Lin Chung-Ying, Fung Xavier C C, Nikoobakht Mehdi, Burri Andrea, Pakpour Amir H
Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
Department of Neurosurgery, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.
Epilepsy Behav. 2017 Sep;74:124-129. doi: 10.1016/j.yebeh.2017.06.011. Epub 2017 Jul 18.
People with epilepsy (PWE) are highly likely to suffer from sexual dysfunction, and dealing with this issue is a challenge for healthcare providers. Unfortunately, there is no theory-driven study that has investigated the counseling practice of healthcare providers for sexual problems in PWE. Therefore, we decided to apply the well-established Theory of Planned Behavior (TPB) to examine factors associated with healthcare providers' sexual counseling in PWE. Apart from TPB, perceived barriers toward providing counseling could be a possible factor that needs to be investigated as well. Therefore, two models explaining sexual counseling practice were proposed. Model 1 included only TPB and Model 2 included TPB incorporated with perceived barriers. Five hundred fifty-nine Iranian healthcare professionals responsible for PWE were recruited across several neurology clinics and asked to complete TPB-specific questionnaires. The same healthcare professionals were asked to complete an additional questionnaire on their attitudes toward sexual counseling 18months later. Structural equation modeling suggested Model 2 to be more useful in explaining sexual counseling practice compared with Model 1. Moreover, attitude and perceived behavioral control showed stronger associations with behavioral intention, whereas subjective norm showed weaker associations. The associations were similar across different healthcare professionals (i.e., medical doctors vs. nurses). In conclusion, TPB incorporated with perceived barriers might be a useful theory for different types of healthcare providers to improve and enhance sexual counseling practice.
癫痫患者（PWE）极有可能出现性功能障碍，而应对这一问题对医疗服务提供者来说是一项挑战。不幸的是，尚无理论驱动的研究调查过医疗服务提供者针对PWE性问题的咨询实践。因此，我们决定应用成熟的计划行为理论（TPB）来研究与医疗服务提供者对PWE进行性咨询相关的因素。除了TPB之外，感知到的提供咨询的障碍可能也是一个需要调查的潜在因素。因此，我们提出了两个解释性咨询实践的模型。模型1仅包含TPB，模型2包含结合了感知障碍的TPB。我们在多家神经内科诊所招募了559名负责PWE的伊朗医疗专业人员，并要求他们填写特定于TPB的问卷。18个月后，我们要求同样这些医疗专业人员填写一份关于他们对性咨询态度的额外问卷。结构方程模型表明，与模型1相比，模型2在解释性咨询实践方面更有用。此外，态度和感知行为控制与行为意图的关联更强，而主观规范的关联较弱。不同医疗专业人员（即医生与护士）之间的关联相似。总之，结合了感知障碍的TPB可能是一种对不同类型医疗服务提供者改善和加强性咨询实践有用的理论。
