多发性硬化症患者性功能障碍的评估：来自神经科医生的观点。
Assessment of sexual dysfunction in patients with multiple sclerosis: a perspective from neurologist.
机构信息
Universidad del Rosario, School of Medicine and Health Sciences, Neuroscience Center Neurovitae-UR, Neuroscience Research Group NEUROS, Bogotá, Colombia.
Neurologia, Fundacion Cardio Infantil Instituto de Cardiologia, Universidad del Rosario, Calle 163A # 13B - 60, Bogota, Colombia.
出版信息
BMC Neurol. 2022 Sep 29;22(1):372. doi: 10.1186/s12883-022-02884-y.
BACKGROUND
Sexual dysfunction (SD) is a common comorbidity in people with multiple sclerosis (pwMS). It affects the quality of life and remains an overlooked condition. The objective of this study was to describe how Colombian neurologists assess and treat SD and explore the barriers during sexual function evaluation.
METHODS
In this observational cross-sectional study we developed a questionnaire for neurologists with 4 sections (demographic data, evaluation and treatment of SD, and possible reasons for not discussing sexual dysfunction.) It was sent via email to 326 Colombian neurologists. We grouped the answers according to the type of consultation (neurologists from a MS program or no MS program). We described through absolute frequencies and proportions.
RESULTS
Fifty neurologists answered the survey. 64% stated that they usually study sexual dysfunction in neurological disorders. The main methods employed were private reading (86%) and attending conferences (14%). 5/50 participants have never attend pwMS; the Sect. 2-4 was not answered by them. 29% work in a MS program, all of them asked their patients about sexual function, but 18.75% of physicians working outside an MS program have never asked about it. Main reasons for not talking about sexual dysfunction were lack of knowledge (65.1%), presence of a companion (65.1%) and lack of time (55.8%). 91% of the neurologists reported that their patients usually and frequently ask about sexual function. Neurologists use informal questions to assess sexual function (80%), although 64.4% said that they are aware of SD questionnaires. When sexual dysfunction is detected, 91% of neurologists refer patients to another specialist and 87% do not start any treatment.
CONCLUSIONS
Colombian neurologists are concerned with sexual function in pwMS, however it remains an underdiagnosed an undertreated condition. It is necessary to strengthen knowledge about the diagnosis and treatment of sexual dysfunction in pwMS, for neurologists and patients. It is also imperative to eliminate barriers around the topic and include sexual function evaluation and treatment as the routine care of pwMS.
背景
性障碍（SD）是多发性硬化症（pwMS）患者常见的合并症。它影响生活质量，仍然是一种被忽视的疾病。本研究的目的是描述哥伦比亚神经科医生如何评估和治疗 SD，并探讨性功能评估过程中的障碍。
方法
在这项观察性横断面研究中，我们为神经科医生设计了一份包含 4 个部分的问卷（人口统计学数据、SD 的评估和治疗，以及不讨论性障碍的可能原因）。通过电子邮件将问卷发送给 326 名哥伦比亚神经科医生。我们根据咨询类型（来自 MS 项目的神经科医生或没有 MS 项目的神经科医生）对答案进行分组。我们通过绝对频率和比例进行描述。
结果
50 名神经科医生回答了调查。64%的人表示他们通常在神经科疾病中研究性功能障碍。主要采用的方法是私人阅读（86%）和参加会议（14%）。5/50 名参与者从未接触过 pwMS；他们没有回答 Sect. 2-4。29%的人在 MS 项目中工作，他们都询问患者的性功能，但在非 MS 项目工作的医生中，18.75%的人从未询问过。不讨论性功能障碍的主要原因是缺乏知识（65.1%）、有伴侣（65.1%）和缺乏时间（55.8%）。91%的神经科医生报告说，他们的患者通常和经常询问性功能。神经科医生使用非正式问题评估性功能（80%），尽管 64.4%的人表示他们知道 SD 问卷。当发现性功能障碍时，91%的神经科医生会将患者转介给其他专家，87%的神经科医生不会开始任何治疗。
结论
哥伦比亚神经科医生关注 pwMS 的性功能，但它仍然是一种诊断不足和治疗不足的疾病。有必要加强神经科医生和患者对 pwMS 中性功能障碍的诊断和治疗的了解。消除该主题周围的障碍并将性功能评估和治疗纳入 pwMS 的常规护理也势在必行。
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