Exploring Current Practices of Multidisciplinary Teams in Enhancing Sexual Function among People with Spinal Cord Injury at Centre for the Rehabilitation of the Paralysed

Abstract

Background: Sexual function is an essential part of overall health and quality of life. Every year around 800 to 1000 new SCI patients are seen in Bangladesh. After spinal cord injury (SCI), many individuals experience sexual dysfunction, which affects their physical, emotional, and marital well-being. In Bangladesh, sexual health is considered a sensitive and taboo topic, and as a result, sexual rehabilitation for SCI patients often receives little attention. Although multidisciplinary teams (MDTs) play an important role in SCI rehabilitation, there is limited evidence regarding their current practices in addressing sexual function at rehabilitation centers such as the Centre for the Rehabilitation of the Paralysed (CRP). Aim: The aim of this study was to explore current practices of multidisciplinary teams in enhancing sexual function among people with spinal cord injury at CRP. Methods: A qualitative research design was used for this study. Purposive sampling was used to choose eleven healthcare experts from various specialties, including physiotherapists, occupational therapists, doctors, nurses, and a psychologist. Face-to face, in-depth, semi-structured interviews under the direction of a self-developed interview guide were used to gather data. Braun and Clarke's six-step method for thematic analysis was used to analyse the data. Results: Eight themes were identified. These were: 1) Profession-specific and clinically diverse sexual rehabilitation practices within the multidisciplinary team; 2) Limited interdisciplinary integration and fragmented communication; 3) Systemic and organizational constraints in service delivery; 4) Gender-related communication barriers; 5) Sociocultural influences on sexual rehabilitation engagement; 6) Psychosocial, relational, and marital impacts of sexual dysfunction; 7) Gender disparities in sexual rehabilitation service utilization; and 8) Recommendations for strengthening sexual rehabilitation services. Discipline-specific interventions are used at CRP to provide sexual rehabilitation, but services are still dispersed because of poor MDT coordination and an excessive dependence on the psychologist. Important obstacles include inadequate organizational integration, a lack of a dedicated unit, inadequate equipment and medication and a lack of professional training. Male patients receive more care than female patients due to erectile dysfunction. Psychosocial and marital issues, such as fear of divorce and fertility issues are also brought on by sexual dysfunction. To improve services, participants suggested a specialized unit, better coordination, organized MDT training and stronger policy support. Conclusion: Sexual rehabilitation remains underdeveloped in SCI care in Bangladesh. Strengthening MDT collaboration, improving training, and establishing dedicated services, and supporting these efforts through appropriate health system and policy level initiatives are essential to enhance sexual health and overall quality of life for individuals with SCI. Key words: Spinal cord injury, Sexual function, Multidisciplinary team, Sexual rehabilitation, Qualitative study.