Caregivers' concerns about the sexual and reproductive health of women with intellectual disability in Iran: a qualitative study.

BACKGROUND: Women with intellectual disability (ID) have many sexual and reproductive problems. This study was conducted to explain the sexual and reproductive health considerations of women with ID from the perspective of their caregivers in a qualitative approach. METHODS: This study was a qualitative research conducted with a content analysis approach in Iran. The sampling method used was targeted sampling with maximum possible variation, which was continued until data saturation. For data collection, in-depth and semi-structured interviews were conducted with 21 participants, including 8 mothers, 6 caregivers, and 7 specialist caregivers who had experience working with women with intellectual disabilities. Data analysis was conducted using the conventional content analysis method proposed by Zhang and Wildemuth. RESULTS: Two main themes, four categories and 12 subcategories emerged from the data analysis. The themes include "Reproductive health concerns" and" "Sexual health concerns". This means that this group of women has many problems with menstrual hygiene and vaginal infections. On the other hand, caregivers were concerned about the manifestations of unconventional sexual behaviors and difficulties in controlling sexual behaviors as well as the risk of sexual abuse. CONCLUSION: The results of the present study show that it is not only necessary to provide women with ID with practical instructions on menstrual hygiene and sexual self-care, but also that regular examinations of the reproductive system by obstetricians or midwives, especially in care centers, seem essential.

Women with intellectual disability, experience many sexual and reproductive problems. The results of previous studies have highlighted the problems related to menstrual hygiene, contraceptive choice, diagnosis and treatment of sexually transmitted diseases, and cancer screening among women with ID. women with intellectual disability are also more exposed to the risk of sexual abuse. In Iran, there are few studies on the sexual and reproductive health of this group, and there is little information in this regard. Therefore, we decided to conduct a study to investigate the sexual and reproductive problems of women with intellectual disability. For this purpose,we interviewed 21 mothers and caregivers who were directly responsible for the care of women with intellectual disability. The results of the study showed that women with intellectual disability have many problems related to menstrual hygiene and vaginal infections. Caregivers were also concerned about inappropriate sexual behaviors among women with intellectual disability and sexual abuse of these women. According to the caregivers, practical training of women with intellectual disability in menstrual hygiene and sexual self-care can help to reduce their sexual and reproductive problems. This training should be visual and repeated. To prevent vaginal infections, regular genital examinations by obstetricians or midwives are also important, especially in care centers.

Development and psychometric evaluation of Sexual and Reproductive Health Assessment Scale for women with educable intellectual disability (SRH-WIDS): a sequential exploratory mixed-method study.

BACKGROUND: Women with Intellectual disability have many problems in their sexual and reproductive health due to their special mental and physical conditions caused by disability. This study aimed to develop and evaluate the psychometric properties of Sexual and Reproductive Health Scale for Women with Educable Intellectual disability. METHODS: This sequential exploratory mixed-method study was conducted at two qualitative and quantitative stages in Tehran, from 2018 to 2020. At the qualitative stage, in-depth and semi-structured interviews were conducted with 21 parents and caregivers of women with intellectual disability to explain the concepts and to generate items. Thereafter, the item pool was formed based on the concepts and themes extracted from the qualitative phase as well as the review of literature. At the second stage, psychometric properties of the scale were assessed. Finally, responsiveness, interpretability, and feasibility of the scale were determined. RESULTS: An item pool containing 95 items was produced at the first stage. At the second stage, the final version of scale was developed. The psychometric properties of this final version were then assessed and the results showed that the instrument has good validity and reliability. The results of exploratory factory analysis showed that the instrument contains seven factors. Accordingly, these factors explained 53% of the total variance of the instrument variables. CONCLUSIONS: The results show that the SRH-WIDS with 25 items has sufficient validity and reliability, so it could be easily used by caregivers to assess the sexual and reproductive health of Women with Educable Intellectual disability. Ethical code: IRI.TUMS.VCR.REC 1397.340.