Integration of Sexual and Relational Mental Representations in Autobiographical Memories is Associated with Sexual Well-Being

Determinants of sexual well-being have often been identified as sexual and relational satisfaction, which both include a focus on partner relationship. Such a conceptualization excludes sexually active single individuals, while confusing sexual and relational satisfaction with sexual well-being as both determinant and outcome. In the present research, we propose an intrapersonal perspective focused on cognitive sexual and relational mental representations as determinants of sexual well-being. Based on behavioral systems theory, we suggest that a high level of integration of sexual and relational mental representations should be associated with sexual well-being indicators, whereas a weaker level of integration should correspond to a lower level of sexual well-being. We developed a novel codification scheme to measure the cognitive integration of sexual and relational mental representations in narratives of sexual autobiographical memories. We examined its associations with sexual well-being indicators (satisfaction, passion, and sociosexuality). In a sample of 142 students, results showed that integration of sexual and relational representations in memories was positively associated with sexual satisfaction and harmonious passion, and negatively with obsessive passion and sociosexual desire. Results suggest that an integrated cognitive organization of sexual and relational mental representations in autobiographical memories can reflect a greater sexual wellbeing. Clinical implications are discussed.

Mirroring Emotions: Patients' Versus Caregivers' Perceptions of Sexual Experience in Parkinson's Disease

Background and aims: The need for intimacy and sexual expression is an essential dimension of quality of life. As patients with Parkinson's disease (PD) have to cope with essential changes in their global and sexual functioning, achieving a satisfying intimate and sexual relationship can be challenging. Sexual experience is a complex process that involves a dyadic relationship. In this study, we aimed to characterize the sexual experience of patients with Parkinson's disease and patients' vs caregivers' perceptions. Methods Twenty-seven PD patients and their caregivers were asked to complete the Arizona Sexual Experience Scale (ASEX) anonymously. They were instructed to refer to their sexual behavior over the past year and to consider behavioral changes that lasted for at least four consecutive weeks. Results Our data suggest that when considering sexual perceptions in PD, there is often agreement of judgment between patients and their partners. Overall, they have a rather good sex life, especially in the early stage of the disease, with similar behavior shown by men and women. Conclusions The effect of PD on the sexual and couple relationship challenges healthcare professionals to focus on the needs of both partners and to plan specific interventions in such a way as to prevent the deterioration of the couples' sexual wellbeing.

Adapting and Usability Testing of an eLearning Resource to Enhance Healthcare Professional Provision of Sexual Support Across Cancer Care

Objectives: To adapt the theory-driven and positively evaluated Maximising Sexual Wellbeing| Prostate Cancer (MSW|PC) eLearning resource to an eLearning resource suitable for health professionals (HPs) working with mixed cancer populations; followed by usability and acceptability testing. Methods: Guided by Person-Based Approach (PBA) and Biopsychosocial Model, the MSW|PC was adapted by combining evidence from the literature, an expert group (n=27: patients, partners and HPs working in cancer care) and the research team. New content was developed relevant for a mixed cancer population. The Maximising Sexual Wellbeing| Cancer Care (MSW|CC) eLearning prototype was usability tested and modified with HPs using ‘think aloud’ interviews (n=18). Results: Many identified sexual challenges were common across cancer populations, with additional information required for breast, colorectal, gynaecological, head and neck and prostate cancers. During the testing phase, navigational difficulties were identified and resolved. HPs reported the MSW|CC as engaging, informative, relevant with helpful communication and signposting tools to support practice.Conclusion: This systematic and iterative PBA, yielded important insights to enhance the content and usability of MSW|CC. This novel resource provides HPs working across cancer care with tools to potentially address the gap in knowledge and skills and positively impact future sexual healthcare provision across cancer care.

Effects of a Brief E-Learning Resource on Sexual Attitudes and Beliefs of Healthcare Professionals Working in Prostate Cancer Care: A Pilot Study

Sexual issues and treatment side effects are not routinely discussed with men receiving treatment for prostate cancer, and support to address these concerns is not consistent across settings. This study evaluates a brief e-learning resource designed to improve sexual wellbeing support and examine its effects on healthcare professionals’ sexual attitudes and beliefs. Healthcare professionals (n = 44) completed an online questionnaire at baseline which included a modified 12-item sexual attitudes and beliefs survey (SABS). Follow-up questionnaires were completed immediately after the e-learning and at 4 weeks. Data were analysed using one-way, repeat measures ANOVAs to assess change in attitudes and beliefs over time. Significant improvements were observed at follow-up for a number of survey statements including ‘knowledge and understanding’, ‘confidence in discussing sexual wellbeing’ and the extent to which participants felt ‘equipped with the language to initiate conversations’. The resource was seen as concise, relevant to practice and as providing useful information on potential side effects of treatment. In brief, e-learning has potential to address barriers to sexual wellbeing communication and promote delivery of support for prostate cancer survivors. Practical methods and resources should be included with these interventions to support implementation of learning and long-term changes in clinical behaviour.

Effects of a Brief e-Learning Resource on Sexual Attitudes and Beliefs of Healthcare Professionals Working in Prostate Cancer Care: A Single Arm Pre and Post‐Test Study

Sexual issues and treatment side effects are not routinely discussed with men receiving treatment for prostate cancer and support to address these concerns is not consistent across settings. This study evaluates a brief e-learning resource designed to improve sexual wellbeing support and examine its effects on healthcare professionals’ sexual attitudes and beliefs. Healthcare professionals (n=44) completed an online questionnaire at baseline which included a modified 12-item sexual attitudes and beliefs survey (SABS). Follow-up questionnaires were completed immediately after the e-learning and at 4 weeks. Data were analysed using one-way, repeat measures ANOVAs to assess change in attitudes and beliefs over time. Significant improvements were observed at follow-up for a number of survey statements including ‘knowledge and understanding’, ‘confidence in discussing sexual wellbeing’ and the extent to which participants felt ‘equipped with the language to initiate conversations’. The resource was seen as concise, relevant to practice, and as providing useful information on potential side effects of treatment. Brief, e-learning has potential to address barriers to sexual wellbeing communication and promote delivery of support for prostate cancer survivors. Practical methods and resources should be included with these interventions to support implementation of learning and long-term changes in clinical behaviour.

Sexual wellbeing in early adolescence: a cross-sectional assessment among girls and boys in urban Indonesia

Background Early adolescence (ages 10–14) is a critical period of physical, cognitive, social and emotional development, which affect sexual and reproductive health and rights (SRHR). Yet, little is known about positive or healthy aspects of sexuality development during this period of life, especially in South East Asia where sexual norms remain restrictive. The objective of this study is to assess the prevalence and correlates of sexual wellbeing among early adolescent girls and boys ages 10–14 years in Indonesia. Methods Data for this cross-sectional study were collected as part of the Global Early Adolescent Study via a school-based survey in three Indonesian urban sites in 2018 (N = 4309). We assessed the prevalence of multiple indicators of sexual wellbeing (e.g. SRHR knowledge and communication, gender attitudes, body satisfaction, self-efficacy, freedom from violence) and tested for differences by sex using Chi-square, Student t-test, and Wilcoxon rank-sum test. Multivariable logistic regression models were used to assess the adjusted odds ratio of selected indicators in relation to sociodemographic factors, romantic relationship status, and sexual activities. Results The mean age of students was 12 years (53% girls); 90% had started puberty. SRHR knowledge and communication was low overall, but higher among boys than girls. Boys were more likely than girls to report high body satisfaction, less feelings of guilt in relation to sexuality, but also to have experienced physical peer violence. In contrast, girls were more likely to hold gender equal attitudes, greater perceived self-efficacy to say ‘no’, and to report being bullied by boys. In multivariable models, romantic relationship experiences, perceived voice (boys and girls) and decision-making (girls) were associated with three or more indicators of sexual wellbeing. Conclusions While young adolescents in Indonesia score high on some aspects of sexual wellbeing, misconceptions, feelings of guilt and uncertainties related to sexuality are common, with clear gender differences. These findings confirm the need for comprehensive sexuality education that begins early in adolescence.