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Hastanede Yatan İnme Sonrası Rehabilitasyon Hastalarında Cinsel İşlev Bozukluğunun Değerlendirilmesi

Yıl 2022, Cilt 12, Sayı 2, 217 - 222, 15.03.2022
https://doi.org/10.16899/jcm.1029596

Öz

Giriş: İnme ile ilişkili faktörlerin fiziksel, biyolojik ve psikososyal alanlarda cinsel işlevler üzerinde önemli etkileri olduğu görülmektedir. Bu çalışma inme sonrası hastaların cinsel fonksiyonlarını etkileyen faktörleri değerlendirmeyi amaçlamaktadır. Gereç-yöntem: Bu çalışmaya 51 (%53,1) erkek ve 45 (%46,9) kadın hasta dahil edildi. Hastaların sosyodemografik ve klinik özellikleri belgelendi. Arizona Cinsel Deneyimler Ölçeği (ASES), Uluslararası Erektil İşlev İndeksi (IIEF) ve Kadın Cinsel İşlev İndeksi (FSFI) ile cinsel işlevler değerlendirildi. Bulgular: Erkeklerin ve kadınların yaş ortalaması sırasıyla 57.76±7.57 ve 60.13±12.71 idi. ASES kesme noktası 11 olduğunda, katılımcıların %88,5'inin (erkeklerde %84,3 ve kadınlarda %93,3) cinsel işlev bozukluğu olduğunu bulduk. Kadınlarda ve erkeklerde cinsel işlev bozukluğu sıklığı arasında anlamlı fark yoktu (p=0.166, Pearson Ki-kare Testi). Tek değişkenli ANOVA sonuçlarına göre yaş (p=0,028) ve BDÖ (p<0,001) değerlerinin ASES üzerinde anlamlı bir etkisi vardı. İnme tarafı (p=0.030), Brunstrumm motor değerlendirme (üst ekstremite) (p=0.028) ve Beck Depresyon Skalası (p<0.001) değerlerinin IIEF toplam değerleri üzerinde anlamlı etkisi vardı. BDS (p=0,001) değerleri FSFI toplam değerlerini önemli ölçüde etkilemiştir. Sonuç: Çalışmamızdan elde edilen veriler, Türkiye'deki rehabilitasyon yataklı kliniklerinde inme sonrası cinsel işlev bozukluklarının anlamlı derecede yüksek olduğunu göstermiştir. İnme sonrası cinsel işlev bozuklukları, hem organik (hemisferik lezyon tarafı vb.) hem de psikososyal (depresyon vb.) olmak üzere birçok etiyolojiyle bağlantılıdır.

Kaynakça

  • Haacke C, Althaus A, Spottke A, Siebert U, Back T, Dodel R. Long-term outcome after stroke: evaluating health-related quality of life using utility measurements. Stroke. 2006;37(1):193-8. https://doi.org/:10.1161/01.STR.0000196990.69412.fb
  • McLaughlin J, Cregan A. Sexuality in stroke care: a neglected quality of life issue in stroke rehabilitation? A pilot study. Sexuality and Disability. 2005;23(4):213-26.
  • Korpelainen JT, Nieminen P, Myllylä VV. Sexual functioning among stroke patients and their spouses. Stroke. 1999;30(4):715-9.
  • Tamam Y, Tamam L, Akil E, Yasan A, Tamam B. Post‐stroke sexual functioning in first stroke patients. European journal of neurology. 2008;15(7):660-6.
  • Rees PM, Fowler CJ, Maas CP. Sexual function in men and women with neurological disorders. The Lancet. 2007;369(9560):512-25.
  • Soyuer F, Öztürk A. The effect of spasticity, sense and walking aids in falls of people after chronic stroke. Disability and rehabilitation. 2007;29(9):679-87.
  • Korpelainen JT, Kauhanen ML, Kemola H, Malinen U, Myllylä VV. Sexual dysfunction in stroke patients. Acta Neurologica Scandinavica. 1998;98(6):400-5.
  • Kimura M, Murata Y, Shimoda K, Robinson RG. Sexual dysfunction following stroke. Comprehensive Psychiatry. 2001;42(3):217-22.
  • Sjögren K, Fugl-Meyer AR. Adjustment to life after stroke with special reference to sexual intercourse and leisure. Journal of Psychosomatic Research. 1982;26(4):409-17.
  • Cheung RT. Sexual functioning in Chinese stroke patients with mild or no disability. Cerebrovascular diseases. 2002;14(2):122-8. Heilman KM, Bowers D, Valenstein E, Watson RT. The right hemisphere: neuropsychological functions. Journal of neurosurgery. 1986;64(5):693-704.
  • Schmitz MA, Finkelstein M. Perspectives on poststroke sexual issues and rehabilitation needs. Topics in stroke rehabilitation. 2010;17(3):204-13.
  • Giaquinto S, Buzzelli S, Nolfe G. Evaluation of sexual changes after stroke. The Journal of clinical psychiatry. 2003;64(3):0-.
  • Holden MK, Gill KM, Magliozzi MR. Gait assessment for neurologically impaired patients: standards for outcome assessment. Physical therapy. 1986;66(10):1530-9.
  • Rw B, Smith M. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys ther. 1987;67(2):206-7.
  • Sawner KA, LaVigne JM, Brunnstrom S. Brunnstrom's movement therapy in hemiplegia: a neurophysiological approach: Lippincott; 1992.
  • Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index: a simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill. Maryland state medical journal. 1965.
  • Hisli N. Beck depresyon envanterinin universite ogrencileri icin gecerliligi, guvenilirligi.(A reliability and validity study of Beck Depression Inventory in a university student sample). J Psychol. 1989;7:3-13.
  • Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research. 1975;12(3):189-98.
  • A. McGahuey AJG, Cindi A. Laukes, Francisco A. Moreno, Pedro L. Delgado, Kathy M. McKnight, Rachel Manber, Cynthia. The Arizona sexual experience scale (ASEX): reliability and validity. Journal of Sex &Marital Therapy. 2000;26(1):25-40. Soykan A. The reliability and validity of Arizona sexual experiences scale in Turkish ESRD patients undergoing hemodialysis. International Journal of Impotence Research. 2004;16(6):531-4.
  • Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49(6):822-30.
  • TURUNÇ T, DEVECİ S, GÜVEL S, PEŞKİRCİOĞLU L. Uluslararası cinsel işlev indeksinin 5 soruluk versiyonunun (IIEF-5) Türkçe geçerlilik çalışmasının değerlendirilmesi. Türk Üroloji Dergisi/Turkish Journal of Urology. 2007;33(1):45-9.
  • Aygin D. The Turkish adaptation of the female function index. Turkiye Klinikleri J Med Sci. 2005;25:393-9.
  • Park J-H, Ovbiagele B, Feng W. Stroke and sexual dysfunction—a narrative review. Journal of the neurological sciences. 2015;350(1-2):7-13.
  • Choi-Kwon S, Kim JS. Poststroke emotional incontinence and decreased sexual activity. Cerebrovascular Diseases. 2002;13(1):31-7.
  • Sikiru L, Shmaila H, Yusuf GS. Erectile dysfunction in older male stroke patients: correlation between side of hemiplegia and erectile function. African journal of reproductive health. 2009;13(2):49-54.
  • Monga TN, Lawson JS, Inglis J. Sexual dysfunction in stroke patients. Archives of Physical Medicine and Rehabilitation. 1986;67(1):19-22.
  • Coslett HB, Heilman KM. Male sexual function: impairment after right hemisphere stroke. Archives of Neurology. 1986;43(10):1036-9.
  • HOWES D, BOLLER F. Simple reaction time: evidence for focal impairment from lesions of the right hemisphere. Brain. 1975;98(2):317-32.
  • Ley RG, Bryden M. A dissociation of right and left hemispheric effects for recognizing emotional tone and verbal content. Brain and cognition. 1982;1(1):3-9.
  • Korpelainen JT, Sotaniemi KA, Myllylä VV. Autonomic nervous system disorders in stroke. Clinical Autonomic Research. 1999;9(6):325-33.
  • Korpelainen JT, Sotaniemi KA, Suominen K, Tolonen U, Myllylä V. Cardiovascular autonomic reflexes in brain infarction. Stroke. 1994;25(4):787-92.
  • Giuliano F, Rampin O. Neural control of erection. Physiology & behavior. 2004;83(2):189-201.
  • Sjögren K. Sexuality after stroke with hemiplegia. II. With special regard to partnership adjustment and to fulfilment. Scandinavian journal of rehabilitation medicine. 1983;15(2):63-9.
  • Trompeter SE, Bettencourt R, Barrett-Connor E. Sexual activity and satisfaction in healthy community-dwelling older women. The American journal of medicine. 2012;125(1):37-43. e1. Kim J-H, Kim O. Influence of mastery and sexual frequency on depression in Korean men after a stroke. Journal of Psychosomatic Research. 2008;65(6):565-9.

Evaluation of Sexual Dysfunction in Hospitalized Post-Stroke Rehabilitation Patients

Yıl 2022, Cilt 12, Sayı 2, 217 - 222, 15.03.2022
https://doi.org/10.16899/jcm.1029596

Öz

Introduction: Stroke-related factors seem to have significant effects on sexual functions in physical, biological, and psychosocial areas. This study aims to evaluate the factors affecting the sexual functions of patients after stroke. Material- methods: This study consisted of 51 (53.1%) male and 45 (46.9%) female patients. Socio -demographics and clinical features of the patients were documented. Sexual functions evaluated with Arizona Sexual Experiences Scale (ASES), International Index of Erectile function (IIEF) and Female Sexual Function Index (FSFI). Results: The mean age of men and women were 57.76±7.57, and 60.13±12.71 years, respectively. When the ASES cut-off point was 11, we found that 88.5% of the participants (84.3% in men and 93.3% in women) had sexual dysfunction. There was no significant difference between the frequency of sexual dysfunction in women and men (p=0.166, Pearson Chi-square Test). According to univariate ANOVA results, age (p=0.028) and BDI (p<0.001) values had a significant effect on ASES. The side of stroke (p=0.030), Brunstrumm motor evaluation (upper extremity) (p=0.028) and Beck Depression Scale (p<0.001) values had a significant effect on IIEF total values. BDS (p=0.001) values significantly affected FSFI total values. Conclusion: The data obtained from our study showed that post-stroke sexual dysfunctions are significantly high in Turkish rehabilitation inpatient clinics. Post-stroke sexual dysfunctions are linked to multiple etiologies, both organic (hemispheric lesion side, etc.) and psychosocial (depression, etc.).

Kaynakça

  • Haacke C, Althaus A, Spottke A, Siebert U, Back T, Dodel R. Long-term outcome after stroke: evaluating health-related quality of life using utility measurements. Stroke. 2006;37(1):193-8. https://doi.org/:10.1161/01.STR.0000196990.69412.fb
  • McLaughlin J, Cregan A. Sexuality in stroke care: a neglected quality of life issue in stroke rehabilitation? A pilot study. Sexuality and Disability. 2005;23(4):213-26.
  • Korpelainen JT, Nieminen P, Myllylä VV. Sexual functioning among stroke patients and their spouses. Stroke. 1999;30(4):715-9.
  • Tamam Y, Tamam L, Akil E, Yasan A, Tamam B. Post‐stroke sexual functioning in first stroke patients. European journal of neurology. 2008;15(7):660-6.
  • Rees PM, Fowler CJ, Maas CP. Sexual function in men and women with neurological disorders. The Lancet. 2007;369(9560):512-25.
  • Soyuer F, Öztürk A. The effect of spasticity, sense and walking aids in falls of people after chronic stroke. Disability and rehabilitation. 2007;29(9):679-87.
  • Korpelainen JT, Kauhanen ML, Kemola H, Malinen U, Myllylä VV. Sexual dysfunction in stroke patients. Acta Neurologica Scandinavica. 1998;98(6):400-5.
  • Kimura M, Murata Y, Shimoda K, Robinson RG. Sexual dysfunction following stroke. Comprehensive Psychiatry. 2001;42(3):217-22.
  • Sjögren K, Fugl-Meyer AR. Adjustment to life after stroke with special reference to sexual intercourse and leisure. Journal of Psychosomatic Research. 1982;26(4):409-17.
  • Cheung RT. Sexual functioning in Chinese stroke patients with mild or no disability. Cerebrovascular diseases. 2002;14(2):122-8. Heilman KM, Bowers D, Valenstein E, Watson RT. The right hemisphere: neuropsychological functions. Journal of neurosurgery. 1986;64(5):693-704.
  • Schmitz MA, Finkelstein M. Perspectives on poststroke sexual issues and rehabilitation needs. Topics in stroke rehabilitation. 2010;17(3):204-13.
  • Giaquinto S, Buzzelli S, Nolfe G. Evaluation of sexual changes after stroke. The Journal of clinical psychiatry. 2003;64(3):0-.
  • Holden MK, Gill KM, Magliozzi MR. Gait assessment for neurologically impaired patients: standards for outcome assessment. Physical therapy. 1986;66(10):1530-9.
  • Rw B, Smith M. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys ther. 1987;67(2):206-7.
  • Sawner KA, LaVigne JM, Brunnstrom S. Brunnstrom's movement therapy in hemiplegia: a neurophysiological approach: Lippincott; 1992.
  • Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index: a simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill. Maryland state medical journal. 1965.
  • Hisli N. Beck depresyon envanterinin universite ogrencileri icin gecerliligi, guvenilirligi.(A reliability and validity study of Beck Depression Inventory in a university student sample). J Psychol. 1989;7:3-13.
  • Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research. 1975;12(3):189-98.
  • A. McGahuey AJG, Cindi A. Laukes, Francisco A. Moreno, Pedro L. Delgado, Kathy M. McKnight, Rachel Manber, Cynthia. The Arizona sexual experience scale (ASEX): reliability and validity. Journal of Sex &Marital Therapy. 2000;26(1):25-40. Soykan A. The reliability and validity of Arizona sexual experiences scale in Turkish ESRD patients undergoing hemodialysis. International Journal of Impotence Research. 2004;16(6):531-4.
  • Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49(6):822-30.
  • TURUNÇ T, DEVECİ S, GÜVEL S, PEŞKİRCİOĞLU L. Uluslararası cinsel işlev indeksinin 5 soruluk versiyonunun (IIEF-5) Türkçe geçerlilik çalışmasının değerlendirilmesi. Türk Üroloji Dergisi/Turkish Journal of Urology. 2007;33(1):45-9.
  • Aygin D. The Turkish adaptation of the female function index. Turkiye Klinikleri J Med Sci. 2005;25:393-9.
  • Park J-H, Ovbiagele B, Feng W. Stroke and sexual dysfunction—a narrative review. Journal of the neurological sciences. 2015;350(1-2):7-13.
  • Choi-Kwon S, Kim JS. Poststroke emotional incontinence and decreased sexual activity. Cerebrovascular Diseases. 2002;13(1):31-7.
  • Sikiru L, Shmaila H, Yusuf GS. Erectile dysfunction in older male stroke patients: correlation between side of hemiplegia and erectile function. African journal of reproductive health. 2009;13(2):49-54.
  • Monga TN, Lawson JS, Inglis J. Sexual dysfunction in stroke patients. Archives of Physical Medicine and Rehabilitation. 1986;67(1):19-22.
  • Coslett HB, Heilman KM. Male sexual function: impairment after right hemisphere stroke. Archives of Neurology. 1986;43(10):1036-9.
  • HOWES D, BOLLER F. Simple reaction time: evidence for focal impairment from lesions of the right hemisphere. Brain. 1975;98(2):317-32.
  • Ley RG, Bryden M. A dissociation of right and left hemispheric effects for recognizing emotional tone and verbal content. Brain and cognition. 1982;1(1):3-9.
  • Korpelainen JT, Sotaniemi KA, Myllylä VV. Autonomic nervous system disorders in stroke. Clinical Autonomic Research. 1999;9(6):325-33.
  • Korpelainen JT, Sotaniemi KA, Suominen K, Tolonen U, Myllylä V. Cardiovascular autonomic reflexes in brain infarction. Stroke. 1994;25(4):787-92.
  • Giuliano F, Rampin O. Neural control of erection. Physiology & behavior. 2004;83(2):189-201.
  • Sjögren K. Sexuality after stroke with hemiplegia. II. With special regard to partnership adjustment and to fulfilment. Scandinavian journal of rehabilitation medicine. 1983;15(2):63-9.
  • Trompeter SE, Bettencourt R, Barrett-Connor E. Sexual activity and satisfaction in healthy community-dwelling older women. The American journal of medicine. 2012;125(1):37-43. e1. Kim J-H, Kim O. Influence of mastery and sexual frequency on depression in Korean men after a stroke. Journal of Psychosomatic Research. 2008;65(6):565-9.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

Ali Nail DEMİR Bu kişi benim
Mersin Şehir Eğitim ve Araştırma Hastanesi
0000-0001-5713-4120
Türkiye


Sanem Aslıhan AYKAN (Sorumlu Yazar)
YEDİTEPE ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0001-7335-5556
Türkiye


Uğur GÜNGÖR DEMİR Bu kişi benim
MERSİN ŞEHİR EĞİTİM VE ARAŞTIRMA HASTANESİ
0000-0002-5084-7280
Türkiye


Hakan TUNÇ Bu kişi benim
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ
0000-0002-8010-7195
Türkiye

Erken Görünüm Tarihi 1 Ocak 2022
Yayımlanma Tarihi 15 Mart 2022
Kabul Tarihi 21 Aralık 2021
Yayınlandığı Sayı Yıl 2022, Cilt 12, Sayı 2

Kaynak Göster

AMA Demir A. N. , Aykan S. A. , Güngör Demir U. , Tunç H. Evaluation of Sexual Dysfunction in Hospitalized Post-Stroke Rehabilitation Patients. J Contemp Med. 2022; 12(2): 217-222.