CE Outcomes, LLC, Birmingham, Alabama 35211, USA.
J Sex Med. 2010 Jul;7(7):2499-508. doi: 10.1111/j.1743-6109.2010.01857.x. Epub 2010 May 26.
Although approximately 40% of women report female sexual problems--and particularly sexual desire disorders, there are numerous practical, professional, and personal barriers to their diagnosis and management by treating clinicians.
To identify practice patterns, perceptions, and barriers to the diagnosis and management of female sexual problems among U.S. practicing primary care physicians (PCPs) and obstetrician/gynecologists (OB/GYNs).
A random sample of practicing U.S. PCPs and OB/GYNs were sent a case-vignette survey by e-mail and fax. Response to the survey was considered consent. A regression model was analyzed to assess predictors of confidence.
Frequency and variability in diagnostic tests ordered and treatment recommendations provided for a patient with diminished sexual desire. Percent of physicians who reported they were confident in treating hypoactive sexual desire disorder (HSDD) and percent who reported significant barriers to initiating a dialogue about sexual health with female patients.
A total of 505 responses were analyzed (8.8% response rate). Of respondents, 21% of OB/GYNs and 38% of PCPs stated they were not at all confident in treating HSDD. The majority of physicians would order a thyroid panel (PCP = 63%, OB/GYN = 53%) to assess a patient's diminished desire and recommended counseling and stress management to treat a patient with sexual complaints (PCP = 48%, OB/GYN = 54%). Regression results identified time constraints, the perceived lack of effective therapies, perceptions regarding patient-physician gender discordance, years in practice, number of patients seen per week, and perceptions regarding continuing medical education and practice experience as significant and independent predictors of confidence in treating HSDD patients.
尽管约有 40%的女性报告存在女性性问题——尤其是性欲障碍，但由于治疗临床医生在实际、专业和个人方面存在诸多障碍，这些问题的诊断和管理仍存在诸多问题。
确定美国初级保健医生（PCP）和妇产科医生（OB/GYN）诊断和管理女性性问题的实践模式、观念和障碍。
通过电子邮件和传真向随机抽取的美国 PCP 和 OB/GYN 执业医生发送病例情况调查报告。对调查的回应被视为同意。分析回归模型以评估信心的预测因素。
为性欲减退的患者开出的诊断性检查和治疗建议的频率和变异性。报告对治疗性欲减退障碍（HSDD）有信心的医生的百分比，以及报告在与女性患者讨论性健康方面存在重大障碍的医生的百分比。
共分析了 505 份回复（8.8%的回复率）。在受访者中，21%的 OB/GYN 和 38%的 PCP 表示他们对治疗 HSDD 一点也没有信心。大多数医生会开甲状腺功能检查（PCP = 63%，OB/GYN = 53%）来评估患者性欲减退的情况，并推荐咨询和压力管理来治疗有性问题的患者（PCP = 48%，OB/GYN = 54%）。回归结果确定了时间限制、认为缺乏有效治疗方法、对医患性别差异的看法、行医年限、每周就诊患者人数以及对继续医学教育和实践经验的看法，这些都是对治疗 HSDD 患者有信心的重要且独立的预测因素。
