Attitudes and Performance of Cardiologists Toward Sexual Issues in Cardiovascular Patients

Sexual Medicine - Tập 5 - Trang e44-e53 - 2017
Razieh Salehian1, Fatemeh Khodaeifar2, Morteza Naserbakht1, Azadeh Meybodi1
1School of Behavioral Science and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran
2Iran University of Medical Sciences, Mental Health Research Center, Tehran, Iran

Tóm tắt

AbstractIntroductionThe aim of the present study was to evaluate the attitudes and performance of cardiologists regarding sexual issues in patients with cardiovascular diseases.MethodsA nationwide survey was conducted in a sample of cardiologists, representative of Iranian cardiologists, in 2015.Main Outcome MeasuresAppropriate questionnaires were developed and used to ask participants about their attitudes, performance, and barriers regarding discussing sexual issues with patients with cardiovascular disease.ResultsThe study population consisted of 202 cardiologists (138 men and 63 women) with a mean age of 44.25 years (SD = 8.45). Overall, 93.15% of cardiologists agreed with the importance of discussing sexual issues with their patients with cardiovascular diseases. Almost 76.7% of cardiologists agreed they had a responsibility to deal with patients' sexual problems, and 79.9% of them were aware of the association of cardiovascular disease with sexual problems of cardiac patients, but only 33% of them were confident in their knowledge and skills in this regard. Only 10.6% of cardiologists reported they frequently or always assessed sexual problems with their patients, but 51.50% of them stated they were responding to patients' questions about sexual problems. There was a significant association between performance and responsibility.ConclusionThe results of this study indicate a gap between cardiologist's attitudes and their actual performance and that their professional responsibility to address patients' sexual issues is a significant parameter for better performance.

Tài liệu tham khảo

Byrne, 2013, Communicating about sexual concerns within cardiac health services: do service providers and service users agree?, Patient Educ Counsel, 92, 398, 10.1016/j.pec.2013.03.010 Hardin, 2007, Cardiac disease and sexuality: implications for research and practice, Nurs Clin North Am, 42, 593, 10.1016/j.cnur.2007.07.006 Jaarsma, 2010, Foreword: addressing sexual function in cardiac patients: do we need guidelines?, J Cardiovasc Nurs, 25, 149, 10.1097/JCN.0b013e3181cbeefe Byrne, 2016, Sexual counselling for sexual problems in patients with cardiovascular disease, 10.1002/14651858.CD010988.pub2 Schumann, 2010, Sexual dysfunction before and after cardiac rehabilitation, Rehabil Res Pract, 2010, 823060 Mulat, 2010, Depressive symptoms and erectile dysfunction in men with coronary artery disease, Urology, 75, 104, 10.1016/j.urology.2009.09.041 Kütmeç, 2011, Effects of sexual function of essential hypertensions in women, Eur J Cardiovasc Nurs, 10, 56, 10.1016/j.ejcnurse.2010.04.004 Kriston, 2010, Effect of sexual function on health-related quality of life mediated by depressive symptoms in cardiac rehabilitation. Findings of the SPARK Project in 493 patients, J Sex Med, 7, 2044 Friedman, 2000, Cardiac disease, anxiety, and sexual functioning, Am J Cardiol, 86, 46, 10.1016/S0002-9149(00)00893-6 Byrne, 2010, General practitioner views about discussing sexual issues with patients with coronary heart disease: a national survey in Ireland, BMC Family Pract, 11, 1, 10.1186/1471-2296-11-40 Doherty, 2011, Cardiac rehabilitation staff views about discussing sexual issues with coronary heart disease patients: a national survey in Ireland, Eur J Cardiovasc Nurs, 10, 101, 10.1016/j.ejcnurse.2010.05.002 Jackson, 2006, REPORT: The Second Princeton Consensus on Sexual Dysfunction and Cardiac Risk: new guidelines for sexual medicine, J Sex Med, 3, 28 Kostis, 2005, Sexual dysfunction and cardiac risk (the Second Princeton Consensus Conference), Am J Cardiol, 96, 313, 10.1016/j.amjcard.2005.03.065 Nehra, 2009, Erectile dysfunction and cardiovascular disease: efficacy and safety of phosphodiesterase type 5 inhibitors in men with both conditions, Mayo Clinic Proceedings, 10.4065/84.2.139 Levine, 2012, Sexual activity and cardiovascular disease a scientific statement from the American Heart Association, Circulation, 125, 1058, 10.1161/CIR.0b013e3182447787 Klein, 2007, The impact of sexual therapy on patients after cardiac events participating in a cardiac rehabilitation program, Eur J Cardiovasc Prev Rehabil, 14, 672, 10.1097/HJR.0b013e3282eea52d Gott, 2003, Barriers to seeking treatment for sexual problems in primary care: a qualitative study with older people, Family Pract, 20, 690, 10.1093/fampra/cmg612 Hadaegh, 2009, Prevalence of coronary heart disease among Tehran adults: Tehran Lipid and Glucose Study, East Mediterr Health J, 15, 157, 10.26719/2009.15.1.157 Safarinejad, 2006, Female sexual dysfunction in a population-based study in Iran: prevalence and associated risk factors, Int J Impot Res, 18, 382, 10.1038/sj.ijir.3901440 Safarinejad, 2003, Prevalence and risk factors for erectile dysfunction in a population-based study in Iran, Int J Impot Res, 15, 246, 10.1038/sj.ijir.3901024 Jamali, 2016, Attitudes about sexual activity among postmenopausal women in different ethnic groups: a cross-sectional study in Jahrom, Iran, J Reprod Infertil, 17, 47 Hashemi, 2013, Evaluation of sexual attitude and sexual function in menopausal age; a population based cross-sectional study, Iran, J Reprod Med, 11, 631 Hackett, 2008, British Society for Sexual Medicine guidelines on the management of erectile dysfunction, J Sex Med, 5, 1841 Nicolai, 2014, What do cardiologists know about the effects of cardiovascular agents on sexual function? A survey among Dutch cardiologists. Part I, Netherl Heart J, 21, 540, 10.1007/s12471-013-0471-2 Purabuli, 2010, Knowledge and attitude of nurses towards sexual activity and training patients with myocardial infarction and their spouses, Iran J Crit Care Nurs, 2, 145 De Souza, 2011, Management of sexual activity of coronary disease patients by cardiologists, Acta Med Port, 24, 249 Thompson, 2008, Sexual health promotion in primary care-activities and views of general practitioners and practice nurses, Prim Health Care Res Dev, 9, 319, 10.1017/S1463423608000881 Nicolai, 2013, Discussing sexual function in the cardiology practice, Clin Res Cardiol, 102, 329, 10.1007/s00392-013-0549-2 Vassiliadou, 2008, Sexual activity cardiological survey among Greek cardiologists, Health Sci J, 102, 25 Debusk, 2000, Management of sexual dysfunction in patients with cardiovascular disease: recommendations of the Princeton Consensus Panel, Am J Cardiol, 86, 62F, 10.1016/S0002-9149(00)01117-6 Nehra, 2012, The Princeton III Consensus recommendations for the management of erectile dysfunction and cardiovascular disease, Mayo Clin Proc, 87, 766, 10.1016/j.mayocp.2012.06.015 Jackson, 2002, A systematic approach to erectile dysfunction in the cardiovascular patient: a consensus statement—update 2002, Int J Clin Pract, 56, 663, 10.1111/j.1742-1241.2002.tb11349.x Abdul Mohsen, 2004, Physicians' knowledge, attitude and practice towards erectile dysfunction in Saudi Arabia, East Mediterr Health J, 10, 648, 10.26719/2004.10.4-5.648 Parish, 2010, Education in sexual medicine: proceedings from the International Consultation in Sexual Medicine, J Sex Med, 7, 3305 Nicolai, 2014, A review of the positive and negative effects of cardiovascular drugs on sexual function: a proposed table for use in clinical practice, Netherl Heart J, 22, 11, 10.1007/s12471-013-0482-z Raheem, The Association of Erectile Dysfunction and Cardiovascular Disease: a systematic critical review, Am J Mens Health Feldman, 1994, Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study, J Urol, 151, 54 Vlachopoulos, 2005, Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: a prospective angiographic study, Eur Urol, 48, 996, 10.1016/j.eururo.2005.08.002 Jaarsma, 2014, Sexual dysfunction in heart failure patients, Curr Heart Fail Rep, 11, 330, 10.1007/s11897-014-0202-z Nicolai, 2014, Do residents in cardiology need more training to make them talk about sex?, Netherl Heart J, 22, 122, 10.1007/s12471-014-0517-0 Al Khaja, 2016, Antihypertensive drugs and male sexual dysfunction: a review of adult hypertension guideline recommendations, J Cardiovasc Pharmacol Ther, 21, 233, 10.1177/1074248415598321 Karavitakis, 2011, Evaluation of sexual function in hypertensive men receiving treatment: a review of current guidelines recommendation, J Sex Med, 8, 2405 Steinke, 2013, Sexual counseling for individuals with cardiovascular disease and their partners, Eur Heart J, 34, 3217, 10.1093/eurheartj/eht270 Dyer, 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 Jaarsma, 2010, Sexual counselling of cardiac patients: nurses' perception of practice, responsibility and confidence, Eur J Cardiovasc Nurs, 9, 24, 10.1016/j.ejcnurse.2009.11.003 Lindau, 2014, Sexual activity and counseling in the first month after acute myocardial infarction among younger adults in the United States and Spain: a prospective, observational study, Circulation, 130, 2302, 10.1161/CIRCULATIONAHA.114.012709 Althof, 2013, Standard operating procedures for taking a sexual history, J Sex Med, 10, 26 Tsimtsiou, 2006, Predictors of physicians' involvement in addressing sexual health issues, J Sex Med, 3, 583 Krouwel, 2015, Management of sexual side effects in the surgical oncology practice: a nationwide survey of Dutch surgical oncologists, Eur J Surg Oncol, 41, 1179, 10.1016/j.ejso.2015.06.009 Hordern, 2007, Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs, Med J Aust, 186, 224, 10.5694/j.1326-5377.2007.tb00877.x Stead, 2003, Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues, Br J Cancer, 88, 666, 10.1038/sj.bjc.6600799 Mellor, 2013, Health care professionals' views on discussing sexual wellbeing with patients who have had a stroke: a qualitative study, PLoS One, 8, e78802, 10.1371/journal.pone.0078802 Nicolai, 2014, Erectile dysfunction in the cardiology practice—a patients' perspective, Am Heart J, 167, 178, 10.1016/j.ahj.2013.10.021 Doumas, 2006, Female sexual dysfunction in essential hypertension: a common problem being uncovered, J Hypertens, 24, 2387, 10.1097/01.hjh.0000251898.40002.5b Post, 2008, Sexological competence of different rehabilitation disciplines and effects of a discipline-specific sexological training, Sex Disabil, 26, 3, 10.1007/s11195-007-9068-2