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Eraslan A, Mohamed AH, Bashir AM, Adani AA, Cimen S. Prevalence and associated factors of sexual dysfunction in female hemodialysis patients: first report from Somalia. BMC Womens Health 2024; 24:48. [PMID: 38238717 PMCID: PMC10795307 DOI: 10.1186/s12905-024-02902-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/12/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Sexual dysfunction is frequent in female hemodialysis patients and is related to poorer quality of life. It is often a neglected topic associated with marked distress and interpersonal difficulties. OBJECTIVE Few studies are reported from Sub-Saharan African Countries (SSA) regarding female sexual dysfunction (FSD) in (HD) patients. The study aims to explore the prevalence and associated factors of FSD in female HD at a sole dialysis centre in Somalia. METHOD Over a one-month period, a cross-sectional study was conducted among women with end-stage renal disease aged 18-50 years who were undergoing a dialysis program for at least three months at the dialysis center of our hospital. The participants were married, and they were living with their partners. Data regarding the sociodemographic features, clinical characteristics, frequency of sexual intercourse per week, and the Female Sexual Function Index (FSFI) scores were collected using a standard face-to-face interview questionnaire. RESULTS During the study period, a total of 115 participants were eligible for the study's inclusion criteria. The mean patient age was 38.5 ± 9.3 years. The most common cause of ESRD was diabetes, which accounted for 53%, followed by hypertension (26.1%) and glomerulonephritis (9.6%). The mean duration of dialysis was 2.9 ± 1.4 years, and approximately two-thirds of the participants (62.5%) were in the program for more than three years. Regarding the frequency of sexual intercourse, 61.7% of female participants performed sexual intercourse less than once time/a week. The prevalence of FSD was 92.2% (n = 106) of all participants. The mean FSFI score of the participants was 16.05 ± 4.48. Longer duration of dialysis program (i.e., more than four years), increasing age (i.e., > 35 years), those with diabetes had scored lower overall FSFI scores. CONCLUSION The prevalence of female sexual dysfunction among Somali female hemodialysis patients was very high, representing a significant problem in end-stage renal disease (ESRD). Our study findings revealed that increasing age, diabetes, and duration of dialysis negatively impact female sexual function and are significantly associated with FSD.
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Affiliation(s)
- Asir Eraslan
- Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia.
| | | | | | | | - Sertac Cimen
- Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
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Effect of Cold Dialysis Solution on the Sexual Dysfunction of Patients with Chronic Renal Failure Undergoing Hemodialysis: A Randomized Clinical Trial. Nephrourol Mon 2021. [DOI: 10.5812/numonthly.118771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The present study aimed to evaluate the effect of cold dialysis solution on the sexual dysfunction of patients with chronic renal failure undergoing hemodialysis. Methods: This randomized clinical trial was conducted with a before and after parallel design among 60 hemodialysis patients diagnosed with sexual dysfunction. The selected subjects were randomly allocated to the two groups of experimental and control (30 per each). Patients in the experimental and control groups underwent hemodialysis for one month using 35.5°C and 37°C dialysis solutions, respectively. Following the procedure, male and female sexual function was assessed in the study groups. Data were collected using the International Index of Erectile Functions, the female sexual function index (FSFI), and a demographic questionnaire. Data analysis was performed using Chi-square, Fisher's exact test, Mann-Whitney U test, t-test, paired t-test, and Wilcoxon test at 95% confidence interval. Results: No significant difference was observed between the experimental and control groups regarding male sexual function before and after the intervention (P > 0.05). However, the Mann-Whitney U test indicated a significant difference in the female subjects’ arousal in the experimental group before (3.68 ± 0.38) and after the intervention (3.98 ± 0.46; z = 2.216; P = 0.027). Conclusions: Cold dialysis solution could only increase the sexual arousal of the women in the experimental group, and no changes were observed in other sexual function domains of the male and female patients. Given the short duration of our intervention, it is recommended that further longitudinal studies be performed on larger cohorts of patients in different geographical regions.
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Stout ME, Hawkins MAW. Temporal Relationships Between Pain During Intercourse (PDI), Loneliness, and Depressive Symptoms Among Women. Sex Med 2021; 9:100444. [PMID: 34649130 PMCID: PMC8766269 DOI: 10.1016/j.esxm.2021.100444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/18/2022] Open
Abstract
Background Painful sex can lead to increased psychological distress, including major depressive disorder, and the experience of loneliness may explain this association. Aims We aimed to investigate loneliness as a mediator between painful sex and depressive symptoms and hypothesized that women who experienced greater pain during intercourse (ie, more severe and more frequent pain) would endorse higher rates of loneliness and, in turn, higher rates of depressive symptoms at a 6-month follow-up. Methods Participants were 148 adults who were assigned female at birth (78.4% white, 77% partnered, 31.14 ± 10.9 years old) and completed an online, anonymous survey including the Female Sexual Function Index (FSFI), UCLA Loneliness Scale-3 (ULS), and demographic information. Main Outcome Measure Depressive symptoms, measured via the Patient Health Questionnaire-8 (PHQ8) at baseline (T1) and 6-month follow-up (T2) were used as the outcomes of the present study. Results Painful sex and ULS at T1 were significantly correlated with each other and with PHQ8 at T1 (r = 0.590). However, change in PHQ8 from T1 to T2 was not significantly correlated with ULS (r = 0.024) or any other key study variables, indicating that that ULS was not a significant mediator of the relationship between painful sex at T1 and change in PHQ8 (standardized indirect effect = 0.011; 99% CI = −0.114 to 0.188). Conclusion These findings are consistent with previous studies highlighting that painful sex is related to depressive symptoms through loneliness cross-sectionally, suggesting that future treatments for depressive symptoms among women who experience painful sex might target loneliness. Stout ME, Hawkins MAW. Temporal Relationships Between Pain During Intercourse (PDI), Loneliness, and Depressive Symptoms Among Women. Sex Med 2021;9:100444.
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Affiliation(s)
- Madison E Stout
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA.
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Soltan MR, Raheem TAA, Soliman SS, Saleh NM, Khatery BH. Depression and anxiety as risk factors for female sexual pain. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00061-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Abstract
Background
Female sexual pain is a complex multifactorial condition. Most of researches have focused on underlying biomedical factors. Although psychological, psychiatric, and relational factors have been studied as possible correlates, limited research has been made in this area about the Egyptian population. The present study aimed to evaluate prevalence of female sexual pain among a sample of Egyptian females and detect its correlation with depression and anxiety. Female sexual function index (FSFI) was used to evaluate sexual pain in 450 women calculating their pain domain scores. Their scores were correlated to demographic data, genital health complaints, depression, and anxiety symptoms.
Results
The prevalence of marked severe sexual pain was 31.6% and that of trivial pain was 68.4% in the studied group. In the study group, 75 (16.7%) females had depressive symptoms, and 40 (8.9%) females had anxiety symptoms. Patients with severe depression had significantly marked severe pain than patients with minimal depression (p < 0.001 respectively). Patients with severe anxiety had significantly lower pain score than patients without (p < 0.001). Pain score had significant negative correlation with each of the depression score (r − 0.524, p < 0.001) and the anxiety score (r − 0.305, p < 0.001). Patients with gynecological causes especially fungal infection had significantly severe marked pain than patients without any other physical causes (< 0.001).
Conclusions
Anxiety, depression, and the presence of gynecological causes especially fungal infection were significantly independent risk factors for more sexual pain.
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Roomaney R, Kagee A, Heylen S. Biopsychosocial predictors of symptoms of depression in a sample of South African women diagnosed with endometriosis. Health Care Women Int 2019; 41:308-329. [PMID: 31242076 DOI: 10.1080/07399332.2019.1624758] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We examined biopsychosocial predictors of symptoms of depression in women with endometriosis. The sample consisted of 202 women with endometriosis who completed a battery of measures including a demographic questionnaire, Beck Depression Inventory, Stellenbosch Endometriosis Quality of life Menstrual characteristics subscale, Short form health survey Physical functioning subscale, and three modular components of the Endometriosis Health Profile 30, namely the Sexual Relationships, Feelings about the Medical Profession, and Feelings about Infertility modules. About 43.1% of the sample reported moderate to severe symptoms of depression. Physical functioning, feelings about the medical profession and sexual relationships were significant predictors of symptoms of depression. The identification of these predictors may enable researchers and practitioners to identify patients to be screened for depression, e.g., patients who report sub-optimal physical functioning, negative feelings about the medical profession and difficult sexual relationships.
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Affiliation(s)
- Rizwana Roomaney
- Department of Psychology, Stellenbosch University, Matieland, South Africa
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Matieland, South Africa
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Stout ME, Meints SM, Hirsh AT. Loneliness Mediates the Relationship Between Pain During Intercourse and Depressive Symptoms Among Young Women. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1687-1696. [PMID: 29511895 PMCID: PMC6035118 DOI: 10.1007/s10508-017-1138-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 11/16/2017] [Accepted: 12/13/2017] [Indexed: 06/08/2023]
Abstract
Previous research suggests that women who experience pain during intercourse also experience higher rates of depressive symptoms. Loneliness might be one factor that contributes to this relationship. We hypothesized that women who experience more severe and interfering pain during intercourse would report higher rates of loneliness and higher rates of depressive symptoms. Further, we hypothesized that loneliness would mediate the relationship between pain during intercourse and depressive symptoms. A total of 104 female participants (85.6% white, 74.03% partnered, 20.9 [3.01] years old) completed an online survey including demographic information, PROMIS Vaginal Discomfort Measure, PROMIS Depression Measure, and Revised UCLA Loneliness Scale. Pearson correlations and bootstrapped mediation analysis examined the relationships among pain during intercourse, loneliness, and depressive symptoms. Pain during intercourse, loneliness, and depressive symptoms were all significantly correlated (p < .05). Results of the mediation analysis indicated that loneliness was a significant mediator of the relationship between pain during intercourse and depressive symptoms (indirect effect = 0.077; 95% CI 0.05-0.19). After accounting for loneliness, pain during intercourse was not significantly related to depressive symptoms, suggesting that loneliness fully mediated the relationship between pain during intercourse and depressive symptoms. These findings are consistent with previous studies highlighting that pain during intercourse is related to depressive symptoms. The current study adds to that literature and suggests that more frequent and severe pain during intercourse leads to more loneliness, which then leads to increased depressive symptoms. This line of work has important implications for treating women who experience depressive symptoms and pain during intercourse.
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Affiliation(s)
- Madison E Stout
- Department of Psychology, Indiana University-Purdue University at Indianapolis, 402 N Blackford St., Indianapolis, IN, 46202, USA
| | - Samantha M Meints
- Department of Psychology, Indiana University-Purdue University at Indianapolis, 402 N Blackford St., Indianapolis, IN, 46202, USA
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University at Indianapolis, 402 N Blackford St., Indianapolis, IN, 46202, USA.
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Effects of Renal Transplantation on Female Sexual Dysfunction: Comparative Study With Hemodialysis and a Control Group. Transplant Proc 2017; 49:2099-2104. [DOI: 10.1016/j.transproceed.2017.07.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/21/2017] [Accepted: 07/30/2017] [Indexed: 11/21/2022]
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Santos PR, Capote Júnior JRFG, Cavalcante Filho JRM, Ferreira TP, Dos Santos Filho JNG, da Silva Oliveira S. Religious coping methods predict depression and quality of life among end-stage renal disease patients undergoing hemodialysis: a cross-sectional study. BMC Nephrol 2017. [PMID: 28623903 PMCID: PMC5474022 DOI: 10.1186/s12882-017-0619-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor quality of life (QOL) and a high prevalence of depression have been identified among end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). We aimed to evaluate the associations between religious/spiritual (R/S) coping methods and both QOL and depression among ESRD patients undergoing hemodialysis (HD). METHODS The sample included 161 ESRD patients over 18 years of age who had been undergoing HD for more than 3 months. R/S coping methods were assessed using the Religious Coping Questionnaire (RCOPE). The RCOPE generates scores (from 1 to 5) for positive and negative R/S coping methods. The higher the score, the more frequent the use of that coping method. Depression was evaluated using the 20-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). Scores on the CES-D range from 0 to 60. A cutoff of 18 was used to define depression. QOL was evaluated using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36); this survey was used to generate scores for the eight dimensions of QOL, which can vary from 0 (worst) to 100 (best). RESULTS We identified a depression prevalence of 27.3%. Positive R/S coping scores were higher among non-depressed than depressed patients (2.98 vs. 2.77; p = 0.037). Positive R/S coping scores were negatively correlated with depression scores (r = -0.200; p = 0.012) and were an independent protective factor for depression (OR = 0.13; CI 95% = 0.02-0.91; p = 0.039). Regarding QOL, a positive correlation was identified between positive R/S coping scores and scores related to general health (r = 0.171; p = 0.030) and vitality (r = 0.183; p = 0.019), and an inverse correlation was identified between negative R/S coping scores and scores in the social functioning (r = -0.191; p = 0.015) and mental health (r = -0.214; p = 0.006) dimensions. In addition, positive R/S coping scores were an independent predictor of higher scores in the bodily pain (β = 14.401; p = 0.048) and vitality (β = 12.580; p = 0.022) dimensions. In contrast, negative R/S coping scores independently predicted lower social functioning scores (β = -21.158; p = 0.017). CONCLUSIONS Our results provide further evidence suggesting that R/S coping methods may be associated with QOL and depression among HD patients. In our opinion, the use of religious resources should be encouraged among HD patients, and psycho-spiritual interventions should be attempted to target religious struggles (negative R/S coping) in patients undergoing HD.
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Affiliation(s)
- Paulo Roberto Santos
- Graduate Program in Health Sciences, Sobral Faculty of Medicine, Federal University of Ceará, Brazil, Rua Comandante Maurocélio Rocha Ponte 100, Sobral, CEP 62.042-280, Brazil. .,Sobral Faculty of Medicine, Federal University of Ceará, Brazil, Rua Comandante Maurocélio Rocha Ponte 100, Sobral, CEP 62.042-280, Brazil. .,, Rua Tenente Amauri Pio, 380 apt. 900, Fortaleza, CE, CEP 60.160-090, Brazil.
| | - José Roberto Frota Gomes Capote Júnior
- Graduate Program in Health Sciences, Sobral Faculty of Medicine, Federal University of Ceará, Brazil, Rua Comandante Maurocélio Rocha Ponte 100, Sobral, CEP 62.042-280, Brazil
| | | | - Ticianne Pinto Ferreira
- Sobral Faculty of Medicine, Federal University of Ceará, Brazil, Rua Comandante Maurocélio Rocha Ponte 100, Sobral, CEP 62.042-280, Brazil
| | | | - Stênio da Silva Oliveira
- Sobral Faculty of Medicine, Federal University of Ceará, Brazil, Rua Comandante Maurocélio Rocha Ponte 100, Sobral, CEP 62.042-280, Brazil
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Santos PR, de Sales Santos ÍM, de Freitas Filho JLA, Macha CW, Tavares PGCC, de Oliveira Portela AC, Campos AMB, de Azevedo ARF, Ary CC, Nobre FP, Carneiro JF, Pontes YMG. Emotion-oriented coping increases the risk of depression among caregivers of end-stage renal disease patients undergoing hemodialysis. Int Urol Nephrol 2017; 49:1667-1672. [PMID: 28523593 DOI: 10.1007/s11255-017-1621-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 05/15/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE We investigated the possible association between coping style and depressive feelings among caregivers of end-stage renal disease patients undergoing hemodialysis. METHODS We studied 107 main caregivers of hemodialysis patients. Main caregiver was defined as the person on whom the patient counts for daily care or the one the patient calls upon in case of difficulties. Demographic data of caregivers and clinical data of patients were collected. The Jalowiec Coping Scale was applied to score two styles of coping: problem-oriented coping (POC) and emotion-oriented coping (EOC). Depression was screened by the 20-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). A score ≥16 was used to classify depression. Comparisons were made by Student's t and Chi-square tests. The Pearson's test was used to assess correlation between scores. Linear and logistic regressions were used, respectively, to test variables as predictors of the CES-D scores and the presence of depression. RESULTS The depression rate among caregivers was 71.9%. In the comparison between depressed and non-depressed caregivers, only EOC score differed, being higher among depressed ones (69.8 vs. 62.4; p < 0.001). EOC score was positively correlated with depression score (r = 0.368; p = <0.001). In the multivariate analysis, EOC independently predicted both the depression score (b = 0.272; p = 0.001) and the presence of depression (OR 1.221; 95% CI 1.123-1.339; p = 0.001). CONCLUSION Our results indicate that EOC is associated with and increases the risk of depression among caregivers of HD patients. We propose that strategies aiming to strengthen POC and diminish EOC can be applied to minimize depressive feelings.
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Affiliation(s)
- Paulo Roberto Santos
- Graduate Program in Family Health, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil. .,School of Medicine, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil.
| | - Ítala Mônica de Sales Santos
- Graduate Program in Family Health, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil
| | | | - Carlos Wellington Macha
- School of Medicine, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil
| | | | - Ana Cláudia de Oliveira Portela
- School of Medicine, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil
| | - Ana Mayara Barros Campos
- School of Medicine, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil
| | - Ana Raquel Ferreira de Azevedo
- School of Medicine, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil
| | - Catarine Cavalcante Ary
- School of Medicine, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil
| | - Felipe Peixoto Nobre
- School of Medicine, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil
| | - Jamille Fernandes Carneiro
- School of Medicine, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil
| | - Yandra Maria Gomes Pontes
- School of Medicine, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil
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Gonidakis F, Kravvariti V, Fabello M, Varsou E. Anorexia Nervosa and Sexual Function. CURRENT SEXUAL HEALTH REPORTS 2016. [DOI: 10.1007/s11930-016-0064-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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van Ek GF, Krouwel EM, Nicolai MP, Bouwsma H, Ringers J, Putter H, Pelger RCM, Elzevier HW. Discussing Sexual Dysfunction with Chronic Kidney Disease Patients: Practice Patterns in the Office of the Nephrologist. J Sex Med 2015; 12:2350-63. [PMID: 26633081 DOI: 10.1111/jsm.13062] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Sexual dysfunction (SD) is a common problem in patients suffering from chronic kidney disease (CKD). Sexual health remains a difficult subject to detect and discuss. Although many studies have been performed on the incidence of SD, little is known about practice patterns when it concerns quality of life (QoL)-related questions such as SD in the nephrologists' practice. AIM The aim of this study was to determine to which extent nephrologists, important renal care providers, discuss SD with their patients and their possible barriers toward discussing this subject. METHODS A 50-item questionnaire was sent to all Dutch nephrologists (n = 312). MAIN OUTCOME MEASURES The survey results. RESULTS The response rate of the survey was 34.5%. Almost all responders (96.4%) stated to address SD in less than half of their new patients. The most important barrier not to discuss SD was patients not expressing their concern regarding SD spontaneously (70.8%). Other important barriers were: "the lack of a suitable moment to discuss" (61.9%) and "insufficient time" (46.9%). Eighty-five percent of the nephrologists stated that insufficient attention was paid to SD and treatment options during their training. Sixty-five percent of the respondents stated to be in need of extending their knowledge on the discussing of SD. CONCLUSIONS Dutch nephrologists do not discuss problems with sexual function routinely. The lack of knowledge, suitable education, and insufficient time are factors causing undervaluation of SD in CKD patients. Implementation of competent sexual education and raising awareness among nephrologists on the importance of paying attention to SD could improve care and QoL for patients with CKD. More research should be performed among patients and other renal care providers to develop an adequate method to enhance our current system.
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Affiliation(s)
- Gaby F van Ek
- Department of Urology, Leiden University Medical Center, Leiden, The Netherlands
| | - Esmée M Krouwel
- Department of Urology, Leiden University Medical Center, Leiden, The Netherlands
| | - Melianthe P Nicolai
- Department of Urology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hanneke Bouwsma
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan Ringers
- Department of Transplant Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Rob C M Pelger
- Department of Urology, Leiden University Medical Center, Leiden, The Netherlands
| | - Henk W Elzevier
- Department of Urology, Leiden University Medical Center, Leiden, The Netherlands
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Iyasere O, Brown EA. Determinants of quality of life in advanced kidney disease: time to screen? Postgrad Med J 2014; 90:340-7. [DOI: 10.1136/postgradmedj-2013-132251] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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