Cardiac Rehabilitation Staff Views about Discussing Sexual Issues with Coronary Heart Disease Patients: A National Survey in Ireland

Abstract

Background: While a healthy sexual life is regarded as an important aspect of quality of life, sexual counselling from healthcare providers for cardiac patients has received little attention in the literature. Aim: To document current practice and assess the needs of cardiac rehabilitation service providers in Ireland with regard to sexual assessment and management for patients. Methods: Cardiac rehabilitation staff in all relevant centres in Ireland responded to a postal questionnaire. Sexual health management was assessed by a series of questions on current practice, staff attitudes, beliefs and perceived barriers to discussing sexual problems. Results: Staff (N = 60; 61% response rate) reported a lack of assessment and counselling protocols for addressing sexual health problems, with little or no onward referral system available. Results also suggest staff believe that patients do not expect them to ask about their sexual concerns. Barriers reported included an overall lack of confidence (45%), knowledge (58%) and training (85%). Conclusion: Development of guidelines, assessment protocols and training for cardiac rehabilitation staff are essential in the area of sexual health problems in order to improve the quality of services for patients with coronary heart disease.

What keeps nurses from the sexual counseling of patients with heart failure?

“…10 Furthermore, a US study on nurses working with patients after a myocardial infarction and national surveys in Ireland and Sweden in cardiac rehabilitation centers and coronary care unit teams have shown comparable findings. 11,14,16 It can be concluded that not discussing sexual health and providing sexual counseling in different cardiac settings is a general problem that does not only relates to HF nurses, but also other cardiac healthcare providers. This limited implementation of sexual counseling in practice may rightfully be called a concern, because a considerable number of HF patients experience sexual difficulties which have a negative effect on their own quality of life and that of their partners.…”

“…[8][9][10][11] To improve patient care in this area, it is important to learn which barriers prevent nurses from discussing sexual health 5 with their patients. A study among cardiac rehabilitation staff showed that barriers experienced included lack of training, the feeling that the patient is not yet ready to discuss issues related to sexual health, and a general lack of knowledge of sexual health.…”

“…A study among cardiac rehabilitation staff showed that barriers experienced included lack of training, the feeling that the patient is not yet ready to discuss issues related to sexual health, and a general lack of knowledge of sexual health. 11 Unfortunately, there is little information available on the current practice of discussing sexual health and providing sexual counseling by HF nurses in the Netherlands. Therefore, the purpose of this study was to examine: (1) the current practice of discussing sexual health in HF clinics in the Netherlands and the perceived responsibility of nurses to address patients' sexual health, (2) the preferred moment during HF treatment to address patients' sexual concerns, and (3) differences in barriers to sexual counseling between nurses who do and who do not discuss this topic.…”

“…These included two subscales of the Nurses Survey of Sexual Counseling of MI Patients and a list of barriers from the Irish CHARMS study 11,14,15 1.…”

“…Barriers: The list of barriers that prevent nurses from discussing sexual health consisted of 16 items, which were created by Doherty et al 11 To gain more insight in other possible barriers, 8 additional items on barriers retrieved from discussions by a group of experts (including a cardiologist, a sexologist, HF nurses, and psychologists)…”