scholarly journals Neglected sexual dysfunction symptoms amongst chronic patients during routine consultations in rural clinics in the North West province

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Deidre Pretorius ◽  
Ian D. Couper ◽  
Motlatso G. Mlambo
Keyword(s):  
Primary Care ◽  
Erectile Dysfunction ◽  
Chronic Illness ◽  
Sexual Dysfunction ◽  
Sexual History ◽  
History Taking ◽  
North West ◽  
The North ◽  
North West Province ◽  
Sexual History Taking

Background: Sexual dysfunction contributes to personal feelings of loss and despair and being a cause of exacerbated interpersonal conflict. Erectile dysfunction is also an early biomarker of cardiovascular disease. As doctors hardly ever ask about this problem, it is unknown how many patients presenting for routine consultations in primary care suffer from symptoms of sexual dysfunction.Aim: To develop an understanding of sexual history taking events, this study aimed to assess the proportion of patients living with symptoms of sexual dysfunction that could have been elicited or addressed during routine chronic illness consultations.Setting: The research was carried out in 10 primary care facilities in Dr Kenneth Kaunda Health District, the North West province, South Africa. This rural area is known for farming and mining activities.Methods: This study contributed to a broader research project with a focus on sexual history taking during a routine consultation. A sample of 151 consultations involving patients with chronic illnesses were selected to observe sexual history taking events. In this study, the patients involved in these consultations completed demographic and sexual dysfunction questionnaires (FSFI and IIEF) to establish the proportions of patients with sexual dysfunction symptoms.Results: A total of 81 women (78%) and 46 men (98%) were sexually active. A total of 91% of the women reported sexual dysfunction symptoms, whilst 98% of men had erectile dysfunction symptoms. The youngest patients to experience sexual dysfunction were a 19-year-old woman and a 26-year-old man. Patients expressed trust in their doctors and 91% of patients did not consider discussion of sexual matters with their doctors as too sensitive.Conclusion: Clinical guidelines, especially for chronic illness care, must include screening for sexual dysfunction as an essential element in the consultation. Clinical care of patients living with chronic disease cannot ignore sexual well-being, given the frequency of problems. A referral to a sexual medicine specialist, psychologist or social worker can address consequences of sexual dysfunction and improve relationships.

General Practitioners' Procedures for Sexual History Taking and Treating Sexual Dysfunction in Primary Care

2014 ◽  
Vol 11 (2) ◽  
pp. 386-393 ◽  
Author(s):  
Sofia Ribeiro ◽  
Violeta Alarcão ◽  
Rui Simões ◽  
Filipe Leão Miranda ◽  
Mário Carreira ◽  
...  
Keyword(s):  
Primary Care ◽  
Sexual Dysfunction ◽  
General Practitioners ◽  
Sexual History ◽  
History Taking ◽  
Sexual History Taking

scholarly journals Sexual history taking: Doctors’ clinical decision-making in primary care in the North West province, South Africa

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Deidré Pretorius ◽  
Ian D. Couper ◽  
Motlatso G. Mlambo
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Sexual Dysfunction ◽  
Clinical Reasoning ◽  
Clinical Decision Making ◽  
Reference Group ◽  
Well Being ◽  
North West ◽  
The North ◽  
North West Province

Background: Clinical reasoning is an important aspect of making a diagnosis for providing patient care. Sexual dysfunction can be as a result of cardiovascular or neurological complications of patients with chronic illness, and if a patient does not raise a sexual challenge, then the doctor should know that there is a possibility that one exists and enquire.Aim: The aim of this research study was to assess doctors’ clinical decision-making process with regards to the risk of sexual dysfunction and management of patients with chronic illness in primary care facilities of the North West province based on two hypothetical patient scenarios.Setting: This research study was carried out in 10 primary care facilities in Dr Kenneth Kaunda health district, North West province, a rural health district.Methods: This vignette study using two hypothetical patient scenarios formed part of a broader grounded theory study to determine whether sexual dysfunction as comorbidity formed part of the doctors’ clinical reasoning and decision-making. After coding the answers, quantitative content analysis was performed. The questions and answers were then compared with standard answers of a reference group.Results: One of the doctors (5%) considered sexual dysfunction, but failed to follow through without considering further exploration, investigations or management. For the scenario of a female patient with diabetes, the reference group considered cervical health questions (p = 0.001) and compliance questions (p = 0.004) as standard enquiries, which the doctors from the North West province failed to consider. For the scenario of a male patient with hypertension and an ex-smoker, the reference group differed significantly by expecting screening for mental health and vision (both p = 0.001), as well as for HIV (p 0.001). The participating doctors did not meet the expectations of the reference group.Conclusion: Good clinical reasoning and decision-making are not only based on knowledge, intuition and experience but also based on an awareness of human well-being as complex and multidimensional, to include sexual well-being.

Sexual history taking in primary care

2021 ◽  
Vol 32 (8) ◽  
pp. 308-311
Author(s):  
Sarah Kipps
Keyword(s):  
Primary Care ◽  
Sexual Health ◽  
Health Professional ◽  
Health Professionals ◽  
Sexual History ◽  
History Taking ◽  
Medical Assessment ◽  
Men And Women ◽  
Sexual History Taking ◽  
The Subject

Sexual history can be neglected in a routine nursing or medical assessment. Sarah Kipps gives tips to assist in making a sexual history taking session as comfortable as possible for both health professional and patient Practitioners in primary care are in a unique position to improve the sexual health of men and women. They can do this by introducing the topic of sexual health into their everyday consultations and thereby normalising the subject as part of routine health for the patient. There is evidence that health professionals find sexual history taking to be one of the more challenging aspects of a consultation. There are a number of different reasons for this: feeling not equipped to ask questions of such a sensitive nature; fear of opening a ‘can of worms’ which cannot be dealt with; and the general social embarrassment and difficulties experienced talking about sex in general. This article will give health professionals some tips and guides to assist in making a sexual history taking session as comfortable as possible for both health professional and patient.

scholarly journals An HIV Primary Care Rotation Improved HIV and STI Knowledge, Enhanced Sexual History-Taking Skills, and Increased Interest in a Career in Infectious Diseases among Medical Students and Residents

2021 ◽  
Author(s):  
Austin A Marshall ◽  
Darcy A Wooten
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Infectious Diseases ◽  
Core Competencies ◽  
Sexual History ◽  
History Taking ◽  
Primary Care Clinics ◽  
Career Pathway ◽  
Hiv Primary Care ◽  
Sexual History Taking

Abstract Rotations in HIV primary care clinics have the potential to teach trainees core competencies and influence their career pathway. We found that fund of knowledge, confidence in obtaining a sexual history, and interest in an ID career all increased following an HIV clinic rotation.

Practices and Barriers in Sexual History Taking: A Cross-Sectional Study in a Public Adult Primary Care Clinic

2020 ◽  
Vol 17 (8) ◽  
pp. 1509-1519
Author(s):  
Leonidas Palaiodimos ◽  
Heather S. Herman ◽  
Erika Wood ◽  
Dimitrios Karamanis ◽  
Cesar Martinez-Rodriguez ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Cross Sectional Study ◽  
Sexual History ◽  
History Taking ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Clinic ◽  
Sexual History Taking

Management of Female Sexual Dysfunction and Sexual History-Taking Survey

2010 ◽  
Author(s):  
Maziar Abdolrasulnia ◽  
Richard M. Shewchuk ◽  
Nancy Roepke ◽  
U. Shanette Granstaff ◽  
John Dean ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Female Sexual Dysfunction ◽  
Sexual History ◽  
History Taking ◽  
Sexual History Taking

scholarly journals The impact of brief quality improvement (QI) projects by medical students in primary care in Gauteng or the North West Province, South Africa

2012 ◽  
Vol 4 (1) ◽  
Author(s):  
Claire Van Deventer ◽  
Nontsikelelo Sondzaba
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Medical Students ◽  
Clinical Skills ◽  
Theory And Practice ◽  
North West ◽  
The North ◽  
North West Province ◽  
The University ◽  
The Impact

Background: The Integrated Primary Care (IPC) rotation is undertaken over six weeks by final year medical students at the University of Witwatersrand. Students are placed in either rural or urban primary health care centres based in Gauteng or the North West Province. As part of the IPC rotation, students undertake short quality improvement (QI) projects. The purpose of this study is to evaluate the impact of the QI projects undertaken over the period stretching from 2006 to 2010. Methods: An observational study of QI reports done by students. Project reports assessed and compared to site marks, indicators of learning assessed and individual and group marks compared.Results: Of 274 projects undertaken, 223 (81.4%) were available for evaluation. Geographical placements and QI themes were categorised. Management issues were most frequently identified as being problematic followed by chronic illnesses. Understanding and applying the principles of QI was partially achieved and gaps were identified for future projects. The most common intervention was training of personnel and design and distribution of posters or pamphlets.Conclusions: Most QI projects were well thought out and relevant to the chosen setting. In the majority of cases, a great deal of effort and creativity went into the process and skills other than clinical skills were employed such as writing, presentation of data in graphs and tables. Integration of theory and practice was achieved only partially.

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