| 1. |
- Murphy, Patrick J., et al.
(författare)
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Sexual counselling for patients with cardiovascular disease: protocol for a pilot study of the CHARMS sexual counselling intervention
- 2016
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Ingår i: BMJ Open. - : BMJ PUBLISHING GROUP. - 2044-6055. ; 6:6
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Sexual problems are common with cardiovascular disease, and can negatively impact quality of life. To address sexual problems, guidelines have identified the importance of sexual counselling during cardiac rehabilitation, yet this is rarely provided. The Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention aims to improve the provision of sexual counselling in cardiac rehabilitation in Ireland. Methods and analysis This is a multicentre pilot study for the CHARMS intervention, a complex, multilevel intervention delivered within hospital-based cardiac rehabilitation programmes. The intervention includes (1) training in sexual counselling for staff, (2) a staff-led patient education and support intervention embedded within the cardiac rehabilitation programme, (3) a patient information booklet and (4) an awareness raising poster. The intervention will be delivered in two randomly selected cardiac rehabilitation centres. In each centre 30 patients will be recruited, and partners will also be invited to participate. Data will be collected from staff and patients/partners at T1 (study entry), T2 (3-month follow-up) and T3 (6-month follow-up). The primary outcome for patients/partners will be scores on the Sexual Self-Perception and Adjustment Questionnaire. Secondary outcomes for patients/partners will include relationship satisfaction; satisfaction with and barriers to sexual counselling in services; sexual activity, functioning and knowledge; physical and psychological well-being. Secondary outcomes for staff will include sexuality-related practice; barriers to sexual counselling; self-ratings of capability, opportunity and motivation; sexual attitudes and beliefs; knowledge of cardiovascular disease and sex. Fidelity of intervention delivery will be assessed using trainer self-reports, researcher-coded audio recordings and exit interviews. Longitudinal feasibility data will be gathered from patients/partners and staff via questionnaires and interviews. Ethics and dissemination This study is approved by the Research Ethics Committee (REC) of the National University of Ireland, Galway. Findings will be disseminated to cardiac rehabilitation staff, patients/partners and relevant policymakers via appropriate publications and presentations.
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| 2. |
- Murphy, Patrick J., et al.
(författare)
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The CHARMS pilot study: a multi-method assessment of the feasibility of a sexual counselling implementation intervention in cardiac rehabilitation in Ireland
- 2018
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Ingår i: Pilot and Feasibility Studies. - : BioMed Central. - 2055-5784. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Many people living with cardiovascular disease (CVD) are affected by sexual problems associated with the condition. International guidelines recommend all patients with CVD should receive sexual counselling, yet this is rarely provided by health professionals. The current study piloted the Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention, a complex multi-level intervention designed to increase the implementation of sexual counselling guidelines in hospital-based cardiac rehabilitation (CR) in Ireland.
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| 3. |
- Arenhall, Eva, 1974-, et al.
(författare)
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Decreased sexual function in partners after patients’ first-time myocardial infarction
- 2018
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 17:6, s. 521-526
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Tidskriftsartikel (refereegranskat)abstract
- Background: A myocardial infarction event affects not only patients but also partners, although how it affects the partners’ sexual function is not studied.Aim: The purpose of this study was to describe and compare how partners experienced their sexual function one year before with one year after first-time myocardial infarction of their partner.Methods: A longitudinal and comparative design was used. Self-reported data on Watts Sexual Function Questionnaire was collected retrospectively at two occasions from 123 partners (87 women and 36 men), measuring the year prior to the first-time myocardial infarction and the year after. Data were analysed using descriptive and inferential statistics.Results: The total score for Watts Sexual Function Questionnaire showed a significant decrease over time. In all four subscales a decrease was found, which were statistically significant in three out of the four subscales (sexual desire, 19.39 vs 18.61; p<0.001, orgasm, 14.11 vs 13.64; p=0.027 and satisfaction, 12.61 vs 12.31; p=0.042). Twenty-six partners reported that their intercourse frequencies decreased over time, while six partners reported an increased intercourse frequency.Conclusions: Partners’ sexual function decreased after patients’ first-time myocardial infarction. It is important for health personnel to offer information and discussion about sexual function and concerns with both patients and partners after a first-time myocardial infarction.
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| 4. |
- Byrne, Molly, et al.
(författare)
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Sexual counselling for sexual problems in patients with cardiovascular disease
- 2016
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Ingår i: Cochrane Database of Systematic Reviews. - : WILEY-BLACKWELL. - 1469-493X .- 1469-493X. ; :2, s. 1-39
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Sexual problems are common among people with cardiovascular disease. Although clinical guidelines recommend sexual counselling for patients and their partners, there is little evidence on its effectiveness.OBJECTIVES: To evaluate the effectiveness of sexual counselling interventions (in comparison to usual care) on sexuality-related outcomes in patients with cardiovascular disease and their partners.SEARCH METHODS: We searched CENTRAL, MEDLINE, EMBASE, and three other databases up to 2 March 2015 and two trials registers up to 3 February 2016.SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs, including individual and cluster RCTs. We included studies that compared any intervention to counsel adult cardiac patients about sexual problems with usual care.DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane.MAIN RESULTS: We included three trials with 381 participants. We were unable to pool the data from the included studies due to the differences in interventions used; therefore we synthesised the trial findings narratively.Two trials were conducted in the USA and one was undertaken in Israel. All trials included participants who were admitted to hospital with myocardial infarction (MI), and one trial also included participants who had undergone coronary artery bypass grafting. All trials followed up participants for a minimum of three months post-intervention; the longest follow-up timepoint was five months.One trial (N = 92) tested an intensive (total five hours) psychotherapeutic sexual counselling intervention delivered by a sexual therapist. One trial (N = 115) used a 15-minute educational video plus written material on resuming sexual activity following a MI. One trial (N = 174) tested the addition of a component that focused on resumption of sexual activity following a MI within a hospital cardiac rehabilitation programme.The quality of the evidence for all outcomes was very low.None of the included studies reported any outcomes from partners.Two trials reported sexual function. One trial compared intervention and control groups on 12 separate sexual function subscales and used a repeated measures analysis of variance (ANOVA) test. They reported statistically significant differences in favour of the intervention. One trial compared intervention and control groups using a repeated measures analysis of covariance (ANCOVA), and concluded: "There were no significant differences between the two groups [for sexual function] at any of the time points".Two trials reported sexual satisfaction. In one trial, the authors compared sexual satisfaction between intervention and control and used a repeated measured ANOVA; they reported "differences were reported in favour of the intervention". One trial compared intervention and control with a repeated measures ANCOVA and reported: "There were no significant differences between the two groups [for sexual satisfaction] at any of the timepoints".All three included trials reported the number of patients returning to sexual activity following MI. One trial found some evidence of an effect of sexual counselling on reported rate of return to sexual activity (yes/no) at four months after completion of the intervention (relative risk (RR) 1.71, 95% confidence interval (CI) 1.26 to 2.32; one trial, 92 participants, very low quality of evidence). Two trials found no evidence of an effect of sexual counselling on rate of return to sexual activity at 12 week (RR 1.01, 95% CI 0.94 to 1.09; one trial, 127 participants, very low quality of evidence) and three month follow-up (RR 0.98, 95% CI 0.88 to 1.10; one trial, 115 participants, very low quality of evidence).Two trials reported psychological well-being. In one trial, no scores were reported, but the trial authors stated: "No treatment effects were observed on state anxiety as measured in three points in time". In the other trial no scores were reported but, based on results of a repeated measures ANCOVA to compare intervention and control groups, the trial authors stated: "The experimental group had significantly greater anxiety at one month post MI". They also reported: "There were no significant differences between the two groups [for anxiety] at any other time points".One trial reporting relationship satisfaction and one trial reporting quality of life found no differences between intervention and control.No trial reported on satisfaction in how sexual issues were addressed in cardiac rehabilitation services.AUTHORS' CONCLUSIONS: We found no high quality evidence to support the effectiveness of sexual counselling for sexual problems in patients with cardiovascular disease. There is a clear need for robust, methodologically rigorous, adequately powered RCTs to test the effectiveness of sexual counselling interventions for people with cardiovascular disease and their partners.
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| 5. |
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| 6. |
- Fransson, Eleonor, et al.
(författare)
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Perceptions of intimate relationships in partners before and after a patient's myocardial infarction
- 2014
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 23:15-16, s. 2196-2204
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES:To describe and explore how partners rate their intimate relationship before and after the patients' first myocardial infarction. A further aim was to investigate the association between partners' rating of their intimate relationship and self-rated health.BACKGROUND:To date, information on how partners experience the intimate relationship before and after a patient's myocardial infarction is sparse.DESIGN:A descriptive and exploratory design with longitudinal data collection.METHODS:The study comprised 127 partners, aged 34-87 years. Data collection included self-reported information on socio-demographic data, intimate relationship and self-rated health one year before and one year after patients' first myocardial infarction. Intimate relationship was assessed by the Swedish version of the Relationship Assessment Scale. Self-rated health was evaluated by the EuroQoL visual analogue scale.RESULTS:In general, partners reported high satisfaction with their intimate relationship both before and after the patients' myocardial infarction. Women reported somewhat lower ratings in their intimate relationship than men before the myocardial infarction. Women increased their ratings after one year, while men on average decreased their ratings. Partners with higher education reported lower ratings for intimate relationship after one year. Those with children living at home rated intimate relationship lower than those without children living at home after one year. Partners' self-rated health status was stable over time. No significant association between intimate relationship and self-rated health was found.CONCLUSIONS:This study provides important insights regarding couples' relationships from the perspective of the partner. Socio-demographic factors such as sex, educational level, having children living at home and employment status may influence how the relationship, from the partners' perspective, is affected by a myocardial infarction event.RELEVANCE TO CLINICAL PRACTICE:This study provides insight into how partners rate their intimate relationship and self-rated health over time before and after patients' myocardial infarction.
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| 7. |
- Jaarsma, Tiny, et al.
(författare)
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20 Things You Didnt Know About Sex and Heart Disease
- 2014
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Ingår i: Journal of Cardiovascular Nursing. - : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049. ; 29:3, s. 207-208
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Jaarsma, Tiny, et al.
(författare)
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Sexual problems in cardiac patients : how to assess, when to refer.
- 2010
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Ingår i: Journal of Cardiovascular Nursing. - 0889-4655 .- 1550-5049. ; 25:2, s. 159-64
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Tidskriftsartikel (refereegranskat)abstract
- It is increasingly realized that discussing sexuality is an important issue in the holistic care for cardiac patients. In this review article, the conditions of a good assessment of sexual problems are identified such as creating an appropriate environment, ensuring confidentiality, and using appropriate language. Second, we present different styles and approaches that can be used to start the assessment, differing between settings, persons, or disciplines. The PLISSIT (permission, limited information, specific suggestion, and intensive therapy) model can be helpful to initiate discussion about sexuality with the cardiac patient and his/her partner. This model is a stepwise approach using various levels of discussion or treatment. Open-ended question can facilitate discussion about sexual concerns, and validated questionnaires or diaries can be used to assess sexual problems. Patients with sexual concerns and problems should be counseled and/or treated appropriately, and adequate follow-up is needed. Additional training and research are needed to further improve the quality of sexual assessment and counseling in cardiac patients.
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| 9. |
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| 10. |
- Lin, Chung-Ying, et al.
(författare)
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Using extended theory of planned behavior to determine factors associated with help-seeking behavior of sexual problems in women with heart failure : a longitudinal study
- 2020
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Taylor & Francis Group. - 0167-482X .- 1743-8942. ; 41:1, s. 54-61
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This study used extended theory of planned behavior (extended TPB) to understand the underlying factors related to help-seeking behavior for sexual problems among Iranian women with heart failure (HF). Methods: We recruited 758 women (mean age = 61.21 +/- 8.92) with HF at three university-affiliated heart centers in Iran. Attitude, subjective norms, perceived behavioral control, behavioral intention, self-stigma of seeking help, perceived barriers, frequency of planning, help-seeking behavior, and sexual function were assessed at baseline. Sexual function was assessed again after 18 months. Structural equation modeling was used to explain change in sexual functioning after 18 months. Results: Attitude and perceived behavioral control were positively correlated to behavioral intention. Behavioral intention was negatively and self-stigma in seeking help was positively correlated to perceived barriers. Behavioral intention was positively and self-stigma in seeking help was negatively correlated to frequency of planning. Perceived behavioral control, behavior intention, and frequency of planning were positively and self-stigma in seeking help and perceived barriers were negatively correlated to help-seeking behavior. Help-seeking behavior was positive correlated to the change of FSFI latent score. Conclusions: The extended TPB could be used by healthcare professionals to design an appropriate program to treat sexual dysfunction in women with HF.
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