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类风湿关节炎患者的性健康与功能障碍:一项横断面单中心研究

Sexual Health and Dysfunction in Patients With Rheumatoid Arthritis: A Cross-sectional Single-Center Study.

作者信息

Bay Laila Twisttmann, Graugaard Christian, Nielsen Dorthe S, Möller Sören, Ellingsen Torkell, Giraldi Annamaria

机构信息

Rheumatology Research Unit, Department of Rheumatology, Odense University Hospital & University of Southern Denmark, Odense, Denmark.

Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

出版信息

Sex Med. 2020 Dec;8(4):615-630. doi: 10.1016/j.esxm.2020.07.004. Epub 2020 Sep 8.

Abstract

INTRODUCTION

An increased risk of sexual health problems is seen among patients with chronic illnesses. The background is likely to be multifactorial, but it remains poorly understood.

AIM

To investigate the sexual health and functioning of patients with rheumatoid arthritis (RA) and to examine gender differences, general population comparisons, and possible somatic, psychological, and disease-specific determinants.

METHODS

A cross-sectional study using a digital questionnaire distributed among 380 patients diagnosed with RA in a Danish university hospital outpatient setting.

MAIN OUTCOME MEASURE

A range of patient-reported outcomes were obtained, including scores from the validated rating scale Changes in Sexual Functioning Questionnaire. Furthermore, individual medical record information was collected.

RESULTS

A total of 329 patients (250 women and 79 men) were included (age range: 25-73 years; mean age: 57.2 years). The Changes in Sexual Functioning Questionnaire scoring indicated an overall sexual dysfunction in 33.8% of men and 58.1% of women.More than one-third (37.6%) of patients felt that RA had made their sex life more complicated, and 32.4% feared that this might someday be the case. In total, 29.2% patients had experienced sexual problems due to their RA treatment. Of the respondents who experienced RA-related fatigue, 46.5% reported that this impacted negatively on their sexual activity. The risk of one or more sexual health adversities was significantly correlated with female gender, older age, moderate or severe depression, moderate to moderately high loneliness, more than 2 comorbidities, and a fatigue score above 75 out of 100 on a visual analogue scale. Compared to the general population, significantly fewer patients with RA considered their sex life important, and significantly fewer patients appraised their current sex life as good or very good. Moreover, significantly more women with RA (32.1%) than women from the general population (15.7%) had not had any sex life during the past year. A vast majority of patients with RA (93.5% of women and 85.5% of men) had not discussed sexual issues with a health-care professional during the last 5 years. Of all, 32.5% would like health-care professionals to address sexual topics in the consultation occasionally.

CONCLUSION

Sexual dysfunction is highly prevalent in patients with RA, but the problems are not regularly addressed in consultations provided by the rheumatology department. Bay LT, Graugaard C, Nielsen DS, et al. Sexual Health and Dysfunction in Patients With Rheumatoid Arthritis: A Cross-sectional Single-Center Study. Sex Med 2020;8:615-630.

摘要

引言

慢性病患者出现性健康问题的风险增加。其背后的原因可能是多方面的,但仍未得到充分理解。

目的

调查类风湿关节炎(RA)患者的性健康状况和性功能,并检查性别差异、与普通人群的比较以及可能的躯体、心理和疾病特异性决定因素。

方法

在丹麦一家大学医院门诊环境中,对380名诊断为RA的患者进行了一项横断面研究,采用数字问卷进行调查。

主要观察指标

获得一系列患者报告的结果,包括来自经过验证的性功能问卷评分量表的得分。此外,还收集了个人病历信息。

结果

共纳入329名患者(250名女性和79名男性)(年龄范围:25 - 73岁;平均年龄:57.2岁)。性功能问卷评分显示,33.8%的男性和58.1%的女性存在总体性功能障碍。超过三分之一(37.6%)的患者认为RA使他们的性生活更加复杂,32.4%的患者担心有朝一日会如此。总共有29.2%的患者因RA治疗而出现性问题。在经历与RA相关疲劳的受访者中,46.5%报告这对他们的性活动产生了负面影响。出现一种或多种性健康问题的风险与女性性别、年龄较大、中度或重度抑郁、中度至中度高度孤独、两种以上合并症以及视觉模拟量表上100分中高于75分的疲劳评分显著相关。与普通人群相比,RA患者中认为性生活重要的人数明显较少,评价当前性生活为良好或非常好的患者也明显较少。此外,过去一年中没有性生活的RA女性(32.1%)比普通人群中的女性(15.7%)明显更多。绝大多数RA患者(93.5%的女性和85.5%的男性)在过去5年中未与医疗保健专业人员讨论过性问题。总体而言,32.5%的患者希望医疗保健专业人员在咨询中偶尔提及性话题。

结论

性功能障碍在RA患者中非常普遍,但在风湿病科提供的咨询中,这些问题并未得到定期解决。Bay LT、Graugaard C、Nielsen DS等。类风湿关节炎患者的性健康与功能障碍:一项横断面单中心研究。性医学2020;8:615 - 630。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1a5/7691882/fad9ca2a5ba0/gr1.jpg

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