神经康复中性功能评估：来自脊髓损伤队列的见解和挑战
神经康复中性功能评估：来自脊髓损伤队列的见解和挑战
Assessing sexual function in neurorehabilitation: insights and challenges from a spinal cord injury cohort
——《性医学杂志》第23卷，第1期，2026年1月——
【摘要】背景：脊髓损伤（SCI）后性功能障碍很常见，并会影响生活质量，但由于不适感和知识不足，医疗保健专业人员可能会回避这一话题。性健康数据的缺失可能会导致研究结果出现偏差，但在脊髓损伤领域，这一问题在很大程度上仍未得到充分研究。目的：描述与其他临床领域相比，性功能数据的缺失情况，并评估在脊髓损伤急性期后专科康复期间，数据收集程序的变化与女性和男性数据缺失之间的关联。方法：本研究利用基于人群的多中心瑞士脊髓损伤（SwiSCI）初始队列研究的数据进行横断面分析，以评估脊髓损伤康复期间多个功能领域的漏诊和评估不完整情况。采用逻辑回归分析比较不同临床评估中的数据缺失情况，并评估性功能数据收集与人口统计学特征、脊髓损伤特征、康复中心和时间段之间的关联。最终标准：国际脊髓学会（ISCoS）数据集中女性性功能和生殖功能、男性性功能、下尿路（LUT）、肠道、皮肤和肺功能的数据缺失情况。结果：在1126名个体（29%为女性）的数据集中，与下尿路、肠道、皮肤和肺功能相比，ISCoS性功能数据集的漏诊率最高（46% vs 2%、4%、2%、2%；P < 0.0001）。不同数据集的评估不完整率也各不相同（性功能 vs 下尿路、肠道、皮肤和肺功能：4% vs 50%、45%、1%、1%；P < 0.0001）。女性完成性功能评估的比例低于男性（43% vs 58%，P < 0.0001）。2013-2016年，3个中心的数据收集率低于26%，但在一个常规提供医生性功能咨询的中心，数据收集率达到67%（P < 0.001）。在开展一项提高意识的活动后，所有中心的数据收集率均提高到≥61%。临床意义：研究结果表明，与其他领域相比，性功能数据收集需要更多关注，例如，需要对医护人员进行相关培训。优势和局限性：这是首项旨在描述性功能数据缺失情况并确定改善脊髓损伤急性期后康复期间性功能数据收集潜在策略的研究；然而，一些影响性功能的障碍因素仍未得到探讨。结论：本研究强调，在脊髓损伤康复期间，性功能数据收集与其他临床领域的数据收集存在显著差异，尤其是在女性患者中。需要开展进一步研究，结合患者和医护人员的视角，探讨性功能评估被忽视的原因。
【关键词】脊髓损伤、康复、性功能障碍、生理性性功能障碍、心理性性功能障碍、数据收集、调查和问卷
[Abstract] Background: Although sexual dysfunction after spinal cord injury (SCI) is common and impacts quality of life, healthcare professionals may avoid this topic due to discomfort and knowledge gaps. Missing sexual health data can bias research findings, yet this issue remains largely unexplored in the context of SCI. Aim: To describe missing sexual function data compared to other clinical domains and evaluate the association between changes in data collection procedures and missing data in females and males during post-acute specialized SCI rehabilitation. Methods: Data from the population-based, multi-center Swiss Spinal Cord Injury (SwiSCI) Inception Cohort study were utilized in cross-sectional analyses to evaluate missed and incomplete assessments across multiple areas of functioning during SCI rehabilitation. Logistic regression analyses were used to compare missing data across clinical assessments and to evaluate the associations between sexual function data collection and demographic characteristics, SCI characteristics, rehabilitation center, and time period. Outcomes: Missing data in the data sets from the International Spinal Cord Society (ISCoS) for female sexual and reproductive function, male sexual function, lower urinary tract (LUT), bowel, skin, and pulmonary function. Results: In data sets from 1126 individuals (29% female), ISCoS sexual function data sets had the highest rates of missed assessments compared to LUT, bowel, skin, and pulmonary function (46% vs 2%, 4%, 2%, 2%; P?<?.0001). Rates of incomplete assessments also varied across data sets (sexual function vs LUT, bowel, skin, and pulmonary: 4% vs 50%, 45%, 1%, 1%; P?<?.0001). Females had a lower percentage of completed sexual function assessments than males (43% vs 58%, P?<?.0001). From 2013-2016, data collection was <26% from the participants at 3 centers, but 67% at a center that routinely included a sexual function consultation with a physician (P?<?.001). Following an awareness initiative, the data collection rate improved to ≥61% at all centers. Clinical Implications: Findings highlight that compared to other domains, sexual function data collection requires additional consideration, for example, training of healthcare providers. Strengths and Limitations: This is the first study aimed at describing missing sexual function data and identifying potential strategies for improving sexual function data collection during post-acute SCI rehabilitation; however, some barriers to addressing sexual function remain unexamined. Conclusion: This study highlights significant disparities in sexual function data collection relative to other clinical domains during SCI rehabilitation, especially among females. Further research, incorporating both patient and provider perspectives, is needed to explore why sexual function assessments are overlooked.
[Key words] Spinal cord injuries, rehabilitation, sexual dysfunction, physiological, sexual dysfunction, psychological, data collection, surveys and questionnaires
论文原文：Collene E Anderson, Gideon Sartorius, Sue Bertschy, et al (2026). Assessing sexual function in neurorehabilitation: insights and challenges from a spinal cord injury cohort. The Journal of Sexual Medicine, Volume 23, Issue 1, January 2026,
https://doi.org/10.1093/jsxmed/qdaf330
（翻译兼责任编辑：MARY）
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