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基层医疗中的性功能障碍:患病率、特征及全科医生的诊断

Sexual dysfunction in primary medical care: prevalence, characteristics and detection by the general practitioner.

作者信息

Read S, King M, Watson J

机构信息

University Department of Psychiatry, Royal Free Hospital School of Medicine, London.

出版信息

J Public Health Med. 1997 Dec;19(4):387-91. doi: 10.1093/oxfordjournals.pubmed.a024665.

Abstract

BACKGROUND

Despite the recent focus on sexual behaviour and AIDs, there are almost no data on the prevalence of sexual dysfunction within primary care settings.

METHOD

One hundred and seventy patients attending a general practice participated in a questionnaire survey of the prevalence and characteristics of sexual problems. The detection rate of the general practitioners (GPs) and indicators in the patient notes were also investigated.

RESULTS

Thirty five per cent of the men (n = 22) reported some form of specific sexual dysfunction: premature ejaculation was identified in 31 per cent of the men; 17 per cent experienced erectile dysfunction, which was associated with current medication, a high mean annual attendance and increasing age. The prevalence of sexual dysfunction in the women was 42 per cent (n = 41); vaginismus was reported by 30 per cent of the sample; 23 per cent of the women suffered from anorgasmia. General sexual dissatisfaction was more common than specific dysfunction; 68 per cent (n = 66) of the women and 75 per cent (n = 54) of the men reported at least one problem with dissatisfaction, avoidance, infrequency or non-communication. The large majority of the sample (70 per cent) considered sexual matters to be an appropriate topic for the GP to discuss. Despite this, sexual problems were recorded in only 2 per cent of the GP notes.

CONCLUSIONS

This study confirms the high prevalence of sexual disorders in the population. Many of these problems are concealed from GPs. Predictors in patients' notes could help GPs to detect those patients with more serious problems.

摘要

背景

尽管近期人们关注性行为和艾滋病,但在初级保健机构中,几乎没有关于性功能障碍患病率的数据。

方法

170名到全科诊所就诊的患者参与了一项关于性问题患病率及特征的问卷调查。同时还调查了全科医生(GP)的检出率以及患者病历中的指标。

结果

35%的男性(n = 22)报告有某种形式的特定性功能障碍:31%的男性被诊断为早泄;17%经历勃起功能障碍,这与当前用药、较高的年均就诊次数和年龄增长有关。女性性功能障碍的患病率为42%(n = 41);30%的样本报告有阴道痉挛;23%的女性患有性高潮障碍。一般性的性不满比特定性功能障碍更为常见;68%(n = 66)的女性和75%(n = 54)的男性报告至少存在一个关于性不满、回避、频率低或沟通不畅的问题。绝大多数样本(70%)认为性问题是全科医生适合讨论的话题。尽管如此,全科医生的病历中仅记录了2%的性问题。

结论

本研究证实了该人群中性功能障碍的高患病率。许多这类问题未被全科医生发现。患者病历中的预测指标有助于全科医生发现那些存在更严重问题的患者。

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