Sexual function and quality of life in individuals post stroke: a cross sectional study in a public health-care setting in South Africa

Abstract

Background Sexual function is commonly affected post stroke because of physiological and psychological factors. The occurrence of sexual dysfunction post stroke has an effect on an individual’s quality of life. Research on sexual function in the stroke population, especially in the South African context, is scarce. The aim of this study was to determine the factors associated with sexual function in an individual post stroke and the association with quality of life.

Method This cross-sectional study took place at Thelle Mogoerane Regional Hospital and included 56 participants who had a stroke. The participant’s level of disability was assessed with the Modified Rankin Scale (MRS). This was followed by administering the Stroke Specific Quality of Life scale (SSQOL) to assess quality of life, a questionnaire to obtain demographic information and information regarding sexual function in participants post stroke. Finally, the Changes in Sexual Functioning Questionnaire (CSFQ-14) was carried out to determine an individual’s sexual function after stroke. Results were analysed with excel and using independent t tests, Chi squared tests, a 2-way ANOVA and correlation coefficients.

Results The average age of the sample was 51,32 (SD= ±13,24) years. The sample was comprised of 32 (57,1%) males and 24 (42,9%) females. According to the CSFQ-14, majority of the study participants (n = 35, 62,5%) had sexual dysfunction after their stroke. No significant relationship was found between sex and sexual dysfunction (p=0,577). The factors associated with sexual dysfunction in individuals post stroke included age, disability, comorbidities, psychosocial factors such as self-esteem, role changes and depression. There was no significant interaction between level of disability and sexual dysfunction. Those with sexual dysfunction were found to have a lower mean SSQOL score (139.94 ± 33.89) than those without sexual dysfunction (149.76 ± 33.77). There was not a significant difference (p=0,298).

Conclusion Sexual dysfunction is a common problem in individuals post stroke with majority of participants in this study experiencing sexual dysfunction since their stroke. There are many factors that are associated with an individual’s sexual function post stroke namely pain, difficulty with positioning, self-esteem issues, lack of motivation and change in desire. Although there was not a significant relationship found between sexual dysfunction and quality of life in individual’s post stroke, it is still an area of concern. Therefore, addressing sexual function in patients post stroke would be beneficial and including sexual rehabilitation as part of the rehabilitation protocol in individuals post stroke would be valuable.