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创伤性脑外伤后性功能障碍
Objective: The frequency of self reported sexual
difficulties was examined in a group of 322 individuals with traumatic
brain injury (TBI) ($N = 193$ men; 129 women) and contrasted with
reports of sexual difficulties in 264 individuals without disability
(152 men; 112 women) residing in the community. Physiological, physical,
and body images problems impacting sexual functioning were examined
individually and then summed into a sexual dysfunction score. Mood,
quality of life, health status and presence of an endocrine disorder
were examined as predictors of sexual difficulties post TBI. Study
design: In this retrospective study, data about sexual difficulties
were analyzed separately for men and women with TBI and without disability.
ANOVAs with post hoc analysis for continuous variables, chi-square
analyses for categorical variables, and ANCOVAs for predictors of
sexual difficulties were utilized. Results: When contrasted to individuals
without disability, individuals with TBI reported more frequent: (1)
physiological difficulties influencing their energy for sex, sex drive,
ability to initiate sexual activities and achieve orgasm; (2) physical
difficulties influencing body positioning, body movement and sensation,
and (3) body image difficulties influencing feelings of attractive
and comfort with having a partner view one's body during sexual activity.
Additional gender specific TBI findings were observed. In comparison
to gender matched groups without disability, men with TBI reported
less frequent involvement in sexual activity and relationships, and
more frequent difficulties in sustaining an erection; women with TBI
reported more frequent difficulties in sexual arousal, pain with sex,
masturbation and vaginal lubrication. While groups differed in core
demographic variables, age was the only demographic variable that
was related to reports of sexual difficulties in individuals with
TBI and men without disability. Age at onset and severity of injury
were negatively related to reports of sexual difficulties in individuals
with TBI. In men with TBI and without disability, the most sensitive
predictor of sexual dysfunction was level of depression. For women
without disability, an endocrine disorder was the most sensitive predictor
of sexual dysfunction. For women with TBI, an endocrine disorder and
level depression combined were the most sensitive predictors of sexual
difficulties. Conclusion: Individuals post TBI report frequent physiological,
physical and body images difficulties which negatively impact sexual
activity and interest. For men post TBI, predictors of sexual difficulties
included age at interview, age at injury, and having milder injuries,
however, depression was the most sensitive predictor of sexual dysfunctions.
For women post TBI, predictors of their sexual difficulties included
age at injury and having milder injuries, however, depression and
an endocrine disorder combined were the most sensitive predictors
of sexual dysfunction. Implications of this study include the need
for broad-based assessment of sexual dysfunction, and the implementation
of treatment studies to enhance sexual functioning post TBI.
【引自NeuroRehabilitation 2000;15(2):107-120】 |
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