Burd Irina D, Nevadunsky Nicole, Bachmann Gloria
Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA, USA.
J Sex Med. 2006 Mar;3(2):194-200. doi: 10.1111/j.1743-6109.2005.00168.x.
Identification of sexual dysfunction may help physicians diagnose problems such as diabetes, pituitary tumors, atherosclerosis, and depression. Sexual concerns are common among patients; however, there is evidence to suggest that these concerns are not appropriately investigated by clinicians.
To examine the impact of physician gender on sexual history taking.
One hundred and thirty-one study questionnaires were sent to OB/Gyns, family practitioners, internists, pediatricians, and surgeons. Physicians were asked to rank their discomfort during interviews with patients of different ages, races, marital status, sexual preference, religious beliefs, and academic achievement, and they were asked to rank their perception of patient discomfort.
A cross-sectional descriptive analysis was generated, Fisher's exact test was performed utilizing SPSS software, and confidence intervals were developed utilizing SAS software.
Of the 78 questionnaires (59%) returned, 69 (88%) reported taking sexual histories. Characteristics identified by physicians as causing discomfort included patient's age younger than 18 and greater than 65, patient's academic achievement below college level, and patient's divorced or single marital status. Moreover, there was a statistically significant difference (P < 0.05) between male and female physicians reporting their discomfort when interviewing males (19% and 50%, respectively) and females (35% and 12%, respectively).
Although a high percentage of practitioners report taking a sexual history, physicians reported and perceived greatest discomfort when interviewing opposite gender patients as well as patients of very young and old ages. It is clear that not only is there a need for physician education on the topic of sexual history taking, but also consideration of the impact of physician and patient gender.
性功能障碍的识别有助于医生诊断诸如糖尿病、垂体瘤、动脉粥样硬化和抑郁症等问题。患者中存在性方面的担忧很常见;然而,有证据表明临床医生并未对这些担忧进行适当调查。
研究医生性别对性病史询问的影响。
向妇产科医生、家庭医生、内科医生、儿科医生和外科医生发放了131份调查问卷。要求医生对与不同年龄、种族、婚姻状况、性取向、宗教信仰和学业成就的患者面谈时的不适感进行排序,并要求他们对患者的不适感进行排序。
进行横断面描述性分析,使用SPSS软件进行Fisher精确检验,使用SAS软件计算置信区间。
在回收的78份问卷(59%)中,69份(88%)报告询问过性病史。医生认为会引起不适感的特征包括患者年龄小于18岁或大于65岁、患者学业成就低于大学水平以及患者离婚或单身的婚姻状况。此外,男性医生和女性医生在面谈男性患者(分别为19%和50%)和女性患者(分别为35%和12%)时报告的不适感存在统计学显著差异(P<0.05)。
尽管有很高比例的从业者报告询问过性病史,但医生在与异性患者以及非常年轻和年老的患者面谈时报告并感觉到最大的不适感。显然,不仅需要对医生进行关于询问性病史主题的教育,还需要考虑医生和患者性别的影响。