Acceptability of Health Professionals’ Address of Sexuality and Erectile Dysfunction - A Qualitative Interview Study with Men in Cardiac Rehabilitation

Abstract

Introduction In the developing phase of the complex health intervention: Physical Activity to reduce Vascular Erectile Dysfunction (PAVED), it is crucial to explore whether men can accept the communicative component regarding information that regular aerobe Physical Activity can reduce Erectile Dysfunction (i-PAVED). This information is provided by health professionals (HPs) in cardiac rehabilitation, where sexuality issues such as erectile dysfunction (ED) are otherwise rarely addressed. Aim To explore how acceptance of cardiac HPs’ address of sexuality, ED, and i-PAVED can be identified in men's narratives. Methods In this descriptive qualitative study, we conducted semi-structured individual interviews with 20 men (range 48-78 years of age) attending municipal cardiac secondary prevention and rehabilitation programmes on their acceptance of HPs’ address of sexuality, ED, and i-PAVED. The Theoretical Framework of Acceptability components (affective attitude, burden, ethicality, intervention coherence, perceived effectiveness, opportunity costs and self-efficacy) and three temporal perspectives (retrospective, concurrent and prospective) were used in the concept-driven first step of a content analysis, which was followed by a thematically data-driven second step. Main Outcome Measures Men anticipated and experiential acceptance was identified in six out of seven components of Theoretical Framework of Acceptability. Results Men acceptance was identified as “expression of interest,” “addressing sexuality,” “attitudes and values,” “understandable and meaningful,” “insights” and “motivation,” whereas no narratives were identified in relation to the component of opportunity costs. Conclusion As an aspect of the development of the complex cardiovascular health care intervention PAVED, this qualitative study showed that men attending cardiac secondary prevention and rehabilitation seemed to prospectively accept the communicative component of PAVED being HPs’ address of sexuality, ED, and i-PAVED, if the HPs are professional, educated and competent in the field of sexual health. Gerbild H, Areskoug-Josefsson K, Larsen CM, et al. Acceptability of Health Professionals’ Address of Sexuality and Erectile Dysfunction - A Qualitative Interview Study with Men in Cardiac Rehabilitation. Sex Med 2021;9:100369.

Using the Theoretical Framework of Acceptability to understand the acceptability of e-training for nurse led prevention of unwanted sexual behaviour in Australia’s residential aged care services

“…13 This framework has been applied to evaluate a wide variety of western healthcare educational interventions. 14,15 Therefore, this study will investigate the acceptability of the USB in RACS intervention using the TFA.…”

Development of the Complex Intervention: Physical Activity to reduce Vascular Erectile Dysfunction

“…In Studies II and III (2,3) and in this thesis, the terms 'men' and 'participants' were used and will be used to emphasize men's active role and an empowerment aspect of the intervention PAVED. The MRC uses the terms 'receivers' or 'recipients' of an intervention, contrasting the MRC term 'providers' of an intervention (12-14), while most scientific articles use the term 'patients'.…”

“…Across the studies, a variety of terms for 'providers of PAVED' was used. In Study I: 'physiotherapists' (1), in Studies II and III: 'health professionals' (2,3), in Study IV: 'healthcare students' (4) and in Study V: Danish health professional students (5). In this thesis, the students are termed 'Danish health professional students', 'future health professionals' and 'future providers of PAVED'.…”

“…Study I was a systematic review (1). Studies II and III were qualitative individual interview studies (2,3). Study IV was a psychometric study (4) and a request for Study V, which was a national survey (5).…”

“…An overview of the physical activity level for the intervention programmes in the included studies in relation to IIEF / ED scores and relative reduction of ED is provided in Paper I, Table 3 (146). They share the same data corpus (147) but use different data sets, as the approach in Study II was a concept-driven content analysis (2) whereas Study III made use of a data-driven analysis (3). Thus, two data sets were created, using a deductive respectively inductive approach in combination with the specific aim and research question of each study.…”