Perspectives on sexual history taking in routine primary care consultations in North West, South Africa: Disconnect between patients and doctors

Pretorius, Deidre; Mlambo, Motlatso G.; Couper, Ian

doi:10.4102/phcfm.v14i1.3286

Cited by 4 publications

(1 citation statement)

References 57 publications

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“… 39 In other studies done by Pretorius et al, sexual symptoms were investigated by way of enquiry in only two patients of the total number consulted. 40 , 41 This, therefore, indicates that a significant number of patients with ED may have been missed or alternatively not being documented, and, therefore, they are most likely not receiving the care they deserve. This healthcare check warrants the appropriate regular screening and intervention for sexual dysfunction in all patients living with DM regardless of sex.…”

Section: Discussionmentioning

confidence: 99%

Compliance of medical practitioners with diabetic treatment guidelines in West Rand, Gauteng

Ohanson

Pretorius

2023

S Afr Fam Pract

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Background: Diabetes mellitus is increasing globally and is associated with multiple complications. Guidelines have been formulated to standardise care among people living with diabetes mellitus (DM), but research shows poor compliance with treatment guidelines. The aim of this study was to assess how well healthcare practitioners in a district hospital in Gauteng complied with the most recent diabetic treatment guideline, Society for Endocrinology Metabolism and Diabetes South Africa (SEMDSA) 2017.Methods: A retrospective cross-sectional review of patient record living with diabetes was done. This study was conducted in the out-patient department of Dr Yusuf Dadoo hospital in the West Rand, Gauteng. A total of 323 records of patients seen from August 2019 to December 2019 were reviewed, and some of the basic variables were assessed according to the most recent diabetic treatment guidelines SEMDSA 2017.Results: Files were audited in four categories: comorbidities, examinations, investigations and the presence of complications. Six monthly glycated haemoglobin (HbA1c) was assessed in 40 (12.4%), annual creatinine assessed in 179 (55.4%) and lipogram in 154 (47.7%) of patients. More than 70% of patients had uncontrolled glycaemia and two people were screened for erectile dysfunction.Conclusion: Monitoring and control parameters were infrequently done as per guideline recommendations. The resultant effects were poor glycaemic control and thus numerous complications.Contribution: Targeted strategies to improve medical practitioner compliance to guidelines including further research to study factors associated with poor compliance with guidelines are needed to improve the overall care of people living with DM in the West Rand and thus minimise the risk of complications among patients in the district.

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Section: Discussionmentioning

confidence: 99%

Compliance of medical practitioners with diabetic treatment guidelines in West Rand, Gauteng

Ohanson

Pretorius

2023

S Afr Fam Pract

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Sexual History Taking: Perspectives on Doctor-Patient Interactions During Routine Consultations in Rural Primary Care in South Africa

2021

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Background: Sexual history taking for risk behavior contributes to improving health outcomes in primary care. Giving the high numbers of people living with AIDS, every patient in South Africa should be offered an HIV test, which implies that a comprehensive sexual history must be taken. Aim: To describe the optimal consultation process, as well as associated factors and skills required to improve disclosure of sexual health issues during a clinical encounter with a doctor in primary health care settings in North West province, South Africa. Methods: This qualitative study, based on grounded theory, involved the video-recording of 151 consultations of adult patients living primarily with hypertension and diabetes. This article reports on the 5 consultations where some form of sexual history taking was observed. Patient consultations were analyzed thematically, which entailed open coding, followed by focused and verbatim coding using MaxQDA 2018 software. Confirmability was ensured by 2 generalist doctors, a public health specialist and the study supervisors. Main Outcome Measure: Sexual history was not taken and patients living with sexual dysfunction were missed. If patients understand how disease and medication contribute to their sexual wellbeing, this may change their perceptions of the illness and adherence patterns. Results: Sexual history was taken in 5 (3%) out of 151 consultations. Three themes emerged from these 5 consultations. In the patient-doctor relationship theme, patients experienced paternalism and a lack of warmth and respect. The consultation context theme included the seating arrangements, ineffective use of time, and privacy challenges due to interruptions and translators. Theme 3, consultation content, dealt with poor coverage of the components of the sexual health history. Conclusion: Overall, sexual dysfunction in patients was totally overlooked and risk for HIV was not explored, which had a negative effect on patients' quality of life and long-term health outcomes. The study provided detailed information on the complexity of sexual history taking during a routine consultation and is relevant to primary health care in a rural setting.

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Addressing sexual health concerns in Tanzania: perceived barriers among healthcare professionals and students in the “training for health professionals” study

Massae,

Mgopa,

Bonilla

et al. 2024

Culture, Health & Sexuality

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Perspectives on sexual history taking in routine primary care consultations in North West, South Africa: Disconnect between patients and doctors

Cited by 4 publications

References 57 publications

Compliance of medical practitioners with diabetic treatment guidelines in West Rand, Gauteng

Compliance of medical practitioners with diabetic treatment guidelines in West Rand, Gauteng

Sexual History Taking: Perspectives on Doctor-Patient Interactions During Routine Consultations in Rural Primary Care in South Africa

Addressing sexual health concerns in Tanzania: perceived barriers among healthcare professionals and students in the “training for health professionals” study

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