When Carol Lewis, PhD, PT, editor of the Journal of Geriatric Rehabilitation, approached us at the APTA Combined Sections Meeting 2015 after our presentation on "Sex in the Second Half: Vibrant and Healthy," we jumped at the opportunity to bring sexual health, function, and activity information to light in this readership. She said that there had not been an issue on sexuality in the past 30 years of the journal and that it was past due.
Sexual activity is a hallmark of vitality and is associated with youth and health. It is one meaningful way that one can express themselves as well as connect intimately. With age, multiple barriers, including physical and psychosocial, may diminish the previous ways in which a person may have had healthy sexual expression. More interest in sexuality in geriatric populations has led to studies evaluating interest, participation, and dysfunctions that may impede sexual function.
The truth is that all health disciplines are expected to address sexuality as an integral part of holistic well-being, and inquiry about sexual activity and goals should be included in rehabilitation.1 To adequately restore and adapt our patients back to functioning lives, we must have an understanding of sexual function and identify physical and psychological barriers to resuming satisfying sexual expression.
Our intention for this edition is to have the following objectives understood by the journal reader:
1. Clinicians and patients should be aware that healthy pain-free pleasurable sexual function and activity is a basic human right.
2. All health care professionals should have adequate knowledge and clinical skills to promote sexual health, function, and activity regardless of age, sexual orientation, cultural, and alternative practices.
3. All patients and clients should be asked about their activities of daily living (ADL) and activities of nightly living (ANL), which include bowel, bladder, sexual function, sleeping, and eating regardless of diagnosis.
4. All patients should have a coordinated interdisciplinary health care team to address their diagnosis and these ADL/ANL fully and completely inclusive of their sexual function.
We reached out to leaders in the disciplines of urology, gynecology, psychiatry, psychology, social work, sexology, women and men's health physical therapy, orthopedic physical therapy, geriatric physical therapy, and nursing and to contribute. We sought clinicians and researchers who actively work in sexual health, function, and activity for their clinical pearls and innovative thinking.
This issue covers a wide range of topics, some strongly supported by evidence-based studies. Other topics had significant lack of study. We decided to utilize Sackett's fundamental argument that case study was an important part of evidence-based medicine for its thought-provoking contribution for further research. We encouraged authors to propose clinical and research ideas when no studies were available.
The literature is clear that health care practitioners do not ask about sexual health, function, and activity.2 It is common to avoid, dismiss, or invalidate the patient/client concerns when the practitioner does not know how to "fix" the problem. In this issue, the articles list "Clinical Recommendations," and there are many resources quoted to allow the clinician to find solutions and further their education in this area. We appreciate the expertise contributed by each author to the address this subject matter comprehensively.
Discussing sexual concerns with a client is every professional's responsibility when providing health care services aimed at the whole person.3
We hope that reading this issue will help the practitioner be more informed, knowledgeable, interested, questioning, open, caring, validating, and resourceful to start another kind of sexual revolution.
-Karen Brandon, DSc, PT, WCS, BCB-PMD
Kaiser Permanente, Fontana, California
Loma Linda University, Loma Linda, California
-Hollis Herman, DPT, PT, MS, OCS, WCS,
BCB-PMD, IF, AASECT, PRPC
Healthy Women Healthy Men Physical Therapy,
Cambridge, Massachusetts
-Jamie Macknet, MSN, APRN-BC
Avants Obstetrics and Gynecology, Loma Linda, California
References