THU0485-HPR Current practice and barriers to the management of sexual issues in rheumatology: Results of a survey of 647 health professionals
Authors: Y. Helland, I. Kjeken, A. Garratt, T.K. Kvien, H. Dagfinrud
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Sexual concerns are prevalent among patients with rheumatic diseases, and there is evidence that patients want disease-related sexual aspects to be addressed in the health care setting (2). However, some previous studies have indicated that sexual issues are generally ignored by health care providers even if health professionals (HPs) generally are positive towards addressing sexuality (1,3). <h3>Objectives</h3> To explore multidisciplinary HPs management of disease related sexual issues in patients with rheumatic diseases and identify their perceived barriers for addressing sexuality as a topic in patient consultations. <h3>Methods</h3> A questionnaire addressing management of sexual issues in patient consultations was mailed to 647 nurses, physicians, physiotherapists, occupational therapists, social workers and psychologists working within rheumatology care. The responses were analysed with descriptive- or group-statistics, and a multivariate logistic regression model was constructed to identify significant determinants for initiating sexual topics. <h3>Results</h3> Mean age of the respondents (n 274, 42% response rate) was 46 years, 87% female. While nearly all considered sexuality a relevant topic in rheumatology care, 71% seldom/never raised the topic in consultations. The patient was the main initiator (53%), and 88% of HPs gave the patient responsibility to initiate. The most important barrier for raising sexual issues was the <i>perceived embarrassment of the patient</i> (83%), followed by <i>lack of time</i> (72%). The HPs with relevant education in sexuality were significantly more comfortable talking about sexuality (p&lt;0.001) and raised sexual issues significantly more often (p&lt;0.001). In the multivariate analyses higher age (OR (95%CI) 3.69 (1.4,9.6), having relevant education (OR 3.16 (1.6,6.3), and being comfortable to some extent (OR 3.62 (1.2,10.7), or a large extent (OR 5.58 (1.7,18.1) were independent determinants for initiating sexual topics, while being a physiotherapist reduced the chance (OR 0.27 (0.1,0.9). <h3>Conclusions</h3> Although health professionals regard sexuality as a relevant topic in rheumatic health care, they seldom raise the topic in consultations. Significant predictors for initiating sexual topics in patient consultations were higher age, having relevant education and being comfortable with addressing sexual issues. The majority of respondents requested more relevant education. <h3>References</h3> Hill J, Bird H, Thorpe R. Effects of rheumatoid arthritis on sexual activity and relationships. Rheumatology (Oxford) 2003 Feb;42(2):280-6. Helland Y, Kvien TK, Steen E, Dagfinrud HS. Patients with rheumatic diseases want information and communication on sexual issues.Ann Rheum Dis 2009;68:773 Haboubi NH, Lincoln N. Views of health professionals on discussing sexual issues with patients. Disabil Rehabil 2003 Mar 18;25(6):291-6. <h3>Disclosure of Interest</h3> None Declared