Participants’ Experiences of a Sexual Counseling Intervention During Cardiac Rehabilitation

Abstract

Background:International guidelines recommend sexual assessment and counseling be offered to all patients with cardiovascular disease during cardiac rehabilitation. However, sexual problems are infrequently addressed. The Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention is a complex, multilevel intervention designed to increase the provision of sexual counseling in cardiac rehabilitation. It was piloted in 2 cardiac rehabilitation centers to assess the acceptability and feasibility of the intervention and to inform and refine a definitive cluster randomized controlled trial protocol.Objectives:The aim of this study was to explore the experiences, perceptions, and opinions of patients, partners, and cardiac rehabilitation staff who participated in the CHARMS staff-led patient education class.Methods:A qualitative, descriptive study using semistructured interviews to collect the data. Cardiac rehabilitation staff (n = 8) were interviewed when the intervention commenced in their center and 3 months later (n = 6). Patients (n = 19) and partners (n = 2) were interviewed after delivery of the class; 7 were interviewed again 3 months postintervention to explore temporal changes in opinions.Results:Most cardiac rehabilitation staff were comfortable delivering the CHARMS intervention but would prefer a less structured format. Some staff perceived discomfort among patients. Few patients reported discomfort. Most patients and partners considered that the intervention was a welcome and acceptable part of a cardiac rehabilitation program.Conclusion:Incorporating sexual counseling into cardiac rehabilitation programs is feasible. Although the views of the patients and staff diverged on a number of issues including the perceived comfort of patients, its inclusion was welcomed by patients and was acceptable overall to both staff and patients.

Sexual counseling for people with acute coronary syndrome: educational video development

“…Knowing the importance of the human sexual dimension and its impacts on quality of life, it is important that professionals are properly qualified to provide the necessary guidance for each patient’s query. It is possible to identify studies that demonstrated that professionals are not in the habit of discussing sexuality with patients, either because they do not feel comfortable and do not consider sexuality as a priority in care or because they have not actually undergone training to address this issue ( 32 - 33 ) .…”

“…The third topic addressed and which is supported by national and international guidelines is the time for resuming sexual activity, with the following recommendations: gradual resumption after seven days of hospital discharge in patients without clinical signs of ventricular dysfunction; the importance of maintaining a calm environment and being rested for sexual activity; and initially opt for positions that require less energy expenditure and facilitate breathing as well as guidance regarding the clinical signs that should be noticed by patients during and after sexual activity ( 33 , 37 , 39 ) .…”

“…Sabendo da importância da dimensão sexual humana e seus impactos na qualidade de vida, é importante que profissionais estejam devidamente habilitados para realizar as orientações necessárias a cada dúvida de um paciente. É possível identificarmos estudos que demonstraram que os profissionais não possuem o hábito de abordar a sexualidade com os pacientes, seja por não se sentirem confortáveis e não considerarem a sexualidade como prioridade no cuidado ou por realmente não terem sido submetidos a um treinamento para abordar essa temática ( 32 - 33 ) .…”

“…A terceira temática abordada e que se sustenta nas diretrizes nacionais e internacionais é o tempo para a retomada da atividade sexual, sendo aconselhados: a retomada gradual após sete dias da alta hospitalar em pacientes sem sinais clínicos de disfunção ventricular; a importância de manter um ambiente tranquilo e estar descansado para a prática sexual; e optar inicialmente por posições que demandem menor gasto de energia e facilitem a respiração, além de orientações quanto aos sinais clínicos que devem ser percebidos pelo paciente durante e após a atividade sexual ( 33 , 37 , 39 ) .…”

The Importance of the Social Sciences in Reducing Tail Biting Prevalence in Pigs

“…For example, the Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention study described a sexual education and support intervention for cardiac patients designed using the Behaviour Change Wheel [75]. This intervention was found to be feasible in practice [76] and acceptable to recipients [77]. There is also evidence that the Behaviour Change Wheel and related theories can be employed to create effective behaviour change interventions.…”