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The impact of heart failure on the sexual response cycle: A systematic review. Heart Lung 2022; 56:50-56. [PMID: 35709645 DOI: 10.1016/j.hrtlng.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Heart failure (HF) is the most prevalent disease among chronic diseases and has been associated with a high prevalence of erectile dysfunction (ED). OBJECTIVE this study aims to analyze research that has as its object of study the sexual activity of patients with HF. METHODS A high-sensitivity search was performed in databases (PUBMED via MEDLINE, Cochrane, EMBASE, Web of Science, SCOPUS AND CINAHL) using descriptors linked to sexuality and heart failure. RESULTS Fifteen studies from 7 countries with a total sample of 6244 participants were included. CONCLUSION It was identified that patients with HF have alterations in their sexual activities, which are more common in males. Among men, it was noticed that the most reported sexual disorder was erectile dysfunction.
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Gerbild H, Areskoug Josefsson K, Marie Larsen C, Schantz Laursen B. Communication about physical activity to reduce vascular erectile dysfunction - A qualitative interview study among men in cardiac rehabilitation. Scand J Caring Sci 2021; 36:839-851. [PMID: 34288023 DOI: 10.1111/scs.13021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Physical activity, a core intervention in cardiac rehabilitation, can reduce vascular erectile dysfunction (ED). ED is a common sensitive problem for men with cardiac diseases, decreasing their quality of life. Cardiac health professionals rarely provide information about ED or its relation to physical activity. Developing health professionals' communicative component of the complex intervention 'Physical Activity to reduce Vascular Erectile Dysfunction' (PAVED) is important. Understanding the receiver needs is essential in designing a complex intervention. AIM To elucidate men's perspectives on cardiac health professionals' communication about PAVED. ETHICAL ISSUES An Institutional Data Protection Agency approved the study. METHODS An interpretive data-driven thematic analysis was applied to individual, qualitative semi-structured interviews with 20 Danish men attending cardiac rehabilitation. RESULTS The men wanted health professionals' communicating about ED, as it was perceived as a major problem diminishing masculinity and tabooed by health professionals. Men wanted help for self-help, which may be possible with the aid of competent health professionals' communication about how to prevent, reduce and cope with ED - including information about PAVED. The men wanted health professionals' communication about ED in various contexts: general information in groups, sexual counselling for individuals and couples and written material. STUDY LIMITATIONS Recruitment was done from a Danish municipality's cardiac rehabilitation, and the transferability of the results may be limited to similar contexts. CONCLUSION Erectile dysfunction was experienced as a major biopsychosocial problem for the men and their partners. The men had a need for health professionals' communication about sexuality, ED and information about PAVED as well as about prevention, reduction and management of ED. The men had a need for professional communication about sexual health.
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Affiliation(s)
- Helle Gerbild
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristina Areskoug Josefsson
- Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Sandnes, Norway.,School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Camilla Marie Larsen
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Birgitte Schantz Laursen
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Nursing Research Unit & Sexological Centre, Aalborg University Hospital, Aalborg, Denmark
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3
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Gerbild H, Areskoug-Josefsson K, Larsen CM, Laursen BS. Acceptability of Health Professionals' Address of Sexuality and Erectile Dysfunction - A Qualitative Interview Study with Men in Cardiac Rehabilitation. Sex Med 2021; 9:100369. [PMID: 34087535 PMCID: PMC8240334 DOI: 10.1016/j.esxm.2021.100369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION In the developing phase of the complex health intervention: Physical Activity to reduce Vascular Erectile Dysfunction (PAVED), it is crucial to explore whether men can accept the communicative component regarding information that regular aerobe Physical Activity can reduce Erectile Dysfunction (i-PAVED). This information is provided by health professionals (HPs) in cardiac rehabilitation, where sexuality issues such as erectile dysfunction (ED) are otherwise rarely addressed. AIM To explore how acceptance of cardiac HPs' address of sexuality, ED, and i-PAVED can be identified in men's narratives. METHODS In this descriptive qualitative study, we conducted semi-structured individual interviews with 20 men (range 48-78 years of age) attending municipal cardiac secondary prevention and rehabilitation programmes on their acceptance of HPs' address of sexuality, ED, and i-PAVED. The Theoretical Framework of Acceptability components (affective attitude, burden, ethicality, intervention coherence, perceived effectiveness, opportunity costs and self-efficacy) and three temporal perspectives (retrospective, concurrent and prospective) were used in the concept-driven first step of a content analysis, which was followed by a thematically data-driven second step. MAIN OUTCOME MEASURES Men anticipated and experiential acceptance was identified in six out of seven components of Theoretical Framework of Acceptability. RESULTS Men acceptance was identified as "expression of interest," "addressing sexuality," "attitudes and values," "understandable and meaningful," "insights" and "motivation," whereas no narratives were identified in relation to the component of opportunity costs. CONCLUSION As an aspect of the development of the complex cardiovascular health care intervention PAVED, this qualitative study showed that men attending cardiac secondary prevention and rehabilitation seemed to prospectively accept the communicative component of PAVED being HPs' address of sexuality, ED, and i-PAVED, if the HPs are professional, educated and competent in the field of sexual health. Gerbild H, Areskoug-Josefsson K, Larsen CM, et al. Acceptability of Health Professionals' Address of Sexuality and Erectile Dysfunction - A Qualitative Interview Study with Men in Cardiac Rehabilitation. Sex Med 2021;9:100369.
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Affiliation(s)
- Helle Gerbild
- Health Sciences Research Centre, UCL University College, Odense, Denmark; Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Kristina Areskoug-Josefsson
- Faculty of Health Science, VID Specialized University, Sandnes, Norway; School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden; Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Camilla Marie Larsen
- Health Sciences Research Centre, UCL University College, Odense, Denmark; Department of Sports Science and Clinical Biomechanics; University of Southern Denmark, Odense, Denmark
| | - Birgitte Schantz Laursen
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Clinical Nursing Research Unit, Aalborg University hospital, Denmark
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4
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Albers LF, van Belzen MA, van Batenburg C, Engelen V, Putter H, den Ouden MEM, Pelger RCM, Elzevier HW. Sexuality in Intimate Partners of People with Cancer: Information and Communication Needs: A Brief Communication. JOURNAL OF SEX & MARITAL THERAPY 2020; 47:197-203. [PMID: 33150859 DOI: 10.1080/0092623x.2020.1828206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Partners of patients with cancer report a negative impact on their sexuality and intimacy and experience a lack of information. Little is known about partners' information needs regarding sexuality and intimacy. The study was conducted with 230 partners of patients with cancer using a questionnaire. 56% stated that cancer had negatively affected their sexuality and intimacy. 60% percent reported a need for information. Except a self-reported negative impact of cancer, no characteristics were associated with a higher need for sexuality related information. Partners prefer information that includes practical advice and experiences from others. It is recommended to provide patients and their partner's information on sexuality and intimacy within routine treatment.
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Affiliation(s)
- Leonore F Albers
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | | | | | - Vivian Engelen
- Dutch Federation of Cancer Patient Organizations, Utrecht, The Netherlands
| | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Marjolein E M den Ouden
- Research Center Technology, Health & Care, Saxion University of Applied Sciences, Enschede, The Netherlands
| | - Rob C M Pelger
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - Henk W Elzevier
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
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5
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Discussing sexuality in cancer care: towards personalized information for cancer patients and survivors. Support Care Cancer 2020; 28:4227-4233. [PMID: 31900615 DOI: 10.1007/s00520-019-05257-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/20/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The needs of cancer patients and survivors regarding discussing sexuality are frequently unmet, with many not receiving adequate information. To optimize information about sexuality and cancer, patients' perspective is needed. The goals of this study were to investigate what kind of information Dutch cancer patients need, their ideas on how to improve communication, and to identify patients who are more in need of information regarding sexuality. METHODS The Dutch Federation of Cancer Patient Organizations developed and conducted a nationwide 28-item online survey. The survey was distributed among cancer patients and survivors. RESULTS In total, 2657 (ex) cancer patients participated, with a median age of 61 years, and half were male (45.2%). Of the respondents, 65% were in need of information about sexuality. Patients ≤ 61 years (p < 0.001), patients with a self-reported negative effect of cancer on sexuality (p < 0.001) and patients who were diagnosed less than 2 years ago (p < 0.04) reported a higher need for information. Regardless of type of cancer, patients were most in need of practical tips and practical information regarding sexuality. To enhance communication about sexuality, 64% of the respondents suggested that it would be of help if care providers give information as standard care. CONCLUSIONS (Ex) cancer patient prefer to receive standard information about sexuality by their care providers. According to patients' preferences, information must include practical tips. Age, self-reported negative effect on sexuality status and time from diagnoses influenced the need for information.
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Albers LF, Haj Mohammad SF, Husson O, Putter H, Pelger RCM, Elzevier HW, Manten-Horst E. Exploring Communication About Intimacy and Sexuality: What Are the Preferences of Adolescents and Young Adults with Cancer and Their Health Care Professionals? J Adolesc Young Adult Oncol 2019; 9:222-238. [PMID: 31670579 DOI: 10.1089/jayao.2019.0065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Purpose: Negative impact of cancer on sexuality is widely known. In adolescents and young adults with cancer (AYA; 15-39 years), treatment can even have a bigger impact as it may interfere with sexual development. AYAs report unmet psychosexual needs, like inadequate support from health care professionals (HCPs). The aim of this study was to determine preferences of AYAs regarding communication about intimacy and sexuality and examine discrepancies between AYA and HCP. Methods: A cross-sectional survey was conducted among AYAs and HCPs in the Netherlands. Results: Communication about sexuality was considered important by >90% of AYAs and HCPs. Of the AYAs, 41% did receive information from a HCP, 21% of them was satisfied with it. HCPs held physicians and nurse practitioners responsible to discuss sexuality; AYAs preferred nurse practitioners and sexologists. Main barriers to initiate a discussion on sexuality are "feeling of shame" for AYAs and "presence of a third party" for HCPs. Most AYAs would like to receive information about sexuality through a website (66%) or conversation with a HCP (64%) before start of treatment (64%). HCPs would be helped by written material (75%) and additional training (71%) to give to AYAs. Conclusion: AYAs do report unmet needs regarding adequate communication about sexuality-related issues. Discrepancy between patients and HCPs illustrates the importance of patient participation. Future research needs to focus on interventions to improve sexuality-related information provision and implementation of these interventions.
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Affiliation(s)
- Leonore F Albers
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - Soemeya F Haj Mohammad
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - Olga Husson
- Dutch AYA "Young and Cancer" Platform, Utrecht, The Netherlands.,Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, The Netherlands.,Division of Clinical Studies, Institute of Cancer Research, London, United Kingdom
| | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Rob C M Pelger
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - Henk W Elzevier
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
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7
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Abstract
PURPOSE OF THE REVIEW To review the current state of literature on sexual dysfunction in adults with congenital heart disease (ACHD). RECENT FINDINGS The prevalence of sexual dysfunction in ACHD is approximately 28%. Compared to age-matched cohorts, the prevalence of sexual dysfunction among ACHD cohorts demonstrates significant variability. ACHD have a lower rate of ever having sexual intercourse and often at a later age. Regardless of complexity, ACHD with sexual dysfunction have higher level of distress, decreased quality of life, and worse New York Heart Association classification. Patients, including heart failure and ACHD, treated with dual angiotensin receptor neprilysin inhibitor have reported improved sexual relationships. The prevalence of sexual dysfunction in ACHD patients is high and sexual dysfunction research in ACHD remains limited. Therefore, the relationship between sexual dysfunction and ACHD remains ill-defined. Cardiologists that participate in the care of these patients should proactively discuss sexual health and provide counseling and therapies to provide high-quality healthcare for ACHD.
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Affiliation(s)
- Sihong Huang
- Congenital Heart Center, Spectrum Health Helen DeVos Children's Hospital, 100 Michigan Street NE (MC248), Grand Rapids, MI, 49503, USA
- Pediatrics and Human Development, Michigan State University College of Human Medicine, 15 Michigan NE, Grand Rapids, MI, USA
- Congenital Heart Center, MC 248, 25 Michigan Street NE, Suite 4200, Grand Rapids, MI, 49503, USA
| | - Stephen C Cook
- Congenital Heart Center, Spectrum Health Helen DeVos Children's Hospital, 100 Michigan Street NE (MC248), Grand Rapids, MI, 49503, USA.
- Pediatrics and Human Development, Michigan State University College of Human Medicine, 15 Michigan NE, Grand Rapids, MI, USA.
- Congenital Heart Center, MC 248, 25 Michigan Street NE, Suite 4200, Grand Rapids, MI, 49503, USA.
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8
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Kałka D, Karpiński Ł, Gebala J, Rusiecki L, Biełous-Wilk A, Krauz ES, Piłot M, Womperski K, Rusiecka M, Pilecki W. Sexual health of male cardiac patients - present status and expectations of patients with coronary heart disease. Arch Med Sci 2017; 13:302-310. [PMID: 28261282 PMCID: PMC5332461 DOI: 10.5114/aoms.2017.65332] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/17/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Due to the pathogenetic association between erectile disorders and cardiovascular diseases, cardiologists consult many patients with erectile dysfunction (ED). The aim of the study was to evaluate sexual function in patients with coronary heart disease (CHD) and the use of sexual knowledge in cardiology practice, both current use and that expected by patients. MATERIAL AND METHODS One thousand one hundred and thirty-six patients (average age: 60.73 ±9.20) underwent a dedicated survey which encompassed demographic data and the presence of modifiable ED risk factors. The presence of ED was assessed using the International Index of Erectile Function (IIEF-5) Questionnaire. RESULTS Sexual problems were discussed by cardiologists with 45 (3.96%) patients. The frequency of initiating the topic was significantly associated with the respondents' education level (p = 0.0031); however, it was not associated with the patients' age, duration of CHD, presence of ED, or modifiable risk factors. Four hundred and sixteen (36.62%) respondents indicated that they expect their cardiologist to take an interest in their ED. Nine hundred and twenty-six (81.51%) patients claimed good sexual function to be important or very important to them. Attitude to sexual function was significantly associated with age (p < 0.0001), duration of CHD (p = 0.0018), education (p = 0.0011), presence of ED (p = 0.0041), diabetes (p = 0.0283) and hyperlipidaemia (p = 0.0014). CONCLUSIONS The low frequency with which cardiologists initiate the topic of ED is in contrast to the expectations of patients with CHD. The majority of these patients regard good sexual maintenance as an important part of their life.
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Affiliation(s)
- Dariusz Kałka
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
- Center of Men’s Health, Wroclaw, Poland
| | - Łukasz Karpiński
- Center of Men’s Health, Wroclaw, Poland
- Center of Cardiac Prevention and Rehabilitation CREATOR, Wroclaw, Poland
| | | | - Lesław Rusiecki
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
| | - Anna Biełous-Wilk
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
| | - Ewa S. Krauz
- Department of Cardiac Rehabilitation, Lower Silesian Heart Diseases Centre “Medinet”, Wroclaw, Poland
| | - Magdalena Piłot
- Department of Cardiac Rehabilitation, Centre of Cardiac Rehabilitation and Cardiac Prevention, Glucholazy, Poland
| | - Krzysztof Womperski
- Department of Cardiac Rehabilitation, Hospital of the Ministry of Interior, Glucholazy, Poland
| | - Małgorzata Rusiecka
- Department of Oncology and Gynaecologic Oncology, Medical University of Wroclaw, Wroclaw, Poland
| | - Witold Pilecki
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
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9
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Nicolai MPJ, Elzevier HW. In response to letter to the editor: Time to integrate sexual function in the health-related quality of life of patients with left ventricular assist devices: The problem is the implementation of sexual healthcare in cardiology. Heart Lung 2017; 46:133-134. [PMID: 28162828 DOI: 10.1016/j.hrtlng.2017.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/09/2016] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
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10
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Salehian R, Khodaeifar F, Naserbakht M, Meybodi A. Attitudes and Performance of Cardiologists Toward Sexual Issues in Cardiovascular Patients. Sex Med 2016; 5:e44-e53. [PMID: 27988217 PMCID: PMC5302380 DOI: 10.1016/j.esxm.2016.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/12/2016] [Accepted: 09/19/2016] [Indexed: 12/22/2022] Open
Abstract
Introduction The aim of the present study was to evaluate the attitudes and performance of cardiologists regarding sexual issues in patients with cardiovascular diseases. Methods A nationwide survey was conducted in a sample of cardiologists, representative of Iranian cardiologists, in 2015. Main Outcome Measures Appropriate questionnaires were developed and used to ask participants about their attitudes, performance, and barriers regarding discussing sexual issues with patients with cardiovascular disease. Results The study population consisted of 202 cardiologists (138 men and 63 women) with a mean age of 44.25 years (SD = 8.45). Overall, 93.15% of cardiologists agreed with the importance of discussing sexual issues with their patients with cardiovascular diseases. Almost 76.7% of cardiologists agreed they had a responsibility to deal with patients' sexual problems, and 79.9% of them were aware of the association of cardiovascular disease with sexual problems of cardiac patients, but only 33% of them were confident in their knowledge and skills in this regard. Only 10.6% of cardiologists reported they frequently or always assessed sexual problems with their patients, but 51.50% of them stated they were responding to patients' questions about sexual problems. There was a significant association between performance and responsibility. Conclusion The results of this study indicate a gap between cardiologist's attitudes and their actual performance and that their professional responsibility to address patients' sexual issues is a significant parameter for better performance.
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Affiliation(s)
- Razieh Salehian
- School of Behavioral Science and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran.
| | - Fatemeh Khodaeifar
- Iran University of Medical Sciences, Mental Health Research Center, Tehran, Iran
| | - Morteza Naserbakht
- School of Behavioral Science and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran
| | - Azadeh Meybodi
- School of Behavioral Science and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran
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11
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Steinke EE, Jaarsma T. Sexual counseling and cardiovascular disease: practical approaches. Asian J Androl 2016; 17:32-9. [PMID: 25219908 PMCID: PMC4291873 DOI: 10.4103/1008-682x.135982] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Patients with cardiovascular disease and their partners expect health care providers to provide sexual counseling to assist them in maintaining sexual quality of life. Evidence suggests however, that there is a gap in integrating evidence into practice and that relatively few cardiac patients receive sexual counseling. This can result in negative psychological, physical, and quality of life outcomes for couples who may needlessly decide sexual activity is too risky and cease all sexual activity. Two scientific statements now exist that provide ample guidance to health care providers in discussing this important topic. Using a team approach that includes physicians, nurses, physical therapists, rehabilitation staff, and others is important to ensure that sexual counseling occurs throughout recovery. In addition, several trials using interventional approaches for sexual counseling provide insight into successful approaches for sexual counseling in practice. This article provides practical strategies and evidence-based approaches for assessment and sexual counseling for all cardiac patients and their partners, and specific counseling for those with ischemic conditions, heart failure, and implanted devices.
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Affiliation(s)
- Elaine E Steinke
- School of Nursing, Wichita State University, 1845 Fairmount, Wichita, Kansas, USA
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12
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Abstract
PURPOSE OF REVIEW Erectile dysfunction is a common sexual disorder affecting 40% of men in the United States. However, the pathophysiologic mechanism involved in the causation of erectile dysfunction is multifactorial and not well delineated. RECENT FINDINGS Several recent studies disclose that erectile dysfunction is the result of multiple interrelated comorbid conditions that include hypertension, coronary artery disease (CAD), heart failure, and diabetes mellitus among them. In addition to comorbid conditions, certain cardiovascular and antihypertensive drugs are also involved in the development of erectile dysfunction, with the most prominent being the thiazide type diuretics, the aldosterone receptor blockers, and the β-adrenergic receptor blockers. Also, knowledge by the patient of the drug and its action on erectile dysfunction may increase the incidence of erectile dysfunction (Hawthorn effect). Before treatment is initiated, patients should be screened for the presence of erectile dysfunction, because this condition is associated with hypertension, CAD, heart failure, diabetes mellitus, and their treatment and an appropriate treatment regimen should be selected. If that fails, the addition of phosphodiesterase 5 inhibitors to the treatment regimen is recommended. The only exception is a patient with CAD treated with organic nitrates, in which the coadministration of phosphodiesterase 5 inhibitors is strictly prohibited. SUMMARY Knowledge of the various comorbid conditions and their treatment associated with the development of erectile dysfunction will help the caring physician to treat his patients appropriately and safely. All these aspects will be discussed in this review.
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13
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Steinke EE, Mosack V, Hill TJ. Change in sexual activity after a cardiac event: the role of medications, comorbidity, and psychosocial factors. Appl Nurs Res 2015; 28:244-50. [DOI: 10.1016/j.apnr.2015.04.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 04/15/2015] [Indexed: 10/23/2022]
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14
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Atrial fibrillation is associated with increased risk of erectile dysfunction: A nationwide population-based cohort study. Int J Cardiol 2015; 190:106-10. [DOI: 10.1016/j.ijcard.2015.04.108] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 04/10/2015] [Accepted: 04/14/2015] [Indexed: 01/24/2023]
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15
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Steinke EE. Sexual dysfunction common in people with coronary heart disease, but few cardiovascular changes actually occur during sexual activity. Evid Based Nurs 2015; 18:19. [PMID: 24809939 DOI: 10.1136/eb-2014-101787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Elaine E Steinke
- School of Nursing, Wichita State University, Wichita, Kansas, USA
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16
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Nicolai MPJ, Elzevier HW. Do residents in cardiology need more training to make them talk about sex? Neth Heart J 2014; 22:122-3. [PMID: 24477423 PMCID: PMC3931858 DOI: 10.1007/s12471-014-0517-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- M P J Nicolai
- Department of Surgery, Westfries Gasthuis, PO Box 600, 1620 AR, Hoorn, the Netherlands,
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