title: Discussing Sexual Dysfunction with Chronic Kidney Disease Patients: Practice Patterns in the Office of the Nephrologist.
abstract: BACKGROUND
  Sexual dysfunction (SD) is a common problem in patients suffering from chronic kidney disease (CKD). Sexual health remains a difficult subject to detect and discuss. Although many studies have been performed on the incidence of SD, little is known about practice patterns when it concerns quality of life (QoL)-related questions such as SD in the nephrologists' practice.
  
  
  OBJECTIVE
  The aim of this study was to determine to which extent nephrologists, important renal care providers, discuss SD with their patients and their possible barriers toward discussing this subject.
  
  
  METHODS
  A 50-item questionnaire was sent to all Dutch nephrologists (n = 312).
  
  
  METHODS
  The survey results.
  
  
  RESULTS
  The response rate of the survey was 34.5%. Almost all responders (96.4%) stated to address SD in less than half of their new patients. The most important barrier not to discuss SD was patients not expressing their concern regarding SD spontaneously (70.8%). Other important barriers were: "the lack of a suitable moment to discuss" (61.9%) and "insufficient time" (46.9%). Eighty-five percent of the nephrologists stated that insufficient attention was paid to SD and treatment options during their training. Sixty-five percent of the respondents stated to be in need of extending their knowledge on the discussing of SD.
  
  
  CONCLUSIONS
  Dutch nephrologists do not discuss problems with sexual function routinely. The lack of knowledge, suitable education, and insufficient time are factors causing undervaluation of SD in CKD patients. Implementation of competent sexual education and raising awareness among nephrologists on the importance of paying attention to SD could improve care and QoL for patients with CKD. More research should be performed among patients and other renal care providers to develop an adequate method to enhance our current system.
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Gaby F
authors.initials: GF
authors.lastname: van Ek
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Esmée M
authors.identifier: http://orcid.org/0000-0003-2727-7539
authors.initials: EM
authors.lastname: Krouwel
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Melianthe P
authors.initials: MP
authors.lastname: Nicolai
authors.affiliation: Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Hanneke
authors.initials: H
authors.lastname: Bouwsma
authors.affiliation: Department of Transplant Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Ringers
authors.affiliation: Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Rob C M
authors.initials: RC
authors.lastname: Pelger
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Henk W
authors.initials: HW
authors.lastname: Elzevier
mesh_terms: D000328:Adult; D037001:Directive Counseling / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009398:Nephrology / Q000458:organization & administration; D017063:Outcome Assessment, Health Care; D010819:Physician's Role; D010820:Physicians / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000592:standards*; D011788:Quality of Life / Q000523:psychology; D012017:Referral and Consultation; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000523:psychology; D060728:Reproductive Health; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Chronic Kidney Diseases; Nephrology; Practice Patterns; Questionnaires; Sexual Dysfunction