Sexual history taking by doctors in primary care in North West province, South Africa: Patients at risk of sexual dysfunction overlooked

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

doi:10.4102/phcfm.v14i1.3238

Cited by 6 publications

(8 citation statements)

References 53 publications

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“…However, sexual dysfunction cuts across gender lines and is a commonly missed symptom in patients with chronic conditions. 36 Further, ED is common among people living with DM, and an additional biomarker for coronary events. 37 The prevalence of ED is estimated to be as high as 70% in Africa, and the risk increases with just 1 year of being diabetic and is made worse in the setting of poor glycaemic controls.…”

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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“…The literature indicates that there is a notable deficiency in communication regarding this matter, resulting in a substantial barrier to the treatment of sexual health for both healthcare professionals and patients. 9 Diabetes has been associated with several consequences, including neuropathy, vascular problems, and hormonal imbalances, all of which have been linked to the development of sexual dysfunction. 5 Nevertheless, the findings from our study and the existing literature suggest that there is a lack of regular inquiry by physicians regarding sexual dysfunction in individuals with diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…Physicians encounter a diverse range of obstacles while engaging in discussions about sexual health with their patients. 9 The problems that individuals may encounter encompass insufficient training and resources, limited time availability, and cultural or personal considerations. The aforementioned scenario presents notable challenges in the identification and management of sexual health issues, resulting in unwarranted reductions in the well-being of individuals with diabetes.…”

Section: Introductionmentioning

confidence: 99%

Do We Care Enough About the Presence of Sexual Problems in Diabetic Patients?

Bilen,

Dayanan,

Ciftel

et al. 2023

IJGM

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Sexual health is not only the absence of sexual dysfunction or disability, but also the presence of physical, emotional, mental, and social well-being related to sexuality. The current study aims to determine whether all adult patients who have applied for their regular health check-ups due to diabetes mellitus had ever voluntarily expressed their sexual problems to a specialist and whether they were asked about the presence of sexual dysfunction. It also aims to determine how the physicians attach importance to the issue. Patients and Methods: All patients aged 18-65 years with type 1 and type 2 diabetes mellitus, who applied to our hospital between the years of January 2021 and 2022, were questioned by filling out a questionnaire for the presence of sexual problems in addition to screening for chronic complications of diabetes mellitus (retinopathy, nephropathy, and neuropathy) and routine history and physical examination. Results:The association between the presence of sexual problems and whether patients were questioned about the relevant issue in their previous controls and gender and age factors, educational background, presence of comorbidities, duration of marriage, and microvascular complications of diabetes mellitus were examined. In a population of 595 patients, 53.78% of the patients stated that they had sexual problems; however, 9.91% had been questioned about this issue by the physician. It was observed that 6.3% of female and 15.3% of male patients had previously consulted a doctor voluntarily due to their sexual problems. Conclusion:This study presents empirical findings that shed light on the inadequacies in healthcare providers' approach to addressing sexual health concerns among individuals diagnosed with diabetes, as well as the shortcomings in patients' effective communication of these concerns.

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“…This study formed one of the six data sets that contributed to a broader grounded theory research 35 that observed 151 video-recorded consultations of patients older than 18 years, who were at risk of sexual dysfunction because of their diagnosis of hypertension and diabetes and the medication they used. This article reported on the data set dealing with open-ended questions in the demographic questionnaire, as well as individual interaction and comments documented as field notes.…”

Section: Methodsmentioning

confidence: 99%

“…Constant comparison was performed between and within data sets and the broader study could conclude with a theoretical direction. 35 A panel consisting of one family physician, a public health specialist and a general practitioner ensured agreement on the coding of the qualitative data.…”

Section: Methodsmentioning

confidence: 99%

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

Pretorius

Mlambo

Couper

2022

Afr. j. prim. health care fam. med.

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Background: Sexual history is rarely taken in routine consultations and research reported on common barriers that doctors experience, such as gender, age and cultural differences. This article focuses on how patients and doctors view sexual history taking during a consultation and their perspectives on barriers to and facilitators of sexual history taking.Aim: This study aimed to explore doctors’ and patients’ perspectives on sexual history taking during routine primary care consultations with patients at risk of sexual dysfunction.Setting: The research was conducted in primary care facilities in the Dr Kenneth Kaunda Health District, North West province.Methods: This was part of grounded theory research, involving 151 adult patients living with hypertension and diabetes and 21 doctors they consulted. Following recording of routine consultations, open-ended questions on the demographic questionnaire and brief interactions with patients and doctors were documented and analysed using open inductive coding. The code matrix and relations browsers in MaxQDA software were used.Results: There was a disconnect between patients and doctors regarding their expectations on initiating the discussion on sexual challenges and relational and clinical priorities in the consultation. Patients wanted a doctor who listens. Doctors wanted patients to tell them about sexual dysfunction. Other minor barriers included gender, age and cultural differences and time constraints.Conclusion: A disconnect between patients and doctors caused by the doctors’ perceived clinical priorities and screening expectations inhibited sexual history taking in a routine consultation in primary care.

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Sexual history taking by doctors in primary care in North West province, South Africa: Patients at risk of sexual dysfunction overlooked

Cited by 6 publications

References 53 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

Do We Care Enough About the Presence of Sexual Problems in Diabetic Patients?

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

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