Communication is key: return to sexual activity after ischemic heart disease hospitalization depends on basic in-hospital education

Abstract

Purpose: In the face of a serious somatic disease that the ischemic heart disease (IHD) is, multiple medical problems, including sexual problems, are pushed to the sidelines. Treatment of thus affected patients is focused primarily on the underlying disease, while sexual dysfunctions, because of the intimate nature of the problem, can often be omitted (not raised in conversation) both by doctors and patients. The aim of this study was therefore to evaluate the impact of a conversation on the sexual activity of a patient hospitalized in the 6-month observation of IHD. Methods: 98 patients (65.3% of them male) hospitalized for IHD (including 32,7% patients with stable angina, 26,5% – with unstable angina, and 40,8% – with myocardial infarction) were included in the study (mean age 57.5 years, ± 6.98 years). Sexuality module of the questionnaire (consisting of 10 items) has been administered during index IHD-related hospitalization and 6 months later (±1 month). The questionnaire-based questions have been original, and provided information on sexual activity of the patient, both preceding the index IHD-related hospitalization as well as in the 6-month period afterwards, on whether the doctor discussed the issue of sexual activity with the patient, who initiated the discussion, and whether it was important for this activity at a later stage. The patients have also been questioned on their opinion as to who ought to initiate discussing sexual activity during the index IHD-related hospitalization. Results: During the index IHD-related hospitalization, 33.7% of patients talk to their doctor about sexual activity. In 9.2% of all cases the patient himself initiated the topic, and in 21.4% it was the doctor. Doctors often discussed sexual activity of patients under 55 years (52.9%), as compared to older patients (25.8%) (p=0.01). 90.8% of the patients preferred that the doctor ought to initiate a conversation about sexual activity, and only 7.2% felt that this conversation should be initiated by the patient or (2%) a psychologist. Patients who discussed sexual activity during hospitalization, were significantly more likely to be sexually active (76,5%) in the 6-month observation period as compared to patients who did not participate in the interview (45.8%) (p=0.004). Conclusions: The lack of conversation about sexual activity during hospitalization for ischemic heart disease is associated with a less likely return to sexual activity within the 6-month observation. According to the patients preference, it is a duty of doctors to initiate a conversation on when the patients can safely return to sexual activity.