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Mohsen Sadatinejad S, Farokhian A, Taghadosi M, Gholamabbas Mosavi S. The effect of sexual counseling on depression, anxiety, stress, sexual knowledge and sexual quality of life in men who have undergone invasive coronary interventions: An RCT. Int J Reprod Biomed 2022; 19:969-978. [PMID: 34977454 PMCID: PMC8717081 DOI: 10.18502/ijrm.v19i11.9912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/25/2020] [Accepted: 08/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background Sexual dysfunctions are common in men with ischemic heart disease, especially in men undergoing therapeutic interventions. Objective This study intended to assess the effect of counseling on depression, anxiety, stress, sexual knowledge and sexual quality of life in men after invasive coronary interventions in the post catheterization department of Kashan Shahid Beheshti Hospital during 2018. Materials and Methods The study population consisted of 54 male participants who had undergone an invasive coronary intervention. The intervention group received counseling and the control group underwent the standard ward routine. Data were collected using the depression anxiety stress scales, Abraham's sexual quality of life, and the Yi-Hung Sexual Knowledge questionnaires before discharge and also two months later. Results Within two months, the intervention group's mean score of sexual knowledge significantly increased, compared with the control group, from 12.37 to 14.81 (p ≤ 0.001). The intervention group's mean score of sexual quality of life also significantly increased, compared with the control group, from 48.2 to 60.7 (p ≤ 0.001). Moreover, the mean anxiety score changed in the intervention group from 11.18 to 5.25, again a significant difference compared with the control group (p = 0.01). But, the differences in the depression and stress scores were not significant. Conclusion Our findings suggest that sexual counseling may improve sexual knowledge, sexual quality of life and anxiety in men following invasive coronary intervention, but might not reduce their stress or depression. Further studies are needed to confirm these findings.
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Affiliation(s)
- Seyyed Mohsen Sadatinejad
- Pediatric Group, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Students Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Farokhian
- Internal Medicine Group, Medicine Faculty, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Taghadosi
- Medical Surgical Nursing, Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
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Pourebrahimi M, Fallahi-Khoshknab M, Taghipour H, Ebadi A, Gholizadeh L, Hosseini M. Confusion at the beginning of sexual intercourse, the challenge of patients after coronary artery bypass graft surgery in Iran: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:92. [PMID: 34084839 PMCID: PMC8150053 DOI: 10.4103/jehp.jehp_752_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 08/11/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND: Many patients suffer from sexual dysfunction after coronary artery bypass graft surgery, but they refuse to propose and follow up on the problem due to the cultural structures prevailing in Iranian society. Untreated sexual dysfunction will disturb the quality of life of these patients. This study was performed to explain the experiences of male patients from sexual problems after coronary artery bypass graft surgery. MATERIALS AND METHODS: This qualitative study was performed with the approach of conventional content analysis in Tehran in 2020. The data were collected through semi-structured interviews with 12 men after coronary artery bypass graft surgery at the hospital's cardiac surgery clinic, as well as the surgeon's clinic. Participants were selected by the targeted sampling method. After obtaining informed consent, the collected data were written word by word, and the content analysis approach was used to name the data, create analytical codes, and determine subcategories and categories. The data were analyzed by MAXQDA 10 software. RESULTS: The findings of this study show that the dimensions of confusion in patients’ sexual intercourse after coronary artery bypass graft surgery in four subcategories of challenges of the first intercourse after surgery, ambiguity in how to obtain information, the ambiguity of sexual issues after surgery, and spouse are concerned about having sexual intercourse. CONCLUSION: The results of this study show that male patients who have undergone coronary artery bypass graft surgery have many ambiguities in the process of sexual intercourse, which passes the beginning of sexual intercourse with fear and avoidance of intercourse. Postoperative patients do not propose these problems with the medical staff when they suffer from sexual dysfunction or ambiguity due to the taboo of talking about sexual intercourse. Eventually, the patient and his or her partner become confused about sexual intercourse after surgery. Therefore, it is recommended that policymakers in the field of health create the culture and planning for solving the ambiguities created in the path of sexual intercourse of these patients.
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Affiliation(s)
- Mohammad Pourebrahimi
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Hamidreza Taghipour
- Department of Cardiovascular Surgery, Atherosclerosis Research Center, Baghiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Mohammadali Hosseini
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Faculty of Health, University of Technology Sydney, Australia
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Firoozjaei IT, Taghadosi M, Sadat Z. Determining the sexual quality of life and related factors in patients referred to the department of cardiac rehabilitation: A cross-sectional study. Int J Reprod Biomed 2021; 19:261-270. [PMID: 33842823 PMCID: PMC8023004 DOI: 10.18502/ijrm.v19i3.8574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 06/13/2020] [Accepted: 09/23/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND One of the neglected issues among cardiovascular participants is sexual activity, which can affect their general quality of life. OBJECTIVE To evaluate the sexual quality of life and its related factors. MATERIALS AND METHODS This cross-sectional study was conducted on 200 cardiovascular participants, referred to the department of rehabilitation of the Shahid Beheshti Hospital of Kashan, Iran in May 2017. Individuals who met the inclusion criteria filled the demographic characteristics questionnaires, including sexual quality of life questionnaire (SQOL)-female and SQOL-male, sexual knowledge post-myocardial infarction scale (SKS-MI), sexual knowledge after coronary artery bypass grafting surgery scale (SKS-CABG), and couple communication scale (CCS). RESULTS In this research, the mean score of SQOL of the participants was 50.02 ± 22.57. According to the results, there was a significant and positive association between the scores of SQOL and CCS (r = 0.540, p ≤ 0.0001), SKS-MI (r = 0.322, p = 0.006), and SKS-CABG (r = 0.178, p = 0.046). The maximum association was observed between SQOL and CCS and the minimum association between SQOL and SKS-CABG. Moreover, there was a relationship between the SQOL and participant's age and level of education. CONCLUSION According to the results of the study, the sexual quality of life scores among participants with MI and CABG was not favorable and this participant suffered from a lack of sexual knowledge.
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Affiliation(s)
- Iman Taghizadeh Firoozjaei
- Medical Surgical Nursing Department, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Taghadosi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Zohre Sadat
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
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Rakhshan M, Toufigh A, Dehghani-firouzabadi A, Yektatalab S. Effect of Cardiac Rehabilitation on Hope Among Cardiac Patients After Coronary Artery Bypass Graft Surgery. Risk Manag Healthc Policy 2020; 13:1319-1326. [PMID: 32922100 PMCID: PMC7457873 DOI: 10.2147/rmhp.s262656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/05/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Following coronary artery bypass graft (CABG) surgery, some patients experience psycho-mental problems such as hopelessness. The Phase 2 cardiac rehabilitation (CR) program is an important element of the secondary prevention program in treating patients with cardiovascular disease (CVD). The present study aimed to determine the effect of the Phase 2 CR program on the level of hope in cardiac patients after CABG surgery. PATIENTS AND METHODS A clinical trial was conducted from July 2017 to late January 2018 at the Heart Surgery Centre, Al-Zahra Hospital, Shiraz, Iran. The target population was patients who sought CR therapy after CABG surgery. A total of 104 cardiac patients were recruited and equally divided into control and intervention groups. The intervention group received 20 sessions of Phase 2 CR program combined with education and counselling during 8 weeks. The control group only received routine observations and education. The data were collected pre- and post-intervention using a demographic form and the Miller Hope Scale (MHS). Descriptive statistics were expressed as percentages, frequency distribution, mean and standard deviation. Paired t-test and independent t-test were used for statistical inference. Data were analyzed using the SPSS statistical software (version 23.0) and P values <0.05 were considered statistically significant. RESULTS There was no significant difference in the mean score of hope between the control and intervention groups before the intervention. However, a significant difference between the groups was observed post-intervention (P<0.001). The results showed a significant difference in the mean score of hope between pre-intervention (182.36±23.07) and post-intervention (216.94±23.05) in the intervention group (P<0.001), whereas the difference in the control group was not significant (P=0.095). The measured post-intervention effect size was high (1.05). CONCLUSION The Phase 2 CR program combined with education and counseling increased hope in CVD patients after CABG surgery.
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Affiliation(s)
- Mahnaz Rakhshan
- Nursing Department, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Afsoon Toufigh
- Student Research Commitee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Shahrzad Yektatalab
- Nursing Department, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Heydarpour B, Ezzati P, Soroush A, Saeidi M, Komasi S. Comparison of Sexual Knowledge between Patients Prepared for Cardiac Surgery and Patients Prepared for Cardiac Rehabilitation in Iran. J Tehran Heart Cent 2020; 14:103-108. [PMID: 31998386 PMCID: PMC6981344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Although sexual death during intercourse occurs rarely in patients with cardiovascular diseases (CVDs), most such patients avoid it because they fear a dangerous event. Given the significance of awareness about this issue among patients with CVDs, we sought to compare sexual knowledge between 2 groups of patients prepared for cardiac surgery and patients prepared for cardiac rehabilitation (CR). Methods: This cross-sectional study, conducted between April and July 2016, recruited 157 patients with CVDs (107 candidates for surgery and 50 patients prepared for CR) in Imam Ali Hospital, in the Iranian city of Kermanshah. The cases, selected through entire counting according to our inclusion criteria, responded to a standard sexual knowledge inventory. Sexual knowledge and professionals responsible in providing sexual rehabilitation from the perspective of patients were compared using the independent t-test and the χ2 test. Results: The participants’ mean age was 55.39±9.82 years (male: 58.6%). Overall, the 2 groups had poor sexual knowledge. Although the CR program started 57.85±13.92 days after surgery, the sexual knowledge of this group of patients was not significantly different from that of the patients prepared for surgery (P=0.904). This difference was not significant between the 2 genders (P=0.077). Finally, concerning the professionals responsible in providing sexual rehabilitation, the patients selected psychologists (P=0.006) and nurses (P=0.012) more frequently in the initial phase of CR program. Conclusion: Sexual knowledge was poor in our CR patients at the outset of the program. Given the poor knowledge in these patients 2 months after surgery and the lack of significant difference in knowledge between these patients and those prepared for surgery, it is advisable that they be provided with the necessary information in this regard in this golden time before hospital discharge.
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Affiliation(s)
- Behzad Heydarpour
- Cardiac Rehabilitation Center, School of Medicine, Imam Ali Hospital, Kermanshah University of Medical Sciences. Kermanshah, Iran
| | - Parvin Ezzati
- Cardiac Rehabilitation Center, School of Medicine, Imam Ali Hospital, Kermanshah University of Medical Sciences. Kermanshah, Iran
| | - Ali Soroush
- Lifestyle Modification Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozhgan Saeidi
- Cardiac Rehabilitation Center, School of Medicine, Imam Ali Hospital, Kermanshah University of Medical Sciences. Kermanshah, Iran
| | - Saeid Komasi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Bdair IAA, ConsTantino RE. Barriers and Promoting Strategies to Sexual Health Assessment for Patients with Coronary Artery Diseases in Nursing Practice: A Literature Review. Health (London) 2017. [DOI: 10.4236/health.2017.93034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Salehian R, Khodaeifar F, Naserbakht M, Meybodi A. Attitudes and Performance of Cardiologists Toward Sexual Issues in Cardiovascular Patients. Sex Med 2016; 5:e44-e53. [PMID: 27988217 PMCID: PMC5302380 DOI: 10.1016/j.esxm.2016.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/12/2016] [Accepted: 09/19/2016] [Indexed: 12/22/2022] Open
Abstract
Introduction The aim of the present study was to evaluate the attitudes and performance of cardiologists regarding sexual issues in patients with cardiovascular diseases. Methods A nationwide survey was conducted in a sample of cardiologists, representative of Iranian cardiologists, in 2015. Main Outcome Measures Appropriate questionnaires were developed and used to ask participants about their attitudes, performance, and barriers regarding discussing sexual issues with patients with cardiovascular disease. Results The study population consisted of 202 cardiologists (138 men and 63 women) with a mean age of 44.25 years (SD = 8.45). Overall, 93.15% of cardiologists agreed with the importance of discussing sexual issues with their patients with cardiovascular diseases. Almost 76.7% of cardiologists agreed they had a responsibility to deal with patients' sexual problems, and 79.9% of them were aware of the association of cardiovascular disease with sexual problems of cardiac patients, but only 33% of them were confident in their knowledge and skills in this regard. Only 10.6% of cardiologists reported they frequently or always assessed sexual problems with their patients, but 51.50% of them stated they were responding to patients' questions about sexual problems. There was a significant association between performance and responsibility. Conclusion The results of this study indicate a gap between cardiologist's attitudes and their actual performance and that their professional responsibility to address patients' sexual issues is a significant parameter for better performance.
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Affiliation(s)
- Razieh Salehian
- School of Behavioral Science and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran.
| | - Fatemeh Khodaeifar
- Iran University of Medical Sciences, Mental Health Research Center, Tehran, Iran
| | - Morteza Naserbakht
- School of Behavioral Science and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran
| | - Azadeh Meybodi
- School of Behavioral Science and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran
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Mc Sharry J, Murphy PJ, Byrne M. Implementing international sexual counselling guidelines in hospital cardiac rehabilitation: development of the CHARMS intervention using the Behaviour Change Wheel. Implement Sci 2016; 11:134. [PMID: 27724957 PMCID: PMC5057276 DOI: 10.1186/s13012-016-0493-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 08/24/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Decreased sexual activity and sexual problems are common among people with cardiovascular disease, negatively impacting relationship satisfaction and quality of life. International guidelines recommend routine delivery of sexual counselling to cardiac patients. The Cardiac Health and Relationship Management and Sexuality (CHARMS) baseline study in Ireland found, similar to international findings, limited implementation of sexual counselling guidelines in practice. The aim of the current study was to develop the CHARMS multi-level intervention to increase delivery of sexual counselling by healthcare professionals. We describe the methods used to develop the CHARMS intervention following the three phases of the Behaviour Change Wheel approach: understand the behaviour, identify intervention options, and identify content and implementation options. Survey (n = 60) and focus group (n = 14) data from two previous studies exploring why sexual counselling is not currently being delivered were coded by two members of the research team to understand staff's capability, opportunity, and motivation to engage in the behaviour. All potentially relevant intervention functions to change behaviour were identified and the APEASE (affordability, practicability, effectiveness, acceptability, side effects and equity) criteria were used to select the most appropriate. The APEASE criteria were then used to choose between all behaviour change techniques (BCTs) potentially relevant to the identified functions, and these BCTs were translated into intervention content. The Template for Intervention Description and Replication (TIDieR) checklist was used to specify details of the intervention including the who, what, how and where of proposed intervention delivery. RESULTS Providing sexual counselling group sessions by cardiac rehabilitation staff to patients during phase III cardiac rehabilitation was identified as the target behaviour. Education, enablement, modelling, persuasion and training were selected as appropriate intervention functions. Twelve BCTs, linked to intervention functions, were identified for inclusion and translated into CHARMS intervention content. CONCLUSIONS This paper details the use of Behaviour Change Wheel approach to develop an implementation intervention in an under-researched area of healthcare provision. The systematic and transparent development of the CHARMS intervention will facilitate the evaluation of intervention effectiveness and future replication and contribute to the advancement of a cumulative science of implementation intervention design.
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Affiliation(s)
- J. Mc Sharry
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, Ireland
| | - P. J. Murphy
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, Ireland
| | - M. Byrne
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, Ireland
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Murphy PJ, Mc Sharry J, Casey D, Doherty S, Gillespie P, Jaarsma T, Murphy AW, Newell J, O'Donnell M, Steinke EE, Toomey E, Byrne M. Sexual counselling for patients with cardiovascular disease: protocol for a pilot study of the CHARMS sexual counselling intervention. BMJ Open 2016; 6:e011219. [PMID: 27342240 PMCID: PMC4932312 DOI: 10.1136/bmjopen-2016-011219] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Sexual problems are common with cardiovascular disease, and can negatively impact quality of life. To address sexual problems, guidelines have identified the importance of sexual counselling during cardiac rehabilitation, yet this is rarely provided. The Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention aims to improve the provision of sexual counselling in cardiac rehabilitation in Ireland. METHODS AND ANALYSIS This is a multicentre pilot study for the CHARMS intervention, a complex, multilevel intervention delivered within hospital-based cardiac rehabilitation programmes. The intervention includes (1) training in sexual counselling for staff, (2) a staff-led patient education and support intervention embedded within the cardiac rehabilitation programme, (3) a patient information booklet and (4) an awareness raising poster. The intervention will be delivered in two randomly selected cardiac rehabilitation centres. In each centre 30 patients will be recruited, and partners will also be invited to participate. Data will be collected from staff and patients/partners at T1 (study entry), T2 (3-month follow-up) and T3 (6-month follow-up). The primary outcome for patients/partners will be scores on the Sexual Self-Perception and Adjustment Questionnaire. Secondary outcomes for patients/partners will include relationship satisfaction; satisfaction with and barriers to sexual counselling in services; sexual activity, functioning and knowledge; physical and psychological well-being. Secondary outcomes for staff will include sexuality-related practice; barriers to sexual counselling; self-ratings of capability, opportunity and motivation; sexual attitudes and beliefs; knowledge of cardiovascular disease and sex. Fidelity of intervention delivery will be assessed using trainer self-reports, researcher-coded audio recordings and exit interviews. Longitudinal feasibility data will be gathered from patients/partners and staff via questionnaires and interviews. ETHICS AND DISSEMINATION This study is approved by the Research Ethics Committee (REC) of the National University of Ireland, Galway. Findings will be disseminated to cardiac rehabilitation staff, patients/partners and relevant policymakers via appropriate publications and presentations.
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Affiliation(s)
- Patrick J Murphy
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Ireland
| | - Jenny Mc Sharry
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Ireland
| | - Dympna Casey
- School of Nursing and Midwifery, NUI Galway, Ireland
| | - Sally Doherty
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Tiny Jaarsma
- Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden
| | | | - John Newell
- HRB Clinical Research Facility, NUI Galway, Ireland
| | | | | | - Elaine Toomey
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Ireland
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Byrne M, Doherty S, Fridlund BGA, Mårtensson J, Steinke EE, Jaarsma T, Devane D. Sexual counselling for sexual problems in patients with cardiovascular disease. Cochrane Database Syst Rev 2016; 2:CD010988. [PMID: 26905928 PMCID: PMC6464754 DOI: 10.1002/14651858.cd010988.pub2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sexual problems are common among people with cardiovascular disease. Although clinical guidelines recommend sexual counselling for patients and their partners, there is little evidence on its effectiveness. OBJECTIVES To evaluate the effectiveness of sexual counselling interventions (in comparison to usual care) on sexuality-related outcomes in patients with cardiovascular disease and their partners. SEARCH METHODS We searched CENTRAL, MEDLINE, EMBASE, and three other databases up to 2 March 2015 and two trials registers up to 3 February 2016. SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs, including individual and cluster RCTs. We included studies that compared any intervention to counsel adult cardiac patients about sexual problems with usual care. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included three trials with 381 participants. We were unable to pool the data from the included studies due to the differences in interventions used; therefore we synthesised the trial findings narratively.Two trials were conducted in the USA and one was undertaken in Israel. All trials included participants who were admitted to hospital with myocardial infarction (MI), and one trial also included participants who had undergone coronary artery bypass grafting. All trials followed up participants for a minimum of three months post-intervention; the longest follow-up timepoint was five months.One trial (N = 92) tested an intensive (total five hours) psychotherapeutic sexual counselling intervention delivered by a sexual therapist. One trial (N = 115) used a 15-minute educational video plus written material on resuming sexual activity following a MI. One trial (N = 174) tested the addition of a component that focused on resumption of sexual activity following a MI within a hospital cardiac rehabilitation programme.The quality of the evidence for all outcomes was very low.None of the included studies reported any outcomes from partners.Two trials reported sexual function. One trial compared intervention and control groups on 12 separate sexual function subscales and used a repeated measures analysis of variance (ANOVA) test. They reported statistically significant differences in favour of the intervention. One trial compared intervention and control groups using a repeated measures analysis of covariance (ANCOVA), and concluded: "There were no significant differences between the two groups [for sexual function] at any of the time points".Two trials reported sexual satisfaction. In one trial, the authors compared sexual satisfaction between intervention and control and used a repeated measured ANOVA; they reported "differences were reported in favour of the intervention". One trial compared intervention and control with a repeated measures ANCOVA and reported: "There were no significant differences between the two groups [for sexual satisfaction] at any of the timepoints".All three included trials reported the number of patients returning to sexual activity following MI. One trial found some evidence of an effect of sexual counselling on reported rate of return to sexual activity (yes/no) at four months after completion of the intervention (relative risk (RR) 1.71, 95% confidence interval (CI) 1.26 to 2.32; one trial, 92 participants, very low quality of evidence). Two trials found no evidence of an effect of sexual counselling on rate of return to sexual activity at 12 week (RR 1.01, 95% CI 0.94 to 1.09; one trial, 127 participants, very low quality of evidence) and three month follow-up (RR 0.98, 95% CI 0.88 to 1.10; one trial, 115 participants, very low quality of evidence).Two trials reported psychological well-being. In one trial, no scores were reported, but the trial authors stated: "No treatment effects were observed on state anxiety as measured in three points in time". In the other trial no scores were reported but, based on results of a repeated measures ANCOVA to compare intervention and control groups, the trial authors stated: "The experimental group had significantly greater anxiety at one month post MI". They also reported: "There were no significant differences between the two groups [for anxiety] at any other time points".One trial reporting relationship satisfaction and one trial reporting quality of life found no differences between intervention and control.No trial reported on satisfaction in how sexual issues were addressed in cardiac rehabilitation services. AUTHORS' CONCLUSIONS We found no high quality evidence to support the effectiveness of sexual counselling for sexual problems in patients with cardiovascular disease. There is a clear need for robust, methodologically rigorous, adequately powered RCTs to test the effectiveness of sexual counselling interventions for people with cardiovascular disease and their partners.
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Affiliation(s)
- Molly Byrne
- National University of Ireland, GalwaySchool of PsychologySt. Anthony'sGalwayCounty GalwayIreland
| | - Sally Doherty
- RCSIDepartment of Population and Health Science, School of PsychologySt Stephens GreenBeaux Lane HouseDublinIreland
| | - Bengt GA Fridlund
- Jönköping UniversitySchool of Health SciencesP O Box 1026JönköpingSweden551 11
| | - Jan Mårtensson
- Jönköping UniversityDepartment of Nursing, School of Health SciencesP O Box 1026JönköpingSweden551 11
| | - Elaine E Steinke
- Wichita State UniversitySchool of Nursing1845 FairmountWichitaKansasUSA67260‐0041
| | - Tiny Jaarsma
- University of LinköpingDepartment of Social and Welfare StudiesKungsgatan 40NorrköpingSweden601074
| | - Declan Devane
- National University of Ireland GalwaySchool of Nursing and MidwiferyUniversity RoadGalwayIreland
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Mosack V, Hill TJ, Steinke EE. Sexual concerns of cardiac patients: predictors and the influence of specific sexual activities. Eur J Cardiovasc Nurs 2015; 14:45-52. [PMID: 24366982 DOI: 10.1177/1474515113517782] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Addressing sexual concerns of cardiac patients is integral to comprehensive patient-centered nursing care, and instruments for use across cardiac populations are needed to promote this activity. Knowing the factors that contribute to sexual concerns provides insights that help to promote inclusion of assessment of relevant sexual activity and provide sexual counseling as a standard of care. AIM This study examined demographic factors, comorbid conditions, and sexual activities as predictive of sexual concerns. Specific sexual activities and demographic variables were also examined for their relation to sexual concerns. METHODS This study was a sub-analysis of a cross-sectional observational study testing a regression model of factors that predicted sexual concerns in a broad sample of cardiac patients in the United States, using a self-report survey method. RESULTS More comorbidities and types of sexual activities contributed to greater sexual concerns reported by respondents. Sexual activities resulting in overall sexual concerns included hugging/kissing, oral sex, and finger penetration. Non-Whites reported more sexual concerns, sexual fears, and symptoms related to sexual activity. Those who were not working/retired from employment reported significantly more sexual concerns and dysfunction, whereas, those who had a smoking/tobacco use history reported more sexual concerns, symptoms, and dysfunction. CONCLUSION This study underscores that cardiac patients across a variety of diagnoses and comorbidities often experience sexual concerns, fears, symptoms, and dysfunction. The strongest predictors of sexual concerns were the number of cardiac and noncardiac comorbidities, thus illustrating the importance of a thorough assessment of these factors when examining sexual concerns of cardiac patients.
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Affiliation(s)
| | - Twyla J Hill
- Department of Sociology, Wichita State University, USA
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Mosack V, Hill TJ, Steinke EE. Sexual concerns of cardiac patients: A psychometric analysis. Int J Nurs Pract 2014; 21:756-63. [DOI: 10.1111/ijn.12291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Victoria Mosack
- School of Nursing; Wichita State University; Wichita Kansas USA
| | - Twyla J Hill
- Department of Sociology; Wichita State University; Wichita Kansas USA
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Pournaghash-Tehrani S, Etemadi S. ED and quality of life in CABG patients: an intervention study using PRECEDE-PROCEED educational program. Int J Impot Res 2013; 26:16-9. [DOI: 10.1038/ijir.2013.27] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 03/10/2013] [Accepted: 05/08/2013] [Indexed: 01/23/2023]
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Byrne M, Doherty S, Murphy AW, McGee HM, Jaarsma T. The CHARMS Study: cardiac patients’ experiences of sexual problems following cardiac rehabilitation. Eur J Cardiovasc Nurs 2013; 12:558-66. [DOI: 10.1177/1474515113477273] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Molly Byrne
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Sally Doherty
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Andrew W Murphy
- Discipline of General Practice, National University of Ireland, Galway, Ireland
| | - Hannah M McGee
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tiny Jaarsma
- Department of Social and Welfare Studies, University of Linköping, Sweden
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Hassan H, Das S. Food pattern and quality of life in metabolic syndrome patients: debatable facts. Eur J Cardiovasc Nurs 2012; 11:255; author reply 256. [PMID: 22457378 DOI: 10.1177/1474515111435876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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