General practitioner views about discussing sexual issues with patients with coronary heart disease: a national survey in Ireland
Tóm tắt
Sexual problems are common among people with coronary heart disease and can adversely affect patients' quality of life. GPs are ideally placed to deal with these problems. Research suggests that GPs are reluctant to address sexual problems but little is known about what currently takes place in practice. The aim of this study was to examine GPs' self-reported behaviour and attitudes to discussing sexual problems with people with coronary heart disease. Design: A cross-sectional survey which administered 230 postal questionnaires to a nationally representative, stratified random sample of GPs in the Republic of Ireland. GPs were asked about current practice, knowledge, awareness and confidence in dealing with sexual problems, barriers to addressing sexual problems, and about improving services in this area. Responses were available for 61 GPs (27% response rate). Seventy percent of GPs reported that they rarely or never discussed sexual problems with coronary patients. While all GPs believed addressing sexual problems was important, many GPs reported lacking awareness, knowledge and confidence in addressing sexual problems. The main barriers were lack of time, feeling the patient wasn't ready and lack of training in the area. GPs wanted more training and guidelines for practice. There is currently no standardised protocol for GPs for dealing with sexual problems among coronary patients. Awareness of these issues appears to be low among GPs. Services could be improved by developing practice guidelines for brief, effective actions or assessments, providing training in the area and improving information resources and support services for referral.
Tài liệu tham khảo
Laumann EO, Paik A, Rosen RC: Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999, 281: 537-44. 10.1001/jama.281.6.537.
Gott M, Hinchliff S: How important is sex in later life? The views of older people. Social Science & Medicine. 2003, 56: 1617-28. 10.1016/S0277-9536(02)00180-6.
DeBusk R, Drory Y, Goldstein I, Jackson G, Kaul S, Kimmel S, Kostis J, Kloner R, Lakin M, Meston C, et al: Management of sexual dysfunction in patients with cardiovascular disease: recommendations of The Princeton Consensus Panel. Americal Journal of Cardiology. 2000, 86: 175-81. 10.1016/S0002-9149(00)00896-1.
Schwarz E, Rodriguez J: Sex and the heart. International Journal of Impotence Research. 2005, 17: S4-6. 10.1038/sj.ijir.3901422.
Kloner R, Mullin S, Shook T, Matthews R, Mayeda G, Burstein S, Peled H, Pollick C, Choudhary R, Rosen R, et al: Erectile dysfunction in the cardiac patient: how common and should we treat?. Journal of Urology. 2003, 170 (2 Pt 2): S46-50. 10.1097/01.ju.0000075055.34506.59.
Drory Y, Kravetz S, Weingarten M: Comparison of sexual activity of women and men after a first acute myocardial infarction. The American Journal of Cardiology. 2000, 85: 1283-1287. 10.1016/S0002-9149(00)00756-6.
Friedman S: Cardiac disease, anxiety, and sexual functioning. The American Journal of Cardiology. 2000, 86: 46-50. 10.1016/S0002-9149(00)00893-6.
Taylor HA: Sexual activity and the cardiovascular patient: guidelines. The American Journal of Cardiology. 1999, 84: 6-10. 10.1016/S0002-9149(99)00116-2.
Roose S, Seidman S: Sexual activity and cardiac risk: is depression a contributing factor?. American Journal of Cardiology. 2000, 86 (2A): 38F-40F. 10.1016/S0002-9149(00)00891-2.
Steinke E: Sexual counseling after myocardial infarction. American Journal of Nursing. 2000, 100: 38-43. 10.2307/3522189.
Steinke E, Swan J: Effectiveness of a videotape for sexual counseling after myocardial infarction. Research in Nursing & Health. 2004, 27: 269-80. 10.1002/nur.20022.
Hatzichristou D, Tsimtsiou Z: Prevention and Management of Cardiovascular Disease and Erectile Dysfunction: Toward A Common Patient-Centered, Care Model. The American Journal of Cardiology. 2005, 96: 80-84. 10.1016/j.amjcard.2005.11.007.
Renshaw D, Karstaedt A: Is there (sex) life after coronary bypass?. Comprehensive Therapy. 1988, 14: 61-66.
Sarkadi A, Roseqvist U: Contradictions in the medical encounter: Female sexual function in primary care contacts. Family Practice. 2001, 18: 161-166. 10.1093/fampra/18.2.161.
Steinke E, Patterson P: Sexual counseling of MI patients by cardiac nurses. Journal of Cardiovascular Nursing. 1995, 10: 81-87.
Albarran JW, Bridger S: Problems with providing education on resuming sexual activity after myocardial infarction: developing written information for patients. Intensive and Critical Care Nursing. 1997, 13: 2-11. 10.1016/S0964-3397(97)80643-X.
Gott M, Hinchliff S, Galena E: General practitioner attitudes to discussing sexual health issues with older people. Social Science & Medicine. 2004, 58: 2093-2103. 10.1016/j.socscimed.2003.08.025.
Dunn K, Croft P, Hackett G: Sexual problems: A study of the prevalence and need for health care in the general population. Family Practice. 1998, 15: 519-524. 10.1093/fampra/15.6.519.
Thompson K, Casson K, Fleming P, Dobbs F, Parahoo K, Armstrong J: Sexual health promotion in primary care - activities and views of general practitioners and practice nurses. Primary Health Care Research and Development. 2008, 9: 319-330. 10.1017/S1463423608000881.
McGee H, Rundle K, Donnelly C, Layte R: The Irish Study of Sexual Health and Relationships Sub Report 2: Sexual Health Challenges and Related Service Provision. 2008, Department of Health and Children and the Crisis Pregnancy Agency. Dublin
Templeton L, Deehan A, Taylor C, Drummond C, Strang J: Surveying general practitioners: does a low response rate matter?[see comment]. British Journal of General Practice. 1997, 47: 91-4.
Finnerty F, Glynn L, Dineen B, Colfer F, MacFarlane A: A postal survey of data in general practice on the prevalence of Acquired Brain Injury (ABI) in patients aged 18-65 in one county in the west of Ireland. BMC Family Practice. 2009, 10: 36-10.1186/1471-2296-10-36.
O'Dowd T, O'Kelly M, O'Kelly F: Structure of General Practice in Ireland. 2006, Irish College of General Practitioners and Trinity College Dublin. Dublin
Ni Shuilleabhain A, O'Kelly M, O'Kelly F, O'Dowd T: Limited options: a report on GP access to services. Irish Journal of Medical Science. 2007, 176: 27-32. 10.1007/s11845-007-0006-1.
Cartwright A: Professionals as responders: variations in and effects of response rates to questionnaires, 1961-1977. BMJ. 1979, ii: 1419-1421.
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