van Ek Gaby F, Keurhorst Dirry, Krouwel Esmée M, Nicolai Melianthe P J, Den Ouden Marjolein E M, Elzevier Henk W, Putter Hein, Pelger Rob C M, Den Oudsten Brenda L
Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands.
Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands.
J Ren Care. 2018 Mar;44(1):30-37. doi: 10.1111/jorc.12228. Epub 2017 Dec 12.
Fifty to eighty percent of patients suffering from chronic kidney disease (CKD) experience a form of sexual dysfunction (SD), even after renal transplantation. Despite this, inquiring about SD is often not included in the daily practice of renal care providers.
This paper explores the perspectives of renal social workers regarding sexual care for patients and evaluates their practice, attitude towards responsibility and knowledge of SD.
A cross-sectional study was conducted using a 41-item online survey.
Seventy-nine members of the Dutch Federation of Social Workers Nephrology.
It was revealed that 60% of respondents discussed SD with a fifth of their patients. Frequency of discussion was associated with experience (p = 0.049), knowledge (p = 0.001), supplementary education (p = 0.006), and the availability of protocols on sexual care (p = 0.007). Main barriers towards discussing SD consisted of 'culture and religion' (51.9%), 'language and ethnicity' (49.4%), and 'presence of a third person' (45.6%). Sufficient knowledge of SD was present in 28% of respondents. The responsibility for discussion was 96% nephrologists and 81% social workers.
This study provides evidence that a part of Dutch nephrology social workers do not provide sexual care regularly, due to insufficient experience and sexual knowledge, absence of privacy and protocols and barriers based on cultural diversity. According to the respondents the responsibility for this aspect of care should be multidisciplinary. Recommendations include a need for further education on the topic, private opportunities to discuss SD and multidisciplinary guidelines on sexual care.
50%至80%的慢性肾脏病（CKD）患者存在某种形式的性功能障碍（SD），即便在肾移植后亦是如此。尽管如此，询问患者性功能障碍情况在肾脏护理人员的日常工作中却常常未被纳入。
本文探讨肾脏社会工作者对患者性护理的看法，并评估他们的实践、对责任的态度以及对性功能障碍的了解程度。
采用一项包含41个项目的在线调查进行横断面研究。
荷兰肾脏病社会工作者联合会的79名成员。
结果显示，60%的受访者曾与五分之一的患者讨论过性功能障碍问题。讨论频率与经验（p = 0.049）、知识（p = 0.001）、补充教育（p = 0.006）以及性护理方案的可获取性（p = 0.007）相关。讨论性功能障碍的主要障碍包括“文化和宗教”（51.9%）、“语言和种族”（49.4%）以及“有第三人在场”（45.6%）。28%的受访者对性功能障碍有足够的了解。96%的肾病学家和81%的社会工作者认为自己有责任进行讨论。
本研究表明，由于经验和性知识不足、缺乏隐私和方案以及文化多样性带来的障碍，部分荷兰肾脏科社会工作者并未定期提供性护理。据受访者称，这方面护理的责任应是多学科的。建议包括需要就该主题进行进一步教育、提供私下讨论性功能障碍的机会以及制定性护理的多学科指南。
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