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Chen M, Zhang Z, Zhou R, Li B, Jiang J, Shi B. The relationship between oxidative balance score and erectile dysfunction in the U.S. male adult population. Sci Rep 2024; 14:10746. [PMID: 38730004 PMCID: PMC11087471 DOI: 10.1038/s41598-024-61287-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 05/03/2024] [Indexed: 05/12/2024] Open
Abstract
Oxidative stress strongly influences the pathophysiology of erectile dysfunction (ED). In this study, we used the oxidative balance score (OBS), a composite index, to measure the effects of oxidative stress triggered by diet and lifestyle factors. Here, we conducted a cross-sectional study to determine the statistical relationship between OBS and ED among adult males in the U.S. The data from 3318 participants in the National Health and Nutrition Examination Survey (NHANES) 2001-2004 were analyzed. Weighted logistic regression was used to correct for confounding factors and acquire nationwide representative estimates. Generalized additive modeling was used to explore the nonlinear relationship. We also supplemented subgroup and sensitivity analysis to examine the robustness of the main results. Multivariate logistic regression indicated a consistent negative linear association between OBS and ED across all participants [OR (95% CI) = 0.96 (0.94, 0.98)]. After categorizing OBS into tertiles, participants in the highest tertile had 43% lower odds of having ED than those in the lowest tertile [OR (95% CI) = 0.57 (0.37, 0.87)]. The generalized additive model also visualized the linear trend of this association. Furthermore, this linear relationship remained relatively consistent, regardless of whether subgroup or sensitivity analyses were performed. Our findings suggest that adopting a lifestyle and diet pattern that promotes favorable OBS may effectively protect against the development of ED, regardless of the underlying causes.
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Affiliation(s)
- Mutong Chen
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
- Shantou University Medical College, Shantou, China.
| | - Zhongfu Zhang
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Rui Zhou
- Clinical Psychology/Psychosomatic Medicine Department, Shenzhen People's Hospital, Shenzhen, China
| | - Baizhi Li
- Shantou University Medical College, Shantou, China
| | - Jiahao Jiang
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Bentao Shi
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
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Napolitano L, Pantano I, Romano L, Cirillo L, Manfredi C, Matrangelo F, Fusco GM, Mauro D, Spirito L, La Rocca R, Arcaniolo D, Franzese CA, Sciorio C, Romano M, De Sio M, Mirone V, Ciccia F. Sexual dysfunctions of rheumatological patients are a neglected issue: Results from a national survey of Italian Society of Rheumatology. Arch Ital Urol Androl 2023:11337. [PMID: PMID: 37254930 DOI: 10.4081/aiua.2023.11337] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 03/30/2023] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION Sexual dysfunctions (SD) are frequently encountered in patients with rheumatologic diseases. In this scenario, a multidisciplinary approach to rheumatologic diseases is often mandatory. The aim of this survey was to assess whether Italian rheumatologists routinely explore sexual health of their patients, their knowledge on the topic, and the barriers to discussing SD in clinical practice. METHODS A 32-items anonymous questionnaire was mailed to members of the Italian Society of Rheumatology (rheumatologists and residents in rheumatology training) in February 2023. The questionnaire aimed to determine attitudes, knowledge, and practice patterns regarding the discussion of SD with rheumatologic patients. A descriptive analysis of responses was performed. RESULTS A total of 162 responses were received. Overall, 50.0% of respondents occasionally asked patients about SD related to their rheumatologic pathologies, while 37.1% never did so. Respondents declared that patients occasionally (82.3%) or never (16.1%) reported SD related to rheumatologic diseases. The main barriers to discussing sexual health were lack of time during medical examination (46.6%), patients' discomfort (44.8%), and lack of knowledge/experience (39.7%). Overall, 41.9% and 33.9% of respondents respectively totally and partially agreed that rheumatologists should routinely investigate patients' sexual health. Most of the respondents (79.0%) thought that discussing sexual health problems could help patients cope with their rheumatologic diseases. Of all respondents, 74.2% felt the need to broaden their personal knowledge about SD. Finally, 45.9% and 34.4% of respondents respectively partially and totally agreed that training courses for rheumatologists could be helpful in the management of sexual health in rheumatological patients. CONCLUSIONS SD was not routinely discussed in rheumatology practice, still remaining a neglected issue. The most frequent explanations for the lack of attention toward SD were lack of time, patients' discomfort, and lack of knowledge/experience. Most of the respondents expressed the possible usefulness of attending SD courses to improve knowledge about these conditions.
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Affiliation(s)
- Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Ilenia Pantano
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples.
| | - Lorenzo Romano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Celeste Manfredi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples.
| | - Francesco Matrangelo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Giovanni Maria Fusco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Daniele Mauro
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples.
| | - Lorenzo Spirito
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples.
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Davide Arcaniolo
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples.
| | | | | | - Marco Romano
- Department of Precision Medicine and Hepatogastroenterology Unit, AOU University Luigi Vanvitelli, Naples.
| | - Marco De Sio
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples.
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Francesco Ciccia
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples.
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Cirillo L, Fusco GM, Di Bello F, Morgera V, Cacace G, Di Mauro E, Mastrangelo F, Romano L, Calace FP, La Rocca R, Napolitano L. Sexual dysfunction: Time for a multidisciplinary approach? Arch Ital Urol Androl 2023; 95:11236. [PMID: 36924366 DOI: 10.4081/aiua.2023.11236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/17/2023] [Indexed: 03/17/2023] Open
Abstract
Sexual health impairment is one of the most important issues worldwide, with an increasing number of men and women affected. Specifically in male sexual dysfunction (SD), several risk factors were established such as atherosclerosis, hypertension, diabetes mellitus, smoking or obesity. The co-presence of more than one of risk factors identifies a condition, defined as the metabolic syndrome (MetS), related directly to the SD. However, not all the physicians involved in the MetS management routinely discussed the sexual impairment, increasing the bothering feelings of patients. Furthermore, the lack of knowledge, insufficient time, lack of attention, ambiguities about responsibility, insufficient training and experience, shared among physicians, regarding the communication and treatment of sexual dysfunction, are all reported factors involved in under-valuation of SD. The current paper represents a warning to the experts, with the aim of increasing the awareness of SD among clinicians and to promote the education, training and collaboration with sex therapists, through a multidisciplinary team, that can lead to a holistic approach in SD assessment and treatment.
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Affiliation(s)
- Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples.
| | - Giovanni Maria Fusco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples.
| | - Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples.
| | - Vincenzo Morgera
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples.
| | - Gianluigi Cacace
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples.
| | - Ernesto Di Mauro
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples.
| | - Francesco Mastrangelo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples.
| | - Lorenzo Romano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples.
| | - Francesco Paolo Calace
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples.
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples.
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples.
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Ruan Z, Xie X, Yu H, Liu R, Jing W, Lu T. Association between dietary inflammation and erectile dysfunction among US adults: A cross-sectional analysis of the National Health and Nutrition Examination Survey 2001-2004. Front Nutr 2022; 9:930272. [PMID: 36438746 PMCID: PMC9691656 DOI: 10.3389/fnut.2022.930272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although chronic low-grade inflammation has been linked to the development of erectile dysfunction (ED), the association between pro-inflammatory diets and ED is unclear. The dietary inflammation index (DII) is a novel method to quantify the inflammatory potential of a diet. OBJECTIVE Our objective was to investigate the association between the DII and ED among US males. DESIGN This cross-sectional study included 3,693 males 20-85 year of age from the National Health and Nutrition Examination Survey (NHANES) 2001-2004. Multivariable-adjusted logistic regression models were used to assess the association between the DII and ED. All analyses accounted for the complex sampling design. RESULTS The mean ± SE of the DII was 0.8 ± 0.1 and 0.4 ± 0.1 among participants with and without ED, respectively. After adjusting for age, race/ethnicity, education, smoking status, physical activity, drinking status, hypertension, diabetes, cardiovascular disease, hypercholesterolemia, BMI, and eGFR, the DII score was associated with ED (odds ratio 1.12; 95% CI: 1.04-1.19). Moreover, this association was also stable in our subgroup analysis or sensitivity analyses. CONCLUSION Dietary inflammatory potential, as estimated by the DII score, is positively associated with ED among US males.
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Affiliation(s)
- Zhijie Ruan
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Xiaoping Xie
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Haoyang Yu
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Ruimin Liu
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Wenjuan Jing
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Tao Lu
- Department of Dermatology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
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Romano L, Zagari RM, Arcaniolo D, Crocetto F, Spirito L, Sciorio C, Gravina AG, Dajti E, Barone B, La Rocca R, De Sio M, Mirone V, Romano M, Napolitano L. Sexual dysfunction in gastroenterological patients: Do gastroenterologists care enough? A nationwide survey from the Italian Society of Gastroenterology (SIGE). Dig Liver Dis 2022; 54:1494-1501. [PMID: PMID: 35710521 DOI: 10.1016/j.dld.2022.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Patients affected by gastrointestinal disorders often experience sexual dysfunction (SD). This creates stress and anxiety which impact on patients' and/or their partners' quality of life. A multidisciplinary approach to SD is often advisable in these patients. This survey assessed if gastroenterologists routinely discuss SD with their patients and the barriers toward discussing SD in clinical practice. METHODS A 29-item questionnaire was sent to members of the Italian Society of Gastroenterology and Digestive Endoscopy (SIGE). A descriptive analysis of responses was performed. RESULTS Out of 714 eligible gastroenterologists, 426 (59.7%), responded.The majority (>70%) never/infrequently investigated SD with their patients and, similarly, most patients never discussed SD during the visit. The most reported reasons were lack of knowledge (58%), time (44%), and embarrassment (30%). However, more than 70% of respondents indicated that all specialists should be able to manage sexual problems, and more than 80% declared that it would be useful for gastroenterologists to attend courses dedicated to the problem of SD. CONCLUSION Despite the high prevalence of SD, counselling was not routinely performed in gastroenterological care. Lack of education/knowledge appeared as the most important factor. Most of responders felt that attending a course on SD might increase the awareness of SD.
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Affiliation(s)
- Lorenzo Romano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Rocco Maurizio Zagari
- Gastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna; Department of Medical and Surgical Sciences, University of Bologna.
| | - Davide Arcaniolo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli'
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy.
| | - Lorenzo Spirito
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli'
| | | | - Antonietta Gerarda Gravina
- Department of Precision Medicine and Hepatogastroenterology Unit, AOU University Luigi Vanvitelli, Naples, Italy.
| | - Elton Dajti
- Gastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna; Department of Medical and Surgical Sciences, University of Bologna.
| | - Biagio Barone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy.
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Marco De Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli'.
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy.
| | - Marco Romano
- Department of Precision Medicine and Hepatogastroenterology Unit, AOU University Luigi Vanvitelli, Naples, Italy.
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy.
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Valeiro C, Matos C, Scholl J, van Hunsel F. Drug-Induced Sexual Dysfunction: An Analysis of Reports to a National Pharmacovigilance Database. Drug Saf 2022; 45:639-650. [PMID: 35386045 DOI: 10.1007/s40264-022-01174-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Sexual dysfunction (SD) is a problem that can affect any phase of the sexual response cycle (such as sexual desire, arousal and orgasm) and individuals of any age. SD can be caused by physical reasons, such as medical conditions, alcoholism or drug abuse; psychological factors, such as stress and anxiety; and different medicines, such as selective serotonin reuptake inhibitors (SSRIs), and their associated adverse effects. AIM The aim of this study was to characterise drugs suspected to have caused SD adverse drug reactions (ADRs) in patients, by conducting a descriptive study based on pharmacovigilance reports. METHODS Reports submitted to the Netherlands Pharmacovigilance Centre Lareb from January 2003 to December 2019 were used to investigate drug-induced sexual disorders. Selected reports had at least one ADR reported in the Medical Dictionary for Regulatory Activities (MedDRA®) System Organ Class (SOC) 'Reproductive system and breast disorders' and the SOC 'Psychiatric disorders' relating to sexual disorders and corrected for drug utilisation (expenditure) for the Dutch population. RESULTS A total of 2815 SD ADRs were reported in the observed period. Data were divided according to three variables: pharmacotherapeutic group, the drug itself, and sex. A total of 722 different SD/pharmacotherapeutic group pairs were observed. The pharmacotherapeutic groups with the highest frequency of SD reports were SSRIs (n = 488, 17.58%), other antidepressants (n = 172, 6.20%) and HMG-CoA reductase inhibitors (n = 149, 5.37%). Distinguishing ADRs by sex, men suffered more from erectile dysfunction, decreased libido and ejaculation disorders, while among women, libido disorders, dyspareunia and SD were the most common ADRs. CONCLUSION Different reactions and disproportionality of reactions were detected between the sexes. Antidepressants, antihypertensives, oral contraceptives, α-blockers, and anti-androgens were the pharmacotherapeutic groups with the highest number of SD reports and corresponding high odds ratios.
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Affiliation(s)
- Carolina Valeiro
- Instituto Politécnico De Coimbra, ESTESC-Coimbra Health School, Farmácia, Coimbra, Portugal
| | - Cristiano Matos
- Instituto Politécnico De Coimbra, ESTESC-Coimbra Health School, Farmácia, Coimbra, Portugal.
| | - Joep Scholl
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Florence van Hunsel
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
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Sexual Dysfunction Among Patients With Chronic Kidney Disease. Semin Nephrol 2022; 41:534-549. [PMID: 34973698 DOI: 10.1016/j.semnephrol.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Sexual dysfunction (SD) in patients with chronic kidney disease is common and negatively impacts quality of life. SD is often under-appreciated because of overall low awareness. Diagnosis of SD is subjective, and manifestations can be different among men and women. Causes of SD are multifactorial, including psychological disorders, hormonal imbalances, vascular disorders, neurological disorders, and medication side effects. Non-specific approaches to improving sexual function include addressing underlying psychological disorders, promoting lifestyle modifications, optimizing dialysis care, and facilitating successful kidney transplantation, whereas treatment with phosphodiesterase type 5 inhibitor, hormone replacement, and mechanical devices can be offered to patients with specific indications.
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Sexuality in Kidney Transplant Recipients: A Qualitative Study. Healthcare (Basel) 2021; 9:healthcare9111432. [PMID: 34828479 PMCID: PMC8625839 DOI: 10.3390/healthcare9111432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 12/02/2022] Open
Abstract
End-stage kidney disease has a negative impact on patients’ quality of life. People who receive a kidney transplant experience an improvement in many areas of their daily life. Sexuality is a general component of health, which can be affected by end-stage kidney disease and kidney transplant. The aim of this study was to explore and understand the experiences and perspectives of kidney transplant recipients regarding their sexuality. A qualitative study based on Gadamer’s hermeneutic philosophy was carried out. Two focus groups and nine interviews were conducted with 18 kidney transplant recipients. Data were audio-recorded, transcribed, and analyzed with the help of qualitative analysis software. Two main themes emerged from the data: (1) “The impact of a kidney transplant on sexuality”, with the subthemes “sexuality is relegated to the background”, “physical decline acts as a sexual inhibitor”, and “changes in sexual activity following a kidney transplant”; (2) “Sexual education in kidney transplant recipients” with the subthemes “sexuality: a hidden concern amongst kidney transplant recipients” and “talking about sexuality with healthcare professionals”. Sexuality is a frequent concern among kidney transplant recipients. The physiological and emotional changes experienced after kidney transplant exert a great influence on their sexuality. Healthcare professionals rarely discuss sexuality concerns with kidney transplant recipients. Professional sexual education and assistance are necessary to improve sexual health satisfaction of kidney transplant recipients.
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Gordijn R, Teichert M, Nicolai MPJ, Elzevier HW, Guchelaar HJ, Hughes CM. Learning From Consultations Conducted by Community Pharmacists in Northern Ireland for Nonprescription Sildenafil: A Qualitative Study Using the Theoretical Domains Framework. Sex Med 2021; 9:100440. [PMID: 34628114 PMCID: PMC8766262 DOI: 10.1016/j.esxm.2021.100440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Nonprescription sildenafil was introduced to the United Kingdom in 2018 as the first pharmacy service concerning sexual function, an important but often ignored factor for quality of life. AIM This study aimed to evaluate pharmacists' views on providing nonprescription sildenafil, their perceptions of the barriers and facilitators to provide this service and strategies to overcome potential barriers, using a theory-based approach. METHODS Community pharmacists were purposefully sampled in Northern Ireland, followed by snowball sampling. Face-to-face interviews were conducted between October 2019 and January 2020. The semi-structured interviews used a piloted topic guide based on the 14-domain Theoretical Domains Framework (TDF). All interviews were audio-recorded, transcribed verbatim and anonymized. Transcripts were analyzed deductively in NVivo 13, utilizing the TDF domains as coding categories. Within each domain, content analysis was utilized to identify barriers and facilitators. MAIN OUTCOME MEASURE Barriers and facilitators within the TDF domains for pharmacists to provide nonprescription sildenafil. RESULTS Ten pharmacists were interviewed to reach data saturation. Eight pharmacists had experience with dispensing nonprescription sildenafil. They valued nonprescription sildenafil as an additional service ("Social/professional role and identity"). Training, concise product guidelines, and private consultation areas were important facilitators ("Environmental context and resources"). The service required trusting clients ("Optimism"), with concerns about abuse and men not visiting their GP. From experience gained, pharmacists became more confident dealing with difficult situations such as patients being vague about their medical history or alcoholism or mental problems as causes for erectile disfunction (ED) ("Skills" and "Beliefs about capabilities"). Pharmacists considered lifestyle and medication causes of ED important but preferred to focus on safe supply. In general, pharmacists were satisfied with the perceived professional recognition, using their clinical knowledge or helping patients resume sexual relationships ("Beliefs about consequences"). CONCLUSION Pharmacists welcomed nonprescription sildenafil to enhance their role as easily accessible healthcare providers for patients. Gordijn R, Teichert M, Nicolai MPJ, et al. Learning From Consultations Conducted by Community Pharmacists in Northern Ireland for Nonprescription Sildenafil: A Qualitative Study Using the Theoretical Domains Framework. Sex Med 2021;9:100440.
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Affiliation(s)
- Rineke Gordijn
- Leiden University Medical Center, Department of Clinical Pharmacy & Toxicology, Leiden, The Netherlands.
| | - Martina Teichert
- Leiden University Medical Center, Department of Clinical Pharmacy & Toxicology, Leiden, The Netherlands
| | - Melianthe P J Nicolai
- Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam, The Netherlands
| | - Henk W Elzevier
- Leiden University Medical Center, Department of Urology and Department of Medical Decision Making, Leiden, The Netherlands
| | - Henk-Jan Guchelaar
- Leiden University Medical Center, Department of Clinical Pharmacy & Toxicology, Leiden, The Netherlands
| | - Carmel M Hughes
- Primary Care Research Group, School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland
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Gordijn R, Nicolai MPJ, Elzevier HW, Guchelaar HJ, Teichert M. An estimation of patients at potential risk for drug-induced sexual dysfunction using pharmacy dispensing data. Fam Pract 2021; 38:292-298. [PMID: 33140832 PMCID: PMC8211144 DOI: 10.1093/fampra/cmaa116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Adverse drug reactions on sexual functioning (sADRs) may seriously decrease a person's quality of life. A multitude of diseases and drugs are known risk factors for sexual dysfunction. To inform patients better about these potential effects, more insight is needed on the estimated number of patients at high risk for sADRs and their characteristics. METHODS This cross-sectional study estimated the number of patients in the Netherlands who were dispensed drugs with a potential very high risk (>10%) or high risk (1-10%) for sADRs as registered in the Summary of Product Characteristics, the official drug information text in Europe. RESULTS In April 2019, 2.06% of the inhabitants of the Netherlands received drugs with >10% risk for sADRs and 7.76% with 1-10% risk. The majority of these patients had at least one additional risk factor for decreased sexual function such as high age or depression. Almost half of the patients were identified with two or more morbidities influencing sexual functioning. Paroxetine, sertraline and spironolactone were the most dispensed drugs with a potential >10% risk for sADRs. One-third of their first dispenses were not followed by a second dispense, with a higher risk of discontinuation for a decreasing number of morbidities. CONCLUSION About 1 in 11 inhabitants of the Netherlands was dispensed a drug with a potential high risk for sADRs, often with other risk factors for sexual complaints. Further research is needed whether these users actually experience sADRs, to understand its impact on multimorbid patients and to provide alternatives if needed.
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Affiliation(s)
- Rineke Gordijn
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Henk W Elzevier
- Department of Urology and Department of Medical Decision Making
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martina Teichert
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands
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Wang Y, Snoep JD, Hemmelder MH, van der Bogt KEA, Bos WJW, van der Boog PJM, Dekker FW, de Vries APJ, Meuleman Y. Outcomes after kidney transplantation, let's focus on the patients' perspectives. Clin Kidney J 2021; 14:1504-1513. [PMID: 34084453 PMCID: PMC8162867 DOI: 10.1093/ckj/sfab008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Indexed: 02/03/2023] Open
Abstract
Graft function and patient survival are traditionally the most used parameters to assess the objective benefits of kidney transplantation. Monitoring graft function, along with therapeutic drug concentrations and transplant complications, comprises the essence of outpatient management in kidney transplant recipients (KTRs). However, the patient's perspective is not always included in this process. Patients' perspectives on their health after kidney transplantation, albeit subjective, are increasingly acknowledged as valuable healthcare outcomes and should be considered in order to provide patient-centred healthcare. Such outcomes are known as patient-reported outcomes (PROs; e.g. health-related quality of life and symptom burden) and are captured using PRO measures (PROMs). So far, PROMs have not been routinely used in clinical care for KTRs. In this review we will introduce PROMs and their potential application and value in the field of kidney transplantation, describe commonly used PROMs in KTRs and discuss structural PROMs implementation into kidney transplantation care.
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Affiliation(s)
- Yiman Wang
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaapjan D Snoep
- Department of Internal Medicine, Tergooi, Hilversum, The Netherlands
| | - Marc H Hemmelder
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Koen E A van der Bogt
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Transplant Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Willem Jan W Bos
- Department of Internal Medicine, St Antonius Hospital, Nieuwegein, The Netherlands
- Department of Internal Medicine, Division of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul J M van der Boog
- Transplant Center, Leiden University Medical Center, Leiden, The Netherlands
- Department of Internal Medicine, Division of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Aiko P J de Vries
- Transplant Center, Leiden University Medical Center, Leiden, The Netherlands
- Department of Internal Medicine, Division of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Yvette Meuleman
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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12
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Barnhoorn PC, Zuurveen HR, Prins IC, van Ek GF, den Oudsten BL, den Ouden MEM, Putter H, Numans ME, Elzevier HW. Unravelling sexual care in chronically ill patients: the perspective of GP practice nurses; Health Service Research. Fam Pract 2020; 37:766-771. [PMID: 32719863 PMCID: PMC7759747 DOI: 10.1093/fampra/cmaa071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Assessment of sexual health is important in chronically ill patients, as many experience sexual dysfunction (SD). The general practice nurse (GPN) can play a crucial part in addressing SD. OBJECTIVE The aim of this cross-sectional study was to examine to which extent GPNs discuss SD with chronically ill patients and what barriers may refrained them from discussing SD. Furthermore, we examined which factors had an association with a higher frequency of discussing SD. METHODS A cross-sectional survey using a 48-item questionnaire was send to 637 GPNs across the Netherlands. RESULTS In total, 407 GPNs returned the questionnaire (response rate 63.9%) of which 337 completed the survey. Two hundred and twenty-one responding GPNs (65.6%) found it important to discuss SD. More than half of the GPNS (n = 179, 53.3%) never discussed SD during a first consultation, 60 GPNs (18%) never discussed SD during follow-up consultations. The three most important barriers for discussing SD were insufficient training (54.7%), 'reasons related to language and ethnicity' (47.5%) and 'reasons related to culture and religion' (45.8%). More than half of the GPNs thought that they had not enough knowledge to discuss SD (n = 176, 54.8%). A protocol on addressing SD would significantly increase discussing during SD. CONCLUSIONS This study indicates that GPNs do not discuss SD with chronically ill patients routinely. Insufficient knowledge, training and reasons related to cultural diversity were identified as most important reasons for this practice pattern. Implementation of training in combination with guidelines on SD in the general practice could improve on the discussing of sexual health with chronic patients.
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Affiliation(s)
- Pieter C Barnhoorn
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden RC, The Netherlands
| | - Hannah R Zuurveen
- Department of Urology, Leiden University Medical Centre, Leiden RC, The Netherlands
| | - Inge C Prins
- Department of Urology, Leiden University Medical Centre, Leiden RC, The Netherlands
| | - Gaby F van Ek
- Department of Urology, Leiden University Medical Centre, Leiden RC, The Netherlands
| | - Brenda L den Oudsten
- Department of Urology, Leiden University Medical Centre, Leiden RC, The Netherlands
| | | | - Hein Putter
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden RC, The Netherlands
| | - Mattijs E Numans
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden RC, The Netherlands
| | - Henk W Elzevier
- Department of Urology, Leiden University Medical Centre, Leiden RC, The Netherlands
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13
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Petit-Steeghs V, Mogami-Asselin GIK, Nijenkamp MD, Spoel M, Broerse JEW, Pittens CACM. Empowering Patients and Health Professionals to Address Sexual Health in the Context of Anorectal Malformations and Hirschsprung's Disease. QUALITATIVE HEALTH RESEARCH 2020; 30:2033-2048. [PMID: 32762414 PMCID: PMC7549282 DOI: 10.1177/1049732320944653] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study is to develop a tool that is aligned with patients' and health professionals' needs to address sexual health in the context of anorectal malformations and Hirschsprung's disease. A multiphased participatory action-research was conducted. First, an inventory of needs was made through interviews (11 patients, 11 professionals), three online focus groups (4 patients, 20 professionals), and a questionnaire (38 patients). Subsequently, four cocreation sessions with in total four patients and nine professionals were organized to translate the needs into a tool (in the form of a website). The websites' functionality was assessed via a questionnaire (n = 34). The website, directed to patients, their parents, and professionals, stimulates awareness, fills knowledge gaps, and shows possibilities for support. The website is expected to change restrictive attitudes toward sexual health and improve the legitimization of the topic needed for the allocation of resources and sexologists' involvement in current care pathways.
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Affiliation(s)
- V. Petit-Steeghs
- Athena Institute, Faculty of
Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Erasmus School of Health Policy
and Management, Erasmus University Rotterdam, Rotterdam, the
Netherlands
| | - G. I. K. Mogami-Asselin
- Athena Institute, Faculty of
Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - M. D. Nijenkamp
- Athena Institute, Faculty of
Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - M. Spoel
- Erasmus University Medical
Center—Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - J. E. W. Broerse
- Athena Institute, Faculty of
Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - C. A. C. M. Pittens
- Athena Institute, Faculty of
Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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14
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Harrison TG, Skrtic M, Verdin NE, Lanktree MB, Elliott MJ. Improving Sexual Function in People With Chronic Kidney Disease: A Narrative Review of an Unmet Need in Nephrology Research. Can J Kidney Health Dis 2020; 7:2054358120952202. [PMID: 32953127 PMCID: PMC7485155 DOI: 10.1177/2054358120952202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/20/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose of review: Sexual dysfunction occurs commonly in people with chronic kidney
disease (CKD) and has been recognized as a research priority. We
sought to evaluate the current state of the literature
addressing sexual dysfunction in people with CKD and identify
barriers and strategies to improve our management of this
important symptom. Sources of information: OVID Medline and Google Scholar were searched for English,
peer-reviewed studies using keywords and terms related to
“Chronic Kidney Disease,” “sexuality,” and “sexual dysfunction
OR function.” Methods: In this narrative review, we describe definitions of sexual
dysfunction and contributors exacerbated by CKD, barriers to
researching sexual dysfunction in people with CKD, and possible
avenues for future research. Key findings: Sexual dysfunction is common in people with CKD and results from a
combination of kidney disease itself, as well as its associated
physical (ie, comorbidities) and nonphysical factors. Barriers
to the study of sexual dysfunction in CKD include inconsistent
disease definitions, stigma, variable efficacy and safety of
established therapies, and evolving gender roles in sexual
function. Potential avenues for future research to improve the
sexual function in people with CKD may include evaluating the
safety and efficacy of established therapies in people with CKD
using a variety of observational and interventional study
designs, engaging people with CKD and multidisciplinary team
members in research, and using implementation science methods to
translate what is known about sexual function into clinical
practice. Concerted efforts are required to break down barriers
and improve sexual function in people with CKD. Patients have
identified this as an important research priority, and national
networks need to direct efforts to reduce symptom burden. Limitations: This narrative review was limited by a paucity of high-quality
studies examining sexual dysfunction specifically in people with
kidney disease.
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Affiliation(s)
- Tyrone G Harrison
- Section of Nephrology, Department of Medicine, University of Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, AB, Canada
| | - Marko Skrtic
- Division of Nephrology, Department of Medicine, University Health Network, Toronto, ON, Canada.,Department of Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Nancy E Verdin
- Patient and Community Engagement Research Unit, O'Brien Institute for Public Health, University of Calgary, AB, Canada
| | - Matthew B Lanktree
- Division of Nephrology, Department of Medicine, St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada
| | - Meghan J Elliott
- Section of Nephrology, Department of Medicine, University of Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, AB, Canada
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15
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Attini R, Cabiddu G, Montersino B, Gammaro L, Gernone G, Moroni G, Santoro D, Spotti D, Masturzo B, Gazzani IB, Menato G, Donvito V, Paoletti AM, Piccoli GB. Contraception in chronic kidney disease: a best practice position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology. J Nephrol 2020; 33:1343-1359. [PMID: 32166655 PMCID: PMC7701165 DOI: 10.1007/s40620-020-00717-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/25/2020] [Indexed: 01/09/2023]
Abstract
Even though fertility is reduced, conception and delivery are possible in all stages of CKD. While successful planned pregnancies are increasing, an unwanted pregnancy may have long-lasting deleterious effects, hence the importance of birth control, an issue often disregarded in clinical practice. The evidence summarized in this position statement is mainly derived from the overall population, or other patient categories, in the lack of guidelines specifically addressed to CKD. Oestroprogestagents can be used in early, non-proteinuric CKD, excluding SLE and immunologic disorders, at high risk of thromboembolism and hypertension. Conversely, progestin only is generally safe and its main side effect is intramestrual spotting. Non-medicated intrauterine devices are a good alternative; their use needs to be carefully evaluated in patients at a high risk of pelvic infection, even though the degree of risk remains controversial. Barrier methods, relatively efficacious when correctly used, have few risks, and condoms are the only contraceptives that protect against sexually transmitted diseases. Surgical sterilization is rarely used also because of the risks surgery involves; it is not definitely contraindicated, and may be considered in selected cases. Emergency contraception with high-dose progestins or intrauterine devices is not contraindicated but should be avoided whenever possible, even if far preferable to abortion. Surgical abortion is invasive, but experience with medical abortion in CKD is still limited, especially in the late stages of the disease. In summary, personalized contraception is feasible, safe and should be offered to all CKD women of childbearing age who do not want to get pregnant.
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Affiliation(s)
- Rossella Attini
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, Turin, Italy
| | | | - Benedetta Montersino
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, Turin, Italy
| | - Linda Gammaro
- Nephrology Ospedale Fracastoro San Bonifacio, San Bonifacio, Italy
| | | | - Gabriella Moroni
- Nephrology, Fondazione Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Domenico Santoro
- Nephrology and Dialysis, Azienda Ospedaliera Universitaria "G. Martino", Messina, Italy
| | - Donatella Spotti
- Nephrology and Dialysis, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Bianca Masturzo
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, Turin, Italy
| | - Isabella Bianca Gazzani
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, Turin, Italy
| | - Guido Menato
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, Turin, Italy
| | - Valentina Donvito
- Department of Internal Medicine, Ospedale Sant'Anna, Città della Salute e della Scienza, Turin, Italy
| | - Anna Maria Paoletti
- Department of Surgical Sciences, Obstetrics and Gynecology, University Hospital of Cagliari, Cagliari, Italy
| | - Giorgina Barbara Piccoli
- Department of Clinical and Biological Sciences, Università di Torino, Turin, Italy. .,Nephrology and Dialysis, Centre Hospitalier Le Mans, Le Mans, France.
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16
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Albers LF, Van Ek GF, Krouwel EM, Oosterkamp-Borgelink CM, Liefers GJ, Den Ouden MEM, Den Oudsten BL, Krol-Warmerdam EEM, Guicherit OR, Linthorst-Niers E, Putter H, Pelger RCM, Elzevier HW. Sexual Health Needs: How Do Breast Cancer Patients and Their Partners Want Information? JOURNAL OF SEX & MARITAL THERAPY 2019; 46:205-226. [PMID: 31762399 DOI: 10.1080/0092623x.2019.1676853] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
It is well known that breast cancer treatment can affect sexuality. This survey evaluated the needs of breast cancer patients and partners regarding sexual care. The majority of patients (80.4%) and partners (73.7%) did not receive any information regarding sexuality. Although only a quarter of all respondents reported a direct need for information regarding sexuality, most valued an opportunity to discuss sexuality. The nurse practitioner was the most preferable care provider to provide information about sexuality, supported by a brochure or website. Patients considered during treatment as most suitable timing of discussing sexuality, and partners before the start of treatment.
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Affiliation(s)
- L F Albers
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - G F Van Ek
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - E M Krouwel
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - G J Liefers
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - M E M Den Ouden
- Research Center Technology, Health & Care, Saxion University of Applied Sciences, Enschede, The Netherlands
| | - B L Den Oudsten
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - E E M Krol-Warmerdam
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - O R Guicherit
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | | | - H Putter
- Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - R C M Pelger
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - H W Elzevier
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
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17
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Komlenac N, Hochleitner M. Predictors for Low Frequencies of Patient-Physician Conversations Concerning Sexual Health at an Austrian University Hospital. Sex Med 2019; 8:100-106. [PMID: 31680029 PMCID: PMC7042158 DOI: 10.1016/j.esxm.2019.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/28/2019] [Accepted: 09/29/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction Studies concerning barriers to patient-physician conversations about sexual health or, specifically, sexual functioning fail to go beyond descriptive analyses of such barriers. Aim To identify barriers that predict the frequency of patient-physician conversations concerning sexual health or sexual functioning. Methods An online survey among physicians was conducted at an Austrian university hospital. Self-constructed questionnaires assessed physicians’ sociodemographic information, frequency of holding a discussion on sexual health or sexual dysfunctions with their patients, and self-perceived barriers to asking patients about sexual health. Stepwise logistic regression models determined barriers that predicted the frequency of patient-physician conversations concerning sexual health or sexual dysfunctions in everyday clinical practice. Main Outcome Measure The outcome variables in the structural equation models were frequency of patient-physician conversations concerning sexual health or sexual dysfunctions in everyday clinical practice. Results One hundred two physicians (53.9% women, 46.1% men; mean age = 41.3 years; SD = 10.6) provided full responses. Of these physicians, 61.8% reported having a discussion on sexual health or sexual dysfunctions with their patients at least rarely in their everyday clinical practice. The barriers most influencing the frequency of such patient-physician conversations were not feeling responsible for this health issue and expecting the patient to initiate such a conversation. Fear of offending the patient and the physician’s own feelings of shame and discomfort were additional factors influencing the frequency of these patient-physician conversations. Clinical Implications Future physician training should address physicians’ responsibilities that include sexual health. Future physician training should also help physicians in overcoming fears of offending a patient, and one’s own feelings of shame and discomfort when addressing patients’ sexual health. Strengths & Limitations This study included physicians across a range of disciplines, who may encounter patients with sexual problems and with their treatments influence a patient’s sexual health and sexual functioning. However, the low response rate and the limited number of participants prevented generalization of findings. Conclusions At an Austrian university hospital, patient-physician conversations concerning sexual health are seldom part of a physician’s everyday clinical practice. Future training for physicians should focus on demonstrating the relevance of sexual health in the physician’s medical discipline and should tackle a physician’s feelings of shame or how to handle patients’ negative reactions during patient-physician conversations concerning sexual health. Komlenac N, Hochleitner M. Predictors for Low Frequencies of Patient-Physician Conversations Concerning Sexual Health at an Austrian University Hospital. Sex Med 2019; 8:100–106.
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Affiliation(s)
- Nikola Komlenac
- Gender Medicine Unit, Medical University of Innsbruck, Innsbruck, Austria.
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18
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de Rooy FBB, Buhmann C, Schönwald B, Martinez-Martin P, Rodriguez-Blazquez C, Putter H, Elzevier HW, van der Plas AA. Discussing sexuality with Parkinson's disease patients: a multinational survey among neurologists. J Neural Transm (Vienna) 2019; 126:1273-1280. [PMID: 31396705 PMCID: PMC6765045 DOI: 10.1007/s00702-019-02053-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/24/2019] [Indexed: 01/23/2023]
Abstract
Sexual dysfunction is a major non-motor feature of Parkinson’s disease (PD) that may affect the quality of life of many patients. In a Dutch survey, we demonstrated that neurologists often fail to discuss sexuality with their patients. Our objective was to determine to which extent neurologists in Spain and Germany address sexuality with their patients and whether cross-cultural differences exist. A 30-item questionnaire was sent out to 1650 German and 460 Spanish neurologists. The questionnaire addressed attitudes, knowledge, barriers, and feelings of responsibility regarding sexuality in PD. 160 German and 32 Spanish respondents completed and returned the questionnaire. The majority of German and Spanish participants discuss sexual dysfunction ‘regularly’ with male patients (61.7% and 78.9%, respectively), but ‘seldom’ with female patients (68.8% and 78.1%, respectively). Important barriers for German and Spanish respondents to discuss sexual dysfunction were patients not expressing sexual complaints spontaneously (52.9% and 75.0%, respectively) and insufficient consultation time (32.2% and 71.9%, respectively). Sexual dysfunction in PD was considered important by 68.3% of German and 96.9% of Spanish participants. German and Spanish neurologists do not routinely discuss sexual dysfunction with their patients, although many of them consider it important to address this topic. It is unclear why this lack of discussing sexual dysfunction is especially found for female patients and whether cultural aspects are involved. We recommend a self-assessment tool for patients to track their symptoms prior to consultation visits and advocate local guidelines that formulate who is responsible for discussing sexual dysfunction.
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Affiliation(s)
- F B B de Rooy
- Department of Urology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
| | - C Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, 20246, Hamburg, Germany
| | - B Schönwald
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, 20246, Hamburg, Germany
| | - P Martinez-Martin
- National Center of Epidemiology and CIBERNED, Institute of Health Carlos III, Madrid, Spain
| | - C Rodriguez-Blazquez
- National Center of Epidemiology and CIBERNED, Institute of Health Carlos III, Madrid, Spain
| | - H Putter
- Department of Medical Statistics, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - H W Elzevier
- Department of Urology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - A A van der Plas
- Department of Neurology, Alrijne Hospital, Simon Smitweg 1, 2353 GA, Leiderdorp, The Netherlands
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19
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Kazmerski TM, Miller E, Sawicki GS, Thomas P, Prushinskaya O, Nelson E, Hill K, Miller A, Jean Emans S. Developing Sexual and Reproductive Health Educational Resources for Young Women with Cystic Fibrosis: A Structured Approach to Stakeholder Engagement. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2019; 12:267-276. [PMID: 30361885 DOI: 10.1007/s40271-018-0342-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Stakeholder engagement, specifically integration of patient and family perspectives about what matters, is increasingly recognized as a critical component of patient-centered healthcare delivery. This study describes a structured approach to and evaluation of stakeholder engagement in the development of novel sexual and reproductive health (SRH) educational resources for adolescent and young adult (AYA) women with cystic fibrosis (CF). METHODS Key stakeholders participated in a systematic series of steps to iteratively develop and adapt patient educational resources. Process measures (stakeholder recruitment, composition, co-learning, and transparency) and proximal outcomes of stakeholder involvement (impact on the development process and satisfaction) were measured via recorded stakeholder recommendations and a stakeholder survey. RESULTS Seventeen stakeholders participated in seven group and two patient-only conference calls. The majority of stakeholders understood their roles, had their expectations met or exceeded, and were satisfied with the frequency and quality of engagement in the project. All stakeholders in attendance provided multiple concrete recommen-dations during the development process. Stakeholders explored the motivations of AYA women with CF related to SRH and agreed that the ideal resource should be online. After reviewing the design of existing resources, stakeholders decided by consensus to partner with a pre-existing young women's health website and created 11 CF-specific SRH guides. CONCLUSIONS This study illuminates a path for a formal process of stakeholder engagement and evaluation in educational resource development centered on the SRH care needs of AYA women with CF. Similar systematic, planned processes could be extended to other populations and aspects of healthcare.
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Affiliation(s)
- Traci M Kazmerski
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University Center, 120 Lytton Ave, Mezzanine Floor Suite M060, Pittsburgh, PA, 15213, USA. .,Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University Center, 120 Lytton Ave, Mezzanine Floor Suite M060, Pittsburgh, PA, 15213, USA.,Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gregory S Sawicki
- Division of Respiratory Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Phaedra Thomas
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Olga Prushinskaya
- Division of Respiratory Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Eliza Nelson
- Division of Respiratory Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Kelsey Hill
- Division of Respiratory Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Anna Miller
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - S Jean Emans
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
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20
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Male sexual dysfunction: A review of literature on its pathological mechanisms, potential risk factors, and herbal drug intervention. Biomed Pharmacother 2019; 112:108585. [DOI: 10.1016/j.biopha.2019.01.046] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/16/2019] [Accepted: 01/16/2019] [Indexed: 02/07/2023] Open
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21
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Hough MR, Githens-Mazer G, Lovegrove C, Oram R, Shepherd M. Renal nurses' lived experiences of discussions about sexuality. ACTA ACUST UNITED AC 2019. [DOI: 10.12968/jokc.2019.4.2.91] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Maxine Ruth Hough
- NIHR CRN Study Support Coordinator and Specialist Research Nurse, Royal Devon and Exeter NHS Foundation Trust
| | - Gayle Githens-Mazer
- Research Delivery Manager and Specialist Research Nurse, Royal Devon and Exeter Hospital
| | - Chris Lovegrove
- Clinical Lead Occupational Therapist and Clinical Research Fellow, Royal Devon and Exeter NHS Foundation Trust, University of Plymouth, School of Health Professions
| | - Richard Oram
- Diabetes UK Harry Keen Research Fellow, University of Exeter
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Kazmerski TM, Nelson EB, Newman LR, Haviland MJ, Luff D, Leichtner AM, Hayes MM, Miller E, Emans SJ, Sawicki GS. Interprofessional provider educational needs and preferences regarding the provision of sexual and reproductive health care in cystic fibrosis. J Cyst Fibros 2019; 18:671-676. [PMID: 30795973 DOI: 10.1016/j.jcf.2019.01.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/25/2019] [Accepted: 01/28/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sexual and reproductive health (SRH) is an important disease-specific concern for adolescent and young adult (AYA) women that is not consistently addressed in cystic fibrosis (CF) centers. This study identifies educational needs and preferences of interprofessional CF providers regarding SRH in AYA women with CF. METHODS Interprofessional CF providers participated in an anonymous survey regarding general and CF-specific SRH knowledge and skills, factors for optimizing SRH care, and preferred approaches for SRH training. We calculated descriptive statistics for all respondents and stratified by provider type. RESULTS A total of 523 providers completed the survey (39% physicians/advanced practice providers, 19% nurses, 20% social workers, and 22% other disciplines). Half reported comfort responding to female AYA SRH concerns; however, only one-third were comfortable asking appropriate questions and confident taking a sexual history. Only 29% were comfortable with their current CF-specific SRH knowledge. Respondents' preferred SRH topics for further training included: pregnancy/parenthood planning, sexual functioning, urinary incontinence, intimate partner violence, and taking a sexual history. Nearly two-thirds felt having connection to women's health specialists familiar with CF would facilitate SRH care. Approximately one-third desired SRH educational materials for providers to view at point-of-care or through online case-based learning; <10% were interested in role playing SRH skills. CONCLUSION Many interprofessional CF providers lack comfort and skills in addressing SRH with AYA women with CF. Provider training needs and approaches identified in this study can be used to develop tailored educational interventions to improve comprehensive CF care.
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Affiliation(s)
- Traci M Kazmerski
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America; Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America.
| | - Eliza B Nelson
- Division of Respiratory Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States of America
| | - Lori R Newman
- Department of Medical Education, Boston Children's Hospital, Boston, MA, United States of America
| | - Miriam J Haviland
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States of America
| | - Donna Luff
- Department of Medical Education, Boston Children's Hospital, Boston, MA, United States of America
| | - Alan M Leichtner
- Department of Medical Education, Boston Children's Hospital, Boston, MA, United States of America
| | - Margaret M Hayes
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America; Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America
| | - S Jean Emans
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States of America
| | - Gregory S Sawicki
- Division of Respiratory Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States of America
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Holmes LJ, Yorke JA, Dutton C, Fowler SJ, Ryan D. Sex and intimacy in people with severe asthma: a qualitative study. BMJ Open Respir Res 2019; 6:e000382. [PMID: 30956803 PMCID: PMC6424302 DOI: 10.1136/bmjresp-2018-000382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction People with severe asthma experience unpredictable daily symptoms requiring an intense treatment regimen impacting on health-related quality of life (QoL). Sexuality contributes to this, yet there is a dearth of research exploring intimacy in people with severe asthma. We aimed to explore the patient's perception of the impact of severe asthma on intimacy, establish their information needs and their perceived role of the healthcare practitioner. Methods We have performed a qualitative study guided by Interpretive Phenomenological Analysis. We interviewed patients diagnosed with severe asthma recruited from a dedicated clinic using purposive sampling. Interviews were audio recorded and transcribed verbatim. Using thematic analysis, the data were analysed for emergent themes. Results The nine interviews provided unique and detailed insights into their perspectives on how living with severe asthma impinges on sexual intimacy. Four superordinate themes emerged: (1) 'Physical intimacy': including disclosure of physical limitations of severe asthma on intimacy; (2) 'Emotional intimacy': the cyclical impact of the often-negative emotional struggle of living with severe asthma on relationships; (3) 'The role of the healthcare professional': a perceived failure of healthcare professionals (HCPs) to tackle sexual intimacy in consultations and (4) 'Image of self': the reported struggle to deal with negative body image and confusion regarding changing relationship roles. Discussion This study is the first to explore the impact of severe asthma on intimacy. We suggest an emphasis on education to raise awareness and help HCPs to address this sensitive topic in this cohort and adopt positive strategies to help improve QoL.
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Affiliation(s)
- Leanne Jo Holmes
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Janelle A Yorke
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Caroline Dutton
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Stephen J Fowler
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester and NIHR Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Dorothy Ryan
- Respiratory Medicine, Beaumont Hospital, Dublin, Ireland
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Poelman MR, Brand HS, Forouzanfar T, Daley EM, Jager DHJ. Prevention of HPV-Related Oral Cancer by Dentists: Assessing the Opinion of Dutch Dental Students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:1347-1354. [PMID: 28741269 PMCID: PMC6280774 DOI: 10.1007/s13187-017-1257-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The aim of this study is to assess dental students' opinions of the dentists' role in primary prevention of human papillomavirus (HPV)-related oral cancer using a cross-sectional web-based survey. A questionnaire, containing questions about knowledge of HPV and oral cancer, confidence in head and neck examination and role of the dentist in preventing HPV-related oral cancer, was sent to all students of the Academic Centre of Dentistry Amsterdam (n = 912). One hundred and twenty-six (n = 126) students completed the questionnaire. Significantly, more master students (75%) than bachelor students (54.3%) were aware that HPV is a causative factor for oral cancer. Master students had more knowledge of HPV than bachelor students, but knowledge about HPV vaccination was irrespective of the study phase. The majority of dental students agreed that it is important to discuss HPV vaccination with patients. Eighty-nine percent of the students think that more education about symptoms of oral cancer will increase screening for oral cancer. Development of a protocol for screening in dental practices was considered even more important. According to dental students, dentists should discuss HPV as a risk factor for oral cancer with patients. Future dentists are willing to be involved in both primary and secondary prevention of HPV-related oral cancer. Therefore, screening for oral cancer and education about HPV vaccination should be integral elements of the dental curriculum.
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Affiliation(s)
- Marcella R Poelman
- Centre for Special Care Dentistry (Stichting Bijzondere Tandheelkunde), Gustav Mahlerlaan 3004, Amsterdam, 1081 LA, the Netherlands
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, Amsterdam, 1081 LA, the Netherlands
| | - Thymour Forouzanfar
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam Movement Sciences, VU University Medical Center, VU University, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, MDC 56, 13201 Bruce B. Downs Blvd, Tampa, 33612, FL, USA
| | - Derk H Jan Jager
- Centre for Special Care Dentistry (Stichting Bijzondere Tandheelkunde), Gustav Mahlerlaan 3004, Amsterdam, 1081 LA, the Netherlands.
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam Movement Sciences, VU University Medical Center, VU University, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
- Department of Oral Health Sciences - Prosthetics section, KU Leuven & University Hospitals Leuven, Box 7001, Kapucijnenvoer 7, Leuven, BE-3000, Belgium.
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25
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Yodchai K, Hutchinson AM, Oumtanee A. Nephrology nurses' perceptions of discussing sexual health issues with patients who have end-stage kidney disease. J Ren Care 2018; 44:229-237. [DOI: 10.1111/jorc.12257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kantaporn Yodchai
- Faculty of Nursing, Adult and Elderly Nursing Department; Prince of Songkla University; Hatyai Songkhla Thailand
| | - Alison M. Hutchinson
- School of Nursing and Midwifery, Deakin University; Centre for Quality and Patient Safety Research; Geelong Australia
| | - Areewan Oumtanee
- Faculty of Nursing; Chulalongkorn University; Patumwan Bangkok Thailand
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Hough M, Shepherd M, Chauhan R, Powell R, Childs J. Exploring NursEs lived Experience of Discussions about Sexual health, with kidney patients in Devon (NEEDS). Nurs Open 2018; 5:442-449. [PMID: 30062038 PMCID: PMC6056471 DOI: 10.1002/nop2.152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 01/24/2018] [Indexed: 11/09/2022] Open
Abstract
AIM The aim of the study is to gain a better understanding about the complexities of discussing sexuality with patients. DESIGN The study will explore how nurses understand the phenomenon by using an Interpretive Phenomenological Approach; the technique encourages deep reflection and rich descriptions about lived experience. METHODS Six nurses will be interviewed using iterative, open-ended questions with prompts to illicit rich data. PREDICTED RESULTS Understand the support required to enable nurses to engage in deeper, more fulfilling conversations with patients about sexuality.
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Affiliation(s)
- Maxine Hough
- Royal Devon and Exeter NHS Foundation TrustExeterUK
| | | | | | - Roy Powell
- Royal Devon and Exeter NHS Foundation TrustExeterUK
| | - Jenny Childs
- University of Saint Mark and Saint JohnPlymouthUK
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27
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van Ek GF, Keurhorst D, Krouwel EM, Nicolai MPJ, Den Ouden MEM, Elzevier HW, Putter H, Pelger RCM, Den Oudsten BL. Unravelling current sexual care in chronic kidney disease: perspective of social workers. J Ren Care 2017; 44:30-37. [PMID: 29230963 DOI: 10.1111/jorc.12228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fifty to eighty percent of patients suffering from chronic kidney disease (CKD) experience a form of sexual dysfunction (SD), even after renal transplantation. Despite this, inquiring about SD is often not included in the daily practice of renal care providers. OBJECTIVES This paper explores the perspectives of renal social workers regarding sexual care for patients and evaluates their practice, attitude towards responsibility and knowledge of SD. DESIGN A cross-sectional study was conducted using a 41-item online survey. PARTICIPANTS Seventy-nine members of the Dutch Federation of Social Workers Nephrology. RESULTS It was revealed that 60% of respondents discussed SD with a fifth of their patients. Frequency of discussion was associated with experience (p = 0.049), knowledge (p = 0.001), supplementary education (p = 0.006), and the availability of protocols on sexual care (p = 0.007). Main barriers towards discussing SD consisted of 'culture and religion' (51.9%), 'language and ethnicity' (49.4%), and 'presence of a third person' (45.6%). Sufficient knowledge of SD was present in 28% of respondents. The responsibility for discussion was 96% nephrologists and 81% social workers. CONCLUSION This study provides evidence that a part of Dutch nephrology social workers do not provide sexual care regularly, due to insufficient experience and sexual knowledge, absence of privacy and protocols and barriers based on cultural diversity. According to the respondents the responsibility for this aspect of care should be multidisciplinary. Recommendations include a need for further education on the topic, private opportunities to discuss SD and multidisciplinary guidelines on sexual care.
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Affiliation(s)
- Gaby F van Ek
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - Dirry Keurhorst
- Department of Social Work, Westfries Hospital, Hoorn, the Netherlands
| | - Esmée M Krouwel
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - Melianthe P J Nicolai
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | | | - Henk W Elzevier
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Rob C M Pelger
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Brenda L Den Oudsten
- Department of Medical and Clinical Psychology and Centre of Research on Psychological and Somatic Disorders, Tilburg University, Tilburg, the Netherlands
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28
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van Ek GF, Krouwel EM, van der Veen E, Nicolai MPJ, Ringers J, Den Oudsten BL, Putter H, Pelger RCM, Elzevier HW. The Discussion of Sexual Dysfunction Before and After Kidney Transplantation From the Perspective of the Renal Transplant Surgeon. Prog Transplant 2017; 27:354-359. [PMID: 29187127 DOI: 10.1177/1526924817731885] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Sexual dysfunction (SD) is a common problem in chronic kidney disease (CKD) and endures in 50% of patients after kidney transplantation (KTx), diminishing patients' expectations of life after KTx. Unfortunately, SD is often ignored by renal care providers. Research questions as part of a research project among all renal care providers, transplant surgeons' perspectives were obtained on sexual health care for KTx recipients, including their opinion on who should be accountable for this care. In addition, surgeons' practice and knowledge regarding SD were evaluated. DESIGN A 39-item questionnaire was sent to all Dutch surgeons and residents specialized in KTx (n = 47). RESULTS Response was 63.8%. None of the respondents discussed SD with their patients, before or after surgery. Most important barrier was that surgeons do not feel accountable for it (73.9%); 91.7% thought this accountability should lie with the nephrologist. Another barrier was insufficient knowledge (39.1%). In 75% of the respondents, (almost) no knowledge regarding SD was present and 87.5% noticed education on SD was insufficient during residence training. DISCUSSION Dutch renal transplant surgeons rarely discuss SD with their patients with CKD, as they do not feel accountable for it; this accountability was appointed to the nephrologist. Knowledge and education regarding SD were found insufficient in enabling surgeons and for some it reflects in barriers toward discussing SD. Results emphasize that accountability for providing sexual health care to patients with CKD should lie elsewhere; however, surgeons could briefly provide information on sexual health after KTx, so unfulfilled expectations may be prevented.
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Affiliation(s)
- Gaby F van Ek
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.,5 Department of Medical Decision Making, Leiden University Medical Center, The Netherlands
| | - Esmée M Krouwel
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.,5 Department of Medical Decision Making, Leiden University Medical Center, The Netherlands
| | - Els van der Veen
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands
| | - Melianthe P J Nicolai
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.,5 Department of Medical Decision Making, Leiden University Medical Center, The Netherlands
| | - Jan Ringers
- 2 Department of Transplant Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Brenda L Den Oudsten
- 3 Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders, Tilburg University, Tilburg, The Netherlands
| | - Hein Putter
- 4 Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Rob C M Pelger
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands
| | - Henk W Elzevier
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.,5 Department of Medical Decision Making, Leiden University Medical Center, The Netherlands
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Provider Attitudes and Practices toward Sexual and Reproductive Health Care for Young Women with Cystic Fibrosis. J Pediatr Adolesc Gynecol 2017; 30:546-552. [PMID: 28163120 DOI: 10.1016/j.jpag.2017.01.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 12/12/2016] [Accepted: 01/03/2017] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVE To investigate the attitudes and practices of cystic fibrosis (CF) providers toward sexual and reproductive health (SRH) care in young women with CF. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS Adult and pediatric US CF providers were sent an online survey exploring their attitudes toward SRH importance, SRH care practices, and barriers/facilitators to SRH care in adolescent and/or young adult women. Descriptive statistics and logistic regression were used to analyze results. MAIN OUTCOME MEASURES Attitudes toward the importance of SRH care in patients with CF and self-report of practice patterns of SRH discussion. RESULTS Respondents (n = 196) were 57% pediatric (111/196) and 24% adult physicians (48/196) and 19% nurse practitioners (NPs)/physician assistants (PAs) (37/196). Ninety-four percent of respondents believed SRH was important for female patients with CF (184/196). More than 75% believed SRH care should be standardized within the CF care model (147/196) and 41% believed the CF team should have the primary role in SRH discussion and care (80/196). For many CF-specific SRH topics, discrepancies emerged between how important respondents believed these were to address and how often they reported discussing these topics in practice. Significant differences in SRH attitudes and practices were present between adult and pediatric physicians. The most significant barriers to SRH care identified were lack of time (70%, 137/196) and the presence of family in clinic room (54%, 106/196). Potential facilitators included training materials for providers (68%, 133/196) and written (71%, 139/196) or online (76%, 149/196) educational resources for patients. CONCLUSION CF providers perceive SRH topics as important to discuss, but identify barriers to routine discussion in current practice. Providers endorsed provider training and patient educational resources as means to improve SRH delivery.
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van Ek GF, Gawi A, Nicolai MPJ, Krouwel EM, Den Oudsten BL, Den Ouden MEM, Schaapherder AF, Putter H, Pelger RCM, Elzevier HW. Sexual care for patients receiving dialysis: A cross-sectional study identifying the role of nurses working in the dialysis department. J Adv Nurs 2017; 74:128-136. [DOI: 10.1111/jan.13386] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2017] [Indexed: 01/23/2023]
Affiliation(s)
- Gaby F. van Ek
- Department of Urology; Leiden University Medical Center; The Netherlands
- Department of Medical Decision Making; Leiden University Medical Center; The Netherlands
| | - Adina Gawi
- Department of Urology; Leiden University Medical Center; The Netherlands
| | - Melianthe P. J. Nicolai
- Department of Urology; Leiden University Medical Center; The Netherlands
- Department of Medical Decision Making; Leiden University Medical Center; The Netherlands
| | - Esmée M. Krouwel
- Department of Urology; Leiden University Medical Center; The Netherlands
- Department of Medical Decision Making; Leiden University Medical Center; The Netherlands
| | - Brenda L. Den Oudsten
- Department of Medical and Clinical Psychology; Centre of Research on Psychological and Somatic Disorders; Tilburg University; The Netherlands
| | | | | | - Hein Putter
- Department of Medical Statistics; Leiden University Medical Center; The Netherlands
| | - Rob C. M. Pelger
- Department of Urology; Leiden University Medical Center; The Netherlands
| | - Henk W. Elzevier
- Department of Urology; Leiden University Medical Center; The Netherlands
- Department of Medical Decision Making; Leiden University Medical Center; The Netherlands
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31
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Albers L, van Ek G, Krouwel E, Elzevier H. Toward implementation of sexual healthcare, Response to: ‘The opinion and practices of providers toward the sexual issues of cervical cancer patients undergoing treatment’. Gynecol Oncol Rep 2017; 20:137-138. [PMID: 29892678 PMCID: PMC5993522 DOI: 10.1016/j.gore.2017.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 03/19/2017] [Indexed: 11/23/2022] Open
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Patient sexual function and hip replacement surgery: A survey of surgeon attitudes. INTERNATIONAL ORTHOPAEDICS 2017; 41:2433-2445. [PMID: 28451752 DOI: 10.1007/s00264-017-3473-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 03/23/2017] [Indexed: 01/26/2023]
Abstract
PURPOSE To explore practises of orthopaedic surgeons (and residents) in addressing sexual function (SF) in patients before and after total hip arthroplasty (THA). METHODS A 26-item questionnaire was sent to health professionals (n = 849); 526 (62.0%) responses were included in the analyses. RESULTS About 78% of the respondents (77.5%) almost never addressed SF. The most mentioned reason was that "patients do not ask" (47.4%) followed by "I am not aware of possible needs" (38.6%). SF was even less discussed (25.9%) in elderly patients (>60 years). The beneficial effect of THA on SF was rated the highest in retired surgeons (p ≤ 0.001), in which male surgeons scored higher than female surgeons (p = 0.002). The importance of sexual dificulties (SD) in the decision to undergo surgery was rated lowest by residents (p = 0.020). Rating the risk for dislocation varied between occupations (p = 0.008) and gender (p = 0.016), female surgeons rated highest (median 5); 54.1% indicated the orthopaedic surgeon is responsible for providing information about the safe resumption of sexual activity. CONCLUSIONS Surgeons show little attention to SF related issues in THA patients, which seems not in accordance to patients' needs. Addressing SF increases throughout a surgeon's career. There were divergent views and there is no "common advice" about the safe resumption of sexual activity. The results emphasize the need for guidelines and training in order to encourage addressing SF both, before and after THA.
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van Ek GF, Krouwel EM, Nicolai MPJ, Den Oudsten BL, Den Ouden MEM, Dieben SWM, Putter H, Pelger RCM, Elzevier HW. What is the role of nephrologists and nurses of the dialysis department in providing fertility care to CKD patients? A questionnaire study among care providers. Int Urol Nephrol 2017; 49:1273-1285. [PMID: 28357675 PMCID: PMC5486613 DOI: 10.1007/s11255-017-1577-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 03/20/2017] [Indexed: 01/28/2023]
Abstract
Purpose This study evaluated current fertility care for CKD patients by assessing the perspectives of nephrologists and nurses in the dialysis department. Methods Two different surveys were distributed for this cross-sectional study among Dutch nephrologists (N = 312) and dialysis nurses (N = 1211). Results Response rates were 50.9% (nephrologists) and 45.4% (nurses). Guidelines on fertility care were present in the departments of 9.0% of the nephrologists and 15.6% of the nurses. 61.7% of the nephrologists and 23.6% of the nurses informed ≥50% of their patients on potential changes in fertility due to a decline in renal function. Fertility subjects discussed by nephrologists included “wish to have children” (91.2%), “risk of pregnancy for patients’ health” (85.8%), and “inheritance of the disease” (81.4%). Barriers withholding nurses from discussing FD were based on “the age of the patient” (62.6%), “insufficient training” (55.2%), and “language and ethnicity” (51.6%). 29.2% of the nurses felt competent in discussing fertility, 8.3% had sufficient knowledge about fertility, and 75.7% needed to expand their knowledge. More knowledge and competence were associated with providing fertility health care (p < 0.01). Conclusions In most nephrology departments, the guidelines to appoint which care provider should provide fertility care to CKD patients are absent. Fertility counseling is routinely provided by most nephrologists, nurses often skip this part of care mainly due to insufficiencies in self-imposed competence and knowledge and barriers based on cultural diversity. The outcomes identified a need for fertility guidelines in the nephrology department and training and education for nurses on providing fertility care.
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Affiliation(s)
- Gaby F van Ek
- Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands.
| | - Esmée M Krouwel
- Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Melianthe P J Nicolai
- Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Brenda L Den Oudsten
- Department of Medical and Clinical Psychology and Centre of Research on Psychological and Somatic Disorders, Tilburg University, Tilburg, The Netherlands
| | | | - Sandra W M Dieben
- Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Rob C M Pelger
- Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Henk W Elzevier
- Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands
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Potential Risk Factors Increasing the Severity of Sexual Dysfunction in Women with Fibromyalgia. SEXUALITY AND DISABILITY 2016. [DOI: 10.1007/s11195-016-9472-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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van Hees PJM, van der Plas AA, van Ek GF, Putter H, Den Oudsten BL, den Ouden MEM, Elzevier HW. Discussing sexuality with patients with Parkinson's disease: a survey among Dutch neurologists. J Neural Transm (Vienna) 2016; 124:361-368. [PMID: 27885433 PMCID: PMC5310558 DOI: 10.1007/s00702-016-1655-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 11/15/2016] [Indexed: 01/04/2023]
Abstract
Sexual functioning is often impaired in patients with Parkinson’s disease (PD) and may affect quality of life of patients and their spouse. However, little is known about the practice patterns of neurologists with regard to discussing sexuality in this field. The aim of this cross-sectional study was to evaluate to what extent neurologists discuss sexuality with PD patients. A 22-item questionnaire was sent to 139 neurologists specializing in PD. The survey contained questions about their attitudes, knowledge, and practice patterns with respect to sexual dysfunction (SD) in patients with PD. The response rate of the survey was 66.9%. Most participants (56.8%) stated that they address sexuality in less than half of their PD patients. High age of patients (42.0%), insufficient consultation time (37.5%), and a lack of patients’ initiative to raise the topic themselves (36.4%) were frequently reported barriers towards discussing sexuality. The majority of participants considered that discussing sexuality is a responsibility that lay with neurologists (85.2%), nurses (73.9%), and patients (72.7%). One quarter of the neurologists reported to have insufficient or no knowledge on SD. The majority of participants regarded screening for SD important or slightly important (85.2%). A large proportion of Dutch neurologists specializing in PD do not routinely discuss sexuality with their PD patients. Sexual healthcare in PD patients may benefit from time-efficient tools and agreements on who is responsible for discussing SD. Furthermore, recommendations in PD guidelines on screening and managing SD should be adapted to fit everyday practice.
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Affiliation(s)
- Petra J M van Hees
- Department of Neurology, Alrijne Hospital, Simon Smitweg 1, 2353 GA, Leiderdorp, The Netherlands. .,Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands.
| | - Anton A van der Plas
- Department of Neurology, Alrijne Hospital, Simon Smitweg 1, 2353 GA, Leiderdorp, The Netherlands
| | - Gaby F van Ek
- Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Brenda L Den Oudsten
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands
| | - Marjolein E M den Ouden
- Research Center of Nursing, Saxion University of Applied Sciences, M.H. Tromplaan 28, 7513 AB, Enschede, The Netherlands
| | - Henk W Elzevier
- Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands
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