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Oliveira LFTS, Arakaki JSO, Vieira EB, Lopes JDL, Lopes CT, Abuchaim EDS, Santos VB. Sexual function, health functionality, and quality of life in females with pulmonary arterial hypertension: a cross-sectional study. J Sex Med 2024; 21:897-903. [PMID: 39104208 DOI: 10.1093/jsxmed/qdae092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/17/2024] [Accepted: 07/11/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) can have several consequences on sexual function, which can lead to worsened quality of life. AIM The study sought to assess sexual function and its association with health functionality and quality of life in females with PAH. METHODS A descriptive cross-sectional study was carried out in pulmonary circulation outpatient clinics from January 2022 to March 2023 in females diagnosed with pulmonary hypertension. Assessment was carried out through the application of the Female Sexual Function Index, the 36-item World Health Organization Disability Assessment Schedule, and the Medical Outcome Study 36-Item Short Form Survey. OUTCOMES Data were analyzed using SPSS version 22.0 and JASP, and Spearman's correlation tests were applied between the instruments, with a P value <.05 considered significant. RESULTS A total of 91 females were assessed. It was identified that 90.1% of females had sexual dysfunction, with worse scores in females with sexual dysfunction in the domains of satisfaction, arousal, and desire, with average health functionality and quality of life. There were significant correlations between the domains of mobility, getting along, life activities, and the overall functionality score with some domains of sexual function, especially arousal and satisfaction. We found significant correlations between some domains of quality-of-life assessment with the domains of desire, arousal, and satisfaction, and with the overall score of sexual function assessment, as well as strong correlations between health functionality and quality of life. CLINICAL IMPLICATION The data reinforce the need for rehabilitation programs and social support for this population. STRENGTHS AND LIMITATIONS This is one of the few studies to evaluate sexual function, quality of life, and health functionality in women with PAH. Due to limitations in data collection, we were unable to assess certain factors such as hormone levels and a history of sexual abuse. CONCLUSION We identified a high prevalence of sexual dysfunction in females with PAH with mild functional impairment and a moderate quality-of-life score with correlations between sexual function, health functionality, and quality of life.
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Affiliation(s)
| | - Jaquelina Sonoe Ota Arakaki
- Pulmonary Circulation Service, Paulista School of Medicine, Federal University of São Paulo, São Paulo 04023-900, Brazil
| | - Elaine Brito Vieira
- Pulmonary Circulation Service, Paulista School of Medicine, Federal University of São Paulo, São Paulo 04023-900, Brazil
| | - Juliana de Lima Lopes
- Paulista Nursing School, Federal University of São Paulo, São Paulo 04024-002, Brazil
| | - Camila Takao Lopes
- Paulista Nursing School, Federal University of São Paulo, São Paulo 04024-002, Brazil
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Abstract
Rationale: The evidence base for rehabilitation in pulmonary hypertension is expanding, but adoption in clinical practice is limited.Objectives: The World Health Organization International Classification for Functioning, Disability and Health identifies three health domains: Body Functions/Structures, Activity and Participation in society. To ensure that the wider impact of rehabilitation in pulmonary hypertension is accurately assessed, it is important that study endpoints reflect all three domains.Methods: A systematic review of the literature was conducted to identify studies of rehabilitation in patients with pulmonary hypertension from 2006 to 2019.Results: Searches across five databases yielded 2,564 articles, of which 34 met eligibility criteria; 50 different outcome measures (mean = 5, minimum = 1, maximum = 9) were identified. When mapped onto the World Health Organization International Classification for Functioning, Disability and Health, 48% of instances of outcome usage were measures of Body Functions/Structure, 33% were measures of Activity, and 18% were measures of Participation. Measures of Participation were not included in seven studies (21%).Conclusions: Studies of rehabilitation in pulmonary hypertension have focused primarily on measures of Body Functions/Structure; the impact in other health domains is not well characterized. Greater inclusion of outcome measures reflecting Activity and Participation in society is needed to allow assessment of the wider impact of rehabilitation in patients with pulmonary hypertension.
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Risal A, Kunwar D, Karki E, Adhikari SP, Bimali I, Shrestha B, Khadka S, Holen A. Adapting World Health Organization Disability Assessment Schedule 2.0 for Nepal. BMC Psychol 2021; 9:45. [PMID: 33731222 PMCID: PMC7972184 DOI: 10.1186/s40359-021-00550-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 03/11/2021] [Indexed: 02/08/2023] Open
Abstract
Background Disability is a vital public health issue for health care programs. Affluent countries usually prioritize disability-related research, while often it remains neglected in resource-poor countries like Nepal. The aim of this study was to make available a translated and culturally adapted version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for measuring disability in the Nepalese population. Methods WHODAS 2.0 (12-items version) was translated into Nepali using a standard forward–backward translation protocol. Purposive and convenience recruitment of participants with psychiatric disabilities was done at the Psychiatry services in a tertiary care hospital. Age and gender-matched participants with physical disabilities were selected from the Internal Medicine department, and participants with no disability were recruited from their accompanying persons. A structured interview in Nepali including the translated WHODAS 2.0 was administered to all participants. Exploratory factor analysis and parallel analysis assessed the construct validity. Content validity was explored, and a quality of life instrument was used for establishing criterion validity. Reliability was measured via Cronbach alpha. Mann–Whitney test explored score differences between the disabled and non-disabled. Results In total, 149 persons [mean age: 40.6 (12.8); 43.6% males, 56.4% females; 61.7% disabled, 38.3% non-disabled] consented to participate. Parallel analysis indicated that a single factor was adequate for the Nepali WHODAS version that captured 45.4% of the total variance. The translated scale got a good Cronbach alpha (= 0.89). Satisfactory construct, content and criterion validity was found. The WHODAS total scores showed a significant difference between the disabled and non-disabled (U = 2002.5; p = 0.015). However, the difference between psychiatric and physical disabilities was not significant, which underscores that the scale is rating disability in general. Conclusion The one-factor structure of the translated and culturally adapted Nepali-version of WHODAS 2.0 showed acceptable validity and an adequate reliability. For epidemiological research purposes, this version of WHODAS 2.0 is now available for measuring global disability in Nepal.
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Affiliation(s)
- Ajay Risal
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal. .,Department of Psychiatry, Dhulikhel Hospital,, Kathmandu University School of Medical Sciences,, Kathmandu University Hospital, GPO Box 11008, Dhulikhel, Kavre, Nepal.
| | - Dipak Kunwar
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.,Department of Psychiatry, Dhulikhel Hospital,, Kathmandu University School of Medical Sciences,, Kathmandu University Hospital, GPO Box 11008, Dhulikhel, Kavre, Nepal
| | - Eliza Karki
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.,Department of Psychiatry, Dhulikhel Hospital,, Kathmandu University School of Medical Sciences,, Kathmandu University Hospital, GPO Box 11008, Dhulikhel, Kavre, Nepal
| | - Shambhu Prasad Adhikari
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.,Department of Physiotherapy, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Inosha Bimali
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.,Department of Physiotherapy, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Barsha Shrestha
- Department of Psychiatry, Dhulikhel Hospital,, Kathmandu University School of Medical Sciences,, Kathmandu University Hospital, GPO Box 11008, Dhulikhel, Kavre, Nepal
| | - Subekshya Khadka
- Department of Psychiatry, Dhulikhel Hospital,, Kathmandu University School of Medical Sciences,, Kathmandu University Hospital, GPO Box 11008, Dhulikhel, Kavre, Nepal
| | - Are Holen
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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