Murphy Patrick J, Mc Sharry Jenny, Casey Dympna, Doherty Sally, Gillespie Paddy, Jaarsma Tiny, Murphy Andrew W, Newell John, O'Donnell Martin, Steinke Elaine E, Toomey Elaine, Byrne Molly
Health Behaviour Change Research Group, School of Psychology, NUI Galway, Ireland.
School of Nursing and Midwifery, NUI Galway, Ireland.
BMJ Open. 2016 Jun 24;6(6):e011219. doi: 10.1136/bmjopen-2016-011219.
Sexual problems are common with cardiovascular disease, and can negatively impact quality of life. To address sexual problems, guidelines have identified the importance of sexual counselling during cardiac rehabilitation, yet this is rarely provided. The Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention aims to improve the provision of sexual counselling in cardiac rehabilitation in Ireland.
This is a multicentre pilot study for the CHARMS intervention, a complex, multilevel intervention delivered within hospital-based cardiac rehabilitation programmes. The intervention includes (1) training in sexual counselling for staff, (2) a staff-led patient education and support intervention embedded within the cardiac rehabilitation programme, (3) a patient information booklet and (4) an awareness raising poster. The intervention will be delivered in two randomly selected cardiac rehabilitation centres. In each centre 30 patients will be recruited, and partners will also be invited to participate. Data will be collected from staff and patients/partners at T1 (study entry), T2 (3-month follow-up) and T3 (6-month follow-up). The primary outcome for patients/partners will be scores on the Sexual Self-Perception and Adjustment Questionnaire. Secondary outcomes for patients/partners will include relationship satisfaction; satisfaction with and barriers to sexual counselling in services; sexual activity, functioning and knowledge; physical and psychological well-being. Secondary outcomes for staff will include sexuality-related practice; barriers to sexual counselling; self-ratings of capability, opportunity and motivation; sexual attitudes and beliefs; knowledge of cardiovascular disease and sex. Fidelity of intervention delivery will be assessed using trainer self-reports, researcher-coded audio recordings and exit interviews. Longitudinal feasibility data will be gathered from patients/partners and staff via questionnaires and interviews.
This study is approved by the Research Ethics Committee (REC) of the National University of Ireland, Galway. Findings will be disseminated to cardiac rehabilitation staff, patients/partners and relevant policymakers via appropriate publications and presentations.
性功能问题在心血管疾病患者中很常见，会对生活质量产生负面影响。为解决性功能问题，相关指南已明确了心脏康复期间性咨询的重要性，但实际提供此类咨询的情况却很少。心脏健康、关系管理与性健康（CHARMS）干预旨在改善爱尔兰心脏康复中性咨询的提供情况。
这是一项针对CHARMS干预的多中心试点研究，该干预是在医院心脏康复项目中实施的复杂、多层次干预措施。干预内容包括：（1）对工作人员进行性咨询培训；（2）在心脏康复项目中嵌入由工作人员主导的患者教育与支持干预；（3）一本患者信息手册；（4）一张提高认识的海报。该干预将在两个随机选择的心脏康复中心实施。每个中心将招募30名患者，并邀请其伴侣参与。将在T1（研究入组）、T2（3个月随访）和T3（6个月随访）时从工作人员以及患者/伴侣处收集数据。患者/伴侣的主要结局指标将是性自我认知与调整问卷的得分。患者/伴侣的次要结局指标将包括关系满意度；对服务中性咨询的满意度及障碍；性活动、功能及知识；身心健康。工作人员的次要结局指标将包括与性相关的实践；性咨询的障碍；对能力、机会和动机的自我评估；性态度和信念；心血管疾病与性方面的知识。将通过培训师自我报告、研究人员编码的音频记录和离职访谈来评估干预实施的保真度。将通过问卷调查和访谈从患者/伴侣及工作人员处收集纵向可行性数据。
本研究已获得爱尔兰国立高威大学研究伦理委员会（REC）的批准。研究结果将通过适当的出版物和报告传播给心脏康复工作人员、患者/伴侣及相关政策制定者。
