Sexuality in heart failure.
Subject: Heart failure (Complications and side effects)
Cardiac patients (Sexual behavior)
Sex (Psychology) (Health aspects)
Authors: Lucas, Lisa M.
Jenkins, Peggy
Pub Date: 03/22/2010
Publication: Name: Journal of the New York State Nurses Association Publisher: New York State Nurses Association Audience: Academic Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2010 New York State Nurses Association ISSN: 0028-7644
Issue: Date: Spring-Summer, 2010 Source Volume: 41 Source Issue: 1
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 242591408
Full Text: Medina, M., Walker, C., Steinke, E., Wright, D., Mosack, V., & Farhound, M. (2009). Sexual concerns and sexual counseling in heart failure. Progress in Cardiovascular Nursing, 24(4), 141-148.

Patients with heart failure (HF) require a complex approach to the provision of care services and patient education. Holistic nursing practice incorporates all sectors of human life including sexuality and sexual activities; however, the research on sexuality in HF patients remains widely deficient. The purpose of this study was to explore patient sexual activity, fears, and counseling in relationship to their HF diagnosis.

A cross-sectional descriptive design receiving Institutional Review Board approval sampled 45 stable, community-based HF patients at outpatient clinics or within their homes. The survey was derived from a 29-item Likert scale instrument (the Exercise and Sexual Activity in Heart Failure Questionnaire) addressing sexual activity, fears, and perceived need for sexual counseling.

The mean age of survey participants was 65.ll ([+ or -] 8.86) years, 67% were male, 73% were married, 85% were Caucasian, and 56% had some higher education. Only 11% of participants denied having sex prior to HF diagnosis; however, 2 months after diagnosis, 53% were not engaging in sexual activities. Sexual fears and concerns were identified as performance limitations, medication effects, symptoms occurring during intercourse, and advisability to engage in sexual activities after HF diagnosis. Only 7% of patients' medical records documented erectile dysfunction as a sexual concern even though 75% of patients experienced erectile dysfunction and 51 % had difficulties reaching climax. The gap between patient reports and documentation suggests that healthcare providers are not addressing these issues. Survey results demonstrated that only 23% of patients with HF had conversations with their healthcare provider regarding sexual activities and concerns, leaving 77% of patients in the dark.

Nearly 6 million American men and women are living with HF (American Heart Association, 20l 0). Healthcare providers frequently overlook sexual counseling and education, but these issues need to become priorities, particularly as HF incidence increases. This study calls for changes to be made in terms of the ways providers address the sexual concerns of individuals diagnosed with HF.

Reference

American Heart Association. (2010). Heart disease and stroke statistics: 20/0 update. Dallas, TX: Author.

Lisa M. Lucas, Hartwick College, Oneonta, NY

Peggy Jenkins, Hartwick College, Oneonta, NY
Gale Copyright: Copyright 2010 Gale, Cengage Learning. All rights reserved.