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Sexuality and intimacy occupations are often considered valued life occupations by individuals and communities and can contribute to quality of life and relationship satisfaction (Diamond & Huebner, 2012; McGrath & Lynch, 2014; Sakellariou & Algado, 2006; Smith et al., 2011). Sexuality and intimacy occupations have the potential to play either enriching or detrimental roles in individuals lived experiences, which supports the notion that healthcare providers must be prepared to address these topics in practice (Collins et al., 2017; Deering et al., 2014; Diamond & Huebner, 2012; Espelage, Basile, Rue, & Hamburger, 2015; Papp, Erchull, Liss, Waaland-Kreutzer, & Godfrey, 2017; Smith et al., 2011). Despite the potentially powerful impact of sexuality and intimacy occupations on quality of life, there is a lackluster response to prioritize these occupations among occupational therapy (OT) clinicians and in OT curricula (Dyer & Nair, 2013; Hattjar, Parker, & Lappa, 2008; McGrath & Lynch, 2014; McGrath & Sakellariou, 2015). This doctoral project (1) identifies restrictive factors which enable OT professionals’ hesitancy to include sexuality and intimacy into scholarly, academic, and clinical practices, (2) identifies solutions informed by dissemination and implementation sciences to dismantle institutional and clinician level restrictions and enable clinical adoption, (3) analyzes available literature related to best practices in marketing, dissemination and implementation, and sexuality education for healthcare providers and (4) conducts a program evaluation of the Institute for Sex, Intimacy and Occupational TherapyLLC. Summative and formative results suggest that ISIOTLLC was successful in (1) generating enthusiasm for the brand and learning products, (2) conducting webinars which influenced clinical adoption, (3) building a coalition of advocates to promote institutional change, and (4) building credibility of the author as a subject matter expert on sexuality and intimacy within the OT profession. The project results will contribute to the profession by equipping OT professionals with a guide for including sexuality and intimacy into their academic or clinical practice. Enhancing clinical adoption of sexuality and intimacy into OT practice will improve the quality of life of the individuals, communities, and populations the profession serves. / 2020-06-18T00:00:00Z

SAMMANFATTNING Bakgrund: Sexuell hälsa är viktigt för välbefinnande. I takt med att en person åldras ökar frekvensen av faktorer med negativ påverkan på sexualiteten. Äldre på särskilda boenden har ytterligare hindrande omständigheter, då miljön inte är uppbyggd för ett privatliv. Det saknas kunskap om hur dessa äldre ser på sin sexualitet. Syfte: Syftet var att undersöka behovet och upplevelsen av sexualitet hos äldre personer på särskilt boende, samt öka medvetenheten och förståelsen för äldres sexualitet hos vårdpersonalen. Metod: En litteraturöversikt gjordes, där tolv studier valdes ut, varav tio från PubMed och CINAHL samt två studier genom snowballing. Resultat: Resultatet genererade fem kategorier och tretton subkategorier. Majoriteten av de äldre uppgav ett fortsatt behov av sexualitet, men att behovet av intimitet och närhet var större än behovet av sex. Fysiska och mentala hinder relaterade till åldrandet togs upp som hinder för sexualitet. Miljön på de särskilda boendena ansågs vara hinder och försvårade möjligheterna till att uttrycka sin sexualitet. Vårdpersonal, anhöriga samt brist i den äldres autonomi var också hindrande faktorer. Tabuer kring äldres sexualitet gick att identifiera hos vårdpersonal, anhöriga och den äldre själv. Slutsats: En majoritet av de äldre i detta examensarbete uppgav ett fortsatt behov av sexualitet. För att främja detta bör sjuksköterskan se till individen. Strukturen på särskilda boenden bör ses över då de i dagsläget inte främjar den äldres möjligheter till sexualitet och intimitet. Oavsett behov av sexualitet behöver sjuksköterskan se den äldre som en vuxen, självbestämmande individ kapabel och behörig att fatta egna beslut gällande sig själv och sin kropp. / ABSTRACT Background: Sexuality is important for the overall health. Factors that affect sexuality increase with aging. Elderly at care home facilities have additional aggravating circumstances since the environment is not built to promote a private life. There is a lack of research and knowledge about how elderly view their sexuality. Aim: The aim was to investigate elderly people’s needs and experiences of sexuality, residing in care homes, as well as to increase the awareness and understanding of the sexuality of the elderly among the care staff. Method: A literature study was conducted using twelve studies. Ten studies were chosen from PubMed and CINAHL and two additional studies were chosen using snowballing. Result: The result generated five categories and thirteen subcategories. The majority of the elderly stated a continued need for sexuality, however the need for intimacy was seen as greater than the need for sex. Physical and mental factors related to aging were mentioned as obstacles for sexuality. The environment in the care home facilities was considered an obstacle and made it difficult to express one's sexuality. Nursing staff, relatives and the elderly's lack of autonomy were also hindering factors. Taboos around the elderly's sexuality could be identified in care staff, relatives and the elderly themselves.  Conclusion: A majority of the elderly in this study stated a continued need for sexuality. To promote this, nurses need to look to the individual. The structure of caring homes needs to be assessed, since they do not promote the elderly’s sexuality. Regardless of needs, nurses need to look at the elder as an adult capable of making their own decisions about themself.

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