“Tại sao không hỏi bác sĩ?” Rào cản trong việc tìm kiếm sự trợ giúp cho các vấn đề tình dục ở người cao tuổi tại Ba Lan

International Journal of Public Health - Tập 65 - Trang 1507-1515 - 2020
Gabriela Gore-Gorszewska1
1Jagiellonian University, Cracow, Poland

Tóm tắt

Dữ liệu hiện có cho thấy người cao tuổi hiếm khi tìm kiếm sự giúp đỡ về mặt y tế hoặc tâm lý cho các vấn đề tình dục của họ. Nghiên cứu hiện tại khám phá những rào cản trong việc tìm kiếm sự trợ giúp mà người cao tuổi từ một quốc gia Trung Âu bảo thủ gặp phải. Ba mươi cuộc phỏng vấn bán cấu trúc đã được thực hiện với cư dân Ba Lan (16 phụ nữ, 14 nam giới) trong độ tuổi từ 65–82. Dữ liệu đã được phân tích theo cách chủ đề, với tính hợp lệ của mã hóa và độ nghiêm ngặt phân tích được đảm bảo xuyên suốt quá trình. Ba rào cản chính trong việc tìm kiếm sự giúp đỡ đã được xác định: không nhận ra các vấn đề tình dục; lo sợ sự không đồng ý của bác sĩ; thiếu kiến thức về cách tiếp cận các dịch vụ phù hợp. Dữ liệu cho thấy mối quan tâm chính của các tham gia là các nhà cung cấp dịch vụ y tế sẽ xem nhẹ vấn đề của họ là không quan trọng. Người cao tuổi ở Ba Lan phải đối mặt với sự thiếu hụt kiến thức cơ bản về chức năng tình dục của họ. Việc áp dụng phương pháp định tính để hiểu lý do tại sao người cao tuổi từ các nền văn hóa bảo thủ không tìm kiếm sự trợ giúp cho các vấn đề tình dục của họ có thể đóng góp cho tài liệu hiện có bằng cách cung cấp bằng chứng từ các bối cảnh văn hóa khác nhau và giúp phát triển cũng như thực hiện các can thiệp phù hợp. Các tác động liên quan đến thái độ của nhà cung cấp dịch vụ y tế đối với những lo ngại của bệnh nhân cao tuổi cũng được thảo luận thêm.

Từ khóa

#Rào cản tìm kiếm sự giúp đỡ #người cao tuổi #vấn đề tình dục #văn hóa bảo thủ #Ba Lan

Tài liệu tham khảo

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. Washington, DC Bauer M, Haesler E, Fetherstonhaugh D (2016) Let’s talk about sex: older people’s views on the recognition of sexuality and sexual health in the health-care setting. Heal Expect 19:1237–1250. https://doi.org/10.1111/hex.12418 Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3:77–101. https://doi.org/10.1191/1478088706qp063oa Chrisler JC, Barney A, Palatino B (2016) Ageism can be hazardous to women’s health: ageism, sexism, and stereotypes of older women in the healthcare system. J Soc Issues 72:86–104. https://doi.org/10.1111/josi.12157 Corona G, Lee DM, Forti G et al (2010) Age-related changes in general and sexual health in middle-aged and older men: results from the European male ageing study (EMAS). J Sex Med 7:1362–1380. https://doi.org/10.1111/j.1743-6109.2009.01601.x Corona G, Rastrelli G, Maseroli E et al (2013) Sexual function of the ageing male. Best Pract Res Clin Endocrinol Metab 27:581–601. https://doi.org/10.1016/j.beem.2013.05.007 Dyer K, das Nair R (2013) Why don’t healthcare professionals talk about sex? A systematic review of recent qualitative studies conducted in the United Kingdom. J Sex Med 10:2658–2670. https://doi.org/10.1111/j.1743-6109.2012.02856.x Ediger RM (2005) History of an institution as a factor for predicting church institutional behaviour. The cases of the Catholic Church in Poland, the Orthodox Church in Romania, and the Protestant Churches in East Germany. East Eur Quart 39:299–324 Fileborn B, Lyons A, Heywood W et al (2017) Talking to healthcare providers about sex in later life: findings from a qualitative study with older Australian men and women. Australas J Ageing 36:E50–E56. https://doi.org/10.1111/ajag.12450 Forbes MK, Eaton NR, Krueger RF et al (2016) Sexual quality of life and aging: a prospective study of a nationally representative sample sexual quality of life and aging. J Sex Res 00:1–12. https://doi.org/10.1080/00224499.2016.1233315 Gewirtz-Meydan A, Levkovich I, Mock M et al (2019) Promoting a discussion on later life sexuality: lessons from sexologist physicians. Sex Relatsh Ther 34:193–210. https://doi.org/10.1080/14681994.2018.1437258 Gore-Gorszewska G (2020) “What do you mean by sex?” A qualitative analysis of traditional versus evolved meanings of sexual activity among older women and men. J Sex Res 00:1–15. https://doi.org/10.1080/00224499.2020.1798333 Gott M, Hinchliff S (2003) Barriers to seeking treatment for sexual problems in primary care: a qualitative study with older people. Fam Pract 20:690–695. https://doi.org/10.1093/fampra/cmg612 Gott M, Hinchliff S, Galena E (2004) General practitioner attitudes to discussing sexual health issues with older people. Soc Sci Med 58:2093–2103. https://doi.org/10.1016/j.socscimed.2003.08.025 Hinchliff S (2016) Sexual health and older adults: suggestions for social science research. Reprod Health Matters 24:52–54. https://doi.org/10.1016/j.rhm.2016.10.001 Hinchliff S, Gott M (2008) Challenging social myths and stereotypes of women and aging: heterosexual women talk about sex. J Women Aging 20:65–81. https://doi.org/10.1300/j074v20n01_06 Hinchliff S, Gott M (2011) Seeking medical help for sexual concerns in mid-and later life: a review of the literature. J Sex Res 48:106–117. https://doi.org/10.1080/00224499.2010.548610 Hinchliff S, Tetley J, Lee D, Nazroo J (2018) Older adults’ experiences of sexual difficulties: qualitative findings from the english longitudinal study on ageing (ELSA). J Sex Res 55:152–163. https://doi.org/10.1080/00224499.2016.1269308 Hinchliff S, Carvalheira AA, Štulhofer A, Janssen E, Hald GM, Træen B (2020) Seeking help for sexual difficulties: findings from a study with older adults in four European countries. Eur J Ageing 17:185–195. https://doi.org/10.1007/s10433-019-00536-8 Ingbrant R (2020) Michalina Wisłocka’s the art of loving and the legacy of Polish sexology. Sex Cult. https://doi.org/10.1007/s12119-019-09696-2 Laumann EO, Paik A, Glasser DB et al (2006) A cross-national study of subjective sexual well-being among older women and men: findings from the global study of sexual attitudes and behaviors. Arch Sex Behav 35:143–159. https://doi.org/10.1007/s10508-005-9005-3 Lindau ST, Gavrilova N (2010) Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing. BMJ 340:580. https://doi.org/10.1136/bmj.c810 Lindau ST, Schumm LP, Laumann EO et al (2007) A study of sexuality and health among older adults in the United States. N Engl J Med 357:762–774. https://doi.org/10.1056/NEJMoa067423 Loe M (2004) Sex and the senior woman: pleasure and danger in the Viagra Era. Sexualities 7:303–326. https://doi.org/10.1177/1363460704044803 Malta S, Hocking J, Lyne J et al (2018) Do you talk to your older patients about sexual health? Aust J Gen Pract 47:807–811 Marshall BL (2012) Medicalization and the refashioning of age-related limits on sexuality. J Sex Res 49:337–343. https://doi.org/10.1080/00224499.2011.644597 Mikołajczak M, Pietrzak J (2015) Psychology of gender through the lens of culture: theories and applications. Psychol Gend Lens Cult Theor Appl. https://doi.org/10.1007/978-3-319-14005-6 Mitchell KR, Wellings K, Nazareth I et al (2011) Scripting sexual function: a qualitative investigation. The Lancet 33:540–553. https://doi.org/10.1111/j.1467-9566.2011.01318.x Moreira ED, Glasser DB, Nicolosi A et al (2008) Sexual problems and help-seeking behaviour in adults in the United Kingdom and continental Europe. BJU Int 101:1005–1011. https://doi.org/10.1111/j.1464-410X.2008.07453.x National Institute for Health and Care Excellence (2012) Appendix H: methodology checklist: qualitative studies. NICE Website. https://www.nice.org.uk/process/pmg6/resources/the-guidelines-manual-appendices-bi-2549703709/chapter/appendix-h-methodology-checklist-qualitative-studies. Accessed 14 Feb 2020 Potts A, Grace VM, Vares T, Gavey N (2006) ‘Sex for life’? Men’ s counter-stories on ‘erectile dysfunction’, male sexuality and ageing. Sociol Health Illn 28:306–329. https://doi.org/10.1111/j.1467-9566.2006.00494.x Rutte A, Welschen LMC, Van Splunter MMI et al (2016) Type 2 diabetes patients’ needs and preferences for care concerning sexual problems. J Sex Marital Ther 42:324–337. https://doi.org/10.1093/fampra/cmg612 Sandberg L (2013) Just feeling a naked body close to you: men, sexuality and intimacy in later life. Sexualities 16:261–282. https://doi.org/10.1177/1363460713481726 Sarkadi A, Rosenqvist U (2001) Contradictions in the medical encounter: female sexual dysfunction in primary care contacts. Fam Pract 18:161–166. https://doi.org/10.1093/fampra/18.2.161 Schaller S, Træen B, Lundin Kvalem I (2020) Barriers and facilitating factors in help-seeking: a qualitative study on how older adults experience talking about sexual issues with healthcare personnel. Int J Sex Health 32:65–80. https://doi.org/10.1080/19317611.2020.1745348 Sinković M, Towler L (2019) Sexual aging: a systematic review of qualitative research on the sexuality and sexual health of older adults. Qual Health Res 29:1239–1254. https://doi.org/10.1177/1049732318819834 Stankowska I (2008) Funkcjonowanie seksualne człowieka w okresie starzenia się i starości. Przegląd terapeutyczny 4:1–24 Stirbu I, Kunst AE, Mielck A, MacKenbach JP (2011) Inequalities in utilisation of general practitioner and specialist services in 9 European countries. BMC Health Serv Res 11:288. https://doi.org/10.1186/1472-6963-11-288 Tobiasz-Adamczyk B, Brzyska M, Woźniak B, Kopacz MS (2009) The current state and challenges for the future of health promotion in Polish older people. Int J Public Health 54:341–348. https://doi.org/10.1007/s00038-009-0054-6 Træen B, Carvalheira A, Kvalem IL et al (2017) Sexuality in older adults (65 +)—an overview of the recent literature, part 2: body image and sexual satisfaction. Int J Sex Heal 29:11–21. https://doi.org/10.1080/19317611.2016.1227012 Woloski-Wruble AC, Oliel Y, Leefsma M, Hochner-Celnikier D (2010) Sexual activities, sexual and life satisfaction, and successful aging in women. J Sex Med 7:2401–2410. https://doi.org/10.1111/j.1743-6109.2010.01747.x World Health Organization (2006) Defining sexual health. Report of a technical consultation on sexual health 28–31 January 2002, Geneva Woźniak M (2015) Sexuality education in Polish schools. Przegląd Socjol LXIV 64:121–135 Zhang T, Liu C, Liu L et al (2019) General practice for the poor and specialist services for the rich: inequality evidence from a cross-sectional survey on Hangzhou residents, China. Int J Equity Health 18:1–10. https://doi.org/10.1186/s12939-019-0966-6