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Savel C, Chausset A, Berland P, Guiguet-Auclair C, Cabane L, Fautrel B, Gaudin P, Guillot P, Hayem G, Lafarge D, Merlin E, Pezière N, Sordet C, Trope S, Tournadre A, Malochet S, Cohen JD. Survey of adolescents' needs and parents' views on sexual health in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2023; 21:95. [PMID: 37670340 PMCID: PMC10478441 DOI: 10.1186/s12969-023-00884-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/28/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Although the advent of new therapeutics for juvenile idiopathic arthritis (JIA) patients has considerably lessened the impact of the disease and reduced its sequelae, the outcomes of JIA remain important in their lives. Disease repercussions and side effects of treatments may affect sexual health and cause psychological distress. This aim of the study was to determine the expectations of adolescent JIA patients and the perceptions of their parents regarding knowledge and communication with healthcare providers (HCPs) in the field of sexual health (SH). METHODS In France, from September 2021 to April 2022, a survey was conducted, using anonymous self-administered questionnaires, among JIA patients (adults (aged 18-45 years) to provide insights from their recollection of their adolescence) and their parents in nine rheumatology centers and three patient associations. RESULTS The responses to the 76 patient questionnaires and 43 parent questionnaires that were collected were analyzed. Half of the patients thought JIA impacted their romantic relationships, but the results were less clear-cut for their sexual activity; and 58.7% of the patients said they would be comfortable discussing the subject with HCPs, but only 26.3% had done so, mainly regarding biomedical issues. The patients and their parents thought that ideally, the topic should be addressed in an individual patient education session at the hospital (51.3% and 34.9%, respectively), in a regular consultation (47.4% and 53.5%), or in a dedicated consultation requested by the adolescent without the adolescent's parents being informed (38.2% and 20.9%). Most of the respondents thought HCPs should be proactive in SH (77.6% of the patients and 69.8% of their parents). More patients than parents said the following digital information tools must be used: videos (29.0% vs. 9.3%, p = 0.0127) and smartphone applications (25.0% vs. 9.3%, p = 0.0372). CONCLUSION HCPs should consider addressing the unmet need for SH discussions during their patient encounters. To meet this need, we propose concrete actions in line with the wishes of patients and parents. CLINICAL TRIAL REGISTRATION NUMBER NCT04791189.
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Affiliation(s)
- Carine Savel
- CRECHE Unit, Department of Pediatrics, INSERM CIC 1405, CHU Clermont-Ferrand, 1 place Lucie & Raymond Aubrac, Clermont-Ferrand, 63100, France.
- Department of Public Health, CHU Clermont-Ferrand, Clermont-Ferrand, France.
| | - Aurélie Chausset
- CRECHE Unit, Department of Pediatrics, INSERM CIC 1405, CHU Clermont-Ferrand, 1 place Lucie & Raymond Aubrac, Clermont-Ferrand, 63100, France
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Claude Bernard University Lyon 1, Lyon, France
| | - Pauline Berland
- Transversal Patient Education Unit, Department of Public Health, CHU Clermont-Ferrand, Clermont- Ferrand, France
| | | | | | - Bruno Fautrel
- Service de Rhumatologie, Sorbonne Université, AP-HP. Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Philippe Gaudin
- University Grenoble Alpes, T-RAIG, TIMC-IMAG, CNRS UMR 5525, Grenoble, France
- Department of Rheumatology, Grenoble Alpes University Hospital, Échirolles, Grenoble, France
| | - Pascale Guillot
- Rheumatology Department, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes, France
| | - Gilles Hayem
- Rheumatology Department, Paris Saint-Joseph Hospital, Paris, France
| | | | - Etienne Merlin
- CRECHE Unit, Department of Pediatrics, INSERM CIC 1405, CHU Clermont-Ferrand, 1 place Lucie & Raymond Aubrac, Clermont-Ferrand, 63100, France
- Department of Pediatrics, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Christelle Sordet
- Department of Rheumatology, National Reference Center for Systemic Autoimmune Diseases (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sonia Trope
- Association Nationale de Défense Contre l'Arthrite Rhumatoïde (ANDAR), Paris, France
| | - Anne Tournadre
- Rheumatology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Jean-David Cohen
- Rheumatology Department, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
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Edens C. The Impact of Pediatric Rheumatic Diseases on Sexual Health, Family Planning, and Pregnancy. Rheum Dis Clin North Am 2021; 48:113-140. [PMID: 34798942 DOI: 10.1016/j.rdc.2021.09.016] [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
A comprehensive review of reproductive health subtopics, including sexual intercourse, romantic relationships, contraception, sexually transmitted infections, pregnancy, and infertility, as they pertain to patients with pediatric rheumatic diseases and those who care for them.
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Affiliation(s)
- Cuoghi Edens
- Department of Pediatrics, Section of Pediatric Rheumatology, University of Chicago Medicine, 5841 South Maryland Avenue, C104-A, MC5044, Chicago, IL 60637, USA; Department of Internal Medicine, Section of Rheumatology, University of Chicago Medicine, 5841 South Maryland Avenue, C104-A, MC5044, Chicago, IL 60637, USA.
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Stransky O, Hunt N, Richards JS, Birru Talabi M. Exploring Family Planning, Parenting, and Sexual and Reproductive Health Care Experiences of Men with Rheumatic Diseases. J Rheumatol 2021; 49:251-255. [PMID: 34782452 DOI: 10.3899/jrheum.210785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore family planning, parenting, and sexual and reproductive health (SRH) care needs and experiences of men with rheumatic diseases. METHODS Men aged 18-45 years who were diagnosed with at least one rheumatic disease and used at least one anti-rheumatic drug were recruited from rheumatology clinics. Research coordinators engaged participants in semi-structured phone interviews. A codebook was developed based on the interview transcripts and used to conduct an inductive thematic analysis. RESULTS Participants ranged in age from 22 to 44 years old (N=20). Most were heterosexual and had at least one child. The most common disease diagnoses were spondyloarthritis, systemic lupus erythematosus, and rheumatoid arthritis. Four themes emerged from the interviews: 1) Men had family planning concerns, particularly related to the heritability of their diseases, their fertility, and potential effects of their medications on their offspring's health; 2) Men felt that fatigue, disability, and/or pain from their diseases either impaired or would impair their abilities to parent; 3) Men often did not discuss sexual dysfunction with their rheumatologists, even when they believed that it arose from their diseases or anti-rheumatic drugs; 4) Men rarely discussed any family planning, parenting, or SRH issues with their rheumatologists-and gender discordance with rheumatologists did not affect men's comfort in discussing these issues. CONCLUSION Men expressed concerns related to family planning, parenting, and SRH, which they rarely discussed with their rheumatologists. Our study suggests that some men's SRH information needs are incompletely addressed in the rheumatology clinical setting.
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Affiliation(s)
- Olivia Stransky
- Center for Women's Health Research and Innovation (CWHRI), Pittsburgh, PA; Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Rheumatology Section, Medicine Service Line, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA. Conflict of Interest: Dr. Birru Talabi's work was supported by the Harold Amos Medical Faculty Development Program (grant). The authors do not have any financial interests or conflicts of interest to disclose. Corresponding Author Mehret Birru Talabi, S700 Biomedical Science Tower; 3500 Lothrop Street Pittsburgh, PA 15261
| | - Nicole Hunt
- Center for Women's Health Research and Innovation (CWHRI), Pittsburgh, PA; Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Rheumatology Section, Medicine Service Line, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA. Conflict of Interest: Dr. Birru Talabi's work was supported by the Harold Amos Medical Faculty Development Program (grant). The authors do not have any financial interests or conflicts of interest to disclose. Corresponding Author Mehret Birru Talabi, S700 Biomedical Science Tower; 3500 Lothrop Street Pittsburgh, PA 15261
| | - John Steuart Richards
- Center for Women's Health Research and Innovation (CWHRI), Pittsburgh, PA; Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Rheumatology Section, Medicine Service Line, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA. Conflict of Interest: Dr. Birru Talabi's work was supported by the Harold Amos Medical Faculty Development Program (grant). The authors do not have any financial interests or conflicts of interest to disclose. Corresponding Author Mehret Birru Talabi, S700 Biomedical Science Tower; 3500 Lothrop Street Pittsburgh, PA 15261
| | - Mehret Birru Talabi
- Center for Women's Health Research and Innovation (CWHRI), Pittsburgh, PA; Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Rheumatology Section, Medicine Service Line, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA. Conflict of Interest: Dr. Birru Talabi's work was supported by the Harold Amos Medical Faculty Development Program (grant). The authors do not have any financial interests or conflicts of interest to disclose. Corresponding Author Mehret Birru Talabi, S700 Biomedical Science Tower; 3500 Lothrop Street Pittsburgh, PA 15261
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Sexual function in female juvenile idiopathic arthritis patients. Adv Rheumatol 2019; 59:13. [DOI: 10.1186/s42358-019-0058-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 03/14/2019] [Indexed: 12/23/2022] Open
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van Weelden M, Lourenço B, Viola GR, Aikawa NE, Queiroz LB, Silva CA. Substance use and sexual function in juvenile idiopathic arthritis. REVISTA BRASILEIRA DE REUMATOLOGIA 2016; 56:323-9. [PMID: 27476625 DOI: 10.1016/j.rbre.2016.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 10/13/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To evaluate alcohol/tobacco/illicit drug use and sexual function in adolescent juvenile idiopathic arthritis (JIA) and healthy controls. METHODS 174 adolescents with pediatric rheumatic diseases were selected. A cross-sectional study with 54 JIA patients and 35 controls included demographic/anthropometric data and puberty markers assessments, physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk and a questionnaire that evaluated sexual function, bullying and alcohol/tobacco/illicit drug use. Clinical/laboratorial data and treatment were also assessed in JIA. RESULTS The median current age was similar between JIA patients and controls [15(10-19) vs. 15(12-18) years, p=0.506]. Frequencies of alcohol/tobacco/illicit drug use were high and similar in both JIA and controls (43% vs. 46%, p=0.829). However, age at alcohol onset was significantly higher in those with JIA [15(11-18) vs. 14(7-18) years, p=0.032], particularly in polyarticular onset (p=0.040). High risk for substance abuse/dependence (CRAFFT score≥2) was found in both groups (13% vs. 15%, p=1.000), likewise bullying (p=0.088). Further analysis of JIA patients regarding alcohol/tobacco/illicit drug use showed that the median current age [17(14-19) vs. 13(10-19)years, p<0.001] and education years [11(6-13) vs. 7(3-12)years, p<0.001] were significant higher in those that used substances. Sexual activity was significantly higher in the former group (48% vs. 7%, p<0.001). A positive correlation was evidenced between CRAFFT score and current age in JIA patients (p=0.032, r=+0.296). CONCLUSION A high risk for substance abuse/dependence was observed in both JIA and controls. JIA substance users were more likely to have sexual intercourse. Therefore, routine screening is suggested in all visits of JIA adolescents.
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Affiliation(s)
- Marlon van Weelden
- Pediatric Rheumatology Unit, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Medical Faculty, VU University, Amsterdam, The Netherlands
| | - Benito Lourenço
- Adolescent Unit, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Gabriela R Viola
- Pediatric Rheumatology Unit, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Nadia E Aikawa
- Pediatric Rheumatology Unit, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Lígia B Queiroz
- Adolescent Unit, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Clovis A Silva
- Pediatric Rheumatology Unit, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Adolescent Unit, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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van Weelden M, Lourenço B, Viola GR, Aikawa NE, Queiroz LB, Silva CA. Substance use and sexual function in juvenile idiopathic arthritis. REVISTA BRASILEIRA DE REUMATOLOGIA 2016; 56:S0482-5004(16)00008-5. [PMID: 26924004 DOI: 10.1016/j.rbr.2015.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/03/2015] [Accepted: 10/13/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE to evaluate alcohol/tobacco/illicit drug use and sexual function in adolescent juvenile idiopathic arthritis (JIA) and healthy controls. METHODS 174 adolescents with pediatric rheumatic diseases were selected. A cross-sectional study with 54 JIA patients and 35 controls included demographic/anthropometric data and puberty markers assessments, physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk and a questionnaire that evaluated sexual function, bullying and alcohol/tobacco/illicit drug use. Clinical/laboratorial data and treatment were also assessed in JIA. RESULTS The median current age was similar between JIA patients and controls [15(10-19) vs. 15(12-18)years, p=0.506]. Frequencies of alcohol/tobacco/illicit drug use were high and similar in both JIA and controls (43% vs. 46%, p=0.829). However, age at alcohol onset was significantly higher in those with JIA [15(11-18) vs. 14(7-18)years, p=0.032], particularly in poliarticular onset (p=0.040). High risk for substance abuse/dependence (CRAFFT score≥2) was found in both groups (13% vs. 15%, p=1.000), likewise bullying (p=0.088). Further analysis of JIA patients regarding alcohol/tobacco/illicit drug use showed that the median current age [17(14-19) vs. 13(10-19)years, p<0.001] and education years [11(6-13) vs. 7(3-12)years, p<0.001] were significant higher in those that used substances. Sexual activity was significantly higher in the former group (48% vs. 7%, p<0.001). A positive correlation was evidenced between CRAFFT score and current age in JIA patients (p=0.032, r=+0.296). CONCLUSION A high risk for substance abuse/dependence was observed in both JIA and controls. JIA substance users were more likely to have sexual intercourse. Therefore, routine screening is suggested in all visits of JIA adolescents.
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Affiliation(s)
- Marlon van Weelden
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil; Faculdade de Medicina, VU University, Amsterdã, Países Baixos
| | - Benito Lourenço
- Unidade do Adolescente, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Gabriela R Viola
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Nadia E Aikawa
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Lígia B Queiroz
- Unidade do Adolescente, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Clovis A Silva
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil; Unidade do Adolescente, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
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Tristano AG. Impact of rheumatoid arthritis on sexual function. World J Orthop 2014; 5:107-111. [PMID: 24829873 PMCID: PMC4017303 DOI: 10.5312/wjo.v5.i2.107] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 01/21/2014] [Accepted: 03/14/2014] [Indexed: 02/06/2023] Open
Abstract
Sexuality is a complex aspect of the human being’s life and is more than just the sexual act. Normal sexual functioning consists of sexual activity with transition through the phases from arousal to relaxation with no problems, and with a feeling of pleasure, fulfillment and satisfaction. Rheumatic diseases may affect all aspects of life including sexual functioning. The reasons for disturbing sexual functioning are multifactorial and comprise disease-related factors as well as therapy. Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by progressive joint destruction resulting from chronic synovial inflammation. It leads to various degrees of disability, and ultimately has a profound impact on the social, economic, psychological, and sexual aspects of the patient’s life. This is a systemic review about the impact of RA on sexual functioning.
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Moorthy LN, Peterson MGE, Hassett AL, Lehman TJA. Burden of childhood-onset arthritis. Pediatr Rheumatol Online J 2010; 8:20. [PMID: 20615240 PMCID: PMC2914068 DOI: 10.1186/1546-0096-8-20] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Accepted: 07/08/2010] [Indexed: 03/04/2023] Open
Abstract
Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality.The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs.
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Affiliation(s)
- Lakshmi N Moorthy
- Robert Wood Johnson Medical School-UMDNJ, Dept. of Pediatrics Room 1361, 89 French Street, New Brunswick, NJ, USA
| | | | - Afton L Hassett
- University of Michigan Medical School, Chronic Pain & Fatigue Research Center, Dept of Anesthesiology, Ann Arbor, MI, USA
| | - Thomas JA Lehman
- Hospital For Special Surgery, 535 East 70th Street, New York, NY, USA
- Weill Medical College of Cornell University, New York, NY, USA
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