Date Presented 04/02/2022
Very little research exists examining how specific education about older adult sexual health and sexual activity may improve OT practitioners’ knowledge of and attitudes toward geriatric sexuality and application to clinical practice. This sequential explanatory mixed-methods research study investigates to what extent education in older adult sexual matters affects OT practitioners’ knowledge, attitudes, and clinical practice in the Occupational Therapy Practice Framework: Domain and Practice (4th ed.) activity of daily living of sexual activity.
Primary Author and Speaker: Robin L. Chilton
Contributing Authors: Jennifer A. Weaver, Sarah Doerrer, Roger Ideishi
PURPOSE: Many older adults find that sexuality and sexual relations remain an important, and often central part of their interpersonal and intimate relationships, and quality of life. The OTPF considers sexual activity as a basic activity of daily living. Very little research exists examining how specific education about older adult sexual health and sexual activity may improve OT practitioners’ knowledge and attitudes towards geriatric sexuality and its application to their clinical practice. The purpose of this study was to provide an online educational course in the area of older adult sexual health and sexual activity to increase OT practitioners’ knowledge, improve their attitudes, and increase the application of knowledge to clinical practice related to sexuality within the geriatric population. It answers the mixed methods research question: In what ways do the interview data about OT practitioners’ knowledge, attitudes, and clinical practice regarding older adult sexual health and sexual activity help to explain the quantitative results about these areas as reported on the pretest to posttest Aging Sexuality Knowledge and Attitudes Scale (ASKAS) results?
DESIGN: Sequential explanatory mixed methods. Participants consisted of licensed OTs and OTAs from any setting who had current or previous clinical practice experience with older adults; they were recruited via email, social media, and word-of-mouth.
METHOD: Participants completed a pretest using the ASKAS, viewed an online educational course on the topic of older adult sexuality, and then completed a posttest ASKAS. The pretest posttest data was examined for normality, correlation, and whether there was a statistically significant difference in knowledge and attitudes. A convenience sample of subjects from the online educational course were selected to participate in a 30–40-minute semi-structured interview to explore the experience and perceptions of OT practitioners regarding older adult sexual health and sexual activity in their clinical practice. Thematic analysis of the qualitative interview transcripts followed an inductive holistic approach using in-vivo and emergent coding to create categories that described the participants’ experiences and perceptions.
RESULTS: Forty-four OT practitioners completed the online educational course and ASKAS pre- and post-test. Statistically significant improvement existed in pretest posttest scores for knowledge (p<.001), but the attitude change scores (p = .198) did not show a statistically significant improvement on the ASKAS using the Wilcoxon Sign Rank Test with a significance value of <.05. Qualitative findings described how the OT practitioners’ lack of knowledge and experience, personal and cultural influences, and clinical priorities regarding older adult sexuality in their health care practice influenced their overall less permissive attitudes on the subject and its general absence within their clinical interventions.
CONCLUSION: Continuing education regarding older adult sexual health and sexual activity had a positive effect on the OT practitioners’ knowledge, but not on the attitudes section of the ASKAS. The online educational course and interview process prompted the therapists to reflect on their implicit bias surrounding sexual matters for older adults. The lack of existing education available on the topic of older adult sexuality for OT students and practitioners presents a significant need for increased content and clinical experience in this area. This topic must be included in academic programs for OT students and continuing education for OT practitioners to expand knowledge and to improve attitudes and comfort levels to address older adult sexuality in their clinical practice.
References
Hyland, A., & McGrath, M. (2013). Sexuality and occupational therapy in Ireland – A case of ambivalence? Disability and Rehabilitation, 35(1), 73-80. https://doi.org/10.3109/09638288.2012.688920
McGrath, M., & Lynch, E. (2014). Occupational therapists’ perspectives on addressing sexual concerns of older adults in the context of rehabilitation. Disability and Rehabilitation, 36(8), 651–657. https://doi.org/10.3109/09638288.2013.805823
Thompson, A. E., O’Sullivan, L. F., Byers, E. S., & Shaughnessy, K. (2014). Young adults’ implicit and explicit attitudes towards the sexuality of older adults. Canadian Journal on Aging, 33(3), 259-270. https://doi.org/10.1017/S0714980814000208
White, C. (1983). A scale for the assessment of attitude and knowledge regarding sexuality in the aged. Archives of Sexual Behavior, p11, 491-502. https://doi.org/10.1007/BF01542474
