through changes in physical, endocrine, cognitive, behavioral, and emotional function. Without intervention, diminished intimacy and/or sexual functioning in individuals with TBI may persist. Although most health care professionals agree that sexuality and intimacy in relationships are significant concerns and should be addressed in rehabilitation, these concerns are not typically discussed during rehabilitation and discharge planning for people with TBI. To address this gap, an expert panel of North American clinicians and researchers convened to develop evidence-informed recommendations to assist clinicians in providing a framework and guidance on how clinicians can support individuals after TBI. Methods: A systematic search of multiple databases was conducted to identify relevant evidence published from 2010 to 2023. The INTIMASY-TBI Expert Panel developed recommendations for optimizing discussions and interventions related to intimacy and sexuality for people with TBI in rehabilitation and community-based programs. For each recommendation, the experts evaluated the evidence by examining the study design and quality to determine the level of evidence. Results: A total of 12 recommendations were developed that address the following topic areas: (1) interprofessional team training, (2) early education on the effects of TBI on intimacy, relationships, and sexuality, (3) creating individualized interventions, (4) education, assessment, and management of the causes of sexual dysfunction, and (5) providing written materials and relationship coaching to persons with TBI and their partners. Two recommendations were supported by Level A evidence, 1 was supported by Level B evidence, and 9 were supported by Level C (consensus of the INTIMASY-TBI Expert Panel) evidence. A decision algorithm was developed to assist clinicians in navigating through the recommendations. Conclusion: The INTIMASY-TBI Guideline is one of the first comprehensive clinical practice guidelines to offer strategies to trained clinicians to discuss the physical, psychosocial, behavioral, and emotional aspects of intimacy and sexuality with persons with TBI. Competing Interests: The authors declare no conflicts of interest. The project described in this manuscript was funded through Neurotrauma grant number 719 from the Ministry of Health and Long-Term Care of Ontario, Canada (Lead: Dr Mark Bayley). The authors declare that no competing financial interests exist. The authors further declare that the funders did not participate in the organization of the project nor the expert panel process, evidence synthesis nor formulation of the recommendations. The views expressed in the publication are the views of the authors and do not necessarily reflect those of the Province of Ontario. (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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