title: The Cardiac Health and Assessment of Relationship Management and Sexuality study: a qualitative inquiry of patient, general practitioner, and cardiac rehabilitation staff views on sexual assessment and counseling for cardiac patients.
abstract: BACKGROUND
  Sexual dysfunction is a problem for some patients with cardiovascular disease. This study was the final phase of the Cardiac Health and Assessment of Relationship Management and Sexuality (CHARMS) study of sexual function, assessment, and counseling for people with coronary heart disease in Ireland.
  
  
  OBJECTIVE
  The aim of this study was to explore the perspectives of patients, cardiac rehabilitation staff, and general practitioners on the provision of sexual assessment and counseling within Irish health services and how it can be optimized.
  
  
  METHODS
  Group interviews with cardiac rehabilitation staff (n = 14) and patients (n = 13) and telephone interviews with general practitioners (n = 9) were conducted. The interviews were semistructured, digitally recorded, transcribed verbatim, and analyzed using qualitative, descriptive analysis.
  
  
  RESULTS
  All 3 stakeholder groups reported that the problem of sexual dysfunction among cardiac patients was an important issue that was underaddressed in practice. Patients want the issue to be addressed in an explicit way throughout and after the rehabilitation process by confident and knowledgeable professionals. Cardiac rehabilitators widely acknowledged the role that they could play in the provision of sexual assessment and counseling, but many were constrained by a perceived lack of knowledge and confidence. Most cardiac rehabilitation staff would welcome relevant guidelines and training. General practitioners were unlikely to initiate a discussion about sexual dysfunction; however, most were confident that patients would be comfortable in raising it. General practitioners would welcome more awareness raising but did not identify a need for specific training or resources.
  
  
  CONCLUSIONS
  Perspectives differed both across and within stakeholder groups about current services and the development of future services. A disconnect exists between the service that the professionals perceive they give and that experienced by patients. Sexual assessment and counseling should be addressed more explicitly, and patients should be empowered to seek individual assessment and counseling at a time that is appropriate for them.
authors: Department of Psychology, National University of Ireland, Galway, Ireland. maureen.death@nuigalway.ie
authors: Maureen
authors: M
authors: D'Eath
authors: Molly
authors: M
authors: Byrne
authors: Sally
authors: S
authors: Doherty
authors: Hannah
authors: H
authors: McGee
authors: Andrew W
authors: AW
authors: Murphy
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003327:Coronary Disease / Q000534:rehabilitation*; D003376:Counseling; D005260:Female; D017144:Focus Groups; D058006:General Practice; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D057240:Patient Preference; D026741:Physical Therapy Modalities; D011369:Professional-Patient Relations; D036301:Qualitative Research; D019529:Sexuality; D018454:Spouses / Q000523:psychology