title: Sexual counselling for patients with cardiovascular disease: protocol for a pilot study of the CHARMS sexual counselling intervention.
abstract: Sexual problems are common with cardiovascular disease, and can negatively impact quality of life. To address sexual problems, guidelines have identified the importance of sexual counselling during cardiac rehabilitation, yet this is rarely provided. The Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention aims to improve the provision of sexual counselling in cardiac rehabilitation in Ireland.
  
  
  
  This is a multicentre pilot study for the CHARMS intervention, a complex, multilevel intervention delivered within hospital-based cardiac rehabilitation programmes. The intervention includes (1) training in sexual counselling for staff, (2) a staff-led patient education and support intervention embedded within the cardiac rehabilitation programme, (3) a patient information booklet and (4) an awareness raising poster. The intervention will be delivered in two randomly selected cardiac rehabilitation centres. In each centre 30 patients will be recruited, and partners will also be invited to participate. Data will be collected from staff and patients/partners at T1 (study entry), T2 (3-month follow-up) and T3 (6-month follow-up). The primary outcome for patients/partners will be scores on the Sexual Self-Perception and Adjustment Questionnaire. Secondary outcomes for patients/partners will include relationship satisfaction; satisfaction with and barriers to sexual counselling in services; sexual activity, functioning and knowledge; physical and psychological well-being. Secondary outcomes for staff will include sexuality-related practice; barriers to sexual counselling; self-ratings of capability, opportunity and motivation; sexual attitudes and beliefs; knowledge of cardiovascular disease and sex. Fidelity of intervention delivery will be assessed using trainer self-reports, researcher-coded audio recordings and exit interviews. Longitudinal feasibility data will be gathered from patients/partners and staff via questionnaires and interviews.
  
  
  
  This study is approved by the Research Ethics Committee (REC) of the National University of Ireland, Galway. Findings will be disseminated to cardiac rehabilitation staff, patients/partners and relevant policymakers via appropriate publications and presentations.
authors.affiliation: Health Behaviour Change Research Group, School of Psychology, NUI Galway, Ireland.
authors.forename: Patrick J
authors.identifier: 0000-0002-2299-1699
authors.initials: PJ
authors.lastname: Murphy
authors.affiliation: Health Behaviour Change Research Group, School of Psychology, NUI Galway, Ireland.
authors.forename: Jenny
authors.initials: J
authors.lastname: Mc Sharry
authors.affiliation: School of Nursing and Midwifery, NUI Galway, Ireland.
authors.forename: Dympna
authors.initials: D
authors.lastname: Casey
authors.affiliation: Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Sally
authors.initials: S
authors.lastname: Doherty
authors.affiliation: School of Business and Economics, NUI Galway, Ireland.
authors.forename: Paddy
authors.initials: P
authors.lastname: Gillespie
authors.affiliation: Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
authors.affiliation: Department of General Practice, NUI Galway, Ireland.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Murphy
authors.affiliation: HRB Clinical Research Facility, NUI Galway, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Newell
authors.affiliation: HRB Clinical Research Facility, NUI Galway, Ireland.
authors.forename: Martin
authors.initials: M
authors.lastname: O'Donnell
authors.affiliation: School of Nursing, Wichita State University, Kansas, USA.
authors.forename: Elaine E
authors.initials: EE
authors.lastname: Steinke
authors.affiliation: School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland.
authors.forename: Elaine
authors.initials: E
authors.lastname: Toomey
authors.affiliation: Health Behaviour Change Research Group, School of Psychology, NUI Galway, Ireland.
authors.forename: Molly
authors.initials: M
authors.lastname: Byrne
mesh_terms: D001294:Attitude to Health; D000072038:Cardiac Rehabilitation / Q000379:methods*; D002318:Cardiovascular Diseases / Q000150:complications*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D009042:Motivation; D010353:Patient Education as Topic; D010564:Personnel, Hospital / Q000193:education; D010865:Pilot Projects; D012649:Self Concept; D012731:Sex Counseling; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000628:therapy*; D011795:Surveys and Questionnaires
keywords: Cardiac rehabilitation; Cardiovascular disease; Complex interventions; Pilot and feasibility studies; Sexual counselling