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Dreischor F, Dancet EAF, Lambalk CB, van Lunsen HW, Besselink D, van Disseldorp J, Boxmeer J, Brinkhuis EA, Cohlen BJ, Hoek A, de Hundt M, Janssen CAH, Lambers M, Maas J, Nap A, Perquin D, Verberg M, Verhoeve HR, Visser J, van der Voet L, Mochtar MH, Goddijn M, Laan E, van Wely M, Custers IM. The web-based Pleasure&Pregnancy programme in the treatment of unexplained infertility: a randomized controlled trial. Hum Reprod 2024:deae220. [PMID: 39352942 DOI: 10.1093/humrep/deae220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 07/22/2024] [Indexed: 10/04/2024] Open
Abstract
STUDY QUESTION Does offering the Pleasure&Pregnancy (P&P) programme rather than expectant management improve naturally conceived ongoing pregnancy rates in couples diagnosed with unexplained infertility? SUMMARY ANSWER The P&P programme had no effect on the ongoing pregnancy rates of couples with unexplained infertility. WHAT IS KNOWN ALREADY Underpowered studies suggested that face-to-face interventions targeting sexual health may increase pregnancy rates. The impact of an eHealth sexual health programme had yet to be evaluated by a large randomized controlled trial. STUDY DESIGN, SIZE, DURATION This is a nationwide multi-centre, unblinded, randomized controlled superiority trial (web-based randomization programme, 1:1 allocation ratio). This RCT intended to recruit 1164 couples within 3 years but was put on hold after having included 700 couples over 5 years (2016-2021). The web-based P&P programme contains psychosexual information and couple communication, mindfulness and sensate focus exercises aiming to help maintain or improve sexual health, mainly pleasure, and hence increase pregnancy rates. The P&P programme additionally offers information on the biology of conception and enables couples to interact online with peers and via email with coaches. PARTICIPANTS/MATERIALS, SETTING, METHODS Heterosexual couples with unexplained infertility and a Hunault-prognosis of at least 30% chance of naturally conceiving a live-born child within 12 months were included, after their diagnostic work-up in 41 Dutch secondary and tertiary fertility centres. The primary outcome was an ongoing pregnancy, defined as a viable intrauterine pregnancy of at least 12 weeks duration confirmed by an ultrasound scan, conceived naturally within 6 months after randomization. Secondary outcomes were time to pregnancy, live birth, sexual health, and personal and relational well-being at baseline and after 3 and 6 months. The primary analyses were according to intention-to-treat principles. We calculated relative risks (RRs, pregnancy rates) and a risk difference (RD, pregnancy rates), Kaplan-Meier survival curves (live birth over time), and time, group, and interactive effects with mixed models analyses (sexual health and well-being). MAIN RESULTS AND THE ROLE OF CHANCE Totals of 352 (one withdrawal) and 348 (three withdrawals) couples were allocated to, respectively the P&P group and the expectant management group. Web-based tracking of the intervention group showed a high attrition rate (57% of couples) and limited engagement (i.e. median of 16 visits and 33 min total visitation time per couple). Intention-to-treat analyses showed that 19.4% (n = 68/351) of the P&P group and 22.6% (n = 78/345) of the expectant management group achieved a naturally conceived ongoing pregnancy (RR = 0.86; 95% CI = 0.64-1.15, RD = -3.24%; 95% CI -9.28 to 2.81). The time to pregnancy did not differ between the groups (Log rank = 0.23). Live birth occurred in 18.8% (n = 66/351) of the couples of the P&P group and 22.3% (n = 77/345) of the couples of the expectant management group (RR = 0.84; 95% CI = 0.63-1.1). Intercourse frequency decreased equally over time in both groups. Sexual pleasure, orgasm, and satisfaction of women of the P&P group improved while these outcomes remained stable in the expectant management group. Male orgasm, intercourse satisfaction, and overall satisfaction decreased over time with no differences between groups. The intervention did not affect personal and relational well-being. Non-compliance by prematurely starting medically assisted reproduction, and clinical loss to follow-up were, respectively, 15.1% and 1.4% for the complete study population. Per protocol analysis for the primary outcome did not indicate a difference between the groups. Comparing the most engaged users with the expectant management group added that coital frequency decreased less, and that male sexual desire improved in the intervention group. LIMITATIONS, REASONS FOR CAUTION The intended sample size of 1164 was not reached because of a slow recruitment rate. The achieved sample size was, however, large enough to exclude an improvement of more than 8% of the P&P programme on our primary outcome. WIDER IMPLICATIONS OF THE FINDINGS The P&P programme should not be offered to increase natural pregnancy rates but may be considered to improve sexual health. The attrition from and limited engagement with the P&P programme is in line with research on other eHealth programmes and underlines the importance of a user experience study. STUDY FUNDING/COMPETING INTEREST(S) Funded by The Netherlands Organisation for Health Research and Development (ZonMw, reference: 843001605) and Flanders Research Foundation. C.B.L. is editor-in-chief of Human Reproduction. H.W.L. received royalties or licences from Prometheus Publishers Springer Media Thieme Verlag. J.B. received support from MercK for attending the ESHRE course 'The ESHRE guideline on ovarian stimulation, do we have agreement?' J.v.D. reports consulting fees and lecture payments from Ferring, not related to the presented work, and support for attending ESHRE from Goodlife and for attending NFI Riga from Merck. A.H. reports consulting fees by Ferring Pharmaceutical company, The Netherlands, paid to institution UMCG, not related to the presented work. H.V. reports consulting fees from Ferring Pharmaceutical company, The Netherlands, and he is a member of the ESHRE guideline development group unexplained infertility and Chair of the Dutch guideline on unexplained infertility (unpaid). M.G. declares unrestricted research and educational grants from Ferring not related to the presented work, paid to their institution VU Medical Centre. The other authors have no conflicts to declare. TRIAL REGISTRATION NUMBER NTR5709. TRIAL REGISTRATION DATE 4 February 2016. DATE OF FIRST PATIENT’S ENROLMENT 27 June 2016.
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Affiliation(s)
- F Dreischor
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - E A F Dancet
- Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven, Belgium
| | - C B Lambalk
- Division of Reproductive Medicine, Department of Obstetrics & Gynaecology, Amsterdam UMC Location VUMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - H W van Lunsen
- Sexology and Psychosomatic Obstetrics and Gynaecology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - D Besselink
- Radboudumc, Department of Obstetrics & Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - J van Disseldorp
- Department of Obstetrics and Gynaecology, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | - J Boxmeer
- Department of Gynaecology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - E A Brinkhuis
- Department of Obstetrics and Gynaecology, Meander MC, Amersfoort, The Netherlands
| | - B J Cohlen
- Isala Fertility Centre, Isala Clinics, Zwolle, The Netherlands
| | - A Hoek
- Department of Obstetrics and Gynaecology, Section Reproductive Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - M de Hundt
- Department of Obstetrics and Gynaecology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | - C A H Janssen
- Department of Obstetrics and Gynaecology, Groene Hart Ziekenhuis, Gouda, The Netherlands
| | - M Lambers
- Department of Obstetrics and Gynaecology, Dijklander Ziekenhuis, Hoorn, The Netherlands
| | - J Maas
- Department of Obstetrics and Gynaecology, Maastricht UMC+, Maastricht, The Netherlands
- Maastricht University GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - A Nap
- Radboudumc, Department of Obstetrics & Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - D Perquin
- Department of Obstetrics and Gynaecology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - M Verberg
- Fertility Clinic Twente, Twente, The Netherlands
| | - H R Verhoeve
- Department of Obstetrics and Gynaecology, OLVG, Amsterdam, The Netherlands
| | - J Visser
- Department of Obstetrics and Gynaecology, Amphia Ziekenhuis, Breda, The Netherlands
| | - L van der Voet
- Department of Obstetrics and Gynaecology, Deventer Hospital, Deventer, The Netherlands
| | - M H Mochtar
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
- Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - M Goddijn
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
- Division of Reproductive Medicine, Department of Obstetrics & Gynaecology, Amsterdam UMC Location VUMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - E Laan
- Sexology and Psychosomatic Obstetrics and Gynaecology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - M van Wely
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
- Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - I M Custers
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
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Patsakos EM, Backhaus S, Farris K, King M, Moreno JA, Neumann D, Sander A, Bayley MT. INTIMASY-TBI Guideline: Optimization of INTIMAcy, SexualitY, and Relationships Among Adults With Traumatic Brain Injury. J Head Trauma Rehabil 2024; 39:395-407. [PMID: 39256160 DOI: 10.1097/htr.0000000000000981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
INTRODUCTION Traumatic brain injury (TBI) can negatively impact intimacy, relationships, and sexual functioning through changes in physical, endocrine, cognitive, behavioral, and emotional function. Without intervention, diminished intimacy and/or sexual functioning in individuals with TBI may persist. Although most health care professionals agree that sexuality and intimacy in relationships are significant concerns and should be addressed in rehabilitation, these concerns are not typically discussed during rehabilitation and discharge planning for people with TBI. To address this gap, an expert panel of North American clinicians and researchers convened to develop evidence-informed recommendations to assist clinicians in providing a framework and guidance on how clinicians can support individuals after TBI. METHODS A systematic search of multiple databases was conducted to identify relevant evidence published from 2010 to 2023. The INTIMASY-TBI Expert Panel developed recommendations for optimizing discussions and interventions related to intimacy and sexuality for people with TBI in rehabilitation and community-based programs. For each recommendation, the experts evaluated the evidence by examining the study design and quality to determine the level of evidence. RESULTS A total of 12 recommendations were developed that address the following topic areas: (1) interprofessional team training, (2) early education on the effects of TBI on intimacy, relationships, and sexuality, (3) creating individualized interventions, (4) education, assessment, and management of the causes of sexual dysfunction, and (5) providing written materials and relationship coaching to persons with TBI and their partners. Two recommendations were supported by Level A evidence, 1 was supported by Level B evidence, and 9 were supported by Level C (consensus of the INTIMASY-TBI Expert Panel) evidence. A decision algorithm was developed to assist clinicians in navigating through the recommendations. CONCLUSION The INTIMASY-TBI Guideline is one of the first comprehensive clinical practice guidelines to offer strategies to trained clinicians to discuss the physical, psychosocial, behavioral, and emotional aspects of intimacy and sexuality with persons with TBI.
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Affiliation(s)
- Eleni M Patsakos
- Author Affiliations: Rehabilitation Sciences, Institute, University of Toronto, Toronto, Ontario (Ms Patsakos and Dr Bayley); KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario (Ms Patsakos and Dr Bayley); Physical Medicine & Rehabilitation, School of Medicine, Indiana University, Indianapolis, Indiana (Drs Backhaus and Neumann); Shepherd Center, Atlanta, Georgia (Ms Farris); Kessler Institute for Rehabilitation, West Orange, New Jersey (Dr King); Faculty of Medicine, McGill University, Montreal, Quebec (Dr Moreno); and Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (Dr Sander)
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Alinejad Mofrad S, Green H, Sawleshwarkar S, Alananzeh I, Fernandez R. Experiences Relating to Sexual Well-Being Among Muslim Gynecological Cancer Survivors: A Systematic Review of Qualitative Studies. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:530-545. [PMID: 39035138 PMCID: PMC11257125 DOI: 10.1089/whr.2023.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 07/23/2024]
Abstract
Background Gynecological cancers are one of the most important threats to women's health worldwide. The objective of this review is to synthesize and present the best available evidence on the experiences relating to sexual well-being among Muslim women with gynecological cancer. Methods The databases searched included Web of Science, Scopus, SID, Google Scholar, ProQuest, MEDLINE, and CINAHL from the inception of the database until August 2021. The review was guided by the JBI methodology used for qualitative systematic reviews. Findings were collated using the meta-aggregation method through JBI SUMARI. Results Eight studies involving Muslim women cancer survivors were included in the review. Meta-synthesis of the eight included studies generated 59 findings, which were organized into 14 categories and combined into four synthesized findings. Conclusions Gynecological cancer and its treatment results in numerous challenges with sexual well-being among Muslim women cancer survivors. Providing information about sexual activity following gynecological cancer, better communication from health care professionals, and support from the husband is essential to overcome the struggle with intimacy and femininity experienced by the women, thus improving the sexual quality of life of Muslim gynecological cancer survivors.
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Affiliation(s)
- Samaneh Alinejad Mofrad
- Department of Nursing and Midwifery, School of Nursing, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Heidi Green
- Australian Centre for Health Engagement, Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, Wollongong, Australia
| | - Shailendra Sawleshwarkar
- Faculty of Medicine and Health, Sydney Infectious Diseases Institute, The University of Sydney, Westmead, Australia
| | - Ibrahim Alananzeh
- University of Wollongong Dubai, School of Humanities, Social Sciences and Health, Dubai, United Arab Emirates
| | - Ritin Fernandez
- School of Nursing and Midwifery, University of Newcastle, Callaghan, Australia
- Centre for Transformative Nursing, Midwifery, and Health Research: A JBI Affiliate Centre
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Mirzaei Damabi N, Begum M, Avery JC, Padhani ZA, Lassi ZS. Unveiling silenced narratives: a scoping review on sexual function challenges in migrant and refugee women. Sex Med Rev 2024; 12:288-298. [PMID: 38462747 DOI: 10.1093/sxmrev/qeae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION Of the approximately 281 million international migrants and 35.3 million refugees around the world, almost half are women. These individuals experience significant stress due to language barriers, financial difficulties, poor living and working conditions, and discrimination. Consequently, concerns related to sexuality may receive lower priority despite their significant impact on overall well-being. OBJECTIVES This scoping review aims to review the sexual function of migrant and refugee women and identify any knowledge gaps in the field. METHODS We conducted a scoping review following the PRISMA-ScR guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews). We searched online databases-Medline, Embase, Emcare, PsycINFO, CINAHL, Scopus, Web of Science, and Cochrane-and gray literature, with no restrictions on year of publication, language, or study design. Utilizing Covidence software, 2 authors screened and extracted data from studies based on predetermined eligibility criteria. A thematic analysis was executed, and findings were reported descriptively. RESULTS Initially, we identified 5615 studies; after screening titles, abstracts, and full texts, we ultimately included 12 studies. The review identified a limited body of research with various unvalidated tools. Moreover, these studies yielded heterogeneous results: migrant women reported less sexual knowledge, experience, and liberal attitudes, resulting in lower rates of desire and arousal as compared with nonmigrants. Some studies showed lower sexual function in migrants, while others found no significant differences between migrants and nonmigrants. The assimilation into Western cultures may influence migrants' sexual attitudes and behaviors. Factors such as education and gender role ideology can also significantly affect sexual function among migrant populations. CONCLUSION This review underscores the limitations in previous sexual function research, emphasizing the need for a more inclusive approach. It also offers valuable insights for codesigning programs to address sexual dysfunction among migrant and refugee women, improving their well-being. Future research should prioritize neglected populations and create culturally sensitive interventions to reduce sexual health disparities in migrants.
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Affiliation(s)
- Negin Mirzaei Damabi
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Mumtaz Begum
- Life Course and Intergenerational Health Research Group, Faculty of Health and Medical Science, University of Adelaide, Adelaide 5005, Australia
| | - Jodie C Avery
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Zahra Ali Padhani
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Zohra S Lassi
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
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Vrancken Peeters NJMC, Vlooswijk C, Bijlsma RM, Kaal SEJ, Kerst JM, Tromp JM, Bos MEMM, van der Hulle T, Lalisang RI, Nuver J, Kouwenhoven MCM, van der Ploeg IMC, van der Graaf WTA, Husson O. Sexual quality of life of adolescents and young adult breast cancer survivors. ESMO Open 2024; 9:102234. [PMID: 38281325 PMCID: PMC10937205 DOI: 10.1016/j.esmoop.2024.102234] [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: 11/12/2023] [Revised: 12/15/2023] [Accepted: 12/28/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND With increasing survival rates of adolescents and young adults (AYAs) with breast cancer, health-related quality of life (HRQoL) becomes more important. An important aspect of HRQoL is sexual QoL. This study examined long-term sexual QoL of AYA breast cancer survivors, compared sexual QoL scores with that of other AYA cancer survivors, and identified factors associated with long-term sexual QoL of AYA breast cancer survivors. MATERIALS AND METHODS Data of the SURVAYA study were utilized for secondary analyses. Sexual QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life cancer survivorship core questionnaire (EORTC QLQ-SURV100). Descriptive statistics were used to describe sexual QoL of AYA cancer survivors. Linear regression models were constructed to examine the effect of cancer type on sexual QoL and to identify factors associated with sexual QoL. RESULTS Of the 4010 AYA cancer survivors, 944 had breast cancer. Mean sexual QoL scores of AYA breast cancer survivors ranged from 34.5 to 60.0 for functional domains and from 25.2 to 41.5 for symptom-orientated domains. AYA breast cancer survivors reported significantly lower sexual QoL compared to AYA survivors of other cancer types on all domains. Age, time since diagnosis, relationship status, educational level, chemotherapy, hormonal therapy, breast surgery, body image, and coping were associated with sexual QoL of AYA breast cancer survivors. CONCLUSIONS AYA breast cancer survivors experience decreased sexual QoL in the long term (5-20 years) after diagnosis and worse score compared to AYA survivors of other cancer types, indicating a clear need to invest in supportive care interventions for those at risk, to enhance sexual well-being.
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Affiliation(s)
- N J M C Vrancken Peeters
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam
| | - C Vlooswijk
- Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht
| | - R M Bijlsma
- Department of Medical Oncology, University Medical Centre, Utrecht
| | - S E J Kaal
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen
| | - J M Kerst
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam
| | - J M Tromp
- Department of Medical Oncology, Amsterdam University Medical Centres, Amsterdam
| | - M E M M Bos
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam
| | - T van der Hulle
- Department of Medical Oncology, Leiden University Medical Centre, Leiden
| | - R I Lalisang
- Department of Internal Medicine, Division of Medical Oncology, GROW-School of Oncology and Reproduction, Maastricht UMC+ Comprehensive Cancer Centre, Maastricht
| | - J Nuver
- Department of Medical Oncology, University Medical Centre Groningen, Groningen
| | - M C M Kouwenhoven
- Department of Neurology, Amsterdam UMC, Amsterdam University Medical Centres, Amsterdam
| | - I M C van der Ploeg
- Department of Surgical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam
| | - W T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam
| | - O Husson
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam; Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands.
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Farahi Z, HashemZadeh M, Farnam F. Sexual counseling for female sexual interest/arousal disorders: a randomized controlled trial based on the "good enough sex" model. J Sex Med 2024; 21:153-162. [PMID: 38181124 DOI: 10.1093/jsxmed/qdad168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 11/08/2023] [Accepted: 12/05/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Female sexual interest/arousal disorder (FSIAD) is the most common female sexual disorder with adverse effects on women's health and interpersonal relationships. AIM This survey evaluated the effects of sexual counseling based on the "good enough sex" (GES) model on the sexual health variables of women with FSIAD. METHODS A randomized clinical trial with a 1:1 allocation ratio was conducted among 80 women with FSIAD in Iran in 2021. Eligible participants were randomly assigned to group A (women) and group B (couples). Women attended 4 weekly online group sexual counseling sessions based on the GES model, each lasting 120 minutes. In group B, husbands participated in sessions 2 and 3. OUTCOMES Women's sexual health parameters-including sexual desire, sexual satisfaction, sexual function, sexual distress, sexual communication, frequency of sexual intercourse, and dysfunctional beliefs-were evaluated before and 3 months after counseling. The significance threshold considered P < .007 due to Bonferroni correction. RESULTS After the intervention, all sexual parameters except sexual dysfunctional beliefs showed significant improvement (P < .001) in both groups. During the follow-up period, the average scores for all sexual variables were slightly higher in group B vs group A. The between-group difference was significant only for frequency of sexual intercourse (P < .01). CLINICAL IMPLICATIONS This study reaffirms the impact of the GES model as biopsychosocial therapy in managing female sexual problems. Considering men's reluctance to accompany their wives to sex clinics, counseling for women alone can play a significant role in solving sexual problems, especially in the case of FSIAD. Online sexual consultation offers cost and time savings, provides a secure space for discussing sensitive topics, and facilitates group program coordination. It ensures universal access to counseling, thereby addressing gender incompatibility issues. It is a powerful, interactive, and acceptable alternative to in-person visits, providing convenience and confidentiality for clients seeking sexual health support. STRENGTHS AND LIMITATIONS The following were among the survey strengths: conducting a randomized controlled trial on women with FSIAD by applying an appropriate model and scales, involving spouses, and evaluating online group sexual counseling. However, the results of this study may not be generalizable to women without partners. CONCLUSION The GES model, emphasizing intimacy and sexual dialogue, reduces unrealistic sexual expectations and improves women's sexual desire and overall health. Our results showed that instead of insisting on the physical presence of husbands in counseling sessions, clinicians should emphasize their emotional support and companionship during the treatment process.
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Affiliation(s)
- Zahra Farahi
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 1416634793, Iran
| | - Mozhgan HashemZadeh
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 1416634793, Iran
| | - Farnaz Farnam
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 1416634793, Iran
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Al-Qerem W, Ling J, Eberhardt J. Validation of an Arabic version of the female version of The Sexual Dysfunctional Beliefs Questionnaire: a factor analysis study. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:94-104. [PMID: 37787027 DOI: 10.1080/0092623x.2023.2260370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Several questionnaires have been developed to evaluate female sexual dysfunction (FSD) and sexual health problems. However, there is a lack of validated versions of these questionnaires in Arabic. One of the most used instruments is the female version of The Sexual Dysfunctional Beliefs Questionnaire (SDBQ). The current study aimed to validate an Arabic version of the SDBQ. The Arabic version of SDBQ-Female was incorporated into an online questionnaire using and distributed among Jordanian Facebook groups and women-only groups. Factor analysis was performed to investigate evidence for the validity of the questionnaire. 530 females (mean age 30 years, SD = 9) completed the questionnaire. Principal component analysis produced the final model composed of 24 items distributed across four factors: Sexual Desire & Pleasure, Affection Primacy, Sexual Conservatism and Age-Related Beliefs. Confirmatory factor analysis was conducted, and fit indices were acceptable (CMIN/DF = 2.52, GFI = 0.91, AGFI = 0.89, CFI = 0.90, SRMR = 0.05 and RMSEA = 0.05). Income level and marital status both influenced FSD beliefs, with higher scores associated with higher income and being single. The Arabic version of the SDBQ-female demonstrated evidence of validity and reliability. Additional research is necessary to explore beliefs related to FSD within an Arabic context.
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Affiliation(s)
- Walid Al-Qerem
- College of Pharmacy, Al-Zaytoonah University of Jordan, Amman11733, Jordan
| | - Jonathan Ling
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Chester Road, Sunderland, UK
| | - Judith Eberhardt
- School of Social Sciences, Humanities and Law, Teesside University, Borough Road, MiddlesbroughTS1 3BA, UK
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Maya ET, Boamah MO, Agyabeng K, Srofenyoh E, Mumuni K, Samba A. Determinants of sexual dysfunction in pregnancy in a large tertiary hospital in Ghana. PLoS One 2023; 18:e0288456. [PMID: 37471375 PMCID: PMC10358996 DOI: 10.1371/journal.pone.0288456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 06/19/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVE To determine the factors associated with sexual dysfunction in pregnancy. METHODS A cross-sectional facility-based study using quantitative methods was carried out among pregnant women attending antenatal clinic of the Greater Accra Regional Hospital from 14th May to 25th June 2018. Four hundred and twenty-seven married or cohabiting women who were at least eight weeks pregnant and have been living together with their partners for at least four weeks prior to the survey were consecutively recruited. The Female Sexual Function Index (FSFI) tool was used to assess their sexual function. Pearson's Chi Square, Fischer's exact, Mann Whitney and Student's t-tests were used for bivariate analysis where appropriate between sexual dysfunction (dependent variable) and demographic, obstetrics and gynecologic factors (independent variables). Multiple logistic regression was done. Statistical significance was set at p-value of less than 0.05 at bivariate and multivariable analyses. RESULTS The mean age of the respondents was 30.8 ± 4.8 years. Their mean gestational age was 32.3 ± 7.1 weeks. Marital status and duration of stay in marriage or cohabitation were significantly associated with sexual dysfunction with adjusted odds ratios of 1.88 (p-value < 0.05) and 1.08 (p-value < 0.05) respectively. CONCLUSION Cohabiting and increasing length of stay with spouse are significantly associated with sexual dysfunction in pregnancy.
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Affiliation(s)
| | - Martin Owusu Boamah
- Department of Obstetrics and Gynecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Kofi Agyabeng
- School of Public Health, University of Ghana, Accra, Ghana
| | - Emmanuel Srofenyoh
- Department of Obstetrics and Gynecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Kareem Mumuni
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana
| | - Ali Samba
- Department of Obstetrics and Gynaecology, Korle-bu Teaching Hospital, Accra, Ghana
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9
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Wnuk M, Charzyńska E. Does Forgiveness Underlie the Relationship Between Religiosity and Meaning in Life Among Members of Sexaholics Anonymous in Poland? JOURNAL OF RELIGION AND HEALTH 2023:10.1007/s10943-023-01842-3. [PMID: 37294376 DOI: 10.1007/s10943-023-01842-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/10/2023]
Abstract
Religiosity and meaning in life are recognized as factors supporting recovery from addictions. However, little is known about the moral mechanisms involved in the relationship between religiosity and meaning in life among individuals with addictions. The main purpose of this study was to test the direct and indirect (through forgiveness by God/higher power and interpersonal forgiveness) relationships between subjective religiosity and the presence of meaning in life among 80 members (72 men and 8 women) of Sexaholics Anonymous (SA) in Poland. The following measures were used: a single-item measure of subjective religiosity, subscales from the Forgiveness Scale and the Heartland Forgiveness Scale, and the Meaning in Life Questionnaire. The sequential mediation model was tested using Hayes PROCESS macro. The results showed a direct positive relationship between subjective religiosity and the presence of meaning in life. Moreover, subjective religiosity was positively related to forgiveness by God/higher power, which, in turn, directly and indirectly (through interpersonal forgiveness) predicted higher levels of the presence of meaning in life. The study suggests that among SA members, religious faith facilitates perceiving one's own life as meaningful, both directly and indirectly, through aspects of forgiveness. Members of SA may benefit from their belief in God/higher power and religiously-rooted forgiveness to support the meaning-making processes.
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Affiliation(s)
- Marcin Wnuk
- Department of Work and Organizational Psychology, Adam Mickiewicz University in Poznań, Szamarzewskiego 89/AB, 60-568, Poznań, Poland
| | - Edyta Charzyńska
- Faculty of Social Sciences, Institute of Psychology, Institute of Pedagogy, University of Silesia in Katowice, Bankowa 12, 40-007, Katowice, Poland.
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10
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Park JJ, Doo SW, Kwon A, Kim DK, Yang WJ, Song YS, Shim SR, Kim JH. Effects of Sexual Rehabilitation on Sexual Dysfunction in Patients with Cardiovascular Disease: A Systematic Review and Meta-Analysis. World J Mens Health 2023; 41:330-341. [PMID: 36593706 PMCID: PMC10042662 DOI: 10.5534/wjmh.220124] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/31/2022] [Accepted: 08/10/2022] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Cardiovascular disease (CVD) is one of the leading causes of death, accounting for one-third of all deaths worldwide. Patients with CVD are three times more likely to complain of sexual dysfunction than healthy people. Causes of sexual dysfunction in patients with CVD include physical/mental changes and drug side effects. The prevalence of sexual dysfunction in patients with CVD has been estimated to be up to 89%. Ordinary treatments such as pharmacotherapy cannot effectively reduce sexual problems. Therefore, sexual rehabilitation has a broad spectrum, including exercise therapy such as pelvic floor muscle treatment, appropriate counseling, a multidisciplinary approach, and partner rehabilitation. In this study, systematic review and meta-analysis was performed to investigate the effect of sexual rehabilitation on sexual problems in patients with CVD. MATERIALS AND METHODS Comprehensive literature searches were conducted using MEDLINE, Cochrane Library electronic database, and EMBASE through June 2022. Questionnaire scores at the end point as outcomes of the study were recorded as were standardized mean difference (SMD) with their 95% confidence intervals (CIs). Meta-regression analysis was conducted for each moderator. We performed a risk of bias evaluation for included studies using the RoB 2 tool. RESULTS The overall SMD in the meta-analysis for sexual rehabilitation versus no-sexual rehabilitation was 0.430 (95% CI, 0.226-0.633). There was a statistical difference between groups. SMD changes were 0.674 (95% CI, 0.308-1.039) at one month and 0.320 (95% CI, 0.074-0.565) at six months. The regression analysis with all variables (number of patients, study duration, and questionnaire types) revealed no significance. CONCLUSIONS This study indicates that sexual rehabilitation is an effective method with high therapeutic potential for sexual dysfunction of patients with CVD. However, for clinical application, well-designed studies with many patients should be conducted in the future and the standardization of rehabilitation protocols is required.
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Affiliation(s)
- Jae Joon Park
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Allison Kwon
- Department of Biochemistry, College of Biological Science, University of California, Davis, CA, USA
| | - Do Kyung Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Sung Ryul Shim
- Department of Health and Medical Informatics, Kyungnam University College of Health Sciences, Changwon, Korea.
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
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11
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Development of a Japanese Version of the Index of Sexual Satisfaction for Use in Couples with Young Children. Behav Sci (Basel) 2022; 12:bs12120503. [PMID: 36546986 PMCID: PMC9774785 DOI: 10.3390/bs12120503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
The occurrence of sexual dysfunction in couples after childbirth is well recognized, yet sexual satisfaction in couples with young children (CYC) has received little research attention. This study sought to enable this construct to be measured by developing and validating a Japanese version of the Index of Sexual Satisfaction (ISS) in CYC. Data were collected using a self-administered questionnaire. Scale construction and validation were conducted using two independent samples drawn from 316 mothers and 272 fathers in Japan who had at least one child aged 6 or younger. Two underlying factors were identified using exploratory factor analysis: sexual satisfaction, measured by eight items, and sexual dissatisfaction, measured by three. Polychoric ordinal alpha coefficients indicated the reliability of the resulting scale (overall: 0.89, factor 1: 0.89, factor 2: 0.78), and confirmatory factor analysis and testing supported its validity, showing good model fit (goodness of fit index: 0.984, root mean square residual: 0.062) and satisfactory composite reliability (scale: 0.93, factor 1: 0.90, factor 2: 0.81) and average variance extracted (all ≥0.5). The Japanese version of the ISS for Couples with Young Children will be useful for investigating sexual satisfaction, which is essential to marital stability.
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12
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Zakhour S, Sardinha A, Levitan M, Berger W, Nardi AE. Instruments for assessing sexual dysfunction in Arabic: A systematic literature review. Transcult Psychiatry 2022; 59:819-830. [PMID: 35818838 DOI: 10.1177/13634615221105120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Sexual health is relevant throughout a person's life; however, studying human sexuality is complex and requires particular care when working with individuals from different cultural and social backgrounds. Much of the research addressing this subject has been conducted in Western countries, and that in non-Western countries is generally based on small sample sizes. The biopsychosocial nature of sexuality and its dysfunctions should be taken into consideration given that it is indispensable when conducting and assessing sexual studies in different countries and cultures. Therefore, culturally sensitive studies that consider cultural contexts and determinants as well as social markers are needed. The topic of sexuality in Arab culture is still enigmatic. This enigma has impacted the advancement of sexual science and limited researchers, health care practitioners, and patients. Thus, the aim of this systematic literature review was to find and assemble all scales and questionnaires regarding human sexual health that have been translated into Arabic and validated in order to promote a critical analysis of the methods used in each instrument and to inform readers and researchers of the limits and potential of each scale. Electronic databases were systematically searched, and eight instruments were selected for inclusion: the Arabic Index of Premature Ejaculation (AIPE), the Sexual Health Inventory for Men (SHIM), the Arabic Female Sexual Function Index (ArFSFI), the Female Genital Self-Image Scale (AVFGSIS), the Arabic Arizona Sexual Experiences Scale (ASEX), the Egyptian Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ-IR), the Saudi Arabian Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire in Arabic (PSIQ-IR), and the Arabic Female Sexual Distress Scale (FSDS). All included instruments showed good validity and reliability for the target population. Future studies are needed to develop culturally sensitive instruments.
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Affiliation(s)
- Stephanie Zakhour
- Institute of Psychiatry (IPUB), Department of Psychiatry & Legal Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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13
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Elshamy AM, Mohamed ES, Al-Malt AM, Ragab OA. Sexual Dysfunction Among Egyptian Idiopathic Parkinson's Disease Patients. J Geriatr Psychiatry Neurol 2022; 35:816-822. [PMID: 34951322 DOI: 10.1177/08919887211063810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND One of the non-motor features of idiopathic Parkinson's disease (IPD) is sexual dysfunction (SD) which is under-recognized and, consequently, undertreated. This study aimed to evaluate SD in patients with IPD. PATIENTS AND METHODS The study was conducted on 67 IPD patients; 30 healthy subjects with age and gender matching with the patients served as the control group. All participants were subjected to sexual function assessment using the Arabic version of Arizona Sexual Experience Scale (ASEX), Mini-Mental State Examination (MMSE), and Beck Depression Inventory (BDI), while the severity of IPD was assessed using the modified Hoehn and Yahr scoring scale and MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). RESULTS There were no statistically significant differences between patients with IPD and the control group regarding MMSE, hypertension, diabetes mellitus, or dyslipidemia. However, BDI scores were significantly higher in patients with IPD. The rate of SD among our patients was 64% compared to 30% in the control group. The total score and subscales of ASEX were significantly higher in IPD patients than in controls. SD showed a significant correlation with the severity of the IPD irrespective of other variables, including patient age, sex, disease duration, hypertension, diabetes, dyslipidemia, smoking, and dose of L-dopa. CONCLUSION SD is a commonly underrated feature in patients with IPD; it should be investigated carefully as it is an important non-motor symptom that correlates with disease severity.
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14
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Klein V, Savaş Ö, Conley TD. How <i>WEIRD</i> and Androcentric Is Sex Research? Global Inequities in Study Populations. JOURNAL OF SEX RESEARCH 2022; 59:810-817. [PMID: 33939579 DOI: 10.1080/00224499.2021.1918050] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Previous researchers have noted the domination of Western, Educated, Industrialized, Rich, and Democratic (WEIRD) samples in fields like psychology. In this study we asked: how WEIRD and androcentric is contemporary sex research? We focused on two historically underrepresented groups in research, namely non-WEIRD and women/gender non-conforming samples. We analyzed 2,223 articles drawn from five leading journals in scientific sexuality research (<i>Archives of Sexual Behavior, Journal of Sex Research, Journal of Sex and Marital Therapy, Journal of Sexual Medicine</i>, and <i>International Journal of Sexual Health</i>). We coded the national context and gender of sampled populations for articles published between 2015 and 2019 in these journals. Results indicated that WEIRD populations dominate the published findings in sex research (ranging from 68% to 88%). Two journals had a higher number of studies that only included men as participants, and one a higher number of samples that consisted of only women, and very few included gender diverse samples (i.e., non-binary, trans*, intersex). Recommendations for improving the current research and publishing practices are discussed.
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Affiliation(s)
- Verena Klein
- Department of Psychology, University of Michigan
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf
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15
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Perceptions and Experiences of Pakistani-Descent Female Adolescents Living in Canada, on Developing Sexuality and Self-Identity. SEXES 2022. [DOI: 10.3390/sexes3030031] [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
Immigrant adolescents make up a substantial proportion of newcomers to Canada. Most newcomer youth from South Asia aged 15 to 24 are from racialized “visible minority” backgrounds. The sexual health needs of female immigrant adolescents in Canada have been largely unmet and have increased in magnitude over the last few years. For immigrant female adolescents, the silence around issues of sexuality needs can affect their physical, emotional, sexual health, and overall well-being as well as their ability to reach their full potential. Evidence suggests that immigrant adolescents lack sexual and reproductive health knowledge and use fewer sexual health-related services and sex education resources than non-immigrant youth. In Pakistani immigrant adolescents, this difference appears to be associated with socio-cultural and religious practices. The purpose of this study was to qualitatively explore the experience of developing sexuality and its relationship to well-being in middle- to late-female adolescents of Pakistani-descent, living in a large urban area in Canada. The study aimed to establish space for dialogue and to bridge the perceived cultural divide on issues of sexuality using the postmodern feminist lens, which often arises between individuals from different cultural backgrounds. Using the interpretive descriptive methodology, a purposive sample of 21 female adolescents who were of first- or second-generation Pakistan-descent was obtained. Participants included female adolescents aged from 14 to 19 years. Data were collected using a semi-structured interview guide and a timeline. A total of 21 first interviews and seven follow up interviews were conducted. The narratives and timelines presented in this study tell the story of female Pakistani adolescents, their narratives, and the timelines reflect the complexities of the sexuality of female adolescents and how they perceive and attribute meanings to their experiences. The study found that living in a bicultural world can cause significant stress and anxiety among female adolescents, especially when making personal life decisions related to sexuality. Moreover, silence around all aspects of female sexuality negatively affects the capacity for desire and pleasure. In addition, the intersection of gender and patriarchy have created layers of power and oppression in adolescent lives that tightly control their sexuality. The participants’ stories reveal the complex interaction of factors that influence the behavior of female adolescents related to sexuality and sexual health. These findings establish the need for cultural awareness while viewing each girl’s experience in relation to the intersectionality of social spheres such as race, ethnicity, culture, and religion. Finally, this study provides implications to policymakers to revise the existing policies and create youth-friendly policies for immigrant youth to draw attention to the hidden voices of female adolescents and increase the awareness of ways to address issues arising in evolving sexuality.
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16
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Temel M, Boyacıoğlu NE, Çaynak S, Çaynak M. Psychosocial and Sexual Life in Morbidly Obese Individuals Following Bariatric Surgery: A Qualitative Study. Bariatr Surg Pract Patient Care 2022. [DOI: 10.1089/bari.2022.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Münire Temel
- Department of Social Service and Counsultancy, Vocational School of Social Sciences, Tekirdağ Namık Kemal Üniversitesi, Tekirdag, Turkey
| | - Nur Elçin Boyacıoğlu
- Department of Gerontology, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sibel Çaynak
- Department of Operating Room Services, Vocational School of Health Services, Antalya Bilim University, Antalya, Turkey
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17
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Tyndall I, Hartland T, Banerjee M, Giacomelli V, Ball I, Churchill S, Pereira A, Lowry R. Tailoring Sexual Health Interventions for Middle-Aged and Older Adults, Including Vulnerable Populations: A Scoping Review. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:593-613. [PMID: 38596395 PMCID: PMC10903680 DOI: 10.1080/19317611.2022.2089313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 04/11/2024]
Abstract
Objective This scoping review aims to synthesize existing literature on good practice in sexual health interventions for adults over 45 years and in vulnerable groups. Methods Using PRISMA-ScR guidelines, search terms focused on sexual health, good practice, and vulnerable groups, in over-45s. Results Of the nine studies that met the inclusion criteria, seven were focused on HIV and risk reduction. Use of alternative methods of communication, alongside inclusion of behavioral and cognitive measures such as condom use and perceived stigma, was key to tailoring interventions. Conclusions This review highlights the imperative for further research on sexual health interventions with these overlooked populations.
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Affiliation(s)
- Ian Tyndall
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Tess Hartland
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Moitree Banerjee
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Victoria Giacomelli
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Isabelle Ball
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Susan Churchill
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Antonina Pereira
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Ruth Lowry
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
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18
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Factors Influencing Sexual Health Service Use by South Asian Immigrant Men Living in Ontario, Canada: A Qualitative Study. SEXES 2022. [DOI: 10.3390/sexes3020021] [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
Introduction: South Asian communities comprise one of the fastest-growing populations in Canada, but there is a paucity of research on if and how immigrant men use sexual health services. Objectives: Our study aimed to understand factors influencing sexual health service use by South Asian immigrant men living in Ontario, Canada. Methods: An interpretive description (ID) research methodology was used, followed by Braun and Clarke’s thematic guidelines to collect and analyze data. Altogether, 18 semi-structured interviews were conducted between May and July 2021 with South Asian immigrant men between 20 and 45 years of age in Ontario. Results: We found that culture shaped the overall perception and use of sexual health services, while the perceived severity of sexual illness also affected the utilization of preventative care. Moreover, there are taboos about sexual health, and while sex positivity and sex negativity exist, sexual health information is shared with trusted sources. We also found South Asian men shared sexual health more openly by following a lifestyle that normalizes sexual health discussions rather than South Asian cultural norms. Conclusions: This study provides a comprehensive understanding of the individual, structural and cultural determinants of health influencing sexual health service use to strengthen existing health communication strategies to improve service utilization for diverse communities in Canada.
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19
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Jiang X, Lu Y, Hong Y, Zhang Y, Chen L. A Network Comparison of Motives behind Online Sexual Activities and Problematic Pornography Use during the COVID-19 Outbreak and the Post-Pandemic Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105870. [PMID: 35627407 PMCID: PMC9141011 DOI: 10.3390/ijerph19105870] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 11/24/2022]
Abstract
Many researchers have considered whether online sexual activities (OSAs) increased over the course of the COVID-19 pandemic and whether these have led to an increase in problematic pornography use (PPU). This study investigated the impact of COVID-19 on PPU through pornography use motivations (PUMs) and OSAs to develop a better understanding of the mechanism and changes affecting PPU. Two groups of Chinese adults were recruited during the initial months of the pandemic (April 2020, n1 = 496) and the post-pandemic period (October 2021, n2 = 504). A network analysis was conducted to compare the structures of PPU symptoms among the two groups. The results showed that PUMs and OSAs were stronger predictors of PPU during the pandemic than post-pandemic (R2pandemic = 57.6% vs. R2post-pandemic = 28.7%). The motives of fantasy, sexual pleasure, stress reduction, and self-exploration were the prominent motivations during these two periods, but we found distinct PPU-related communities. PPU, sexual pleasure, and viewing sexually explicit materials (a type of OSAs) constituted a community during the pandemic but not in the post-pandemic’s network. The present study indicated that the pandemic may not have been the only factor impacting the higher rate of PPU. Instead, the higher frequency of OSAs during the pandemic may have been a strategy to cope with stress and to safely satisfy sexual desire.
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Affiliation(s)
- Xiaoliu Jiang
- School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China; (X.J.); (Y.L.)
| | - Yingfei Lu
- School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China; (X.J.); (Y.L.)
| | - Youjuan Hong
- School of Nursing, Fujian Medical University, Fuzhou 350108, China;
| | - Ying Zhang
- Department of Physical Education, Fuzhou University, Fuzhou 350108, China
- Correspondence: (Y.Z.); (L.C.)
| | - Lijun Chen
- School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China; (X.J.); (Y.L.)
- Correspondence: (Y.Z.); (L.C.)
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20
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Ruiz de Viñaspre-Hernández R, Garrido-Santamaria R, Urra-Martínez R, Sáenz-Cabredo P, Martínez-Tofe J, Burgos-Esteban A, Gea-Caballero V, Antón-Solanas I, Santolalla-Arnedo I, Juárez-Vela R. Transcultural Adaptation and Validation of the Spanish Version of the Sexual Satisfaction Scale for Women (SSS-W-E). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189663. [PMID: 34574588 PMCID: PMC8464659 DOI: 10.3390/ijerph18189663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/06/2021] [Accepted: 09/13/2021] [Indexed: 12/01/2022]
Abstract
Background: Sexual satisfaction is a complex and multidimensional concept. It encompasses physical, emotional, relational and cultural dimensions, and constitutes an essential component of sexual health, as well as an indicator of quality of life and wellbeing. The Sexual Satisfaction Scale for Women (SSS-W) was designed in the United States, and it is a valid and reliable tool to measure women’s sexual satisfaction. Aim: The aim of this study was to culturally adapt and translate the SSS-W into Spanish and analyze its psychometric properties. Methods: First, the original instrument was culturally adapted and translated from English to Spanish. Then, we tested the psychometric properties of the instrument in its Spanish version in a sample of 316 women who attended a family planning clinic in Logroño, Spain. Internal consistency reliability of the whole scale and each subscale separately was measured using Cronbach’s alpha. Factorial validity of the SSS-W in its Spanish version was analyzed using exploratory factor analysis through the Kaiser–Meyer–Olkin measure of sample adequacy and Bartlett’s Sphericity test. Results: The Cronbach’s alpha coefficients of the total scale and each subscale were satisfactory (>0.7). Exploratory factor analysis confirmed the five hypothetical dimensions of the scale in its Spanish version. The five dimensions (contentment, communication, compatibility, relational concern, and personal concern) explained 60% of the total variance of the scale; factor analysis using varimax rotation revealed strong loads in each of the five components. Conclusions: The SSS-W in its Spanish version is a valid and reliable tool to assess sexual satisfaction in Spanish women of reproductive age and, therefore, can be used both in clinical practice and for the investigation of sexual health.
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Affiliation(s)
- Regina Ruiz de Viñaspre-Hernández
- Department of Nursing, University of La Rioja, 26004 Logroño, La Rioja, Spain; (R.R.d.V.-H.); (A.B.-E.); (R.J.-V.)
- Biomedical Research Center of La Rioja (CIBIR), Healthcare System Sustainability Research Unit (GISOSS), 26004 Logroño, La Rioja, Spain;
| | - Rosana Garrido-Santamaria
- Government of La Rioja, Planificación Center, 26004 Logroño, La Rioja, Spain; (R.G.-S.); (R.U.-M.); (P.S.-C.)
| | - Raquel Urra-Martínez
- Government of La Rioja, Planificación Center, 26004 Logroño, La Rioja, Spain; (R.G.-S.); (R.U.-M.); (P.S.-C.)
| | - Paula Sáenz-Cabredo
- Government of La Rioja, Planificación Center, 26004 Logroño, La Rioja, Spain; (R.G.-S.); (R.U.-M.); (P.S.-C.)
| | - Jesús Martínez-Tofe
- Biomedical Research Center of La Rioja (CIBIR), Healthcare System Sustainability Research Unit (GISOSS), 26004 Logroño, La Rioja, Spain;
- Government of La Rioja, Hospital San Pedro, 26004 Logroño, La Rioja, Spain
| | - Amaya Burgos-Esteban
- Department of Nursing, University of La Rioja, 26004 Logroño, La Rioja, Spain; (R.R.d.V.-H.); (A.B.-E.); (R.J.-V.)
- Biomedical Research Center of La Rioja (CIBIR), Healthcare System Sustainability Research Unit (GISOSS), 26004 Logroño, La Rioja, Spain;
| | - Vicente Gea-Caballero
- Faculty of Health Sciences, International University of Valencia, 46002 Valencia, Spain
- Correspondence: (V.G.-C.); (I.S.-A.)
| | - Isabel Antón-Solanas
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Iván Santolalla-Arnedo
- Department of Nursing, University of La Rioja, 26004 Logroño, La Rioja, Spain; (R.R.d.V.-H.); (A.B.-E.); (R.J.-V.)
- Biomedical Research Center of La Rioja (CIBIR), Healthcare System Sustainability Research Unit (GISOSS), 26004 Logroño, La Rioja, Spain;
- Correspondence: (V.G.-C.); (I.S.-A.)
| | - Raúl Juárez-Vela
- Department of Nursing, University of La Rioja, 26004 Logroño, La Rioja, Spain; (R.R.d.V.-H.); (A.B.-E.); (R.J.-V.)
- Biomedical Research Center of La Rioja (CIBIR), Healthcare System Sustainability Research Unit (GISOSS), 26004 Logroño, La Rioja, Spain;
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Hargons CN, Dogan J, Malone N, Thorpe S, Mosley DV, Stevens-Watkins D. Balancing the sexology scales: a content analysis of Black women's sexuality research. CULTURE, HEALTH & SEXUALITY 2021; 23:1287-1301. [PMID: 32744470 PMCID: PMC7855161 DOI: 10.1080/13691058.2020.1776399] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Existing research adopting a sex positive and intersectional framework for investigating Black women's sexualities is scarce. We conducted a 46-year (1972-2018) content analysis of sexualities research focussed on Black women. It sought to examine which sexualities topics were published most; whether the publications aligned with sex-positive, neutral or negative discourse; what methodologies were used; and differences in how various identities were investigated among Black women. Using human coding, we applied an integrative approach to the content analysis. Results found 245 articles meeting criteria. Approximately one-third of articles within the analysis focussed on the topic of sexually transmitted infections (STIs), HIV and sexual risk behaviours among Black women. Only 6.5% of articles utilised a sex-positive discourse. Quantitative articles were the most published methodology, and publications disproportionately overlooked Black women's intersectional identities. Implications for future research and practice are discussed.
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Affiliation(s)
- Candice Nicole Hargons
- Department of Educational, School and Counseling Psychology, University of Kentucky Lexington, KY, USA
- Corresponding Author: Candice Nicole Hargons
| | - Jardin Dogan
- Department of Educational, School and Counseling Psychology, University of Kentucky Lexington, KY, USA
| | - Natalie Malone
- Department of Educational, School and Counseling Psychology, University of Kentucky Lexington, KY, USA
| | - Shemeka Thorpe
- Department of Public Health Education, University of North Carolina Greensboro, Greensbo, NC, USA
| | - Della V. Mosley
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Danelle Stevens-Watkins
- Department of Educational, School and Counseling Psychology, University of Kentucky Lexington, KY, USA
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Rullo JE, Sood R, Fokken SC, Sood A, Frohmader KS, Croghan IT, Schroeder DR, Faubion SS. Couples' Use of Online Stress Management and Resiliency Training for Sexual Health Concerns: A Randomized Controlled Trial. Sex Med 2021; 9:100404. [PMID: 34280591 PMCID: PMC8360907 DOI: 10.1016/j.esxm.2021.100404] [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: 01/22/2021] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 01/07/2023] Open
Abstract
Introduction Mindfulness is a promising intervention for female sexual dysfunction (FSD); however, of the mindfulness interventions studied, few treat the woman and her partner. Aim We developed a brief online mindfulness, resilience, and psychoeducation intervention, Stress Management and Resiliency Training for Sexuality (Sex SMART), for women with sexual health concerns and their partners. Methods Women with female sexual interest/arousal disorder and their partners were recruited between February 24, 2015, and October 6, 2016, and randomized to treatment or control groups (received educational pamphlets). The treatment intervention comprised of an online SMART and sexual health psychoeducation module. Main Outcome Measures The Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Sexual Desire Inventory-2 (SDI-2), Revised Dyadic Adjustment Scale (RDAS), International Index of Erectile Function (IIEF), and other subjective measures were used to assess sexual function and sexual distress at baseline and 12 weeks. Results The study included 60 women and their partners (30 couples in each group). In both groups, sexual function by total FSFI scores and sexual distress scores significantly improved at 12 weeks compared with baseline, with no significant between-group differences (FSFI effect estimate for Sex SMART vs control = +1.4 (90% CI [–0.6 to +3.4]; P=.13). Both participants and partners randomized to the intervention reported significantly improved attitude and feelings, comfort as a sexual person, and subjective sexual functioning at 12 weeks. The findings provide preliminary evidence for efficacy of an online intervention for couples with sexual health problems. Conclusions A brief online mindfulness, resilience, and psychoeducation–based intervention showed no significant improvement in many outcomes (FSFI, FSDS-R, SDI-2, RDAS) of sexual health versus controls. Although this is the first online randomized controlled trial to evaluate a mindfulness-based therapy intervention, it was limited by its lack of population diversity and high attrition rate. Significant improvements in subjective sexual health and partner sexual function by the International Index of Erectile Function were reported only in the intervention group. Rullo JE, Sood R, Fokken SC, et al. Couples’ Use of Online Stress Management and Resiliency Training for Sexual Health Concerns: A Randomized Controlled Trial. Sex Med 2021;9:100404.
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Affiliation(s)
- Jordan E Rullo
- Menopause and Women's Sexual Health Clinic, Rochester, Minnesota; Department of Clinical Psychology, The University of Utah, Salt Lake City, Utah.
| | - Richa Sood
- Menopause and Women's Sexual Health Clinic, Rochester, Minnesota; Center for Women's Health, Rochester, Minnesota
| | - Shawn C Fokken
- Division of General Internal Medicine, Rochester, Minnesota
| | - Amit Sood
- Viterbo University, La Crosse, Wisconsin
| | | | - Ivana T Croghan
- Division of General Internal Medicine, Rochester, Minnesota; Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
| | | | - Stephanie S Faubion
- Center for Women's Health, Rochester, Minnesota; Division of General Internal Medicine, Mayo Clinic, Jacksonville, Florida
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Akalin A, Ozkan B. Sexual myths and attitudes regarding sexuality of nursing students: A mixed method study. Perspect Psychiatr Care 2021; 57:1497-1504. [PMID: 33373074 DOI: 10.1111/ppc.12717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To determine the nursing students' sexual myths and attitudes regarding sexuality, and to explore their views towards sexual care in practice. DESIGN AND METHODS A mixed-method sequential explanatory design was used. Data were collected using Questionnaire Form, Sexual Myths Scale (SMS), Sexual Attitude and Beliefs Scale (SABS), and Focus-Group Interview Form. FINDINGS The average scores on the SMS and the SABS were 58.66 ± 18.74 and 37.50 ± 6.97, respectively, indicating students' sexual myths and their attitudes regarding sexuality were moderate. A positive, significant correlation was found between SMS and SABS scores (p < 0.001). In the interviews, the views on the barriers and facilitators in sexual care and the negative effect of sexual myths on sexual care were revealed. PRACTICE IMPLICATIONS Courses regarding sexuality should include into nursing curriculum from the first years of undergraduate education.
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Affiliation(s)
- Ayse Akalin
- Department of Nursing, Faculty of Health Sciences, Duzce University, Duzce, Turkey
| | - Birgul Ozkan
- Department of Nursing, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
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24
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Horne M, Youell J, Brown LJE, Simpson P, Dickinson T, Brown-Wilson C. A scoping review of education and training resources supporting care home staff in facilitating residents' sexuality, intimacy and relational needs. Age Ageing 2021; 50:758-771. [PMID: 33681969 PMCID: PMC8123381 DOI: 10.1093/ageing/afab022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Indexed: 11/22/2022] Open
Abstract
Background Having positive intimate, sexual and relational experiences is an important issue for older adults in care settings, yet little is known on the extent to which nursing staff and care workers have received education or training in addressing and meeting these needs among older residents. This scoping review aimed to identify and examine what education and training resources exist to assist nursing staff and care workers to meet their residents’ needs in this area. Methods and analysis Using the Arksey and O’Malley framework, we systematically searched papers and grey literature to identify education interventions and resources that aimed to facilitate care home staff to meet their residents’ sexuality, intimacy and relational needs. Results Eleven studies (one dissertation) and three education resources met the inclusion criteria; most were conducted in the USA and Australia. Across the studies and resources identified, the education content was mixed and the methodology, presentation, design and duration varied widely. The focus of the education interventions and resources was to increase knowledge and improve and/or change attitudes towards the: (i) sexual expression of older people living in residential aged care, (ii) sexuality and ageing and (iii) expression of sexuality in people with dementia. Conclusion Few education interventions and training resources were identified. The findings suggest that education interventions can improve knowledge and/or change care staff attitudes, in the short-term, towards older people’s sexuality, intimacy and relational needs in care home settings, which can lead to facilitating staff to enhance person-centred care in this area of need.
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Affiliation(s)
- Maria Horne
- Faculty of Medicine and Health, School of Healthcare, University of Leeds, Leeds, UK
| | - Jane Youell
- Faculty of Medicine and Health, School of Healthcare, University of Leeds, Leeds, UK
| | - Laura J E Brown
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Paul Simpson
- Department of Applied Health and Social Care, Edge Hill University, Ormskirk, UK
| | - Tommy Dickinson
- Department of Mental Health Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
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The impact of mastectomy on Iranian women sexuality and body image: a systematic review of qualitative studies. Support Care Cancer 2021; 29:5571-5580. [PMID: 33754199 DOI: 10.1007/s00520-021-06153-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/16/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE Mastectomy in women is perceived as losing feminine identity and reducing sexual attraction. The aim of this review is to explore the perception and impacts of mastectomy on Iranian women with breast cancer on their sexuality and body image. METHODS The review used a systematic literature search that followed the guidelines of the Joanna Briggs Institute (JBI). The data sources PubMed, Scopus, Web of Science, Google Scholar, SID, ProQuest, MEDLINE, and CINAHL (via the EBSCOhost) were systematically searched. Quality appraisal, data extraction, and findings from the included studies were pooled using meta-aggregation with the Qualitative Assessment and Review Instrument (JBI-QARI). RESULTS Eight studies involving 163 women aged from 31 to 65 years, who had mastectomy, were included. A total of 31 findings were extracted and were aggregated into 4 categories and then further grouped into two synthesized findings: (1) fear of losing spouse's sexual monopoly and (2) overcoming the challenges of losing femininity. CONCLUSIONS This review found even in Muslim countries such as Iran women's breasts are perceived as sexually attractive, and changes in body shape can lead to subsequent challenges in marital relationships.
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26
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Nursing Students’ Perspectives on Sexual Development of Children with Intellectual Disability. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-021-09681-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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27
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Pardell-Dominguez L, Palmieri PA, Dominguez-Cancino KA, Camacho-Rodriguez DE, Edwards JE, Watson J, Leyva-Moral JM. The meaning of postpartum sexual health for women living in Spain: a phenomenological inquiry. BMC Pregnancy Childbirth 2021; 21:92. [PMID: 33509133 PMCID: PMC7844957 DOI: 10.1186/s12884-021-03578-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 01/20/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Sexual health is a multidimensional phenomenon constructed by personal, social, and cultural factors but continues to be studied with a biomedical approach. During the postpartum period, a woman transitions to mother, as well as partner-to-parent and couple-to-family. There are new realities in life in the postpartum period, including household changes and new responsibilities that can impact the quality of sexual health. This phenomenon is understudied especially in the context of Spain. The purpose of this study was to describe the lived experience of postpartum sexual health among primiparous women giving birth in Catalonia (Spain). METHODS This was a phenomenological study with a purposive sample of primiparous women. Data was collected through semi-structured interviews until saturation. Analysis followed Colaizzi's seven-step process with an eighth translation step added to limit cross-cultural threats to validity. Also, the four dimensions of trustworthiness were established through strategies and techniques during data collection and analysis. RESULTS Ten women were interviewed from which five themes emerged, including: Not feeling ready, inhibiting factors, new reality at home, socio-cultural factors, and the clinician within the health system. Returning to sexual health led women to engage in experiential learning through trial and error. Most participants reported reduced libido, experienced altered body image, and recounted resumption of sexual activity before feeling ready. A common finding was fatigue and feeling overloaded by the demands of the newborn. Partner support was described as essential to returning to a meaningful relationship. Discussions about postpartum sexual health with clinicians were described as taboo, and largely absent from the care model. CONCLUSION Evidence-based practices should incorporate the best evidence from research, consider the postpartum sexual health experiences and preferences of the woman, and use clinician expertise in discussions that include the topic of postpartum sexual health to make decisions. As such, human caring practices should be incorporated into clinical guidelines to recognize the preferences of women. Clinicians need to be authentically present, engage in active communication, and individualize their care. More qualitative studies are needed to understand postpartum sexual health in different contexts, cultures, and countries and to identify similarities and differences through meta-synthesis.
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Affiliation(s)
- Lidia Pardell-Dominguez
- Department d'Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213. Campus de la UAB, 08193, Bellaterra, (Cerdanyola del Vallès), Barcelona, Spain
| | - Patrick A Palmieri
- Vicerrectorado de Investigación, Universidad Norbert Wiener, Av. Arequipa 444, 15046, Lima, Peru. .,College of Graduate Health Studies, A. T. Still University, 800 West Jefferson Street, Kirksville, MO, 63501, USA. .,Center for Global Nursing, Texas Woman's University, 6700 Fannin Street, Houston, TX, 77030, USA. .,Center for Qualitative Research, EBHC South America: A Joanna Briggs Institute Affiliated Group, Calle Cartavio 402, 15023, Lima, Peru.
| | - Karen A Dominguez-Cancino
- Center for Qualitative Research, EBHC South America: A Joanna Briggs Institute Affiliated Group, Calle Cartavio 402, 15023, Lima, Peru.,Universidad Científica del Sur, Carr. Panamericana Sur 19, Villa EL Salvador, 15067, Lima, Peru.,Escuela de Salud Pública, Universidad de Chile, Independencia 939, Independencia, 8380453, Santiago de Chile, Chile
| | - Doriam E Camacho-Rodriguez
- Center for Qualitative Research, EBHC South America: A Joanna Briggs Institute Affiliated Group, Calle Cartavio 402, 15023, Lima, Peru.,School of Nursing, Universidad Cooperativa de Colombia, Calle 30, Santa Marta, Magdalena, Colombia
| | - Joan E Edwards
- Center for Global Nursing, Texas Woman's University, 6700 Fannin Street, Houston, TX, 77030, USA.,Nelda C. Stark College of Nursing, Texas Woman's University, 6700 Fannin St, Houston, TX, 77030, USA
| | - Jean Watson
- Watson Caring Science Institute, 4450 Arapahoe Avenue, Suite 100, Boulder, CO, 80304, USA.,College of Nursing, Anschutz Medical Campus University of Colorado, 13120 East 19th Avenue, Aurora, CO, 80045, USA
| | - Juan M Leyva-Moral
- Department d'Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213. Campus de la UAB, 08193, Bellaterra, (Cerdanyola del Vallès), Barcelona, Spain.,Center for Global Nursing, Texas Woman's University, 6700 Fannin Street, Houston, TX, 77030, USA.,Center for Qualitative Research, EBHC South America: A Joanna Briggs Institute Affiliated Group, Calle Cartavio 402, 15023, Lima, Peru
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28
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Spousal sexual life issues after gynecological cancer: a qualitative study. Support Care Cancer 2021; 29:3857-3864. [PMID: 33386988 DOI: 10.1007/s00520-020-05912-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Sexual life is a multidimensional issue that can be affected negatively after gynecological cancer. The aim of this study was to reveal what sexuality life difficulties Iranian women with gynecological cancers experience. METHODS A qualitative approach was conducted through face-to-face semi-structured interviews with 16 Iranian women with gynecological cancer and then analyzed with conventional content analysis. RESULTS Three themes emerged from the data: (1) participant's struggle to maintain the sexual monopoly of the husband, (2) deterioration of intimacy, and (3) unpleasant bed-life experiences. Most women are ashamed to talk about their sexual relationships problems, and on the other hand, nurses and physicians ignore to talk about their sexual problems, so these women are alone in the face of this problem. CONCLUSION Although women with gynecological cancer experience sexual problems such as reluctant to have sex and lack of enjoyment, they struggle to maintain sexual life with their husbands. These women do not have enough support. They believe that sexuality is a shameful issue, and they are reluctant to ask questions about it. Health professionals need to talk about the possibility of sexual problems due to changes in their bodies caused by cancer. These women need to be encouraged to talk about these problems, with consideration to their religious and cultural differences.
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Abstract
Technology is giving rise to artificial erotic agents, which we call erobots (erôs + bot). Erobots, such as virtual or augmented partners, erotic chatbots, and sex robots, increasingly expose humans to the possibility of intimacy and sexuality with artificial agents. Their advent has sparked academic and public debates: some denounce their risks (e.g., promotion of harmful sociosexual norms), while others defend their potential benefits (e.g., health, education, and research applications). Yet, the scientific study of human-machine erotic interaction is limited; no comprehensive theoretical models have been proposed and the empirical literature remains scarce. The current research programs investigating erotic technologies tend to focus on the risks and benefits of erobots, rather than providing solutions to resolve the former and enhance the latter. Moreover, we feel that these programs underestimate how humans and machines unpredictably interact and co-evolve, as well as the influence of sociocultural processes on technological development and meaning attribution. To comprehensively explore human-machine erotic interaction and co-evolution, we argue that we need a new unified transdisciplinary field of research-grounded in sexuality and technology positive frameworks-focusing on human-erobot interaction and co-evolution as well as guiding the development of beneficial erotic machines. We call this field Erobotics. As a first contribution to this new discipline, this article defines Erobotics and its related concepts; proposes a model of human-erobot interaction and co-evolution; and suggests a path to design beneficial erotic machines that could mitigate risks and enhance human well-being.
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Affiliation(s)
- Simon Dubé
- Department of Psychology, Concordia University, Montreal, QC Canada
| | - Dave Anctil
- Department of Philosophy, Jean-de-Brebeuf College, Montreal, QC Canada
- Observatoire sur les Impacts Sociétaux de l’Intelligence Artificielle et du Numérique, Laval University, Québec, QC Canada
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Heredia D, Rider GN. Intersectionality in Sex Therapy: Opportunities for Promoting Sexual Wellness Among Queer People of Color. CURRENT SEXUAL HEALTH REPORTS 2020. [DOI: 10.1007/s11930-020-00270-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mantica G, De Rose AF, Ambrosini F, Gallo F, Gaboardi F, Durand F, Van der Merwe A, Terrone C. The Italian andrology patient is changing. Broader cultural knowledge is needed! Int J Impot Res 2020; 33:572-573. [PMID: 32286526 DOI: 10.1038/s41443-020-0280-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/06/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Guglielmo Mantica
- Department of Urology-Policlinico San Martino Hospital, University of Genova, Genova, Italy.
| | - Aldo Franco De Rose
- Department of Urology-Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Francesca Ambrosini
- Department of Urology-Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Fabrizio Gallo
- Department of Urology, San Paolo Hospital, Savona, Italy
| | - Franco Gaboardi
- Department of Urology-San Raffaele Turro Hospital, San Raffaele University, Milan, Italy
| | - Felice Durand
- Department of Urology-Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - André Van der Merwe
- Department of Urology, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Carlo Terrone
- Department of Urology-Policlinico San Martino Hospital, University of Genova, Genova, Italy
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Chapa HO, Fish JT, Hagar C, Wilson T. Prevalence of female sexual dysfunction among women attending college presenting for gynecological care at a university student health center. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:52-60. [PMID: 30388952 DOI: 10.1080/07448481.2018.1515751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 07/09/2018] [Accepted: 08/19/2018] [Indexed: 06/08/2023]
Abstract
Objective: To estimate the prevalence of female sexual dysfunction (FSD) among women attending college (18-29 years of age) presenting for routine gynecological care at a university-based student health center. Participants: Location: University affiliated women's health care clinic. Methods: Study design: Descriptive, cross sectional study. Primary endpoint: Estimated prevalence of FSD in the 18-29-year- old population. A subanalysis between those with and without recent sexual activity was performed. Logistic Regression was performed to identify potential predictors of FSD among those affected. Results: Of 310 women, FSFI was estimated as ranging from 35.5% (not sexually active) to 42.3% (sexually active). Those of younger age (18-21), with prior mental health diagnosis, and self-reported problems with arousal were at increased risk for FSD. Conclusion: Screening for FSD in the 18-29-year-old population is justified and recommended.
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Affiliation(s)
- Hector O Chapa
- Texas A&M University, College of Medicine, Bryan, TX, USA
| | - James T Fish
- Texas A&M University, Student Health Services, College Station, TX, USA
| | - Carley Hagar
- Texas A&M University, Rudder Tower, College Station, TX, USA
| | - Tiffany Wilson
- Texas A&M University, Rudder Tower, College Station, TX, USA
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Rubin JD, Conley TD, Klein V, Liu J, Lehane CM, Dammeyer J. A cross-national examination of sexual desire: The roles of ‘gendered cultural scripts’ and ‘sexual pleasure’ in predicting heterosexual women's desire for sex. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2019.07.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Papadopoulou C, Sime C, Rooney K, Kotronoulas G. Sexual health care provision in cancer nursing care: A systematic review on the state of evidence and deriving international competencies chart for cancer nurses. Int J Nurs Stud 2019; 100:103405. [DOI: 10.1016/j.ijnurstu.2019.103405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 07/02/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022]
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Tirgari B, Rafati F, Mehdipour Rabori R. Effect of Sexual Rehabilitation Program on Anxiety, Stress, Depression and Sexual Function among Men with Coronary Artery Disease. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:632-642. [PMID: 30912471 DOI: 10.1080/0092623x.2019.1599091] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background: Patients with coronary artery disease suffer from diminished sexual activity leading to anxiety, stress, and depression. Sexual rehabilitation is the key to the care and treatment process of such patients. Purpose: The present study aimed to examine the effect of sexual rehabilitation program on anxiety, stress, depression and sexual function in men with coronary artery disease. Methods: This was a clinical trial study conducted on 80 male patients suffering from coronary artery disease referred to CCU (Coronary Care Unit) wards in Kerman, Iran. Sample was randomly assigned into two intervention and control groups. The intervention consisted of the sexual rehabilitation program which included two components of education and exercise. Using IIEF (International Index of Erectile Function) and DASS21 (Depression, Anxiety, Stress Scale) anxiety, stress, depression and sexual function have been examined before and one-month after intervention in the two groups. The collected data were analyzed with SPSS version 19 (IBM, Armonk, New York), using descriptive and inferential statistics (such as Pearson correlation coefficient, independent t test, and analysis of variance). Results: Result showed that the intervention group had significantly lower mean scores in anxiety, stress, depression and sexual function compared to the control group (p < 0.0001). Conclusion: According to the results, sexual rehabilitation reduced anxiety, stress, and depression and improved sexual function among men with coronary artery disease. Therefore, it is recommended sexual rehabilitation be an integral part of cardiac rehabilitation.
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Affiliation(s)
- Batool Tirgari
- Nursing Research Center, School of Nursing And Midwifery, Kerman University of Medical Sciences , Kerman , Iran
| | - Fatemeh Rafati
- Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences , Kerman , Iran
| | - Roghayeh Mehdipour Rabori
- Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences , Kerman , Iran
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Kietpeerakool C, Aue‐aungkul A, Galaal K, Ngamjarus C, Lumbiganon P. Nerve-sparing radical hysterectomy compared to standard radical hysterectomy for women with early stage cervical cancer (stage Ia2 to IIa). Cochrane Database Syst Rev 2019; 2:CD012828. [PMID: 30746689 PMCID: PMC6370917 DOI: 10.1002/14651858.cd012828.pub2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Radical hysterectomy is one of the standard treatments for stage Ia2 to IIa cervical cancer. Bladder dysfunction caused by disruption of the pelvic autonomic nerves is a common complication following standard radical hysterectomy and can affect quality of life significantly. Nerve-sparing radical hysterectomy is a modified radical hysterectomy, developed to permit resection of oncologically relevant tissues surrounding the cervical lesion, while preserving the pelvic autonomic nerves. OBJECTIVES To evaluate the benefits and harms of nerve-sparing radical hysterectomy in women with stage Ia2 to IIa cervical cancer. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 4), MEDLINE via Ovid (1946 to May week 2, 2018), and Embase via Ovid (1980 to 2018, week 21). We also checked registers of clinical trials, grey literature, reports of conferences, citation lists of included studies, and key textbooks for potentially relevant studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) evaluating the efficacy and safety of nerve-sparing radical hysterectomy compared to standard radical hysterectomy for women with early stage cervical cancer (stage Ia2 to IIa). DATA COLLECTION AND ANALYSIS We applied standard Cochrane methodology for data collection and analysis. Two review authors independently selected potentially relevant RCTs, extracted data, evaluated risk of bias of the included studies, compared results and resolved disagreements by discussion or consultation with a third review author, and assessed the certainty of evidence. MAIN RESULTS We identified 1332 records as a result of the search (excluding duplicates). Of the 26 studies that potentially met the review criteria, we included four studies involving 205 women; most of the trials had unclear risks of bias. We identified one ongoing trial.The analysis of overall survival was not feasible, as there were no deaths reported among women allocated to standard radical hysterectomy. However, there were two deaths in among women allocated to the nerve-sparing technique. None of the included studies reported rates of intermittent self-catheterisation over one month following surgery. We could not analyse the relative effect of the two surgical techniques on quality of life due to inconsistent data reported. Nerve-sparing radical hysterectomy reduced postoperative bladder dysfunctions in terms of a shorter time to postvoid residual volume of urine ≤ 50 mL (mean difference (MD) -13.21 days; 95% confidence interval (CI) -24.02 to -2.41; 111 women; 2 studies; low-certainty evidence) and lower volume of postvoid residual urine measured one month following operation (MD -9.59 days; 95% CI -16.28 to -2.90; 58 women; 2 study; low-certainty evidence). There were no clear differences in terms of perioperative complications (RR 0.55; 95% CI 0.24 to 1.26; 180 women; 3 studies; low-certainty evidence) and disease-free survival (HR 0.63; 95% CI 0.00 to 106.95; 86 women; one study; very low-certainty evidence) between the comparison groups. AUTHORS' CONCLUSIONS Nerve-sparing radical hysterectomy may lessen the risk of postoperative bladder dysfunction compared to the standard technique, but the certainty of this evidence is low. The very low-certainty evidence for disease-free survival and lack of information for overall survival indicate that the oncological safety of nerve-sparing radical hysterectomy for women with early stage cervical cancer remains unclear. Further large, high-quality RCTs are required to determine, if clinically meaningful differences of survival exist between these two surgical treatments.
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Affiliation(s)
- Chumnan Kietpeerakool
- Khon Kaen UniversityDepartment of Obstetrics and Gynaecology, Faculty of Medicine123 Mitraparb RoadAmphur MuangKhon KaenThailand40002
| | - Apiwat Aue‐aungkul
- Khon Kaen UniversityDepartment of Obstetrics and Gynaecology, Faculty of Medicine123 Mitraparb RoadAmphur MuangKhon KaenThailand40002
| | - Khadra Galaal
- Princess Alexandra Wing, Royal Cornwall HospitalGynaecological OncologyTruroUKTR1 3LJ
| | - Chetta Ngamjarus
- Khon Kaen UniversityDepartment of Epidemiology and Biostatistics, Faculty of Public Health123 Miltraparp RoadKhon KaenKhon KaenThailand40002
| | - Pisake Lumbiganon
- Khon Kaen UniversityDepartment of Obstetrics and Gynaecology, Faculty of Medicine123 Mitraparb RoadAmphur MuangKhon KaenThailand40002
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Wang P, Ai J, Davidson PM, Slater T, Du R, Chen C. Nurses' attitudes, beliefs and practices on sexuality for cardiovascular care: A cross-sectional study. J Clin Nurs 2018; 28:980-986. [PMID: 30338867 DOI: 10.1111/jocn.14692] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/21/2018] [Accepted: 09/30/2018] [Indexed: 12/18/2022]
Abstract
AIMS AND OBJECTIVES To describe nurses' attitudes, beliefs, and practices regarding sexuality care for patients with cardiovascular disease. BACKGROUND Limited sexual activity is common among patients with cardiovascular disease, yet assessment of sexuality and counselling is frequently not undertaken by nurses. DESIGN Cross-sectional study. METHODS This study recruited 268 cardiac nurses from seven tertiary hospitals in five cities of Henan province. The Sexual Attitudes and Beliefs Survey, along with investigator-developed questions regarding practices and perceived barriers, was administered to the nurses. The STROBE checklist was used to ensure quality reporting during this observational study (see Supporting Information Data S1). RESULTS The average age of nurses who participated was 31.81 years (SD = 7.41). The average score of Sexual Attitudes and Beliefs Survey was 47.72 (SD = 7.40), indicating moderate attitudinal barriers for nurses to discuss sexual activities with patients. Most nurses (91%) perceived that sexuality was too private to discuss with patients. Only 20% of nurses expressed that they would provide time to discuss sexual concerns with patients. Eighty per cent of nurses revealed that they felt uncomfortable discussing sexuality; moreover, they believed that hospitalised patients were too sick to be engaged in these types of conversations. Additionally, almost 85% of nurses conveyed that they have never conducted discussions regarding sexuality care in patients with cardiovascular disease. The most frequently reported perceived barriers preventing nurses from discussing sexual concerns included fear of offending patients (77.2%), uncertainty of how to communicate with patients (69.4%), feelings of embarrassment (67.5%), lack of safe and private environments (61.9%) and lack of knowledge (54.9%). CONCLUSION Nurses in this cross-sectional sample rarely discussed sexual concerns with their patients. There were several key barriers identified by nurses regarding providing sexuality care, including personal attitudes and beliefs, limited skills and knowledge, culture and organizational-related barriers. RELEVANCE TO CLINICAL PRACTICE Targeted training for nurses and creating a culturally safe environment is recommended to improve management of sexuality in patients with CVD.
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Affiliation(s)
- Panpan Wang
- School of Nursing, Zhengzhou University, Zhengzhou, China.,Nursing Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiansai Ai
- Nursing Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Patricia M Davidson
- Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Tammy Slater
- Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Ruofei Du
- Nursing Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Changying Chen
- School of Nursing, Zhengzhou University, Zhengzhou, China.,Nursing Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Wendland EM, Horvath JDC, Kops NL, Bessel M, Caierão J, Hohenberger GF, Domingues CM, Maranhão AGK, de Souza FMA, Benzaken AS. Sexual behavior across the transition to adulthood and sexually transmitted infections: Findings from the national survey of human papillomavirus prevalence (POP-Brazil). Medicine (Baltimore) 2018; 97:e11758. [PMID: 30113461 PMCID: PMC6112916 DOI: 10.1097/md.0000000000011758] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 07/07/2018] [Indexed: 11/26/2022] Open
Abstract
The sexual behaviors of 15- to 24-year-olds increase the risk of this population to acquire sexually transmitted infections (STIs). The present study aimed to describe the sexual behavior in the transition to adulthood Brazilian population and its association with STI history.We analyzed cross-sectional data collected from 8562 sexually active women and men who participated in the National Survey of Human Papillomavirus Prevalence (POP-Brazil). This large-scale survey enrolled participants from 26 Brazilian capitals and the Federal District. Professionals from primary care facilities were trained to collect data utilizing a standardized questionnaire with questions on sociodemographic, sexual behavior, and drug use. We constructed a Poisson model with robust variance for both crude and adjusted analysis to investigate the associations between the variables. To adjust the distribution of the sample to the study population, we weighted the measures by the population size in each city and by gender.There were differences in several aspects from sexual behavior between genders. The majority of men reported an early sexual initiation, more sexual partners, and a different practice in sexual positions when compared with women. Women reported use of contraception more frequently than men (P < .001). The use of alcohol and drugs and the use of drugs before sexual intercourse impact in STIs equally between the genders. Exclusive for women, the presence of any STI was associated with the practice of vaginal sex and other types of intercourse (adjusted prevalence ratio [APR] 1.43, 95% CI 1.08-1.88). For men, the number of sexual partners in the last year (APR 1.02, 95% CI 1.01-1.04), not having vaginal sex (APR 3.25, 95% CI 1.78-5.92) and sexual experience with someone of the same sex (APR 4.05, 95% CI, 2.88-5.70) were associated with a higher presence of STIs.This is the first report regarding sexual behavior in a nationally representative population sample in Brazil. This study provides more valid estimates of sexual behavior and associated STIs, identifying important differences in sexual behavior and identifying predictors for referred STIs among females and males.
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Affiliation(s)
- Eliana Marcia Wendland
- Hospital Moinhos de Vento
- Federal University of Health Science of Porto Alegre, Porto Alegre, Brazil
| | | | | | | | | | | | | | | | - Flavia Moreno Alves de Souza
- Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis, Brazilian Ministry of Health, Brazil
| | - Adele Schwartz Benzaken
- Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis, Brazilian Ministry of Health, Brazil
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