Sexual Mindfulness and the Libido of Generativity: A Psychoanalytic Perspective on Future-Oriented Desire and Couple Well-Being

Spinal deformity can have a severe impact on the patient's sexual health. Eventually, this can lead to depression and relationship distress. Spinal surgical management is suggested to improve sexual function, however, the literature concerning these aspects is still scarce. This study evaluated which factors predicted improvement in sexual health in patients with adult spinal deformity (ASD) who underwent surgical treatment. Multicentric retrospective study based on a prospectively collected ASD database. Data of patients who underwent surgical correction and had a 2-year follow-up were collected. The association between different patient-reported outcome measures and ODI question 8 (Q8, sexual health) was explored with Pearson correlations and Principal Component Analysis (PCA). Improvement in sexual health was evaluated through a 1-point decrease on Q8. Comparisons between improved and non-improved patients and the non-response to the preoperative Q8 wereassessed. Data from 880 patients were collected. Moderate correlations were revealed between ODI and COMI-back, SRS-22, and SF-36 items and confirmed with PCA. The main factors associated to a non-response to Q8 were being of an older age, having worse sagittal imbalance, and having a specific nationality. Patients with an improvement in sexual health at 2years were the ones with a worse baseline quality of life, older patients with a greater sagittal correction, and a better improvement of the level of physical activity. Non-response to Q8 was correlated to age and nationality. Long-segment ASD surgery could improve sexual health, which was correlated to physical activity improvement, severe deformity with worse preoperative quality of life, and better postoperative sagittal correction.

BackgroundDespite being a critical survivorship care issue, there is a clear gap in current knowledge of the optimal treatment of sexual dysfunction in men with prostate cancer. There is sound theoretical rationale and emerging evidence that exercise may be an innovative therapy to counteract sexual dysfunction in men with prostate cancer. Furthermore, despite the multidimensional aetiology of sexual dysfunction, there is a paucity of research investigating the efficacy of integrated treatment models. Therefore, the purpose of this study is to: 1) examine the efficacy of exercise as a therapy to aid in the management of sexual dysfunction in men with prostate cancer; 2) determine if combining exercise and brief psychosexual intervention results in more pronounced improvements in sexual health; and 3) assess if any benefit of exercise and psychosexual intervention on sexual dysfunction is sustained long term.Methods/DesignA three-arm, multi-site randomised controlled trial involving 240 prostate cancer survivors will be implemented. Participants will be randomised to: 1) ‘Exercise’ intervention; 2) ‘Exercise + Psychosexual’ intervention; or 3) ‘Usual Care’. The Exercise group will receive a 6-month, group based, supervised resistance and aerobic exercise intervention. The Exercise + Psychosexual group will receive the same exercise intervention plus a brief psychosexual self-management intervention that addresses psychological and sexual well-being. The Usual Care group will maintain standard care for 6 months. Measurements for primary and secondary endpoints will take place at baseline, 6 months (post-intervention) and 1 year follow-up. The primary endpoint is sexual health and secondary endpoints include key factors associated with sexual health in men with prostate cancer.DiscussionSexual dysfunction is one of the most prevalent and distressing consequences of prostate cancer. Despite this, very little is known about the management of sexual dysfunction and current health care services do not adequately meet sexual health needs of survivors. This project will examine the potential role of exercise in the management of sexual dysfunction and evaluate a potential best-practice management approach by integrating pharmacological, physiological and psychological treatment modalities to address the complex and multifaceted aetiology of sexual dysfunction following cancer.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12613001179729.

The final chapter in this section - Chapter 9: Health improvement perspectives: transformation within services through reaching out – continues to explore the importance of taking a broad model of sexual health into conceptualising sexual health and in targeting activity to those most vulnerable to poor sexual health outcomes. The first sexual health strategy for Scotland emphasised the need for this approach, and in this chapter Phil Eaglesham from NHS Health Scotland describes the significant role of health improvement in promoting good sexual health in Scotland and reviews its contribution to population health. Mr Eaglesham gives an overview of the tenets of health improvement practice in Scotland and the UK, and provides evidence of work from a health improvement perspective to address the needs of those most at risk of poor sexual health outcomes and to advocate for improved outcomes. These include men who have sex with men, as well as young people as a group, and examples are given of good practice in sexual health improvement especially in relation to partnership working, linked to specialist services and supporting multi-agency approaches. Two examples from Greater Glasgow and Clyde, Archway – for those who have been recently raped or seriously sexually assaulted, and Open Road – for men involved in prostitution, are given as useful case studies. The chapter ends by suggesting that sexual health improvement approaches contribute to broader population health in Scotland by often providing the only routes for rapid access to healthcare and support for those marginalised in our society.

The aim of this paper is to explore some reasons for the lack of focus on ethnicity and sexual health in nursing research, and suggest ways to advance the nursing evidence-base required for practice development. The United Kingdom National Strategy for Sexual Health and human immunodeficiency virus published in July 2001 highlighted the continued rise in sexual ill health amongst minority ethnic groups. In order to improve sexual health, research evidence is needed explain why particular ethnic groups appear to be at greater risk of sexual ill health. The Strategy identified nurses as key to bringing about improvements in sexual health. Nursing research includes many studies exploring links between ethnicity and health. However, with the exception of extensive work on human immunodeficiency virus/acquired immunodeficiency syndrome as a specific disease, nursing research into ethnicity has not systematically included sexual health. Literature searches were conducted using the BIDS database, World Wide Web and United Kingdom Department of health website between June 2000 and August 2003. Papers written in English incorporating the keywords 'sexual health', 'sexually transmitted infection' and 'health and ethnicity' in the title or abstract were selected for review. Nursing research into the association between sexual health and ethnicity is rare. It has been hampered by a variety of political and social constraints concerning the nature of sexual health practice in nursing, researching sexual health, and researching ethnicity and health. The result is a dearth of research evidence to support the development of sexual health practice and the education of healthcare professionals to underpin care of minority ethnic clients. Barriers to researching ethnicity and sexual health by nurses must be addressed through nursing education and practice. Without this, a detailed evidence base will fail to materialize and healthcare practices to implement the priorities to improve sexual health in minority ethnic communities will remain undeveloped.

Little research has evaluated the associations of mindfulness training on couple romantic and sexual well-being and no research has examined the role of sexual mindfulness within an intervention. We introduced the Sexual Mindfulness Project (SMP) that addressed sexual relationships through daily mindfulness, sexual mindfulness (remaining aware and non-judgmental during sexual experiences), communication, and problem-solving skills which was taught in a structured intervention. We examined the effects of this program with committed couples (N = 5) who attended a two-session version of this project. We use mixed methods and examined themes from participant interviews and explored how sexual mindfulness in romantic and sexual relationships may prompt feelings of connection and intimacy. Qualitative results indicated improvement in individual, romantic, and sexual well-being. In addition, as appropriate, we integrate quantitative findings of change in sexual mindfulness and the other outcomes using retrospective pre-post design. We used a retrospective pre/post test to avoid reference frame bias, as sexual mindfulness is a skill that individuals may over-estimate on a pretest as participants know little about how to evaluate their sexual mindfulness. We found that the participants’ perception of the mechanism of change included their efforts to slow down, pay attention to their own sexual experience and/or feelings, communicate more effectively, and then address those feelings or thoughts with their partner in a non-judgmental, open, and accepting way.

Women and gender-diverse people with early psychosis are at risk for suboptimal sexual health outcomes, yet little research has explored their sexual health experiences. This study explored sexual health experiences and related priorities among women and gender-diverse people with early psychosis, to identify opportunities for improvements in sexual health and well-being. Semi-structured individual qualitative interviews explored how patient participants (n = 19, aged 18-31 years, cisgender and transgender women and non-binary individuals) receiving clinical care from early psychosis programmes in Ontario, Canada, experienced their sexual health, including sexual function and behaviour. Thematic analysis was conducted, with triangulation from interviews/focus groups with clinicians (n = 36) who provide sexual and mental healthcare for this population. Three key themes were identified based on patient interviews: theme 1 was the impact of psychotic illness and its treatments on sexual function and activity, including variable changes in sex drive, attitudes and behaviours during acute psychosis, vulnerability to trauma and medications; theme 2 related to intimacy and sexual relationships in the context of psychosis, with bidirectional effects between relationships and mental health; and theme 3 comprised autonomy, identity and intersectional considerations, including gender, sexuality, culture and religion, which interplay with psychosis and sexual health. Clinicians raised each of these priority areas, but emphasised risk prevention relative to patients' more holistic view of their sexual health and well-being. Women and non-binary people with early psychosis have wide-ranging sexual health priorities, affecting many facets of their lives. Clinical care should incorporate this knowledge to optimise sexual health and well-being in this population.

Introduction: Sexual health is one of the main aspects of health and investigation of its relevant factors is so important for primary healthcare. Aim: The present study was conducted to determine the role of meta-cognitive belief and emotion regulation strategies in predicting Sexual health of married women. Method: This research is a descriptive correlation study. The statistical population of the study was all the married women in Ardabil City in 2020. Out of the mentioned population, 110 people were selected as the samples. Data collection was done by Meta-Cognitive Belief Questionnaire (Wells & Cartwright-Hatton, 2004), Emotion Regulation Strategies Scale (Gross & John, 2003), and Sexual Health Scale (Manavi Pour, 2008). Research data were analyzed using Pearson correlation coefficient and multiple regression using SPSS18 software. Results: The results showed a significant relationship between meta-cognitive belief -0.62 and emotion regulation strategies (Reappraisal 0.56 and Suppression -0.43) with Sexual health in married women. Also, the results of multiple regression showed that meta-cognitive belief and emotion regulation strategies can predict the Sexual health of married women by 0.55 (p<0.05). Conclusion: Regarding the effect of meta-cognitive belief and emotion regulation strategies on sexual health in married women, it is suggested for psychologists and health experts to pay more attention the role of these variables in the improvement of sexual health in married women.

The aim of this systematic review and meta-analysis was to explore and evaluate the effect of psychosocial interventions in improving sexual health outcomes among post-treatment patients with pelvic cancer. Inclusion and exclusion criteria were pelvic cancer survivors; psychosocial interventions; studies with a control group and measures of sexual health. Five databases were searched for literature along with an inspection of the included studies' reference lists to extend the search. Risk of bias was assessed with the RoB2 tool. Standardised mean difference (SMD) with a random effects model was used to determine the effect size of psychosocial interventions for sexual health in patients with pelvic cancers. Thirteen studies were included, with a total number of 1,541 participants. There was a large heterogeneity regarding the type of psychosocial intervention used with the source found in a leave one out analysis. Six studies showed statistically significant improvements in sexual health, while three showed positive but non-significant effects.The summary effect size estimate was small SMD = 0.24 (95% confidence interval [CI]: 0.05 to 0.42, p = 0.01). There is limited research on psychosocial interventions for sexual health in pelvic cancer patients. There are also limitations in the different pelvic cancer diagnoses examined. Commonly, the included articles examined physical function rather than the whole sexual health spectrum. The small effect sizes may in part be due to evaluation of psychosocial interventions by measuring physical dysfunction. Future research should broaden sexual health assessment tools and expand investigations to more cancer types.

The Mediterranean diet (MD) has been previously proven to have various health-related benefits; however, its effect on women’s reproductive health over a lifespan is yet to be summarized. This study aimed to summarize the evidence-based knowledge regarding the association between the MD and selected reproductive health outcomes. By searching PubMed, ScienceDirect, and Google Scholar databases, as well as reference lists, 21 studies were included in this narrative review. The available evidence was very limited; however, there is some suggestion that higher adherence to the MD may be positively associated with a lower risk of early age menarche (1 study) and shorter menstrual cycles (1 study), but is unrelated to dysmenorrhea (1 study). Moreover, no study to date has examined the relationship between the MD and the onset age of natural menopause. Considering reproductive health diseases, there was limited evidence that a higher adherence to the MD was associated with a lower risk of premenstrual syndrome (1 study), an improvement in sexual health and a lower prevalence of sexual dysfunction (3 studies), and an improvement in the general condition of with endometriosis and the pain they can experience (1 study). The largest number of studies were found for polycystic ovarian syndrome (PCOS; 7 studies) and infertility (6 studies). Results showed that a higher adherence to the MD was associated with a lower risk of infertility, while results for PCOS were unclear, but mostly indicated a beneficial trend. Further investigations are necessary to establish the role of adherence to the MD in reproductive health maintenance and its possible role in the prevention and treatment of reproductive health diseases in women.

In recent years, the treatment of pulmonary arterial hypertension (PAH) has gradually increased, including new drugs and surgical methods, the mortality rate of PAH patients has significantly decreased, and the average survival rate has significantly improved. However, there was no obvious improvement in sexual health, mental health, and quality of life (QoL) in patients with PAH.Although an important dimension of QoL, little is known about sexual health and sexual health-related QoLof patients with PAH in China. In this study, the female sexual function index (FSFI)scale, the Symptom Checklist-90 (SCL-90), and emPHasis-10 were used to evaluate PAH associated with congenital heart disease (CHD-PAH) patients' sexual function, mental health, and QoL. The score of sexual function in female CHD-PAH patients ranged from 4.40 to 34.80 points, and the average score was 26.80 (19.00-27.80) points. The detection rate of sexual dysfunction was 48.30%. The FSFIscore of all dimensions of the sexual dysfunction group was significantly lower than that of the nonsexual dysfunction group. In addition, the scores of SCL-90 and emPHasis-10 were significantly higher than that of the nonsexual dysfunction group (p < 0.01). The sexual function was negatively correlated with mental health (r = -0.58,p < 0.01) and QoL (r = -0.62,p < 0.01) in female CHD-PAH patients. The sexual function of female patients with CHD-PAH is not optimistic. Sexual health may impact mental health and overall QoL in female PAH patients. Reasonable intervention measures should be taken to improve their sexual health, so as to improve their overall QoL.

Menopause represents a significant life transition for women, often accompanied by physical, psychological, and sexual health challenges. With the increasing life expectancy in women, a considerable part of their life will be spent in the postmenopausal period. The decline in estrogen levels leads to vasomotor symptoms, such as hot flashes and night sweats, as well as psychological symptoms, including anxiety, depression, and irritability. Sexual dysfunction is another key concern, with many menopausal women experiencing reduced libido, vaginal dryness, and pain during intercourse. This study aimed to evaluate the impact of menopause on sexual health. The study sample consisted of 100 menopausal and 101 non-menopausal women aged 45-55. An anonymous questionnaire included sociodemographic questions, the Female Sexual Function Index (FSFI), the DASS-21 index, MENQOL index, Pittsburgh Sleep Quality Index, SF-12 questionnaire, and the Hot Flash-Related Daily Interference Scale (HFRS). The results showed that menopausal women had significantly lower sexual desire, arousal, lubrication, orgasm, and satisfaction, with higher levels of sexual discomfort and pain (P&lt;0.001). Increased sexual and vasomotor symptoms were associated with poorer sexual function, while psychological distress (anxiety, depression, and stress) compounded the challenges of sexual dysfunction. Poor sleep quality also had adverse effects on sexual health. Menopause is strongly associated with declines in sexual function, highlighting the need for healthcare providers to offer guidance and treatment options tailored to women's health history and preferences. Lifestyle changes, like regular physical exercise and a healthy diet, alongside psychological and medical interventions, can play a role in the improvement of sexual health and quality of life.

Patient-Parent Reported Quality of Life Assessment Post Hematopoietic Stem Cell Transplant for Sickle Cell Disease: Validation and Clinical Application of Sickle Cell Disease Burden Index

To assess the impact of stress and workload on sexual health and quality of life (QOL) of the medical residents in training. A total of 339 male and female medical residents from 11 specialties were surveyed. Level of stress, sexual health and QOL were measured using validated questionnaires. Overall, 49% of the female and 11% of male residents had sexual dysfunction, and 47% and 34% respectively indicated being very to mostly dissatisfied with their sexual life. Both the frequency of sexual activity and quality of relationship with partner decreased during residency compared with the time immediately prior to residency. This decline was irrespective of gender, specialty or year of residency. A majority of residents (75% of women and 54% of men) were identified to be at high levels of stress using a validated questionnaire. In women, stress negatively influenced most domains of sexual health including desire, arousal and satisfaction; in men, satisfaction was significantly affected by high levels of stress. Long hours of work (> 70 h per week) impacted sexual health less profoundly than did stress. Among both male and female residents, QOL was significantly lower among residents who experienced sexual dysfunction and dissatisfaction compared with those with normal sexual functioning. Our results highlight the importance of stress-management efforts in residency programmes and provide evidence that limiting work hours alone may not lead to significant improvement in sexual health and QOL during residency.

Background:Sexual health of RA patients is an aspect of the care often neglected and about which little is known. Qualisex is a simple (10 questions) and valid tool investigating impact...

BackgroundThe rationale for the English National Chlamydia Screening Programme (NCSP) has been questioned. There has been little analysis, however, of what drove the NCSP’s establishment and how it was implemented. Such analysis will help inform the future development of the NCSP. This study used a qualitative, theory-driven approach to evaluate the rationale for the NCSP’s establishment and implementation.MethodsSemi-structured interviews with 14 experts in chlamydia screening were undertaken. The interview data were analysed with policy documents and commentaries from peer-reviewed journals (published 1996–2010) using the Framework approach.ResultsTwo themes drove the NCSP’s establishment and implementation. The first, chlamydia control, was prominently referenced in documents and interviews. The second theme concerned the potential for chlamydia screening to advance wider improvements in sexual health. In particular, screening was expected to promote sexual health services in primary care and encourage discussion of sexual health with young people. While this theme was only indirectly referenced in policy documents, it was cited by interviewees as a strong influence on implementation in the early years. However, by full rollout of the Programme, a focus on screening volume may have limited the NCSP’s capacity to improve broader aspects of sexual health.ConclusionsA combination of explicit and implicit drivers underpinned the Programme’s establishment. This combination may explain why there was widespread support for its introduction and why implementation of the NCSP was inconsistent. The potential to improve young people’s sexual health more comprehensively should be made explicit in future planning of the NCSP.