Cardiovascular changes resulting from sexual activity and sexual dysfunction after myocardial infarction: integrative review

Determining the sexual quality of life and related factors in patients referred to the department of cardiac rehabilitation: A cross-sectional study

BACKGROUND

One of the neglected issues among cardiovascular participants is sexual activity, which can affect their general quality of life.

OBJECTIVE

To evaluate the sexual quality of life and its related factors.

MATERIALS AND METHODS

This cross-sectional study was conducted on 200 cardiovascular participants, referred to the department of rehabilitation of the Shahid Beheshti Hospital of Kashan, Iran in May 2017. Individuals who met the inclusion criteria filled the demographic characteristics questionnaires, including sexual quality of life questionnaire (SQOL)-female and SQOL-male, sexual knowledge post-myocardial infarction scale (SKS-MI), sexual knowledge after coronary artery bypass grafting surgery scale (SKS-CABG), and couple communication scale (CCS).

RESULTS

In this research, the mean score of SQOL of the participants was 50.02 ± 22.57. According to the results, there was a significant and positive association between the scores of SQOL and CCS (r = 0.540, p ≤ 0.0001), SKS-MI (r = 0.322, p = 0.006), and SKS-CABG (r = 0.178, p = 0.046). The maximum association was observed between SQOL and CCS and the minimum association between SQOL and SKS-CABG. Moreover, there was a relationship between the SQOL and participant's age and level of education.

CONCLUSION

According to the results of the study, the sexual quality of life scores among participants with MI and CABG was not favorable and this participant suffered from a lack of sexual knowledge.

Sexual Knowledge in Post-Myocardial Infarction Patients: A Cross-Sectional Study

Background

Adequate sexual knowledge is a key component of cardiac rehabilitation. Sexual knowledge in post-myocardial infarction (MI) patients is unknown. Thus, we conducted this study to investigate the sexual knowledge of post-myocardial infarction patients and their accessibility to sexual counseling.

Methodology

Between July and September 2018, a cross-sectional survey was carried out in 6six major hospitals in Karachi. The non-probability convenient sampling technique was used to include all patients meeting the inclusion criteria. To reduce biases, face-to-face interviews were conducted by investigators who were trained prior to the start of data collection. Knowledge was assessed using the Swedish version of the "Sex after MI Knowledge Test" questionnaire, where a higher score meant higher knowledge. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0 (IBM Corp., Armonk, NY) The t-test was applied to compare the knowledge score between males and females.

Results

There was a total of 278 MI patients with a mean age of 54 years, of which 60% were men. The "Sex After MI Knowledge Test" scores varied between 37 and 67 (mean score 51 ± 5). None of the participants obtained the maximum possible test score of 75. The most frequently occurring score was 49 (16%). Around half of the participants (48%) incorrectly believed that sex cannot be safely resumed within a few weeks after the heart attack. Limited knowledge was found in questions pertaining to alcohol, viagra, and late evening being the best time to have sex. Medical knowledge was provided to only 27% (n=76) of the participants, of whom 77% (n=58) received it from the hospital staff itself. A significant difference existed in scores obtained by males and females, with males having a higher score and the mean difference in scores being 1.7 (p=0.015).

Conclusion

Lack of sexual knowledge in MI patients due to the inadequacy of healthcare providers and the social stigma surrounding the topic causes marital strain leading to low quality of life.

Psychometric Evaluation of the Sex After Myocardial Infarction Knowledge Test in Iranian Context

PURPOSE

To translate, adapt, and assess the psychometric properties of the Sex After MI Knowledge Test in Iranian context (where MI is myocardial infarction).

DESIGN AND METHODS

A cross-sectional descriptive survey was performed. The sample comprised 250 patients with MI. Confirmatory factor analysis was applied to extract three indicators.

FINDINGS

The Sex After MI Knowledge Test indicated good reproducibility (Cronbach's α = .76, Intraclass correlation (ICC) = 0.729, CI = 0.7280-0.781, p < .001 ICC: Intraclass correlation). Nonnormed and normed fit indices (FI) were 0.89, and incremental and comparative FIs were 0.90. Goodness-of-fit index (GFI) and adjusted GFI were below the criteria. After a varimax rotation, the first six items of the instrument explained 58.71% of total variance.

PRACTICE IMPLICATIONS

The instrument showed acceptable psychometric properties in terms of construct validity and internal consistency. The instrument might be used to stimulate conversations patients with MI regarding sexual knowledge and concerns.

Another Chance at Life: Jordanian Patients' Experience of Going Through a Myocardial Infarction

BACKGROUND AND PURPOSE

Myocardial infarction (MI) is a life-threatening health condition that has physical, spiritual, emotional, and social changes. Understanding feelings and thoughts of patients who suffered MI attacks is essential to recovery. Among Jordanian patients who suffered an acute attack of MI, the aim of the study was to describe the experiences and the varied meanings that they assign to their experiences.

METHODS

A qualitative hermeneutic phenomenological research design was used. Five participants were engaged in in-depth semistructured interviews. The participants were identified using a purposeful sampling technique, after being admitted at a coronary care unit in a university hospital located in Amman, the capital city of Jordan. The hospital provides a full range of cardiovascular medical and surgical care for patients admitted from different socioeconomic levels. Transcribed data were analyzed following inductive qualitative content analysis method.

RESULTS

The experience of MI was a traumatizing event characterized by life-threatening symptoms, and participants feared they would not come back home. However, cultural values and religiosity among the Jordanian patients played a major role in facilitating their positive coping during and after the MI attack. The participants' recount of their experience was summed-up into 5 major themes: frightening experience, needed support, religiosity, experiencing changes, and lifestyle modifications. After the MI attack, most of the participants felt that they had given another chance to live, showing a pressing need to make healthier lifestyle modifications to avoid another MI attack.

IMPLICATIONS FOR PRACTICE

Health care workers should need not only pay attention on physical and physiological caring aspects but should also consider other patients' needs, while supporting the patients and their family members.

Predictors of change in sexual activity after cardiac diagnosis: Elements to inform sexual counseling

Safely returning to sexual activity after being diagnosed with a cardiac condition is at the core of sexual counseling strategies. To further inform sexual counseling, this study examined changes in sexual activity before and after a cardiac diagnosis. Logistic analysis was used to suggest factors that can contribute to a change in sexual activity among cardiac patients. Reduced frequency in sexual activity after a cardiac diagnosis was influenced by greater sexual concerns and a history of smoking, as well as by education and employment status. These findings suggest that cardiac patients experiencing significant concerns about resuming sexual activity need added support through the mental health system.

Relationship Between Ischemic Heart Disease and Sexual Satisfaction

AIM

Ischemic heart disease is a life-threatening condition. Considerable doubts exist over the effects of this disease on patients' sexual activity and satisfaction. The aim of this study was to evaluate the relationship between ischemic heart disease and sexual satisfaction.

METHODS

In a retrospective cohort study, the convenience sample of 150 patients exposure with ischemic heart disease and 150 people without exposure it was drawn from Shahid Beheshti hospital, Kashan, Iran. Sampling was performed from March to September 2014. We employed the Larson's Sexual Satisfaction Questionnaire for gathering the data. Data were analyzed using descriptive statistics and Chi-square, t-test and linear regression analysis.

RESULTS

The means of sexual satisfaction in patients exposure with ischemic heart disease and among the subjects without exposure it were 101.47±13.42 and 100.91±16.52, respectively. There was no significant difference between the two groups regarding sexual satisfaction. However, sexual satisfaction was significantly correlated with gender and the use of cardiac medications (P value<0.05).

CONCLUSION

The level of sexual satisfaction in patients with exposure ischemic heart disease is similar to the people without exposure it. Moreover, the men and the patients who do not receive cardiac medications have higher levels of sexual satisfaction. Nurses who are providing care to patients with ischemic heart disease need to pay closer attention to patient education about sexual issues.

Patients’ Experiences of Sexual Activity Following Myocardial Ischemia

The purpose of this article is to describe patients’ experiences of sexual activity after suffering myocardial ischemia. We conducted semi-structured qualitative interviews with people who had suffered myocardial ischemia in the last 6 to 24 months before the interview. We used maximum variation sampling method. After reaching theoretical saturation, a 19-informants sample was formed. Data were analyzed using the Giorgi method. Four themes were identified: “sexual activity becomes different,” “determinants of the return to sexual activity,” “how sexual activity ought to be,” and “sexual information received.” Patients showed a decrease both in frequency and desire for sexual activity influenced by fear of sexual activity and health care professionals’ recommendations. These recommendations were about “avoiding sexuality at the beginning” and conducting “sexual activity without overdoing it.” Health care professionals should educate patients about the right time to resume sexual activity. Nurses can help patients to deal with fears related to sexual activity.