论述中风患者的性行为：性康复的新时代

Talking about Sexuality in Stroke Individuals: The New Era of Sexual Rehabilitation

——原载《临床医学杂志》2023年第12卷第12期——

<Journal of Clinical Medicine>, 2023, 12(12)

【摘要】中风是全球死亡和残疾的最大原因之一。在过去的二十年中，在运动和认知功能障碍的早期和长期治疗方面已经实现了重大目标，提高了患者及其护理人员的生活质量。然而，仍然存在一个未解决的临床问题：性功能障碍。多种病因，包括器质性（如病变定位、病前医疗问题和药物）和心理社会（如害怕复发、丧失自尊、角色转变、焦虑和抑郁），都与性缺陷有关。在这篇透视综述中，我们报告了关于这个严重影响这些患者的生活质量的关键主题的最后一个证据。事实上，尽管患者通常不会透露他们对性的担忧，但文献表明他们会就这个问题寻求帮助。另一方面，康复领域的临床医生并不总是能够轻松或准备好处理神经系统患者的性行为和性功能。应推出新阶段的培训课程，包括不同的医生、护士、康复专家和社会工作者，学习如何处理与性有关的话题。 因此，专业的性咨询师现在应该成为中风治疗和康复的一个结构化组成部分，并利用新的有效工具（即PLISSIT模型；TDF计划）来改善生活质量。

【关键词】中风；性功能障碍；整体干预；康复

[Abstract] One of the largest causes of mortality and disability worldwide is stroke. In the last twenty years significant objectives have been achieved in the early and chronic treatment of motor and cognitive dysfunctions, increasing the quality of life in patients and their caregivers. However, there is an unresolved clinical issue that remains: sexual dysfunctions. Multiple etiologies, including organic (such as lesion localization, premorbid medical problems, and drugs) and psychosocial (such as fear of recurrences, loss of self-esteem, role shifts, anxiety, and depression), are associated with sexual deficits. In this perspective review, we reported the last piece of evidence about this crucial topic which drastically affects the quality of life of these patients. Indeed, although patients may often not disclose their sexual concerns, literature demonstrates that they seek help concerning this issue. On the other side, clinicians working in the rehabilitation field are not always comfortable or prepared to deal with sexuality and sexual function in neurological patients. A new phase of the training course should be launched including different physicians, nurses, rehabilitation specialists, and social workers, to learn how to deal with topics related to sexuality. As a result, professional sexual counselors should now become a structured part of stroke settings and rehabilitation with new effective tools (i.e., PLISSIT model; TDF program) for improving quality of life.

[Key words] stroke; sexual dysfunction; holistic intervention; rehabilitation

论文原文：Marianna Contrada, Antonio Cerasa, Caterina Pucci, Irene Ciancarelli, Giovanni Pioggia, Paolo Tonin and Rocco Salvatore Calabrò (2023). Talking about Sexuality in Stroke Individuals: The New Era of Sexual Rehabilitation. Journal of Clinical Medicine, 2023, 12(12), 3988.

https://doi.org/10.3390/jcm12123988

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