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Lukumay GG, Mushy SE, Mgopa LR, Mkoka DA, Massae AF, Mwakawanga DL, Rosser BRS, Kohli N, Rohloff CT, Ross MW, Trent M. Healthcare professional students' skills in sexual health communication and history taking: inter-rater reliability of standardized patients and faculty ratings in dar es Salaam, tanzania- a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:627. [PMID: 38840085 PMCID: PMC11155028 DOI: 10.1186/s12909-024-05607-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 05/27/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Low- and middle-income countries face a disproportionate impact of sexual health problems compared to high-income countries. To address this situation proper interpersonal communication skills are essential for clinician to gather necessary information during medical history-taking related to sexual health. This study aimed to evaluate the interrater reliability of ratings on sexual health-related interpersonal communication and medical history-taking between SPs and trained HCP faculty for health care professional students. METHODS We conducted a cross-sectional comparative study to evaluate the interrater reliability of ratings for sexual health-related interpersonal communication and medical history-taking. The data were collected from medical and nursing students at Muhimbili University of Health and Allied Sciences, who interviewed 12 Standardized Patients (SPs) presenting with sexual health issues. The video-recorded interviews rated by SPs, were compared to the one rated by 5 trained Health Care Professional (HCP) faculty members. Inter-rater reliability was evaluated using percent agreement (PA) and kappa statistics (κ). RESULTS A total of 412 students (mean age 24) were enrolled in the study to conduct interviews with two SPs presenting with sexual health concerns. For interpersonal communication (IC), the overall median agreement between raters was slight (κ2 0.0095; PA 48.9%) while the overall median agreement for medical sexual history-taking was deemed fair (κ2 0.139; PA 75.02%). CONCLUSION The use of SPs for training and evaluating medical and nursing students in Tanzania is feasible only if they undergo proper training and have sufficient time for practice sessions, along with providing feedback to the students.
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Affiliation(s)
- Gift G Lukumay
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania.
| | - Stella Emmanuel Mushy
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Lucy R Mgopa
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Dickson Ally Mkoka
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Agnes F Massae
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Dorkasi L Mwakawanga
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - B R Simon Rosser
- University of Minnesota, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Nidhi Kohli
- University of Minnesota, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Corissa T Rohloff
- University of Minnesota, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Michael W Ross
- University of Minnesota, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Maria Trent
- Johns Hopkins University School of Medicine, 200 N. Wolfe Street, #2056, Baltimore, MD, 21287, USA
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Miranda DPR, Constanza Micolich V, Goset K, Salas SP. Knowledge, practice and communication barriers for oncology doctors in Chile when addressing the sexuality of their patients. Ecancermedicalscience 2024; 18:1665. [PMID: 38439800 PMCID: PMC10911666 DOI: 10.3332/ecancer.2024.1665] [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: 07/20/2023] [Indexed: 03/06/2024] Open
Abstract
Introduction Communication in a doctor-patient relationship constitutes a crucial aspect in medicine, and its multiple dimensions encompass a wide variety of ethical issues. Communication is particularly relevant in oncology, because it requires continually dealing with sensitive topics in one of the most highly vulnerable situations as a human: illness and proximity to death. Sexuality is one of these topics because it constitutes an area that is frequently affected by cancer and cancer treatment, which may include causing significant distress, the reinforcement of a negative self-image, relationship conflicts and a permanent memory of having cancer. The objective of this research is to describe the perception of knowledge and communications practices used by oncology doctors with respect to sexual health in the care of their patients, as well as the barriers found when it comes to confronting the topic. Methods An exploratory quantitative, descriptive and cross-sectional study was carried out, in which a self-administered questionnaire was given to oncology doctors who practise in Chile. This questionnaire had 41 closed questions with answers on a Likert scale and was previously validated by being reviewed and applied to a pilot group of five professionals (one medical bioethics expert and four doctors in the field of oncology). The data were analysed with the SPSS statistical program v. 20, using descriptive statistics. Results The main results show that the surveyed doctors consider sexuality to be an important part of patients' quality of life. However, this finding does not align with the practices given for including it as part of clinical care. The professionals refer as the main barriers those that are attributed to the structural functioning of the institution, giving little value to those barriers related to personal aspects or those associated with patient characteristics and/or behaviors. Conclusion The results of this study show that, despite oncology doctors seeing sexuality as an important aspect of the quality of life of their patients, they do not include the topic in clinical care. Given that one of the main barriers is obstacles relating to the institution, it is necessary to create political institutions that create the conditions for including this area as a relevant part of cancer patient care.
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Affiliation(s)
| | | | - Karen Goset
- Bioethics Centre, Faculty of Medicine, Clinica Alemana Universidad del Desarrollo, Santiago 7610507, Chile
| | - Sofia P Salas
- Bioethics Centre, Faculty of Medicine, Clinica Alemana Universidad del Desarrollo, Santiago 7610507, Chile
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Stowell M, Hall A, Warwick S, Richmond C, Eastaugh CH, Hanratty B, McDermott J, Craig D, Spiers GF. Promoting sexual health in older adults: Findings from two rapid reviews. Maturitas 2023; 177:107795. [PMID: 37454470 DOI: 10.1016/j.maturitas.2023.107795] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/01/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Sexual health throughout the life course is increasingly recognised as important to maintaining one's overall health, wellbeing, and relationships. We aimed to provide an overview of the evidence on sexual health needs and sexual health promotion in later life. METHODS We undertook two rapid reviews, drawing on systematic review evidence. Searches were conducted in Epistemonikos. Studies were eligible if they reported evidence about the sexual health needs of, or sexual health promotion interventions for, people aged 50+ years. Evidence was quality assessed and summarised in a narrative synthesis. RESULTS Fifteen systematic reviews were included in Review 1 (sexual health needs) and 12 in Review 2 (interventions). Key concerns and needs of older adults included the impacts of cultural stigma/misperceptions, barriers to sexual expression, and a need for tailored support in a welcoming environment. Key concerns and needs of health and social care professionals included mixed attitudes towards and knowledge of later-life sexuality and a need for more training and education. Approaches to promoting sexual health in later life included training and workshops for care home professionals, education for older people at risk of/living with HIV, and interventions to address sexual health-related symptoms of menopause. Gaps in the evidence from current reviews and methodological issues in primary studies were identified. CONCLUSION Older people have specific needs relating to their sexual health. Health and social care professionals working with older people may benefit from education/training around sexuality in later life. Evidence on effective interventions and strategies is limited.
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Affiliation(s)
- Melanie Stowell
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK.
| | - Alex Hall
- School of Health Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Stephanie Warwick
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Catherine Richmond
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Claire H Eastaugh
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Barbara Hanratty
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Jane McDermott
- School of Health Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Dawn Craig
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Gemma Frances Spiers
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
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Van Overmeire R, Vesentini L, Vanclooster S, Bilsen J. Discussing sexual health among Flemish patients with Parkinson’s disease. Acta Neurol Belg 2022; 123:497-505. [PMID: 36153464 DOI: 10.1007/s13760-022-02086-w] [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: 04/19/2022] [Accepted: 09/01/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Parkinson's disease (PD) can lead to sexual dysfunction. Yet, studies have shown that neurologists do not often discuss possible sexual health consequences with their patients. Thus, in this study, we investigated the communication on sexual health between healthcare workers and PD patients in Flanders, Belgium. METHODS Through an online survey, PD patients were contacted. Sexual dysfunction was measured with the Arizona Sexual Experience Scale (ASEX), stage of PD with the Hoehn and Yahr scale, and self-made questions on the communication between healthcare workers and PD patients. RESULTS In total, 100 PD patients responded, of which 23% had possible sexual dysfunction. Of these respondents, 60% had never received any information about possible sexual health consequences. More than half (58%) of the patients felt their neurologist should provide information on possible sexual health consequences, though only 14% had ever received information from their neurologist. Male respondents expressed a greater need for information than female respondents (p = .049), although no difference between both groups in receiving information was found (p = .294). In addition, low to middle educated people generally received more information than higher educated people (p = .018).. The more severe the disease is, as measured by the Hoehn and Yahr scale, the more information a patient receives (p = .012). The most frequently mentioned barriers in discussing sexual health are a lack of initiative by the neurologist (41%) and awkwardness to discuss sexuality (41%). CONCLUSION This study showed that PD patients expect information from neurologists on possible sexual health consequences, but seldom receive information. More attention should be given to training neurologists in discussing sexual health. Table 1 Characteristics of the sample (N = 100) N % Gender Male 59 59 Female 41 41 Education level Lower 4 4 Middle 42 42 Higher 54 54 Relationship status No partner 10 10 Partner 90 90 Stage of Parkinson (Hoehn & Yahr scale) Stage 0 3 3 Stage 1 36 36 Stage 1.5 12 12 Stage 2 9 9 Stage 2.5 6 6 Stage 3 21 21 Stage 4 9 9 Stage 5 4 4 Time since diagnosis Less than 1 years ago 10 10 1-2 years 13 13 2-5 years 32 32 5-10 years 29 29 Longer than 20 years 13 13 10-15 years 2 2 15-20 years 1 1 Received information on sexual health consequences from… Treating neurologist 14 14 GP 9 9 Geriater 0 0 Nurses 2 2 Psychotherapist 3 3 Sexuologist 1 1 Kinesitherapist 2 2 Other 4 4 Who do you think should provide you information on sexual health consequences Treating neurologist 58 58 GP 43 43 Geriater 3 3 Nurses 6 6 Psychotherapist 23 23 Sexuologist 17 17 Kinesitherapist 3 3 Other 2 2 How would you like to receive information on possible sexual health consequences? Brochure 38 38 Online (e.g. website) 38 38 Posters in waiting room 3 3 Personal conversation with healthcare worker 51 51 Other 1 1 From what moment do you think possible sexual health consequences of Parkinson's disease should be discussed? From the moment of diagnosis 52 52 From moment patient indicates he/she experiences problems 33 33 From moment that the neurologist feels it should be discussed 9 9 Should not be discussed 6 6 Need for information on possible sexual health consequences No need 31 31 A little need 19 19 Some need 21 21 Need 24 24 A lot of need 5 5 How often has healthcare personnel given you information on sexual health consequences Never 60 60 Seldom 25 25 Sometimes 12 12 Regularly 3 3 At every consultation 0 0 ASEX No possible sexual dysfunction 77 77 Possible Sexual dysfunction (score equal to or higher than 19) 23 23 How important are sexual activities for you? Not important 20 20 Slightly important 33 33 Somewhat important 22 22 Important 18 18 Very important 7 7 I avoid sexual contact because of my disease Agree completely 8 8 Agree 16 16 Agree somewhat 30 30 Disagree 28 28 Completely disagree 18 18 I feel unsatisfied with my sex life due to my disease Agree completely 16 16 Agree 22 22 Agree somewhat 32 32 Disagree 20 20 Completely disagree 10 10 Mean Standard deviation Age 66.97 8.88 ASEX 16.02 4.53 Table 2 Associations of ASEX, need for information, receiving information ASEX p Need for information p Receiving information p Gender Male 16.08 0.948 55.31 0.049 48.69 0.294 Female 16.11 44.13 43.38 Education level Low-middle 15.83 0.068 53.26 0.356 53.41 0.018 High 16.20 48.06 41.49 Need for information and receiving information scores are mean ranks due to non-parametric tests ASEX scores are means Table 3 Correlations between variables ASEX Age Need for information Receiving information Hoehn and Yahr Importance of sex life Avoiding sex Unsatisfied with sex life ASEX - - 0.04 0.27* 0.07 - 0.09 - 0.12 - 0.10 - 0.23* Age - - 0.20 0.10 0.41*** - 0.28** - 0.16 0.08 Need for information - 0.14 - 0.11 0.38*** - 0.13 - 0.46*** Receiving information - 0.22* - 0.03 - 0.08 - 0.08 Hoehn and Yahr - - 0.17 - 0.32** - 0.17 Importance of sex life - 0.24* - 0.07 Avoiding sex - 0.48*** Unsatisfied with sex life - *p < .05 **p < .01 ***p < .001 Table 4 Regression analyses B (S.E.) Exp(B) P Pseudo R2 Nagelkerke Pseudo R2 Cox & Snell Need for information 0.013 0.19 0.14 Gender - 1.23 (0.48) 0.29 0.010 Education level - 0.62 (0.43) 0.54 0.149 Hoehn and Yahr 0.01 (0.11) 1.01 0.925 ASEX 0.10 (0.06) 1.11 0.060 Receiving information 0.047 0.14 0.11 Gender - 0.53 (0.45) 0.59 0.232 Education level - 0.61 (0.41) 0.54 0.137 Hoehn and Yahr 0.29 (0.14) 1.33 0.012 ASEX 0.01 (0.05) 1.01 0.788 Table 5 Barriers to discuss sexual health % (that agree with statements) I do not feel comfortable to discuss sexuality with my neurologist 33 I wait until the neurologist begins discussing it 41 My neurologist is either too young or too old 11 My neurologist is of the other gender 26 Reasons that have to do with my faith or attitude towards sexuality 12 I do not have the feeling there is a solution for these problems (with sexual health) 31 My Parkinson related symptoms overshadow my possible sexual health problems 39 It feels awkward to discuss sexual acts like masturbation or discuss buying of sexual aiding tools 41 My family/partner/friends are present during consultation 37 Reasons that have to do with my sexual orientation 11.
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Affiliation(s)
- Roel Van Overmeire
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Lara Vesentini
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Stephanie Vanclooster
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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Cooper CA, Sloan MJ, Singh A, Fantus RJ, Raheem OA. A Historical and Contemporary Review of Questionnaires Used in the Management of Post-Radical Prostatectomy Patients. Sex Med Rev 2022; 10:681-690. [PMID: 37051967 DOI: 10.1016/j.sxmr.2022.04.003] [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: 03/15/2022] [Revised: 04/20/2022] [Accepted: 04/23/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Patients undergoing radical prostatectomy (RP) face obstacles to recovery spanning the domains of erectile and sexual function; urinary function; and health-related quality of life (HRQoL). Numerous patient-directed questionnaires exist that serve to assist in the care of these men. AIM To describe patient-directed questionnaires of historical and contemporary relevance involving the evaluation and treatment of men after radical prostatectomy. METHODS A comprehensive review of peer-reviewed publications on the topic was performed. Using PubMed, the search terms used were: "radical prostatectomy; erectile function; lower urinary tract symptoms; sexual dysfunction; urinary incontinence; and health-related quality of life. MAIN OUTCOME MEASURE We aimed to summarize questionnaires and survey devices of historical and contemporary importance for the care of men after RP. RESULTS Many questionnaires have been developed specifically for, or conscripted for use in, the care of men after RP. Some of the oldest questionnaires relating to sexual function, urinary function, and general and cancer-specific QoL are important and still utilized in the routine clinical care of post-RP patients. However, recent devices that may offer clinicians a more comprehensive understanding to aid in the evaluation and care of these men. CONCLUSIONS Post-RP patients face numerous challenges that require a thoughtful approach, one that is broad enough to identify a variety of potential physical and emotional disturbances, yet granular enough to identify appropriate areas for intervention. While there is not a "best" questionnaire for this population, having an appropriate understanding of the current available instruments and what information they provide may help clinicians more thoroughly assess and treat these men. Castillo O, Chen IK, Amini E, et al. Male Sexual Health Related Complications Among Combat Veterans. Sex Med Rev 2022;XX:XXX-XXX.
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Affiliation(s)
- Caleb A Cooper
- Section of Urology, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA
| | - Matthew J Sloan
- Section of Urology, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA
| | - Armaan Singh
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Richard J Fantus
- Section of Urology, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA; Section of Urology, Department of Surgery, NorthShore University Health System, Evanston, IL, USA
| | - Omer A Raheem
- Section of Urology, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA.
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Hong ZM, Chen ZL, Feng JL, Wang SJ, Qiu JF, Zeng YL, Wang Q, Wang JS. Mechanistic analysis of erectile dysfunction in a depression rat model. J Int Med Res 2022; 50:3000605221100334. [PMID: 35615771 PMCID: PMC9152200 DOI: 10.1177/03000605221100334] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Objective Most men suffering from depression have different degrees of erectile dysfunction (ED), but the relationship between depression and ED is not clear. This study explored the effect of depression on erectile function in rats and the underlying mechanism. Methods The potential targets and key signaling pathways of depression and ED were predicted through bioinformatics analysis, and a depression rat model was established by inducing chronic restraint stress. Pathological changes in rat penis tissue were studied by hematoxylin and eosin staining. The serum dopamine level was quantified by an enzyme-linked immunosorbent assay. The expression of related proteins and mRNA was detected by western blotting and real-time quantitative reverse transcription-polymerase chain reaction. Results Hematoxylin and eosin staining showed pathological damage in the penile tissue of the model group rats. The serum dopamine level, dopamine receptor D2 (DRD2) and solute carrier family 6 member 3 (SLC6A3) protein levels in penile tissue, and DRD2 and SLC6A3 mRNA levels were lower in the model group than in the control group. Conclusion The decrease in erectile function in the depression rat model was related to dysfunction of the dopamine system and dopaminergic synapse signaling pathway.
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Affiliation(s)
- Zhi-Ming Hong
- Department of Andrology, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen, China
| | - Zi-Long Chen
- Department of Andrology, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen, China
| | - Jun-Long Feng
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Sheng-Jie Wang
- Department of Andrology, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen, China
| | - Jun-Feng Qiu
- Department of Andrology, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen, China
| | - Yang-Ling Zeng
- Department of Andrology, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen, China
| | - Quan Wang
- Department of Andrology, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen, China
| | - Ji-Sheng Wang
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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Al-Shaiji TF. Breaking the Ice of Erectile Dysfunction Taboo: A Focus on Clinician–Patient Communication. J Patient Exp 2022; 9:23743735221077512. [PMID: 35128040 PMCID: PMC8808006 DOI: 10.1177/23743735221077512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Erectile dysfunction is a common yet complex problem facing men and their partners worldwide. It continues to be an under reported issue despites its high prevalence and negative impact as well as the availability of successful treatment. One of the main reasons for such a problem is the stigma surrounding it as a complaint and the deep-seated fear to discuss it. This paper aims to highlight the reasons behind the taboo and dilemma behind erectile dysfunction reporting and discusses means to overcome this stigma focusing on clinician–patient communication.
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Affiliation(s)
- Tariq F. Al-Shaiji
- Urology Unit, Al-Amiri Teaching Hospital, Kuwait City, Kuwait
- Kuwait Institute for Medical Specialization (KIMS), Kuwait City, Kuwait
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8
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Urso D, Leta V, Rukavina K. Management strategies of sexual dysfunctions in Parkinson's disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 162:97-116. [PMID: 35397790 DOI: 10.1016/bs.irn.2021.12.004] [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: 06/14/2023]
Abstract
Sexual dysfunctions (SD) are frequent and highly disabling nonmotor manifestations of Parkinson's disease (PD) but are also potentially treatable. Neurologists should actively discuss, recognize and treat sexual health issues as an integral part of the management of the disease. In this chapter, we provide recommendations for managing and treating both primary and secondary SD in PD. Many sexual problems can be, at least partially, improved by adjusting the treatment of motor, nonmotor symptoms and comorbidities. Although some treatments of primary SD are evidence-based, many therapeutic options have not been yet systematically studied in patients with PD. The development of new treatments and repurposing of existing remedies in patients with PD remain an unmet need.
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Affiliation(s)
- Daniele Urso
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, United Kingdom; Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari 'Aldo Moro', "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.
| | - Valentina Leta
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Katarina Rukavina
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, United Kingdom
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Effects of a Brief E-Learning Resource on Sexual Attitudes and Beliefs of Healthcare Professionals Working in Prostate Cancer Care: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910045. [PMID: 34639350 PMCID: PMC8508566 DOI: 10.3390/ijerph181910045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/10/2021] [Accepted: 09/16/2021] [Indexed: 01/22/2023]
Abstract
Sexual issues and treatment side effects are not routinely discussed with men receiving treatment for prostate cancer, and support to address these concerns is not consistent across settings. This study evaluates a brief e-learning resource designed to improve sexual wellbeing support and examine its effects on healthcare professionals' sexual attitudes and beliefs. Healthcare professionals (n = 44) completed an online questionnaire at baseline which included a modified 12-item sexual attitudes and beliefs survey (SABS). Follow-up questionnaires were completed immediately after the e-learning and at 4 weeks. Data were analysed using one-way, repeat measures ANOVAs to assess change in attitudes and beliefs over time. Significant improvements were observed at follow-up for a number of survey statements including 'knowledge and understanding', 'confidence in discussing sexual wellbeing' and the extent to which participants felt 'equipped with the language to initiate conversations'. The resource was seen as concise, relevant to practice and as providing useful information on potential side effects of treatment. In brief, e-learning has potential to address barriers to sexual wellbeing communication and promote delivery of support for prostate cancer survivors. Practical methods and resources should be included with these interventions to support implementation of learning and long-term changes in clinical behaviour.
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Krouwel EM, Albers LF, Nicolai MPJ, Putter H, Osanto S, Pelger RCM, Elzevier HW. Discussing Sexual Health in the Medical Oncologist's Practice: Exploring Current Practice and Challenges. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:1072-1088. [PMID: 31209770 PMCID: PMC7679345 DOI: 10.1007/s13187-019-01559-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Sexuality is a significant quality-of-life concern for many cancer patients. Patients may be disadvantaged if they are not informed and not offered sexual health care. We sought to reveal oncologists' current practice and opinions concerning sexual counselling. The aim of this study was to explore the knowledge, attitude and practice patterns of Dutch medical oncologists regarding treatment-related sexual dysfunction. Questionnaires were sent to 433 members of the Dutch Society of Medical Oncology. The majority (81.5%) of the 120 responding medical oncologists (response rate 30.6%) stated they discussed sexual function with fewer than half of their patients. At the same time, 75.8% of the participating oncologists agreed that addressing sexual function is their responsibility. Sexual function was discussed more often with younger patients and patients with a curative treatment intent. Barriers for avoiding discussing sexual function were lack of time (56.1%), training (49.5%) and advanced age of the patient (50.4%). More than half (64.6%) stated they had little knowledge about the subject and the majority (72.9%) wanted to acquire additional training in sexual function counselling. Medical oncologists accept that sexual function counselling falls within their profession, yet they admit to not counselling patients routinely concerning sexual function. Only in a minority of cases do medical oncologists inform their patients about sexual side effects of treatment. Whether they counsel patients is related to how they view patient's prognosis, patient's age, and self-reported knowledge. Findings indicate there is a role for developing education and practical training.
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Affiliation(s)
- E M Krouwel
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - L F Albers
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands.
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands.
| | - M P J Nicolai
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - H Putter
- Department of Medical Statistics, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - S Osanto
- Department of Oncology, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - R C M Pelger
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - H W Elzevier
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
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Wazqar DY. Sexual health care in cancer patients: A survey of healthcare providers' knowledge, attitudes and barriers. J Clin Nurs 2020; 29:4239-4247. [PMID: 32786162 DOI: 10.1111/jocn.15459] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/30/2020] [Accepted: 07/24/2020] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To assess the knowledge and attitudes of healthcare providers regarding sexual health care in cancer patients in Saudi Arabia and explore possible barriers influencing their attitudes. BACKGROUND A growing body of research emphasises the importance of healthcare providers addressing the sexual problems of cancer patients. The literature, however, shows that cancer treatment-related sexual problems are not frequently discussed by healthcare providers as expected. In Saudi Arabia, sexual health care in oncology daily practice has not been addressed sufficiently. METHODS A cross-sectional correlational study was conducted with a convenience sample of 150 healthcare providers from a university teaching and referral hospital providing cancer and palliative care in Jeddah City, Saudi Arabia. The study methods were compliant with the STROBE checklist. Data were collected by Sexual Healthcare Attitudes and Knowledge survey. Descriptive and inferential statistics and Pearson's correlations were performed. A content analysis was used to enhance understanding and support study's findings. RESULTS Participants had a poor knowledge related to sexual health care in cancer patients, and the low mean attitudes score also represents negative attitudes and higher levels of barriers. Participants had insufficient knowledge about assessment and evaluation of sexual health in cancer patients, and did not know about sexual dysfunction resulting from cancer and its treatment. Knowledge and attitudes had a significantly positive correlation. CONCLUSION The study findings indicate there is room for improvement in the sexual health-related knowledge among oncology nurses, doctors and radiation oncologists. Helping healthcare providers overcome barriers to discussing cancer patients' sexual issues needs a careful evaluation of the knowledge, attitudes and barriers that keep them from discussing such issues. RELEVANCE TO CLINICAL PRACTICE It is imperative to improve healthcare providers' sexuality knowledge about cancer patients through introducing sexual health-based continuing education programmes, availability of resources (educational materials and clinical checklists) and training in oncology daily practice.
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Affiliation(s)
- Dhuha Youssef Wazqar
- Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
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12
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Hollyhead C, Branney P. The feasibility of psychometric measures for body image and lymphedema for routine practice. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2020. [DOI: 10.1111/ijun.12217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Peter Branney
- Division of PsychologyUniversity of Bradford Bradford UK
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13
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Dyer A, Kirby M, White ID, Cooper AM. Management of erectile dysfunction after prostate cancer treatment: cross-sectional surveys of the perceptions and experiences of patients and healthcare professionals in the UK. BMJ Open 2019; 9:e030856. [PMID: 31585974 PMCID: PMC6797309 DOI: 10.1136/bmjopen-2019-030856] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Erectile dysfunction (ED) is known to be a common consequence of radical treatment for prostate cancer (PCa) but is often under-reported and undertreated. This study aimed to explore how ED in patients with PCa is managed in real-life clinical practice, from the perspective of patients and healthcare professionals (HCPs). DESIGN AND SETTING This is a UK-wide cross-sectional survey of men with ED after treatment for PCa which covered assessment and discussion of erectile function, provision of supportive care and satisfaction with management. Parallel surveys of primary and secondary HCPs were also conducted. RESULTS Responses were received from 546 men with ED after PCa treatment, 167 primary (general practitioners and practice nurses) and 94 secondary care HCPs (urologists and urology clinical nurse specialists). Survey findings revealed inadequate management of ED in primary care, particularly underprescribing of effective management options. A fifth of men (21%) were not offered any ED management, and a similar proportion (23%) were not satisfied with the way HCPs addressed their ED concerns. There was poor communication between HCPs and men, including failure to initiate discussions about ED and/or involve partners, with 12% of men not told that ED was a risk factor of PCa treatment. These issues seemed to reflect poor access to effective ED management or services and lack of primary HCP confidence in managing ED, as well as confusion over the roles and responsibilities among both HCPs and men. CONCLUSIONS This study confirms the need for better support for men from HCPs and more tailored and timely access to effective ED management after treatment for PCa. A clearly defined pathway is required for the discussion and management of ED, starting from the planning stage of PCa treatment. Improved adherence to ED management guidelines and better education and training for primary care HCPs are areas of priority.
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Affiliation(s)
- Amy Dyer
- Knowledge Team, Prostate Cancer UK, London, UK
| | - Mike Kirby
- The Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, Hertfordshire, UK
- The Prostate Centre, London, UK
| | - Isabel D White
- Department of Pastoral and Psychological Care, Royal Marsden NHS Foundation Trust, London, UK
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14
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15
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Taylor Smith A, Dumas A. Class-based masculinity, cardiovascular health and rehabilitation. SOCIOLOGY OF HEALTH & ILLNESS 2019; 41:303-324. [PMID: 30515828 DOI: 10.1111/1467-9566.12827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Men in economically advanced societies are more at-risk of dying prematurely due to heart disease than women, and this risk is inversely related to their socioeconomic status (SES). While the strong influence of socioeconomic factors on self-management of chronic diseases is important, the impact of masculinity must also be considered. This study examines the social variation in preventive health lifestyles of men from two contrasting socioeconomic groups who have suffered from a cardiovascular incident requiring hospitalization. It draws chiefly on Pierre Bourdieu's sociocultural theory of the practice (habitus and symbolic violence). Qualitative data was collected through 60 in-depth, semi-structured interviews with Canadian men (average age 57.3). Results indicate that participants from both socioeconomic groups share aspirations towards personal fulfilment (achieving a sense of security, preserving autonomy and gaining social recognition) after their heart incident, but apply different strategies in pursuit of these aspirations that have distinctive effects on healthy lifestyles. This study emphasise the importance of drawing on theoretical approaches in public health that have the potential to combine universal with context-specific views of human experience in order further understand health and lifestyle inequalities.
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Affiliation(s)
| | - Alex Dumas
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
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16
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Rabathaly PA, Chattu VK. An exploratory study to assess primary care physicians' attitudes toward talking about sexual health with older patients in Trinidad and Tobago. J Family Med Prim Care 2019; 8:626-633. [PMID: 30984685 PMCID: PMC6436267 DOI: 10.4103/jfmpc.jfmpc_325_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: A good quality sex life and interest in sex are positively associated with health in middle-aged and later life. For effective diagnosis of sexual health problems, an appropriate discussion about sexual health issues including a sexual history is advised. The sexual health care delivery and management during consultations by primary care physicians is relatively unexplored, especially for older patients. This paper aims to explore primary health care physicians’ (PCPs) attitudes to sexual health care and management of middle-aged and older patients in Trinidad and Tobago. Methods: In-depth, semi-structured interviews were conducted with 35 PCPs in Trinidad and Tobago. Topics examined included physician-patient relations, sexual health care management challenges, communication and sexual history taking practices, and training needs of PCPs. The framework analysis method was adopted for analysis. Results: Most doctors stated that they were not comfortable with conducting a sexual history with their older patients, and they rarely discussed or initiated talking about sexual health with them. Barriers included time constraints, inappropriate environmental conditions for privacy, inadequate professional referral services, insufficient medical training in sexual function in middle and old age, reluctant patient behavior, conflicting personal beliefs on sexuality, and socio-cultural factors. Conclusion: PCPs may be reluctant to raise sexual health-related issues with their older patients, and these older patients may not initiate this discussion because of discomfort and embarrassment. Consequently, physicians’ inability to effectively communicate with these patients could result in missed opportunities for interventions and patients’ concerns may remain unheard and their sexual problems untreated.
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Affiliation(s)
- Patrice A Rabathaly
- Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Vijay Kumar Chattu
- Public Health and Primary Care Unit, Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
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17
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Eeltink CM, Witte BI, Stringer J, Liptrott S, Babic A, Greenfield DM, Salooja N, Incrocci L, Visser O, Verdonck-de Leeuw IM, Duarte RF, Zweegman S. Health-care professionals' perspective on discussing sexual issues in adult patients after haematopoietic cell transplantation. Bone Marrow Transplant 2017; 53:235-245. [PMID: 29247220 DOI: 10.1038/s41409-017-0027-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 12/23/2022]
Abstract
The majority of adult patients have sexual concerns after post-haematopoietic cell transplantation. Even so, health-care professionals (HCP) do not routinely discuss these problems. We, therefore, surveyed all the members of the European Society for Blood and Marrow Transplantation to evaluate the barriers and facilitators to discussing sexual issues. The 73-item web-survey was completed by 166 registered nurses (RNs) and 126 medical doctors (MDs). Sixty-eight percent reported that they seldom discussed sexual issues. Younger MDs (p < 0.001) and those who work in non-western European countries (p = 0.003), RNs with probably less sexual education themselves (p = 0.002), MDs and RNs who have limited knowledge about sexual complications (p < 0.001) and MDs and RNs who feel uncomfortable discussing sexual issues (p < 0.001) are all less likely to discuss these matters. The major perceived barriers were that patients might be embarrassed if sexual issues were discussed in the presence of a relative (60% RNs, 67% MDs) and that professionals prefer patients to raise sexual issues themselves (54% RNs, 44% MDs). The most important perceived facilitator was for the patient to initiate discussion (≥ 90% for RNs and MDs). Overall, haematopoietic cell transplantation survivors may not be receiving the support on sexual issues they probably need.
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Affiliation(s)
- Corien M Eeltink
- Cancer Center Amsterdam, Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Birgit I Witte
- Cancer Center Amsterdam, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Jacqui Stringer
- Department of Complementary Health and Wellbeing, The Christie NHS Foundation Trust, Manchester, UK
| | - Sarah Liptrott
- Department of Haemato-oncology, European Institute of Oncology, Milan, Italy
| | - Aleksandra Babic
- IOSI-Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
| | - Diana M Greenfield
- Specialised Cancer Services, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.,Department of Oncology and Metabolism, University of Sheffield, England, UK
| | - Nina Salooja
- Department of Hematology, Hammersmith hospital, Imperial College, London, UK
| | - Luca Incrocci
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Otto Visser
- Department of Hematology, Isala Hospital, Zwolle, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Cancer Center Amsterdam, Department of Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Department of Otolaryngology, VU University Medical Center, Amsterdam, The Netherlands.,EMGO+ Institute, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Rafael F Duarte
- Department of Hematology, University Hospital Puerta de Hierro, Madrid, Spain
| | - Sonja Zweegman
- Cancer Center Amsterdam, Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
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18
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Medical treatment of erectile dysfunction: too many medical prescriptions? Urologia 2017; 84:121-129. [PMID: 28708203 DOI: 10.5301/uj.5000250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2017] [Indexed: 12/21/2022]
Abstract
Erectile dysfunction (ED) is a worldwide commonly reported condition; epidemiological data showed a prevalence ranging from 2.3 to 53.4% within different population subsets. In this context, the advent of phosphodiesterase type 5 inhibitors (PDE5is) in the second mid of 1990s has deeply changed the treatment scenario of this bothersome condition. Being user-friendly compounds with an excellent overall safety profile, PDE5is emerged as the first-line treatment for ED, thus overcoming topical alprostadil and intracavernous injections (ICIs). However, available data on treatment-utilization patterns and medical prescriptions of PDE5is showed a range of as wide as 22-78% of patients reporting to purchase PDE5is even without a proper medical prescription. Moreover, an increase in the recreational use of PDE5is among young men has been observed in the last decades, with a worrisome diffusion of potential health-risky behaviours associated with this habit. Indeed, treatment of ED should carefully follow internationally based clinical guidelines to avoid inappropriate drug prescriptions, which may eventually expose treated patients to drug-related side effects. Thereof, a careful assessment of the so-called modifiable and reversible ED risk factors along with a patient-tailored screening for potential contraindications to the treatment itself should be performed in every case. Lastly, although conclusive data still lack, the potential association between life-risky PDE5is side effects (i.e. cardiovascular adverse events, melanoma skin cancer and worsening of prostate cancer outcomes) should be carefully taken into account when counselling patients for ED treatment.
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19
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Correlates of CVD and discussing sexual issues with physicians among male military veterans. Maturitas 2016; 92:168-175. [PMID: 27621256 DOI: 10.1016/j.maturitas.2016.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/01/2016] [Accepted: 07/29/2016] [Indexed: 01/23/2023]
Abstract
PURPOSE This study aims to identify socio-demographic and health behavior factors associated with cardiovascular disease (CVD) diagnosis and patient-physician communication concerning sexual issues among older Veterans. METHODS Cross-sectional data were collected from 635 male Veterans over age 55 years as part of the 2010 National Social Life, Health and Aging Project, a nationally-representative, population-based study of community-dwelling older Americans. Two independent logistic regression analyses were performed. RESULTS Over 33% of Veterans were aged 75 years or older. Over one-half of participants reported having a CVD diagnosis (58%) and sexual intercourse within the previous year (58%); over one-third (37%) reported having one or more sexual dysfunctions and discussing sexual issues with their physician (42%). Veterans diagnosed with CVD were significantly more likely to self-identify as racial/ethnic minorities (OR=1.89, P=0.021), have more chronic disease comorbidities (OR=1.23, P=0.041), and have more sexual dysfunctions (OR=1.19, P=0.028). Veterans diagnosed with CVD were significantly less likely to report having sex within the previous year (OR=0.53, P=0.005). Veterans who reported discussing sexual issues with a physician were significantly more likely to be ≥75 years (OR=1.79, P=0.010), and report more than a high school education (OR=1.62, P=0.016), CVD diagnosis (OR=1.59, P=0.015), sex within the previous year (OR=1.69, P=0.033), and trouble achieving/maintaining an erection (OR=3.39, P<0.001). IMPLICATIONS These findings suggest older male Veterans, particularly racial/ethnic minorities and those less-educated, may benefit from VA and community-based aging and sexual health/counseling services. These services should promote increased patient-physician communication as well as referrals between physicians and sex health/counseling specialists.
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20
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21
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Zhou ES, Nekhlyudov L, Bober SL. The primary health care physician and the cancer patient: tips and strategies for managing sexual health. Transl Androl Urol 2016; 4:218-31. [PMID: 26816826 PMCID: PMC4708119 DOI: 10.3978/j.issn.2223-4683.2014.11.07] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
There is a large and growing population of long-term cancer survivors. Primary care physicians (PCPs) are playing an increasingly greater role in the care of these patients across the continuum of cancer survivorship. In this role, PCPs are faced with the responsibility of managing a range of medical and psychosocial late effects of cancer treatment. In particular, the sexual side effects of treatment which are common and have significant impact on quality of life for the cancer survivor, often go unaddressed. This is an area of clinical care and research that has received increasing attention, highlighted by the presentation of this special issue on Cancer and Sexual Health. The aims of this review are 3-fold. First, we seek to overview common presentations of sexual dysfunction related to major cancer diagnoses in order to give the PCP a sense of the medical issues that the survivor may present with. Barriers to communication about sexual health issues between patient/PCPs in order are also described in order to emphasize the importance of PCPs initiating this important conversation. Next, we provide strategies and resources to help guide the PCP in the management of sexual dysfunction in cancer survivors. Finally, we discuss case examples of survivorship sexual health issues and highlight the role that a PCP can play in each of these case examples.
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Affiliation(s)
- Eric S Zhou
- 1 Dana-Farber Cancer Institute, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA ; 2 Harvard Vanguard Medical Associates, Boston, Massachusetts, USA
| | - Larissa Nekhlyudov
- 1 Dana-Farber Cancer Institute, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA ; 2 Harvard Vanguard Medical Associates, Boston, Massachusetts, USA
| | - Sharon L Bober
- 1 Dana-Farber Cancer Institute, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA ; 2 Harvard Vanguard Medical Associates, Boston, Massachusetts, USA
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22
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Chellayadhas JY, Achrekar MS, Bakshi G, Shetty R, Carvalho M. Development of Booklet on Male Sexual Dysfunction, its Measures and Assessing its Impact on Knowledge of Patients with Urological Cancers. Asia Pac J Oncol Nurs 2016; 3:382-389. [PMID: 28083556 PMCID: PMC5214872 DOI: 10.4103/2347-5625.196495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: Urological cancer and its surgeries have great impact on male sexuality which could have physical or emotional consequences. In India, speaking openly about the sexual matter is a taboo and an aspect considered forbidden. Therefore, the aim of the present study is to develop an information booklet about male sexual dysfunction and assess its impact on knowledge of patients with urological cancers. Methods: Information booklet was developed after literature review, and its content validity was established. Reliability of the questionnaire was 0.95. A randomized control trail using pre- and post-test design was used for 30 male urological cancer patients and was assigned to experimental group (15) who received information booklet and control group (15) who received standard treatment. Subjects in the experimental group were provided with opinionnaire during posttest. Data were analyzed using descriptive and inferential statistics. Results: In experimental group, 40% of the subjects were ≤ 40 years, whereas 27% in the control group (P = 0.699). The pre- and post-mean difference score was significantly higher in experimental group (mean difference - 5) than control group (mean difference - 0.4). All subjects (100%) opined that the information booklet was useful, adequate, self-explanatory, sequential, and clear. Conclusions: Information in the booklet will help subjects to understand the common sexual problems after urological surgeries and help them to cope with the problems, thereby improving their quality of life.
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Affiliation(s)
| | - Meera Sharad Achrekar
- Nursing Department, Advanced Centre for Treatment, Research and Education in Cancer, Navi Mumbai, Maharashtra, India
| | - Ganesh Bakshi
- Department of Urology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Rani Shetty
- Leelabai Thackersey College of Nursing, S. N. D. T University, Mumbai, Maharashtra, India
| | - Maria Carvalho
- Nursing Department, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Flynn KE, Lindau ST, Lin L, Reese JB, Jeffery DD, Carter J, Baron SR, Abramsohn E, Weinfurt KP. Development and Validation of a Single-Item Screener for Self-Reporting Sexual Problems in U.S. Adults. J Gen Intern Med 2015; 30:1468-75. [PMID: 25893421 PMCID: PMC4579234 DOI: 10.1007/s11606-015-3333-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 01/12/2015] [Accepted: 03/30/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Brief self-assessment of sexual problems in a clinical context has the potential to improve care for patients through the ability to track trends in sexual problems over time and facilitate patient-provider communication about this important topic. However, instruments designed for research are typically too long to be practical in clinical practice. OBJECTIVE To develop and validate a single-item self-report clinical screener that would capture common sexual problems and concerns for men and women. DESIGN We created three candidate screener items, refined them through cognitive interviews, and administered them to a large sample. We compared the prevalence of responses to each item and explored the discrepancies between items. We evaluated the construct validity of the items by comparing them to scores on the Patient-Reported Outcomes Measurement Information System® Sexual Function and Satisfaction (PROMIS® SexFS) measure. PARTICIPANTS Local patients participated in two rounds of cognitive interviews (n = 7 and n = 11). A probability-based random sample of U.S. adults comprised the item-testing sample (n = 3517). MAIN MEASURES The items were as follows: 1) a yes/no item on any sexual problems or concerns ("general screener"), 2) a yes/no item on problems experienced for 3 months or more during the past 12 months, with a list of examples ("long list screener"), and 3) an item identical to the long list screener except that examples appeared individually as response options and respondents could check all that applied ("checklist screener"). KEY RESULTS All of the screeners tested showed evidence for basic validity and had minimal missing data. Percentages of women and men endorsing the screeners were 10 % and 15 % (general); 20 % and 17 % (long list); and 38 % and 30 % (checklist), respectively. Participants who endorsed the screeners had lower function compared to those who did not endorse them. CONCLUSIONS We recommend the checklist screener for its specificity and ability to identify specific problems associated with decreased sexual function.
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Affiliation(s)
- Kathryn E Flynn
- Center for Patient Care and Outcomes Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
| | - Stacy Tessler Lindau
- Department of Obstetrics/Gynecology, University of Chicago, Chicago, IL, USA.,Department of Medicine-Geriatrics, Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Li Lin
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Diana D Jeffery
- Defense Health Agency, Department of Defense, Falls Church, VA, USA
| | - Jeanne Carter
- Departments of Surgery and Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Shirley R Baron
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Emily Abramsohn
- Department of Obstetrics/Gynecology, University of Chicago, Chicago, IL, USA
| | - Kevin P Weinfurt
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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Intimate relationships and sexual function in partnered patients in the year before and one year after a myocardial infarction: A longitudinal study. Eur J Cardiovasc Nurs 2015; 14:468-77. [DOI: 10.1177/1474515115571061] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 01/14/2015] [Indexed: 01/23/2023]
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White ID, Wilson J, Aslet P, Baxter AB, Birtle A, Challacombe B, Coe J, Grover L, Payne H, Russell S, Sangar V, Van As N, Kirby M. Development of UK guidance on the management of erectile dysfunction resulting from radical radiotherapy and androgen deprivation therapy for prostate cancer. Int J Clin Pract 2015; 69:106-23. [PMID: 25283500 PMCID: PMC4309408 DOI: 10.1111/ijcp.12512] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
AIM To develop a management strategy (rehabilitation programme) for erectile dysfunction (ED) after radiotherapy (RT) or androgen deprivation therapy (ADT) for prostate cancer that is suitable for use in a UK NHS healthcare context. METHODS PubMed literature searches of ED management in this patient group together with a survey of 28 experts in the management of treatment-induced ED from across the UK were conducted. RESULTS Data from 19 articles and completed questionnaires were collated. The findings discussed in this article confirm that RT/ADT for prostate cancer can significantly impair erectile function. While many men achieve erections through PDE5-I use, others need combined management incorporating exercise and lifestyle modifications, psychosexual counselling and other erectile aids. This article offers a comprehensive treatment algorithm to manage patients with ED associated with RT/ADT. CONCLUSION Based on published research literature and survey analysis, recommendations are proposed for the standardisation of management strategies employed for ED after RT/ADT. In addition to implementing the algorithm, understanding the rationale for the type and timing of ED management strategies is crucial for clinicians, men and their partners.
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Affiliation(s)
- I D White
- Urology Unit, The Royal Marsden NHS Foundation Trust, London & Sutton, UK
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Sporn NJ, Smith KB, Pirl WF, Lennes IT, Hyland KA, Park ER. Sexual health communication between cancer survivors and providers: how frequently does it occur and which providers are preferred? Psychooncology 2014; 24:1167-73. [PMID: 25534170 DOI: 10.1002/pon.3736] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 10/22/2014] [Accepted: 11/18/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND Sexual health concerns in cancer survivors are often unaddressed by providers. Study objectives were to assess cancer survivors' reported rates of communication with oncology providers about sexual health, preference for such communication with their oncology or primary care providers (PCPs), and factors associated with these communication rates and preferences. METHODS Sixty-six patients attending a cancer survivorship clinic were asked how often their oncologist addressed and initiated discussion about sexual functioning and whether they wanted their oncologist or PCP to ask about their sexual health. We also assessed whether various sociodemographic characteristics and levels of depression, anxiety, and sexual satisfaction were associated with survivors' sexual health communication rates and preferences. RESULTS 41% of patients wanted their oncologist to ask about sexual health and 58% of patients wanted their PCP to ask about sexual health. Over 90% of patients reported that their oncologist infrequently addressed sexual health concerns and that their oncologist was unlikely to initiate such discussions. Education level influenced whether patients wanted their oncologist to ask about sexual health. Age, education level, and insurance type influenced whether patients wanted their PCP to ask about sexual health. Levels of depression, anxiety, and sexual satisfaction were not associated with communication rates or preferences. CONCLUSIONS Patients attending a survivorship clinic reported infrequent communication about sexual health with their oncology providers, despite wanting their providers to ask about sexual health concerns.
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Affiliation(s)
- Nora J Sporn
- University of Kansas, Department of Psychology, Lawrence, KS, USA
| | - Kelly B Smith
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - William F Pirl
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Inga T Lennes
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Kelly A Hyland
- Massachusetts General Hospital Cancer Center, Boston, MA, USA.,Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Massachusetts General Hospital Cancer Center, Boston, MA, USA.,Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA
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Halley MC, May SG, Rendle KAS, Frosch DL, Kurian AW. Beyond barriers: fundamental 'disconnects' underlying the treatment of breast cancer patients' sexual health. CULTURE, HEALTH & SEXUALITY 2014; 16:1169-80. [PMID: 25138386 DOI: 10.1080/13691058.2014.939227] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Sexual health concerns represent one of the most frequently experienced and longest-lasting effects of breast cancer treatment, but research suggests that service providers rarely discuss sexual health with their patients. Existing research examining barriers to addressing patients' sexual health concerns has focused on discrete characteristics of the provider-patient interaction without considering the broader context in which these interactions occur. Drawing on the experiences of 21 breast cancer survivors, this paper explores three ways in which fundamental cultural and structural characteristics of the cancer care system in the USA may prevent breast cancer survivors from addressing their sexual health concerns, including: (1) when patients discussed sexual health with their providers, their providers approached sexuality as primarily physical, while participants experienced complex, multidimensional sexual health concerns; (2) specialisation within cancer care services made it difficult for patients to identify the appropriate provider to address their concerns; and (3) the structure of cancer care literally disconnects patients from the healthcare system at the time when sexual side effects commonly emerged. These data suggest that addressing breast cancer survivors' sexual health concerns requires a multifaceted approach to health systems change.
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Affiliation(s)
- Meghan C Halley
- a Palo Alto Medical Foundation Research Institute , Palo Alto , CA , USA
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Same RV, Bell DL, Rosenthal SL, Marcell AV. Sexual and reproductive health care: adolescent and adult men's willingness to talk and preferred approach. Am J Prev Med 2014; 47:175-81. [PMID: 24951042 DOI: 10.1016/j.amepre.2014.03.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 02/28/2014] [Accepted: 03/22/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Sexually active adolescent and adult men have substantial sexual and reproductive health (SRH) needs, but little is known about their willingness and preferred approach to talk about SRH with their healthcare provider. PURPOSE To examine participants' willingness to talk about 11 SRH topics, including sexually transmitted disease (STD) risk; human papilloma virus (HPV) vaccine; condom use; female birth control methods; emergency contraception; concerns about sexual performance or making someone pregnant; being a father; relationships; testicular cancer; and acne, with their healthcare provider and their preferred approach (provider- or self-initiated). METHODS This cross-sectional clinic-based survey of 346 men aged 16-35 years was conducted in 2011. Bivariate analyses conducted in 2012 examined variation in study outcomes by participants' predisposing (age, race/ethnicity); enabling (education, past provider SRH discussion); and need factors (SRH concern). RESULTS Almost all participants (84%-98%) were willing to talk about all SRH topics. The top three topics included STD risk (98%); testicular cancer (98%); and HPV vaccine (97%). Among those willing to talk, the majority preferred their provider initiate the discussion (52%-88%). Participants reporting past provider discussions were more likely to prefer that their provider initiate discussions on condom use, female birth control methods, concerns about sexual performance and making someone pregnant, and relationships. Study outcomes did not vary by any other participant predisposing, enabling, or need factors. CONCLUSIONS These findings indicate that adolescent and adult men are willing to discuss a wide range of SRH topics with their healthcare provider. Providers need to move beyond whether male patients want to talk about these topics and instead proactively promote these conversations.
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Affiliation(s)
- Robert V Same
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - David L Bell
- Columbia University Medical Center, Columbia University, New York, New York
| | - Susan L Rosenthal
- Columbia University Medical Center, Columbia University, New York, New York
| | - Arik V Marcell
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland.
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Ribeiro S, Alarcão V, Simões R, Miranda FL, Carreira M, Galvão‐Teles A. General Practitioners' Procedures for Sexual History Taking and Treating Sexual Dysfunction in Primary Care. J Sex Med 2014; 11:386-93. [DOI: 10.1111/jsm.12395] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Berry MD, Berry PD. Integrative Approaches to the Treatment of Erectile Dysfunction. CURRENT SEXUAL HEALTH REPORTS 2014. [DOI: 10.1007/s11930-014-0012-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Berry MD, Berry PD. Contemporary Treatment of Sexual Dysfunction: Reexamining the Biopsychosocial Model. J Sex Med 2013; 10:2627-43. [DOI: 10.1111/jsm.12273] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Costa P, Grandmottet G, Mai HD, Droupy S. Impact of a first treatment with phosphodiesterase inhibitors on men and partners' quality of sexual life: results of a prospective study in primary care. J Sex Med 2013; 10:1850-60. [PMID: 23679019 DOI: 10.1111/jsm.12186] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Phosphodiesterase type 5 inhibitors (PDE5is) as oral treatment for erectile dysfunction (ED) facilitate the management of ED in primary care. Still, compliance is low and general practitioners (GPs) do not always feel confident with this pathology. AIM.: The aim of this paper is to evaluate the impact of a first treatment with PDE5i on the patient and his partner and the management of ED by GPs. METHODS The Evaluation après traitement de la dyfonction erectile, du bien-êtré émotionnel d'un patient en fonction de la rigidité de son érection survey was a longitudinal, observational French study with prospective collection of data from the GP, the patient, and his partner at baseline and after 3 months of treatment. GPs benefited from a short educational session before starting the survey. MAIN OUTCOME MEASURES The main outcome measures are the Erection Hardness Score (EHS), Self-Esteem and Relationship (SEAR) questionnaire, Index of Sexual Life (ISL), and Erectile Dysfunction Inventory of Treatment Satisfaction. RESULTS A total of 478 men aged 19-80 years (mean 57 years) were included in the survey by 229 GPs. Before treatment, EHS was mostly grade 1 (28%) or 2 (44%). At the end of the survey, an improvement was reported for 88% of the patients and 58% achieved maximum score EHS 4 (penis completely hard and fully rigid). Mean SEAR scores significantly increased after 3 months for self-esteem, overall and sexual relationship, and more notably with greater improvement in EHS (P < 0.001). Improvement in partners' ISL scores was significantly higher with greater improvement in EHS (P < 0.001) and in SEAR score for self-esteem. The safety profile of PDE5i was good with few adverse events, mostly headaches. More than 80% of the participating GPs considered that the survey had changed their management of ED. CONCLUSION After 3 months of treatment with PDE5i, a significant improvement in self-esteem was observed in patients with ED, associated with improvement in erection.
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Affiliation(s)
- Pierre Costa
- Service d'urologie, Hôpital Carémeau, Nîmes, France.
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Althof SE, Parish SJ. Clinical Interviewing Techniques and Sexuality Questionnaires for Male and Female Cancer Patients. J Sex Med 2013; 10 Suppl 1:35-42. [DOI: 10.1111/jsm.12035] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shindel AW, Parish SJ. CME Information:Sexuality Education in North American Medical Schools: Current Status and Future Directions (CME). J Sex Med 2013; 10:3-17; quiz 18. [DOI: 10.1111/j.1743-6109.2012.02987.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Althof SE, Rosen RC, Perelman MA, Rubio-Aurioles E. Standard Operating Procedures for Taking a Sexual History. J Sex Med 2013; 10:26-35. [DOI: 10.1111/j.1743-6109.2012.02823.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Salonia A, Ferrari M, Saccà A, Pellucchi F, Castagna G, Clementi MC, Matloob R, Briganti A, Rigatti P, Montorsi F. Delay in Seeking Medical Help in Patients with New‐Onset Erectile Dysfunction Remained High Over and Despite the PDE5 Era—An Ecological Study. J Sex Med 2012; 9:3239-46. [DOI: 10.1111/j.1743-6109.2012.02953.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Smith ML, Honoré Goltz H, Ahn S, Dickerson JB, Ory MG. Correlates of chronic disease and patient-provider discussions among middle-aged and older adult males: Implications for successful aging and sexuality. Aging Male 2012; 15:115-23. [PMID: 22201700 DOI: 10.3109/13685538.2011.641184] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Effective erectile dysfunction (ED) treatments and cardiovascular disease (CVD) and diabetes risk assessments are available, but require patient-provider communication. The present study explored this issue using 2010 National Social Life, Health and Aging Project data for males age 57 years and older (n = 1011). METHODS Multinomial logistic regression was performed to compare factors associated with being without CVD/diabetes (39.9%), being diagnosed with CVD only (43.1%), and having comorbid CVD/diabetes (CVD 17.0%). Logistic regression compared factors associated with having ever discussed sexual issues with physicians. RESULTS CVD-only participants were more likely to be ≥ 75 years (p = 0.004) and smoke (p = 0.019); CVD&D participants were more likely to report activity limitations (p < 0.001) and less likely to have sex within the previous year (p = 0.014). Compared to CVD-only, men with CVD&D were more likely to be minorities, obese, have daily activity limitations, and report erectile difficulties (all p < 0.05). Males discussing sexual issues with physicians were more likely to report higher education [OR = 1.68, p = 0.001], have sex in previous year [OR = 1.73, p = 0.006], and have erectile difficulties [OR = 2.26, p < 0.001]. DISCUSSION Increased patient and provider awareness and communication are needed to lifestyle behaviors, promote self-care practices, and improve health care utilization among male patients affected by chronic disease and ED.
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Affiliation(s)
- Matthew Lee Smith
- The University of Georgia, College of Public Health, 330 Ramsey Center, 315 River Road, Athens, GA 30602, USA.
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Corona G, Ricca V, Bandini E, Rastrelli G, Casale H, Jannini EA, Sforza A, Forti G, Mannucci E, Maggi M. SIEDY scale 3, a new instrument to detect psychological component in subjects with erectile dysfunction. J Sex Med 2012; 9:2017-26. [PMID: 22594968 DOI: 10.1111/j.1743-6109.2012.02762.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION We previously developed and validated a structured interview (SIEDY) dealing with the organic (Scale 1), relational (Scale 2), and psychological (Scale 3) components of erectile dysfunction (ED). AIM To identify a pathological threshold for SIEDY Scale 3 and to analyze Scale 3 score with biological and psychological correlates in subjects with sexual dysfunction. METHOD A pathological threshold of SIEDY Scale 3 score in predicting subjects with a medical history of psychopathology and using psychiatric drugs was identified through receiver operating characteristic (ROC) curve analysis in a sample of 484 patients (Sample A). MAIN OUTCOME MEASURE Sensitivity and specificity, along with possible interactions with biological and psychological (Middlesex Hospital Questionnaire, MHQ-score) correlates were verified in a further sample of 1,275 patients (Sample B). RESULTS In sample A, 39 (8%) and 60 (12.4%) subjects reported a positive medical history for psychiatric disturbances or for the use of psychotropic medication, respectively. The association with both conditions was present in 28 (5.8%) subjects. ROC curve showed that SIEDY Scale 3 score predicts psychopathology with an accuracy of 69.5 ± 5.9% (P<0.002), when a threshold of 3 was chosen. When the same threshold was applied in Sample B, it identified a higher ranking in MHQ-A (free-floating anxiety), MHQ-S (somatized anxiety) and MHQ-D (depressive symptoms) subscales, even after adjustment for age and Σ-MHQ (a broader index of general psychopathology). In the same sample, we also confirmed that pathological Scale 3 score was related to a higher risk of psychopathology at medical history or to the use of psychotropic drugs as well as with risky lifestyle behaviors, including smoking and alcohol abuse, and elevated BMI. CONCLUSIONS SIEDY represents an easy tool for the identification of patients with a relevant intra-psychic component who should be considered for psychological/psychiatric treatment.
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Affiliation(s)
- Giovanni Corona
- Andrology and Sexual Medicine Unit, Department of Clinical Physiopathology, University of Florence, Florence Italy
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Clegg M, Towner A, Wylie K. Should questionnaires of female sexual dysfunction be used in routine clinical practice? Maturitas 2012; 72:160-4. [PMID: 22521685 DOI: 10.1016/j.maturitas.2012.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 03/20/2012] [Indexed: 10/28/2022]
Abstract
AIMS The aim of this paper is to explore the potential value of questionnaires in routine clinical practice to assess female sexual dysfunction (FSD), and to identify if this could increase the competence of a physician in the initial management of women with these problems. The rationale to encourage Health Care Professionals (HCPs) to engage women in dialogue about their sexual health is that it may enhance a woman's quality of life (which may lead to improved general health) and might lead to timely interventions and possible preventative measures for certain diseases. METHOD A short literature review of the most relevant publications was undertaken evaluating current practice. RESULTS FSD can have a negative impact on women's well-being and can also be an early symptom of underlying disease. Many HCPs do not broach the subject, consequently women do not get the opportunity either to voice their sexual concerns or access appropriate services. Review of currently available FSD questionnaires suggests that many but not all are generally inappropriate for use in routine clinical practice. Kriston et al.'s STEFFI-2 may be an appropriate starting point. Evidence suggests that this would facilitate discussion of sexual matters between the HCP and the women, and increase the likelihood of FSD being diagnosed. CONCLUSIONS Following this review of the literature, the authors strongly recommend that HCPs include FSD questionnaires as part of their routine engagement with women. However, the questionnaire would need to be used as part of the overall assessment and cannot replace a detailed case history and examination, which should lead to effective treatment and management of FSD. The authors recommend further research in the following areas: • Effective training for HCPs. • FSD as an early presentation of sub-clinical disease. • The cost-benefit of early treatment of FSD. • A standardised, validated FSD screening tool. • Benefits of using FSD screener in routine clinical practice.
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Sexual problems in Parkinson's disease: The multidimensional nature of the problem and of the intervention. J Neurol Sci 2011; 310:139-43. [DOI: 10.1016/j.jns.2011.05.050] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2011] [Revised: 05/24/2011] [Accepted: 05/26/2011] [Indexed: 11/19/2022]
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Sofer M, Yehiely R, Greenstein A, Bar-Yosef Y, Matzkin H, Chen J. Endourological procedures and sexual dysfunction: a prospective multivariate analysis. BJU Int 2011; 109:250-3. [DOI: 10.1111/j.1464-410x.2011.10232.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Flynn KE, Reese JB, Jeffery DD, Abernethy AP, Lin L, Shelby RA, Porter LS, Dombeck CB, Weinfurt KP. Patient experiences with communication about sex during and after treatment for cancer. Psychooncology 2011; 21:594-601. [PMID: 21394821 DOI: 10.1002/pon.1947] [Citation(s) in RCA: 205] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 01/29/2011] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We studied patients' experiences with oncology providers regarding communication about sexual issues during and after treatment for cancer. METHODS During development of the Patient-Reported Outcomes Measurement Information System (PROMIS(®)) Sexual Function measure, we collected focus group and survey data on communication with oncology professionals about sexual problems. We conducted 16 focus groups with patients and survivors (n = 109) and analyzed the discussions for major themes, including experiences discussing sex during oncology visits. During testing of the PROMIS Sexual Function measure, we assessed experiences discussing sexual problems with oncology professionals (n = 819) and measured bivariate associations between asking for information from clinicians and sexual function and satisfaction with sex life. RESULTS Most patients and survivors (74%) thought that discussions with oncology professionals about sexual problems were important, but whether they had ever received information about sexual function from a provider varied by cancer type (23% lung, 29% breast, 39% colorectal, and 79% prostate). Those who had asked an oncology professional about sexual problems had significantly greater interest in sexual activity as well as more sexual dysfunction. CONCLUSIONS Sexual problems are a widespread concern among patients and survivors, but there is much variation in experiences of communication about sexual issues, and many patients do not receive the information they need from their oncology providers. There are large differences in sexual function between patients who do and do not ask providers about sexual problems. Sexual health has yet to be fully integrated into oncology care, even for cancers involving sex organs.
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Affiliation(s)
- Kathryn E Flynn
- Duke Clinical Research Institute, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27715, USA.
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Ivarsson B, Sjoberg T, Fridlund B. Health professionals’ views on sexual information following MI. ACTA ACUST UNITED AC 2010; 19:1052-4. [DOI: 10.12968/bjon.2010.19.16.78202] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bodil Ivarsson
- Department of Cardiothoracic Surgery, Lund University and Skane University Hospital, Lund, Sweden
| | - Trygve Sjoberg
- Department of Cardiothoracic Surgery, Lund University and Skane University Hospital, Lund, Sweden
| | - Bengt Fridlund
- School of Health Sciences, Jonkoping University, Jonkoping, Sweden
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Kristofferzon ML, Johansson I, Brännström M, Arenhall E, Baigi A, Brunt D, Fridlund B, Nilsson U, Persson S, Rask M, Wieslander I, Ivarsson B. Evaluation of a Swedish Version of the Watts Sexual Function Questionnaire (WSFQ) in Persons with Heart Disease: A Pilot Study. Eur J Cardiovasc Nurs 2010; 9:168-74. [DOI: 10.1016/j.ejcnurse.2009.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Revised: 12/10/2009] [Accepted: 12/15/2009] [Indexed: 10/20/2022]
Affiliation(s)
- Marja-Leena Kristofferzon
- Department of Caring Science and Sociology, University of Gävle, SE-801 76 Gävle, Sweden
- Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ingela Johansson
- Department of Medical and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping Heart Centre, Linköping University Hospital, Sweden
- Molde University College, Faculty of Health Sciences, Molde, Norway
| | | | - Eva Arenhall
- Department of Cardiology, Örebro University Hospital and School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Amir Baigi
- General Practice and Public Health, Halland County Council, Falkenberg, Sweden
| | - David Brunt
- School of Health Sciences and Social Work, Växjö University, Växjö, Sweden
| | - Bengt Fridlund
- School of Health Sciences and Social Work, Växjö University, Växjö, Sweden
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Ulrica Nilsson
- Department of Anaesthesia and Intensive Care and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden
| | - Sylvi Persson
- School of Health Sciences and Social Work, Växjö University, Växjö, Sweden
| | - Mikael Rask
- School of Health Sciences and Social Work, Växjö University, Växjö, Sweden
| | - Inger Wieslander
- School of Health Sciences, Jönköping University, Jönköping, Sweden
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
| | - Bodil Ivarsson
- Department of Cardiothoracic Surgery, Lund University Hospital and Lund University, Lund, Sweden
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Abstract
INTRODUCTION Patients with Parkinson's disease (PD) report frequent sexual dissatisfaction, desire, arousal and orgasmic problems. Motor and non-motor symptoms contribute to further manifestations of sexual dysfunction (SD). Studies have indicated that the need for intimacy and sexual expression are important dimensions of quality of life for PD patients. Inquiry about sexual functioning may be overlooked by neurologists due to time constraints, confusion about sexual conversation, and lack of proper training. METHODS Practical strategies will be presented. "Open Sexual Communication" (OSEC) module will be used to overcome barriers for sexual discussion. Suggestion for further assessment and analysis of cases will enable understanding of specific sexual interventions adapted for PD patients. RESULTS Physicians will be empowered to address sexual problems of PD patients and encounter a range of practical interventions. CONCLUSIONS The physical and emotional changes in PD and treatment of the disease have a major effect on SD of patients and their partners. All patients may experience impairment of sexual function and quality of life. Health care providers can proactively address sexual health issues by providing information, by recognizing and treating the sexual needs of PD patients and by referring them to specialists.
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Affiliation(s)
- Gila Bronner
- Sexual Medicine Center, Dept. of Urology, Sheba Medical Center, Tel-Hashomer, Israel.
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Abstract
BACKGROUND Sexual dysfunction is an important issue that affects many cancer survivors who are increasingly being cared for by internists. OBJECTIVE To examine the attitudes and reported practices of internists regarding survivorship care as it pertains to sexual dysfunction. DESIGN Surveys were sent to 406 physicians affiliated with the Department of Internal Medicine at the University of Colorado Denver School of Medicine. Of the 319 eligibles, 227 were returned (71% RR). MAIN RESULTS Of the 227 responders, 46% were "somewhat/very" likely to initiate a conversation about sexual dysfunction; 62% "never/rarely" addressed sexual dysfunction. Each additional weekly hour spent in patient care was associated with a 2% increase in the likelihood of sexual dysfunction being addressed or discussions about sexual dysfunction being initiated. Reported inadequate preparation/formal training around survivorship issues was associated with sexual dysfunction being addressed less often (odds ratio [OR] = 0.45). Perception of patient anxiety or fears about health was associated with sexual dysfunction being addressed more often (OR = 2.38). Perceived preparedness to evaluate long-term effects was associated with a greater likelihood of physicians initiating discussions about sexual functioning (OR = 2.49). CONCLUSIONS Cancer survivors receive their long-term care from internists. Our results suggest that sexual dysfunction is often not addressed during their follow-up care. Additional training is needed to prepare physicians to negotiate this difficult issue.
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Wittmann D, Montie JE, Hamstra DA, Sandler H, Wood DP. Counseling patients about sexual health when considering post-prostatectomy radiation treatment. Int J Impot Res 2009; 21:275-84. [PMID: 19609297 PMCID: PMC2834328 DOI: 10.1038/ijir.2009.32] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 06/08/2009] [Accepted: 06/12/2009] [Indexed: 01/08/2023]
Abstract
Prostate cancer is the second most frequently diagnosed cancer in men in the United States. Many men with clinically localized prostate cancer survive for 15 years or more. Although early detection and successful definitive treatments are increasingly common, a debate regarding how aggressively to treat prostate cancer is ongoing because of the effect of aggressive treatment on the quality of life, including sexual functioning. We examined current research on the effect of post-prostatectomy radiation treatment on sexual functioning, and suggest a way in which patient desired outcomes might be taken into consideration while making decisions with regard to the timing of radiation therapy after prostatectomy.
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Affiliation(s)
- D Wittmann
- Department of Urology, University of Michigan, Ann Arbor, MI 48109-5330, USA.
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Abstract
With improved cancer survival rates, it is becoming increasingly important to focus on quality of life issues throughout all stages of cancer treatment. Sexual problems often result from the physical and psychological side effects associated with cancer and cancer treatment regimens, yet few cancer patients recall discussing sexual risks before treatment or treatment options for sexual dysfunction after treatment. This review summarizes the literature, to date, on patient and clinician communication about sexual dysfunction. Patients' views about the importance of these discussions and patient and clinician barriers to sexual dysfunction communication are presented. We adapted a behavioral health counseling model, the 5 A's, and present it as a proposed framework for sexual health communication with cancer patients in a multidisciplinary setting.
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De Berardis G, Pellegrini F, Franciosi M, Pamparana F, Morelli P, Tognoni G, Nicolucci A. Management of Erectile Dysfunction in General Practice. J Sex Med 2009; 6:1127-1134. [DOI: 10.1111/j.1743-6109.2008.01093.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Baumgartner MK, Hermanns T, Cohen A, Schmid DM, Seifert B, Sulser T, Strebel RT. Patients' Knowledge about Risk Factors for Erectile Dysfunction is Poor. J Sex Med 2008; 5:2399-404. [DOI: 10.1111/j.1743-6109.2008.00866.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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