Rundblad Lucas, Zwisler Ann Dorthe, Johansen Pernille Palm, Holmberg Teresa, Schneekloth Nanna, Giraldi Annamaria
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Danish Knowledge Center for Rehabilitation and Palliative Care, University of Southern Denmark and University Hospital Odense, Nyborg, Denmark; Sexological Clinic, Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Danish Knowledge Center for Rehabilitation and Palliative Care, University of Southern Denmark and University Hospital Odense, Nyborg, Denmark.
J Sex Med. 2017 Jun;14(6):785-796. doi: 10.1016/j.jsxm.2017.04.673.
Ischemic heart disease and heart failure often lead to sexual difficulties in men, but little is known about the sexual difficulties in women and patients with other heart diagnoses or the level of information patients receive about the risk of sexual difficulties.
To investigate perceived sexual difficulties and associated factors in a mixed population of men and women newly diagnosed with heart disease and provide insight into sexual counseling and information given by health care professionals.
This article reports on a cross-sectional, questionnaire study sent to a randomly selected sample of men and women newly diagnosed with heart failure, ischemic heart disease, atrial fibrillation, or heart valve surgery. Eligible patients were identified by diagnosis using the Danish National Patient Register, which contains all diagnoses.
Sexual difficulties were self-reported using single-item questions, and factors associated with sexual difficulties were collected from the survey and national registers.
The study population consisted of 1,549 men and 807 women (35-98 years old) with heart failure (n = 243), ischemic heart disease (n = 1,036), heart valve surgery (n = 375), and atrial fibrillation (n = 702). Sexual difficulties were reported by 55% of men and 29% of women. In a multiple regression analysis, difficulties in men were associated with being older (≥75 years old; odds ratio [OR] = 1.97, 95% CI = 1.13-3.43), having heart failure (OR = 2.07, 95% CI = 1.16-3.71), diabetes (OR = 1.80, 95% CI = 1.15-2.82), hypertension (OR = 1.43, 95% CI = 1.06-1.93), receiving β-blockers (OR = 1.37, 95% CI = 1.02-1.86), or having anxiety (OR = 2.25, 95% CI = 1.34-3.80) or depression (OR = 2.74, 95% CI = 1.38-5.43). In women, difficulties were significantly associated with anxiety (OR = 3.00, 95% CI = 1.51-5.95). A total of 48.6% of men and 58.8% of women did not feel informed about sexuality, and 18.1% of men and 10.3% of women were offered sexual counseling.
Heart disease increases the risk of sexual difficulties and there is a need for improved information and counseling about sex and relationships for patients.
This large nationwide survey of men and women combined a survey with administrative data from national registries. However, this study used non-validated single-item questions to assess sexual difficulties without addressing sexual distress.
More than half the men and one fourth the women across common heart diagnoses had sexual difficulties. No difference was found among diagnoses, except heart failure in men. Despite guidelines recommending sexual counseling, sexual difficulties were not met by sufficient information and counseling. Rundblad L, Zwisler AD, Johansen PP, et al. Perceived Sexual Difficulties and Sexual Counseling in Men and Women Across Heart Diagnoses: A Nationwide Cross-Sectional Study. J Sex Med 2017;14:785-796.
缺血性心脏病和心力衰竭常导致男性性功能障碍，但对于女性以及患有其他心脏疾病诊断的患者的性功能障碍情况，以及患者所获得的关于性功能障碍风险的信息水平，人们了解甚少。
调查新诊断出心脏病的男性和女性混合人群中感知到的性功能障碍及相关因素，并深入了解医疗保健专业人员提供的性咨询和信息情况。
本文报告了一项横断面问卷调查研究，该研究发送给了从新诊断出患有心力衰竭、缺血性心脏病、心房颤动或心脏瓣膜手术的男性和女性中随机抽取的样本。通过使用包含所有诊断信息的丹麦国家患者登记册，根据诊断确定符合条件的患者。
通过单项问题自我报告性功能障碍情况，并从调查和国家登记册中收集与性功能障碍相关的因素。
研究人群包括1549名男性和807名女性（年龄在35 - 98岁之间），患有心力衰竭（n = 243）、缺血性心脏病（n = 1036）、心脏瓣膜手术（n = 375）和心房颤动（n = 702）。55%的男性和29%的女性报告存在性功能障碍。在多元回归分析中，男性的性功能障碍与年龄较大（≥75岁；优势比[OR]=1.97，95%置信区间[CI]=1.13 - 3.43）、患有心力衰竭（OR = 2.07，95% CI = 1.16 - 3.71）、糖尿病（OR = 1.80，95% CI = 1.15 - 2.82）、高血压（OR = 1.43，95% CI = 1.06 - 1.93）、服用β受体阻滞剂（OR = 1.37，95% CI = 1.02 - 1.86），或患有焦虑症（OR = 2.25，95% CI = 1.34 - 3.80）或抑郁症（OR = 2.74，95% CI = 1.38 - 5.43）有关。在女性中，性功能障碍与焦虑症显著相关（OR = 3.00，95% CI = 1.51 - 5.95）。共有48.6%的男性和58.8%的女性感觉未得到关于性方面的信息，18.1%的男性和10.3%的女性接受过性咨询。
心脏病会增加性功能障碍的风险，患者需要获得关于性和人际关系方面更好的信息及咨询。
这项针对男性和女性的大型全国性调查将调查与来自国家登记册的行政数据相结合。然而，本研究使用未经验证的单项问题来评估性功能障碍，且未涉及性困扰问题。
在常见心脏疾病诊断中，超过一半的男性和四分之一的女性存在性功能障碍。除男性心力衰竭外，各诊断之间未发现差异。尽管指南推荐进行性咨询，但性功能障碍患者未得到足够的信息和咨询。伦德布拉德L、兹维斯拉德AD、约翰森PP等。不同心脏疾病诊断的男性和女性中感知到的性功能障碍及性咨询：一项全国性横断面研究。《性医学杂志》2017年；14：785 - 796。
