Adult Diabetes and Quality of Life, Psychosocial Issues, and Sexual Health

Gynaecological practices are changing constantly, with more emphasis on management in primary care, conservative, rather than surgical, management of conditions, and an increase in sub-specialization such as gynaecological oncology and urogynaecology. This chapter reflects these changes and covers the commonest areas in this interesting field. Sexual health is a specialty in its own right. The number of cases of sexually transmitted infections are rising in the UK, despite efforts to raise awareness of safe sex, so knowledge of their presentations is important. The UK also has the highest rate of teenage pregnancy in Europe, and the Government has set targets to improve access to contraceptive advice for women. In recent years, astounding advances have been made in the treatment of human immunodeficiency virus (HIV) infection, and people with HIV can now expect to have a much better quality of life. Although this chapter primarily focuses on diseases affecting women, we have included questions on the sexual health of men to represent the full spectrum of sexual health practice.

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Sexuality in older persons

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0149 ◽

2017 ◽

pp. 1149-1156

Author(s):

Marcello Maggio ◽

Fulvio Lauretani ◽

Gian Paolo Ceda

Keyword(s):

Quality Of Life ◽

Sexual Health ◽

General Health ◽

Primary Care Physicians ◽

Older Persons ◽

Early Recognition ◽

Sexual Symptoms ◽

Related Quality ◽

Public Audience

Sexuality is defined as the dynamic outcome of physical capacity, motivation, attitudes, opportunity for partnership, and sexual conduct. Sexual health in older persons is a topic deserving increasing interest and attention for both a public audience and physicians. Over half of people over 65 years of age, report sexual dysfunction, women more so than men. Since sexual health is dependent on general health and can be considered a mirror of general health, its assessment should be part of the routine clinical assessment, even in older subjects. However, asking about sexual health especially in older persons is often a difficult or embarrassing task for many primary care physicians. In addition, many patients find difficult to raise sexual issues with their doctor. Early recognition of sexual symptoms is the first step to starting multimodal treatments aimed at improving sexual health and related quality of life in older persons.

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Psychosocial Issues of Patients With Implantable Cardioverter Defibrillators

American Journal of Critical Care ◽

10.4037/ajcc2005.14.4.294 ◽

2005 ◽

Vol 14 (4) ◽

pp. 294-303 ◽

Cited By ~ 44

Author(s):

Sandra B. Dunbar

Keyword(s):

Quality Of Life ◽

High Risk ◽

Standard Therapy ◽

Ventricular Arrhythmias ◽

Evidence Based ◽

Psychosocial Issues ◽

Implantable Cardioverter Defibrillators ◽

Life Threatening ◽

Cardioverter Defibrillators

Use of implantable cardioverter defibrillators has become standard therapy for patients at high risk for life-threatening ventricular arrhythmias. Although acceptance of the device is generally high among patients and their families, quality of life and psychosocial issues associated with use of the defibrillators deserve greater attention to improve outcomes. Psychosocial issues, their ramifications, and theory-and evidence-based approaches to improving outcomes are described.

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How Are You Feeling? Who Wants To Know? Patients’ and Oncologists’ Preferences for Discussing Health-Related Quality-of-Life Issues

Journal of Clinical Oncology ◽

10.1200/jco.2000.18.18.3295 ◽

2000 ◽

Vol 18 (18) ◽

pp. 3295-3301 ◽

Cited By ~ 238

Author(s):

S.B. Detmar ◽

N.K. Aaronson ◽

L.D. V. Wever ◽

M. Muller ◽

J.H. Schornagel

Keyword(s):

Quality Of Life ◽

Health Care Providers ◽

Physical Symptoms ◽

Psychosocial Issues ◽

Care Providers ◽

Health Related Quality ◽

Wide Range ◽

Related Quality ◽

Health Related

PURPOSE: This study investigated (1) the attitudes of cancer patients toward discussing health-related quality-of-life (HRQL) issues; (2) the association between such attitudes and patients’ characteristics; and (3) oncologists’ attitudes and self-reported behavior regarding these same issues. PATIENTS AND METHODS: Two hundred seventy-three patients receiving palliative chemotherapy and ten physicians were asked to complete a series of questionnaires. RESULTS: Almost all patients wanted to discuss their physical symptoms and physical functioning and were also willing to address their emotional functioning and daily activities. However, 25% of the patients were only willing to discuss these latter two issues at the initiative of their physician. Patients varied most in their willingness to discuss their family and social life, with 20% reporting no interest in discussing these issues at all. Female patients were more reluctant to discuss various HRQL issues than male patients. Older and less well-educated patients were more likely to prefer that their physician initiate discussion of HRQL issues. All physicians considered it to be primarily their task to discuss the physical aspects of their patients’ health, whereas four physicians indicated that discussion of psychosocial issues was a task to be shared with other health care providers. All physicians indicated that they generally defer to their patients in initiating discussion of psychosocial issues. CONCLUSION: Although both patients and oncologists seem willing to discuss a wide range of HRQL issues, communication regarding psychosocial issues may be hampered by competing expectations as to who should take the lead in initiating such discussions.

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