Let’s talk about sex: exploring factors influencing the discussion of sexual health among chronically Ill patients in general practice

Barnhoorn, Pieter; Prins, Inge; Zuurveen, Hannah; Oudsten, Brenda L. Den; Ouden, Marjolein E.M. den; Numans, Mattijs E.; Elzevier, Henk W.; Ek, Gaby F. van

doi:10.1186/s12875-022-01660-8

Cited by 10 publications

(6 citation statements)

References 36 publications

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“…In fact, if the patients themselves do not spontaneously raise the topic of sexual health, most physicians fail to address it with chronic patients in GP [47]. Furthermore, patients with genitourinary issues may also have to get undressed for clinical examination, which makes them vulnerable, thus requiring greater physician empathy and consideration, which may also explain why PPPE was lower in those patients.…”

Section: Discussionmentioning

confidence: 99%

Context explains much of patient-perceived physician empathy in general practice

Lelorain,

Descamps,

Grignoli

et al. 2024

Preprint

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Background. Patient-perceived physician empathy (PPPE) is associated with numerous positive outcomes for patients, quality of care and health expenditure. Research into the factors that explain PPPE is therefore crucial, but the focus has often been placed on physician-related predictors of PPPE. In general practice, however, many barriers to empathy may be contextual, such as lack of time, or patient-related, such as multimorbidity. Consequently, our aim was to explore the effect of these variables on PPPE in general practice. Methods. In a cross-sectional design, 50 randomly recruited physicians were compelled to include 20 consecutive adult patients with one or more chronic disease(s). The characteristics of the doctors and their work environment were collected (e.g. gender, age, peer-group participation or lack of participation, urban or rural area, working alone or with other colleagues, caseload, etc.). Physicians filled in patients’ diseases, and patients filled in validated questionnaires on their health, emotional skills (i.e their ability to identify, express and regulate emotions) and their perception of physician empathy (CARE scale). Multilevel linear regressions were performed using SAS. Results. The median PPPE was 45 (n = 762), with higher rates in patients who had had seven or more consultations with the physicians in the last 12 months and lower in patients with genitourinary and upper gastrointestinal diseases. In consultations ≤ 20 minutes, the length of consultation was associated with higher PPPE in interaction with patients’ emotional skills: the positive effect of longer consultations on PPPE was stronger in patients with low emotional skills, whereas patients with high emotional skills were able to perceive high empathy even in very short consultations of 5–10 minutes. Among the 11 physician-related candidate variables, only physician age had a significant effect. Conclusions. Patient-related and, especially, contextual variables explained PPPE much more than physician-related variables. Consultations with infrequently seen patients and patients with low emotional skills should ideally last at least 20 minutes to allow the empathic process to unfold. Patients with genitourinary and upper-gastrointestinal diseases should be given special consideration, as they may encounter intimate issues or specific needs requiring more attention.

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Section: Discussionmentioning

confidence: 99%

Context explains much of patient-perceived physician empathy in general practice

Lelorain,

Descamps,

Grignoli

et al. 2024

Preprint

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“…However, they seldom asked about possible side effects related to sexual health during follow-up consultations 25 . In a Dutch study 33 of 204 questionnaires completed by general practitioners, 68% of participants never discussed sexual dysfunction with their chronically ill patients during the first consultation, but 54% discussed the issue during a follow-up visit. Two previous studies 34 , 35 among nursing students examined this issue.…”

Section: Discussionmentioning

confidence: 99%

The knowledge of and educational interest in sexual medicine among Finnish medical and midwifery students: A web-based study

Manninen,

Polo-Kantola,

Riskumäki

et al. 2024

Eur J Midwifery

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INTRODUCTION Many elements of life can affect sexual health; thus, healthcare professionals require good knowledge of sexual medicine to encounter patients with these issues. We aimed to study final-year medical and midwifery students’ self-reported knowledge of factors associated with sexuality and their knowledge of how to evaluate and treat/counsel patients with sexual problems. In addition, educational interests regarding sexual medicine were assessed. METHODS In a cross-sectional study, a web-based questionnaire was distributed to final-year medical (n=233) and midwifery (n=131) students graduating between December 2018 and May 2019 in Finland. RESULTS Both student groups self-reported insufficient knowledge of how to consider sexuality in mentally ill patients, how to encounter victims of domestic violence/sexual abuse, and how multiculturalism affects sexuality. In addition, compared to the midwifery students, the medical students were more likely to self-report insufficient knowledge of the basics of sexual pleasure and treating the lack of it (p<0.001), including how to treat sexual problems due to relationship problems (p<0.001) or chronic diseases (p=0.015). Although several educational areas of interest arose, both student groups had two mutual most desirable educational interests: 1) reasons for dyspareunia and its treatment, n=117/233 (50.2%) for medical students, and n=60/131 (45.8%) for midwifery students; and 2) lack of sexual desire and its treatment, n=100/233 (42.9%) for medical students, and n=55/131 (42.0%) for midwifery students. CONCLUSIONS In both student groups, the self-reported knowledge of sexual medicine was insufficient. Thus, more education on sexual medicine should be included in the curricula of medical and midwifery education.

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“… 15 , 16 Factors for health professionals failing to identify and manage patients with sexual dysfunction could be time constraints, low awareness of sexual dysfunction, lack of training about diagnostic tools and treatment options, cultural barriers and fear of broaching the topic. 17 , 18 In contrast, up to 91% of patients indicated that they would be comfortable if their health professional raised the issue. 18 In addition, many people with sexual health concerns do not even attempt to seek medical help.…”

Section: Challenges To Sexual Healthcarementioning

confidence: 99%

Enhancing sexual health in primary care: Guidance for practitioners

Ramlachan,

Naidoo

2024

South African Family Practice

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Sexual health is an integral aspect of overall health and well-being and is fundamental to the sustainable development of societies worldwide. The World Health Organization (WHO) defines sexual health as ‘a state of physical, emotional, mental, and social well-being in relation to sexuality’. However, addressing sexual health has been afforded low priority in primary healthcare systems. Primary care practitioners (PCPs), who play a crucial role in providing comprehensive care to communities, receive little training on screening and managing individuals with sexual health problems. The scope of services ranges from education, prevention and screening, to management of sexual health matters. Patients with noncommunicable diseases (NCDs), such as stroke, cancer, heart disease and diabetes, are at increased risk for sexual dysfunction, possibly because of common pathogenetic mechanisms, such as inflammation. This is of considerable importance in the sub-Saharan African context where there is a rapidly increasing prevalence of NCDs, as well as a high burden of HIV. Strategies to improve the quality of sexual health services in primary care include creating a safe and non-judgemental practice environment for history-taking among gender-diverse populations, utilising effective screening tools aligned with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for sexual dysfunctions. In particular, the International Consultation on Sexual Medicine (ICSM -5) diagnostic and treatment algorithm can empower primary care providers to effectively address sexual dysfunctions among patients and improve the quality of care provided to communities regarding sexual and reproductive health.

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Let’s talk about sex: exploring factors influencing the discussion of sexual health among chronically Ill patients in general practice

Cited by 10 publications

References 36 publications

Context explains much of patient-perceived physician empathy in general practice

Context explains much of patient-perceived physician empathy in general practice

The knowledge of and educational interest in sexual medicine among Finnish medical and midwifery students: A web-based study

Enhancing sexual health in primary care: Guidance for practitioners

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