When the Topic Turns to Sex: CASE SCENARIOS IN SEXUAL COUNSELING AND CARDIOVASCULAR DISEASE

Sexual counseling for people with acute coronary syndrome: educational video development

OBJECTIVE

to assess validity evidence of an educational video on safe sexual activity after acute coronary syndrome.

METHOD

study in three phases: video development; content validity analysis by 11 experts; and analysis of validity based on response processes by seven people with coronary disease. The content validity ratio (CVR) was calculated with critical values for the second phase of 0.63 and for the third of 1.0.

RESULTS

the video addressed the importance of resuming sexual activity and positions that consume less energy, clinical warning signs, the importance of adhering to treatment and a welcoming environment for sexual practice. A CVR above the critical value was obtained with a total of 4 minutes and 41 seconds.

CONCLUSION

the educational video brings together adequate content validity evidence and can be used as a tool for patients after acute coronary syndrome.

Australian health professionals' perspectives on discussing sexual activity and intimacy with people who have had a heart attack: a qualitative study

BACKGROUND

Sexual activity and intimacy contribute to wellbeing throughout adult life, including after a heart attack. Providing support and information about sexual activity and intimacy after a heart attack is recognised as part of a comprehensive approach to cardiac rehabilitation. Previous research shows that patients expect health professionals to initiate discussions about sexual activity and intimacy, but that this seldom occurs.

METHODS

Drawing on qualitative survey responses from a range of Australian health professionals working in cardiac care and rehabilitation, this research examined their perspectives on discussing sexual activity and intimacy with their patients, and patients' partners. Using a social constructionist approach, thematic analysis was used to identify themes expressed by participants.

RESULTS

Discussions about sexual activity and intimacy after heart attack were perceived as nebulous and taboo. The predominance of an illness - rather than wellness - framing of these discussions and a tendency for health professionals to make judgement calls contributed to discussions not occurring. Health professionals also identified a range of intrapersonal, interpersonal and structural obstacles to discussions, including embarrassment, fear of patients' embarrassment, a lack of role clarity, the absence of a clear protocol or training to guide practice, and a lack of time, privacy and patient resources.

CONCLUSIONS

Such discussions require normalisation, careful timing, sufficient time and adequate privacy. Staff training, a protocol and appropriate patient resources are needed to support health professionals to initiate discussions. Further research is required that investigates the impact of specific resources and training on health professionals' practice and patient outcomes.