Barnhoorn P C, Prins Inge C, Zuurveen Hannah R, Oudsten Brenda L den, Ouden Marjolein E M den, Numans Mattijs E, Elzevier Henk W, van Ek Gaby F
Department of Public Health and Primary Care, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2300 RC, The Netherlands.
Department of Psychiatry, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2300 RC, The Netherlands.
BMC Prim Care. 2022 Mar 19;23(1):49. doi: 10.1186/s12875-022-01660-8.
Chronic diseases are often associated with sexual dysfunction (SD). Little is known about the practice patterns of general practitioners (GPs) regarding sexual care for chronically ill patients. Therefore, the aim of this study was to examine; to what extent GPs discuss SD with chronically ill patients; the barriers that may stop them; and the factors associated with discussing SD.
A cross-sectional survey using a 58-item questionnaire was sent to 604 Dutch GPs. Descriptive statistics and associations were used for analysis of the data.
Nearly 58% (n = 350) of all GPs approached gave a response and 204 questionnaires were analysable (33.8%). Almost 60% of respondents considered discussing SD with patients important (58.3%, n = 119). During the first consultation, 67.5% (n = 137) of the GPs reported that they never discussed SD. The most important barrier stopping them was lack of time (51.7%, n = 104). The majority (90.2%, n = 184) stated that the GP was responsible for addressing SD; 70.1% (n = 143) indicated that the GP practice somatic care nurse (GPN) was also responsible. Nearly 80% (n = 161) of respondents were unaware of agreements within the practice on accountability for discussing SD. This group discussed SD less often during first and follow-up consults (p = 0.002 and p < 0.001, respectively). Of the respondents, 61.5% (n = 116) felt that they had received insufficient education in SD and 74.6% (n = 150) stated that the subject is seldom discussed during training. Approximately 62% of the GPs (n = 123) wanted to increase their knowledge, preferably through extra training. According to 53.2% of the GPs (n = 107) it was important to improve the knowledge of the GPN. The most frequently mentioned tool that could help improve the conversation about SD was the availability of information brochures for patients (n = 123, 60.3%).
This study indicates that Dutch GPs do not discuss SD with chronically ill patients routinely, mainly due to lack of time. An efficient tool is needed to enable GPs to address SD in a time-saving manner. Increased availability of informational materials, agreements on accountability within GP practices, and extra training for the GPs and GPNs could improve the discussion of SD.
慢性病常与性功能障碍（SD）相关。关于全科医生（GP）为慢性病患者提供性保健的实践模式，人们了解甚少。因此，本研究的目的是调查：全科医生与慢性病患者讨论性功能障碍的程度；可能阻碍他们的障碍；以及与讨论性功能障碍相关的因素。
使用一份包含58个条目的问卷对604名荷兰全科医生进行横断面调查。采用描述性统计和关联性分析对数据进行分析。
所有被调查的全科医生中近58%（n = 350）做出了回应，204份问卷可用于分析（33.8%）。近60%的受访者认为与患者讨论性功能障碍很重要（58.3%，n = 119）。在首次咨询时，67.5%（n = 137）的全科医生报告称他们从未讨论过性功能障碍。阻碍他们的最重要障碍是时间不足（51.7%，n = 104）。大多数人（90.2%，n = 184）表示全科医生负责处理性功能障碍问题；70.1%（n = 143）指出全科医生诊所的躯体护理护士（GPN）也有责任。近80%（n = 161）的受访者不知道诊所在讨论性功能障碍责任方面的协议。这一组在首次和后续咨询中讨论性功能障碍的频率较低（分别为p = 0.002和p < 0.001）。在受访者中，61.5%（n = 116）觉得他们在性功能障碍方面接受的教育不足，74.6%（n = 150）表示在培训期间很少讨论这个话题。约62%的全科医生（n = 123）希望增加他们的知识，最好是通过额外培训。53.2%的全科医生（n = 107）认为提高躯体护理护士的知识很重要。最常被提及的有助于改善关于性功能障碍讨论的工具是为患者提供信息手册（n = 123，60.3%）。
本研究表明，荷兰全科医生通常不与慢性病患者常规讨论性功能障碍，主要原因是时间不足。需要一种有效的工具，使全科医生能够以节省时间的方式处理性功能障碍问题。增加信息材料的可获取性、全科医生诊所内关于责任的协议以及对全科医生和躯体护理护士的额外培训，可能会改善对性功能障碍的讨论。
