title: Determinants of doctors' decisions to inquire about sexual dysfunction in Malaysian primary care settings.
abstract: BACKGROUND
  Perceptions of how receptive men are to sexual health inquiry may affect Malaysian primary care doctors' decisions to initiate such a discussion with their male patients. This paper quantifies the impact of doctors' perceptions of men's receptivity on male sexual health inquiry. Sexual health inquiry is one of the five areas in a study on determinants of offering preventive health checks to Malaysian men.
  
  
  METHODS
  This was a cross sectional survey among primary care doctors in Malaysia. The questionnaire was based on an empirical model defining the determinants of primary care doctors' intention to offer health checks. The questionnaire measured: (I) perceived receptivity of male patients to sexual health inquiry; (II) doctors' attitudes towards the importance of sexual health inquiries; (III) perceived competence and, (IV) perceived external barriers. The outcome variable was doctors' intention in asking about sexual dysfunction in three different contexts (minor complaints visits, follow-up visits and health checks visits). All items were measured on the Likert scale of 1 to 5 (strongly disagree/unlikely to strongly agree/likely) and internally validated.
  
  
  RESULTS
  198 doctors participated (response rate 70.4%). Female primary care doctors constituted 54.5%. 78% of respondents were unlikely to ask about sexual dysfunction in visits for minor complaints to their male patients, 43.6% in follow up visits and 28.2% in health checks visits. In ordinal regression analysis, positive perception of men's receptivity to sexual health inquiry significantly predicted the doctors' intention in asking sexual dysfunction in all three contexts; i.e., minor complaints visits (P=0.013), follow-up visits (P<0.0001) and health checks visits (P=0.002). Perceived competence in sexual health inquiry predicted their intention in the follow-up visits (P=0.006) and health checks visits (P<0.001). Lower cost to health checks only predicted their intention in the follow-up visits (P=0.010).
  
  
  CONCLUSIONS
  Whilst sexual health inquiry should be initiated in an appropriate context, 'perceived receptivity' to sexual health inquiry significantly affected doctors' intention in initiating sexual health inquiry to their male patients. Malaysian men's health may be substantially improved by strategies that assist doctors to identify patient 'receptivity'.
authors.affiliation: 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Seng Fah
authors.initials: SF
authors.lastname: Tong
authors.affiliation: 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Wah Yun
authors.initials: WY
authors.lastname: Low
authors.affiliation: 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Shaiful Bahari
authors.initials: SB
authors.lastname: Ismail
authors.affiliation: 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Lyndal
authors.initials: L
authors.lastname: Trevena
authors.affiliation: 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Wilcock
keywords: Health check; decision making; men’s health; primary care physicians; sexual dysfunction
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