Assessment and Documentation of Sexual Health Issues of Recent Combat Veterans Seeking VHA Care

Abstract

Introduction Sexual health is an important aspect of human existence associated with disease and overall health. Despite these associations and the existence of medical treatments to improve sexual function, sexual health is often overlooked in health care. Recent combat veterans may be particularly vulnerable to sexual health issues due to their deployment-related health issues such as mental health conditions, prescription medications use, and psychosocial challenges. Aim This study assesses the sexual health issues of recent combat veterans seeking care at a Veterans Affairs Medical Center (VAMC) documented in the primary care and mental health notes from the first 6 months of care. Main Outcome Measures Documentation of sexual health issues in the progress notes (coded into categories), primary care vs. mental health care visit note, initial vs. follow-up visit notes, and templated vs. non-templated text. Methods This is a retrospective chart review of the first 158 consecutive patients seen for an initial assessment in the VAMC post-deployment clinic. Medical records were reviewed and text of sexual health issues and relevant patient and care characteristics were abstracted and coded into variables. Results Almost 25% of patients had documented sexual health issues in the first 6 months of care. We coded 52 separate sexual health issues into 13 distinct categories. Overall, most sexual health issues were documented in mental health care notes, in non-templated text, and at follow-up visits. The use of templated text appeared to drive the documentation of low libido (the most common sexual health issue) in mental health care notes. Conclusions Sexual health issues are prevalent in recent combat veterans seeking care at a VAMC, but patterns of documentation suggest that they may be under-reported or incompletely addressed. A more systematic and provider-initiated approach to assessment of sexual health may promote fuller discussion of sexual health issues and optimize management.

Sexual Functioning in Military Personnel: Preliminary Estimates and Predictors

“…Physical and psychosocial factors are differentially predictive of SFPs across demographic characteristics. Although causal ordering is uncertain, it is clear that there is a strong relationship between sexual functioning and psychosocial factors [14]. Specifically, the presence of mental and physical health problems were related to high levels of SFPs.…”

“…SFPs present a significant reduction in QOL and can impair self-confidence and sense of masculinity in male military personnel [6,13]. The transitions that military personnel experience can further exacerbate sexual functioning, mental health, and other problems, and can strain intimate relationships [14][15][16][17][18][19]. Unfortunately, SFPs, like many of the invisible wounds of war, are stigmatizing, which limits treatment seeking [20,21].…”

An Exploration of Returning Veterans' Sexual Health Issues Using a Brief Self-Report Measure

“…Helmer et al. [17] examined a sample of returning veterans' records during the first 6 months of VA care and found a slightly higher rate of sexual dysfunction documented (25%). However, Helmer et al.…”

“…This study uses the same chart review tool described in Helmer et al. [17]. The chart review was created by the third author (DAH) based on first‐hand knowledge of the clinical setting and a review of relevant factors from the literature.…”

“…Previous research estimates of sexual health concerns among returning veterans range from 5.5% to 25% [17,18]. Importantly, Helmer et al.…”