Increased authoritarianism in graduating students' attitudes emphasises clearly the need for future research and redesigning communication curricula. Furthermore, the influence of gender and relationship with religion on attitudes towards the doctor-patient relationship should be explored further, in order to eliminate disparities in the provision of patient-centred medical care.

Introduction Health care professionals, especially nurses, through their contact with patients, play an important role in encouraging discussions about sexual concerns. Aim To explore perceptions on sexual health issues and how these might inhibit or enhance Greek nurses’ ability to incorporate sexual health assessment into everyday practice. Main Outcome Measures A discussion guide was used as checklist to ensure that the basic issues would be addressed. Topics related to the areas of interest were either brought up from the participants or introduced by the moderator. Methods The study recruited a purposive sample of 44 Greek staff nurses (SN) attending a course leading to their professional upgrading. A qualitative research design was employed using seven focus groups. Discussions started with nurses’ perceived definitions of sexual health and proceeded with open-ended questions. Transcripts were analyzed using thematic analysis based on the principles of grounded theory. Results Three central themes were identified from transcripts’ thematic analysis: subjective perception of sexual health, discussing sexual problems, and educational and training needs. Participants’ perceptions of sexual health centred mainly on the emotional and somatic dimensions. Regarding clinical practice, a variety of personal and contextual reasons limit nurses’ willingness to talk about sexuality with patients, such as gender and age differences, familial upbringing, lack of time and privacy, and restricted perception of nursing role. All nurses stressed the need for further specialized training not only in physiology issues related to sexuality, but also most importantly in communication skills. Conclusions Although Greek nurses acknowledge the importance of sexual health assessment, they believe that sexual history taking is not within the range of their professional tasks. Since holistic care demands sexual health assessment and intervention to be an integral part of nursing practice, it is necessary to introduce courses in their curriculum and experiential workshops addressing the multidimensionality of sexuality.

Purpose To explore the life satisfaction of patients with erectile dysfunction (ED) and to examine the relation between severity of ED and life satisfaction. Materials and Methods The study sample was recruited from patients who presented in an andrologic outpatient clinic complaining of ED. All patients underwent the basic clinical evaluation and were assessed by the International Index of Erectile Dysfunction (IIEF) and the Life Satisfaction Inventory (LSI). Results The study included 69 patients with ED (age range 22–71 years, mean 49.5, SD 13.7). The LSI appeared to have satisfactory internal consistency (Cronbach's alpha = 0.82). Men with ED had significantly lower satisfaction with their sexual life (t = −13.756, d.f. = 68, P = 0.000), but also significantly lower total score of satisfaction with their life (t = −2.793, d.f. = 68, P = 0.007) compared with available normative data from healthy population. However, when compared with controls, men with ED showed significantly higher satisfaction scores on their financial status (t = 5.075, d.f. = 68, P = 0.000) and on their leisure time activities (t = 4.029, d.f. = 68, P = 0.000). Regarding ED severity, mild ED affects patients’ satisfaction with sexual life less than do moderate and severe ED. Interestingly, no difference was identified between moderate and severe ED groups. Conclusions Men who seek help for ED have lower satisfaction with sexual life and lower satisfaction with their overall life compared with healthy people. Severity of ED seems to be an important factor, as men with moderate ED perceive the impact of ED on their life satisfaction equally with those with severe ED. ED patients gain more satisfaction from other domains of their life, provided they adopt coping behaviors that help compensate for their low overall life satisfaction. Furthermore, as ED patients do not differ from healthy people in their expressed subjective rating of quality of life (QoL), life satisfaction may be more sensitive than QoL assessment in the evaluation of the impact of ED on our patients’ life.

Psychiatric morbidity is highly prevalent in patients with ED, potentially affecting treatment outcome. Because lifetime psychological problems were reported by more than half of the patients, a psychosocial history seems mandatory. Partner support appeared to have a significant role in the patient psychological state.

Introduction Patients' sexual concerns are frequently underestimated because of health professionals' reluctance to address sexual health issues. Though it has been documented that sexual attitudes are extremely influential in everyday clinical practice, limited data exist on identifying health professionals' attitudes. Aim To explore sexual attitudes in medical students and students in allied health professions. Main Outcome Measures The Derogatis Sexual Functioning Inventory (DSFI)–Attitude Subscale was used to assess sexual attitudes. Methods The sample included 1st and 4th year college students enrolled in the following academic departments/schools of two academic institutions leading to health professions: medical school, psychology, pharmaceutical school, nursing and midwifery. Demographic data were obtained relating to sexual behaviors and information sources on sexual issues. Data were analyzed using independent samples t-test and two-way analysis of variance, as well as logistic regression and Pearson's correlation coefficient. Results A total of 714 students (81.9% females) participated in the study: 48.5% 1st year students and 51.5% seniors with a mean age of 20.17 years (SD=1.87, range 17–25). Using iterative cluster analysis on DSFI scores, participants were divided in conservative (N=167), liberal (N=224), and neutral (N=323) clusters. A significant gender difference on sexual attitudes was obtained (P <0.001) with male students being more liberal compared to females (mean=18.26 and mean=11.13, respectively). Differences were also revealed for the field but not for the year of study. Analysis also revealed that liberalism in sexual attitudes is more likely to be affected by a liberal stance toward religion (OR: 2.39), receiving information for sexual matters mainly from peers (OR: 1.86), and media influence on students' sexual life (OR: 1.68). Conclusions Gender, personal values, and experiences influence students' attitudes toward sexual issues. Since negative attitudes can impede effective sexual health consultations, it is imperative to incorporate courses on effective communication and human sexuality in the medical and allied health professions curricula that will enhance students' awareness of their own values and prejudices.

Purpose To report female sexual problems and concerns, as presented by women calling a help–line, and to evaluate women’s help–seeking behavior regarding sexual matters. Materials and Methods The study included all telephone calls from women who called for sexual concerns to a help–line dedicated to sexual problems during a 5–year period. During the call, the counselor addresses demographic characteristics of the caller, the sexual problem reported, their sexual function, any previous doctor contacts, coexisting physical and mental health problems, couple’s relationship, and lifestyle factors that may influence sexual function. Data processing employed descriptive statistics and logistic regression analysis in order to detect possible associations between categorical variables. Results Of a total of 3,523 calls made by women, 2,287 full forms were analyzed, reflecting a response rate of 64.9%. Most women (46.6%) called for problems encountered by their partners, 45.1% called for their own sexual problems, while 5.9% were calling for their children. Only 34.3% of them had already consulted a doctor. The most frequently reported difficulties were achieving orgasm (25.6%), reduced sexual desire (16.9%), and pain during intercourse (6.1%). Women in the 40–49 age group had the higher odds ratios for the sexual problems reported (reduced sexual desire: odds ratio [OR] 5.0; difficulties achieving orgasm: OR 6.3; pain during intercourse: OR 5.8). Both married and single women had high risk of experiencing low levels of sexual desire (40% and 30%, respectively). Conclusions Women’s sexual concerns are not devoted to their sexual problems, but also their partner’s and children’s problems. Most frequently reported sexual problems are difficulties in reaching orgasm and reduced sexual desire. However, women are reluctant to seek medical advice on their sexual concerns. There is a need for general practitioners and family doctors to become aware of the possibility of a sexual problem and to be trained on how to manage this at a primary care level.

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Purpose To describe the development and assess the outcome of a workshop on erectile dysfunction (ED) management based on participating physicians evaluations. Method The study involved physicians who attended a workshop offered throughout the country, during a 3-year period. The workshop included tutorials, video-based dramatizations, and role-play sessions. A pilot study investigated the workshop's impact on physicians’ attitudes toward patient-centeredness and sexual behavior issues; Patient–Practitioner Orientation Scale (PPOS) and Cross Cultural Attitude Scale (CCAS) were administered before and after the course. New knowledge acquisition, quality of presentation, and workshop's usefulness in their clinical practice were the dimensions used for workshop's evaluation. Analysis used quantitative and qualitative methods. Results A total of 194 questionnaires were administered during the pilot study and the response rate was 53.6%. A shift in attitudes toward patient-centeredness and less judgmental attitude toward patients’ sexual attitudes were revealed (total PPOS score and Sharing subscale: P < 0.05, CCAS: P < 0.001). Six hundred physicians were asked to evaluate the workshops and the response rate was 62.3%. The tutorial session for “medical treatment of ED” (P < 0.001) and the role-play on sexual history taking (P < 0.05) received higher evaluation scores. Qualitative analysis showed that the most frequently reported category referred to the appropriateness of role-play as a teaching and awareness-raising technique (31.25%); a need for changes in clinical practice and communication patterns was identified by 20% of the participants who stressed the necessity for multidisciplinary approach, as well as the adoption of a nonjudgmental attitude toward patients. Conclusion Training courses on ED management, using a combination of tutorial and interactive sessions, constitute an effective way of providing knowledge, enhancing physicians’ communication skills with ED patients, and influencing attitudes toward patient-centeredness in sexual issues. Such results strongly support the establishment of sexual medicine courses at continuing medical education curricula.