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      Abordagem da vida sexual feminina nos Cuidados de Saúde Primários Translated title: Women’s attitudes to attention to sexuality in primary care consultations

      rapid-communication

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          Abstract

          Objectivo: Identificar obstáculos à abordagem da vida sexual nas consultas de Planeamento Familiar/Saúde da Mulher da Unidade de Saúde Familiar (USF) do Castelo, na perspectiva das utentes, a fim de desenvolver estratégias facilitadoras dessa mesma abordagem. Tipo de Estudo: Estudo transversal, descritivo e observacional Local: USF do Castelo - Agrupamento de Centros de Saúde Seixal e Sesimbra População: Mulheres com 18 ou mais anos frequentadoras das consultas de Planeamento familiar/Saúde da Mulher da USF do Castelo Métodos: Aplicação de questionário auto-preenchido, anónimo e confidencial em consultas de planeamento familiar entre 15 de Março e 15 de Maio de 2010. Base de dados e tratamento estatístico realizados no Microsoft® Office Excel 2007. Resultados: Foram analisados 161 questionários em que 5% das mulheres referiram ter problemas a nível sexual. Do total das analisadas, 76% consideram importante abordar a sexualidade na consulta médica, sendo que 19,3% afirmam fazê-lo frequentemente. Relativamente às razões apontadas como barreiras à abordagem deste tema, destacam-se a vergonha por parte das utentes (42,5%), o receio de que o médico não considere o tema importante (12,6%) e a falta de tempo na consulta (10,3%). Conclusões: Ao conhecermos as principais barreiras apontadas pelas utentes da USF do Castelo à inserção do tema vida sexual na consulta, concluímos que é necessário que o médico mostre que existe à-vontade, disponibilidade e necessidade de o fazer.

          Translated abstract

          Objective: To identify women’s attitudes to attention to sexuality in women’s health consultations in the Castelo Family Health Unit (USF do Castelo), in order to develop strategies to promote attention to this issue. Study type: Cross-sectional study. Setting: USF do Castelo - ACES Seixal e Sesimbra Population: Women over 18 years of age, attending woman’s health consultations in USF do Castelo Methods: Anonymous questionnaires were distributed to women attending woman’s health consultations between March 15th and May 15th, 2010. Data entry and analysis were performed using Microsoft® Office Excel 2007. Results: Completed questionnaires were received from 161 women. In 5%, women referred to sexual problems. In the sample, 76% consider it important to address sexuality in the medical consultation, but only 19.2% discuss this frequently. Barriers identified include embarrassment (42.3%), fear that the doctor finds the theme unimportant (12.4%) and lack of time in the consultation (10.3%). Conclusions: Given the barriers identified by patients of USF do Castelo to the discussion of sexuality in the consultation, we suggest that doctors should demonstrate confidence and willingness to discuss sexuality with their patients.

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          Most cited references17

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          "Opening a can of worms": GP and practice nurse barriers to talking about sexual health in primary care.

          There is evidence that health professionals do not discuss sexually related issues in consultations as often as patients would like. Although primary care has been identified as the preferred place to seek treatment for sexual health concerns, little is known either of the factors that prevent GPs and practice nurses initiating such discussions or of how they feel communication in this area could be improved. The purpose of the present study was to identify barriers perceived by GPs and practice nurses to inhibit discussion of sexual health issues in primary care and explore strategies to improve communication in this area. Semi-structured interviews were conducted with 22 GPs and 35 practice nurses recruited from diverse practices throughout Sheffield. The term 'can of worms' summarized participants' beliefs that sexually related issues are highly problematic within primary care because of their sensitivity, complexity and constraints of time and expertise. Particular barriers were identified to discussing sexual health with patients of the opposite gender, patients from Black and ethnic minority groups, middle-aged and older patients, and non-heterosexual patients. Potential strategies to improve communication about sexual health within primary care included training, providing patient information and expanding the role of the practice nurse; however, several limitations to these approaches were identified. GPs and practice nurses do not address sexual health issues proactively with patients, and this area warrants further attention if policy recommendations to expand the role of primary care within sexual health management are to be met.
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            Survey says patients expect little physician help on sex.

            C Marwick (1999)
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              The proactive sexual health history.

              Family physicians must proactively address the sexual health of their patients. Effective sexual health care should address wellness considerations in addition to infections, contraception, and sexual dysfunction. However, physicians consistently underestimate the prevalence of sexual concerns in their patients. By allocating time to discuss sexual health during office visits, high-risk sexual behaviors that can cause sexually transmitted diseases, unintended pregnancies, and unhealthy sexual decisions may be reduced. Developing a routine way to elicit the patient's sexual history that avoids judgmental attitudes and asks the patient for permission to discuss sexual function will make it easier to gather the necessary information. Successful integration of sexual health care into family practice can decrease morbidity and mortality, and enhance well-being and longevity in the patient.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                rpcg
                Revista Portuguesa de Clínica Geral
                Rev Port Clin Geral
                Associação Portuguesa dos Médicos de Clínica Geral (Lisboa )
                0870-7103
                November 2011
                : 27
                : 6
                : 548-552
                Affiliations
                [1 ] ACES de Seixal-Sesimbra
                [2 ] ACES Setúbal-Palmela
                [3 ] ACES de Seixal-Sesimbra
                Article
                S0870-71032011000600010
                eaad944e-c2ee-46ea-8364-9321a45cb045

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Portugal

                Self URI (journal page): http://www.scielo.mec.pt/scielo.php?script=sci_serial&pid=0870-7103&lng=en
                Categories
                MEDICINE, GENERAL & INTERNAL

                Internal medicine
                Sexuality,Primary Health Care,Female,Sexualidade,Cuidados de Saúde Primários,Género Feminino

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