Perdas significativas, luto e atividade sexual após a lesão medular: uma revisão de escopo

Abstract

Objective: To describe what the studies have said about significant losses, bereavement and sexual activity after spinal cord injury. Method: This is a scoping review conducted in accordance with the recommendations of the Joanna Briggs Institute, described according to the indications of the latest version of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and registered with the Open Science Framework (OSF), with access available at: https://osf.io/x6d4n. The research question was based on the acronym PCC: Population (spinal cord injury), Concept (significant losses, bereavement and sexual activity) and Context (studies published in the literature). Five scientific databases were used: APA-PsycInfo, Web of Science, Scopus, Cochrane Library and BVS Portal. We included studies in any language that addressed significant losses, bereavement and the sexual activity of people after spinal cord injury, without limiting the year of publication. Data was collected blindly by two independent reviewers using Google spreadsheets® and Rayyan® software, meeting the eligibility criteria. A descriptive qualitative analysis of the data was carried out and the results were presented in figures, tables, flowcharts and discursive writing. Results: 6 studies were included, which presented accounts of experiences after spinal cord injury. The data show that one of the main losses that leads to grief associated with sexual activity is bodily changes and loss/alterations in genital sensations significantly affect the sexual experience of people with spinal cord injury, and this factor was associated with feelings of loss of sexually attractive appearance, especially for women and impacted self-esteem and identity, both female and male and the process of grief elaboration was not strongly investigated and described in the studies included. Discussion: It has been shown that sexual activity is a major concern for people who have suffered a spinal cord injury and the impact of this loss can be reflected in the experience of mourning as a possibility of elaboration, whether or not it is perceived by the mourners. However, further research is needed to identify and classify the losses and grief associated or not with sexual activity, making it possible to cope better. Final considerations: There are few studies that address the losses associated with the sexual activity of people with spinal cord injuries and identify the development of grief in the face of such loss, although studies have been identified that point to this relationship.