Teine Family Medicine Clinic, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
Teine Family Medicine Clinic, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan.
Fam Med Community Health. 2021 Jan;9(1). doi: 10.1136/fmch-2020-000403.
Erectile dysfunction (ED) is a common problem among middle-aged males and men often do not talk about sexual problems with their primary care physicians (PCPs). We hypothesised that many Japanese men who meet the criteria for ED would not recognise their condition based on responses to an internationally validated scale. Our secondary aims were to examine potential barriers to seeking treatment for ED by their PCPs. We sought to elucidate their perspectives about male sexual dysfunction qualitatively. Through merging of the quantitative and qualitative findings, we sought an enhanced understanding of the factors affecting sexual dysfunction treatment.
A cross-sectional, self-administered mixed methods survey was distributed at a suburban family medicine clinic in Sapporo, Japan. Eligible participants were 40 to 69-year-old men who came for routine scheduled visits from 5 November to 21 December 2018. During the office visit, participants completed a confidential 11-item survey addressing sexual dysfunction including the 5-item version of the International Index of Erectile Function scale and open-ended questioning.
Teine Family Medicine Clinic, a suburban family medicine clinic in Sapporo, Japan.
We enroled 66 male patients aged 40-69 years who presented for routine outpatient care in the Teine Family Medicine Clinic.
Of surveyed participants, 39% (26/66) reported having sexual dysfunction, but 92% (61/66) met ED criteria. Of respondents, 48% (16/33) had desire for treatment, but only one man had discussed sexual dysfunction with his PCP. Among the 12 desiring treatment from PCPs, the main barriers to discussing were shame (n=7) and lack of awareness that PCPs can treat ED (n=5). These men's perspectives about sexual dysfunction included viewing sexual dysfunction as normal ageing, attributing sexual dysfunction to decreased libido, considering sexual activity for a healthy life, having good rapport with PCPs, having incomplete knowledge about treatment and lacking an intimate relationship. Through a resulting model, the merged mixed methods findings illustrate how patient perceptions can reinforce or attenuate issues of awareness, desire for treatment and barriers to access.
In a Japanese primary care setting, the majority of participating male patients met ED criteria on an internationally validated measure, namely, the five-item version of the International Index of Erectile Function, but many were not aware of their ED. Misperceptions, lack of knowledge and personal factors are barriers to treatment. The mixed methods findings suggest misperceptions and personal attributes reinforce or attenuate awareness, preference for treatment and barriers to access. We conclude PCPs should routinely inquire about sexual dysfunction of men at risk and offer treatment to men who would benefit.
勃起功能障碍（ED）是中年男性的常见问题，男性通常不会与初级保健医生（PCP）谈论性问题。我们假设，许多符合 ED 标准的日本男性不会根据国际公认量表的反应来识别自己的病情。我们的次要目的是研究男性通过 PCP 寻求 ED 治疗的潜在障碍。我们试图从质的角度阐明他们对男性性功能障碍的看法。通过将定量和定性研究结果合并，我们试图更深入地了解影响性功能障碍治疗的因素。
在日本札幌的一个郊区家庭医学诊所进行了一项横断面、自我管理的混合方法调查。符合条件的参与者是年龄在 40 至 69 岁之间的男性，他们于 2018 年 11 月 5 日至 12 月 21 日期间定期预约就诊。在就诊期间，参与者完成了一项关于性功能障碍的机密 11 项调查，包括国际勃起功能指数的 5 项版本和开放式问题。
日本札幌的 Teine 家庭医学诊所，一个郊区家庭医学诊所。
我们招募了 66 名年龄在 40-69 岁之间的男性患者，他们在 Teine 家庭医学诊所接受常规门诊治疗。
在接受调查的参与者中，39%（26/66）报告存在性功能障碍，但 92%（61/66）符合 ED 标准。在回答者中，48%（16/33）有治疗意愿，但只有一名男性与 PCP 讨论过性功能障碍。在 12 名希望从 PCP 处获得治疗的男性中，讨论的主要障碍是羞耻感（n=7）和缺乏 PCP 可以治疗 ED 的意识（n=5）。这些男性对性功能障碍的看法包括将性功能障碍视为正常衰老、将性功能障碍归因于性欲下降、认为性行为有益于健康、与 PCP 关系良好、对治疗知之甚少以及缺乏亲密关系。通过一个由此产生的模型，合并后的混合方法研究结果说明了患者的看法如何加强或削弱对意识、治疗意愿和获得治疗的障碍的认识。
在日本初级保健环境中，大多数参与的男性患者在国际公认的量表上符合 ED 标准，即国际勃起功能指数的 5 项版本，但许多人并未意识到自己的 ED。误解、缺乏知识和个人因素是治疗的障碍。混合方法研究结果表明，误解和个人特征加强或削弱了意识、治疗偏好和获得治疗的障碍。我们得出结论，PCP 应常规询问有风险的男性的性功能障碍，并为受益的男性提供治疗。
