Implementation and evaluation of a stroke sexual health practice profile for rehabilitation in Ontario, Canada

ObjectiveThis study aimed to implement and evaluate a structured, team-based approach to integrating sexual health into stroke rehabilitation using the Permission-Limited Information-Specific Suggestions-Intensive Therapy model, operationalized through the Stroke Sexual Health Practice Profile.DesignQuality Improvement Initiative.SettingOntario, Canada.ParticipantsPatients attending inpatient or outpatient stroke rehabilitation.InterventionThe Stroke Sexual Health Practice Profile was developed collaboratively by an interprofessional team and implemented within a stroke rehabilitation program. It outlined standardized practices across the Permission-Limited Information-Specific Suggestions-Intensive Therapy framework, including scripts, educational materials, and documentation protocols.Main measuresOutcomes included staff knowledge, comfort, and approaches to addressing sexual health, participation in educational activities, patient awareness and comfort discussing sexual health, and documentation of sexual health practices in clinical charts.ResultsPreimplementation surveys identified gaps in patients' awareness of poststroke sexual health and providers' confidence in addressing it. Among eligible staff, 86.3% completed online modules and 62.1% attended workshops, which were associated with significant improvements in knowledge and comfort. These gains were partially sustained at 6 months. Postimplementation patient surveys demonstrated improved awareness and comfort discussing sexual health. Chart audits showed increased documentation of sexual health discussions over time.ConclusionsThe Stroke Sexual Health Practice Profile supported integration of sexual health into stroke rehabilitation by improving clinician knowledge and confidence and increasing documentation of care. Sustained improvements may require ongoing reinforcement and system-level supports.