Promoting a discussion on later life sexuality: Lessons from sexologist physicians

Gewirtz‐Meydan, Ateret; Levkovich, Inbar; Mock, Moshe; Gur, Uri; Ayalon, Liat

doi:10.1080/14681994.2018.1437258

Cited by 12 publications

(13 citation statements)

References 51 publications

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“…However, it seems that the main barrier for women and men in this study was not shame or embarrassment, but the anticipation of a doctor disregarding any “irrelevant” issue raised during the consultation. This is consistent with the reported opinions of healthcare professionals, who often perceive the sex-related issues of their older patients as irrelevant or less important than other medical problems (Gott et al 2004 ; Malta et al 2018 ; Gewirtz-Meydan et al 2019 ). Yet, in the current study, this dismissive attitude was also experienced by older patients when introducing non - sexual concerns, which reinforced their reluctance to discuss any new problem during a consultation.…”

Section: Discussionsupporting

confidence: 80%

“…This supports the findings of Fileborn et al ( 2017 ) concerning the impact of doctors’ affirmative responses on the openness of older Australian adults when discussing sex in a healthcare setting. This further indicates that the doctors’ attitudes towards their patients’ concerns (attentive and empathetic versus insensitive and authoritarian) play a vital role in older adults’ decisions to introduce a sexual problem or not during a consultation (Hinchliff and Gott 2011 ; Gewirtz-Meydan et al 2019 ; Schaller et al 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…Despite sexual expression and sexual health now being recognised as an unarguable aspect of quality of life and well-being at all life stages, the literature indicates that sexual health in later life is not integrated into standard healthcare (Gott et al 2004 ; World Health Organization 2006 ; Lindau and Gavrilova 2010 ). Older adults report numerous barriers to discussing sex-related issues in a healthcare context, while physicians tend to consider older patients’ sexuality as outside their domain (Malta et al 2018 ; Gewirtz-Meydan et al 2019 ). It leads to a relatively small number of older adults receiving medical or psychological treatment for their sexual problems (Lindau et al 2007 ; Moreira et al 2008 ; Bauer et al 2016 ).…”

Section: Introductionmentioning

confidence: 99%

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“Why not ask the doctor?” Barriers in help-seeking for sexual problems among older adults in Poland

Gore-Gorszewska

2020

Int J Public Health

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Objectives Existing data show that older adults rarely seek medical or psychological help for their sexual problems. The current study explores the barriers in help-seeking faced by older adults from a conservative Central European country. Methods Thirty semi-structured interviews were conducted among Polish residents (16 women, 14 men) aged 65–82. The data were analysed thematically, with coding validity and analytical rigour ensured throughout the process. Results Three main barriers in seeking help were identified: not recognising sexual problems; fear for the doctors’ disapproval; lack of knowledge how to access appropriate services. The data reveal that the participants’ main concern is that health providers would dismiss their problems as trivial. Older adults from Poland suffer from the lack of fundamental knowledge about their sexual functioning. Conclusions Employing qualitative methodology to understand why older adults from conservative cultures do not seek help for their sexual problems might contribute to existing literature by providing evidence from different cultural settings, and help to develop and implement appropriate interventions. Implications related to health providers’ attitude towards older patients’ concerns are further discussed.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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“Why not ask the doctor?” Barriers in help-seeking for sexual problems among older adults in Poland

Gore-Gorszewska

2020

Int J Public Health

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“…In her integrative review of HIV-related risks in older adulthood, Savasta [43] found that 88% of the articles reported that "system failures," such as lack of patient-provider communication and insufficient education programs, were associated with increased prevalence of HIV among older adults. As first-line responders in STI and HIV/AIDS prevention, physicians can be most effective by proactively assessing older patients' STI knowledge during periodic health exams and initiating routine discussions regarding sexual-health matters [44][45][46][47][48]. Yet, there are several known barriers to physicians engaging in these patient-provider discussions, including not understanding the importance of sexuality in later life [46]; having limited communication training skills, educational materials, and self-efficacy to talk about sexual health with older patients [24,45,48]; and lacking time to initiate these discussions [49].…”

Section: Discussionmentioning

confidence: 99%

Sexually Transmitted Infection Knowledge among Older Adults: Psychometrics and Test–Retest Reliability

Smith

Bergeron

Goltz

et al. 2020

IJERPH

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Sexually transmitted infections (STI) among older adults have dramatically increased in recent years, especially among those who are widowed and divorced. The purposes of this study were to: (1) identify STI-related knowledge among older adults; (2) report the psychometric properties of a tool commonly used to assess STI-related knowledge among younger populations using data from adults 65 years and older; and (3) determine test-retest reliability of the tool. Data were analyzed from 43 adults, aged 65–94 years, using the 27-item Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ). Participants completed identical instruments on two separate days with approximately two weeks between. After responses were coded for correctness, composite scores were created. Cronbach’s reliability coefficients were calculated to determine response consistency, and Pearson’s r coefficients were used to assess test–retest reliability. Of 27 possible correct answers, participants reported an average of 11.47 (±6.88) correct responses on Day 1 and 11.67 (±7.33) correct responses on Day 2. Cronbach’s alpha coefficients for the 27-item composite scale were high for both days (0.905 and 0.917, respectively), which indicates strong response consistency. Pearson’s r coefficients were high between responses for the 27-item composite scale on Days 1 and 2 (r = 0.882, P < 0.01), which indicates strong test–retest reliability. Pearson’s r coefficients were high between responses for all but three of the 27 items when assessed separately. Findings suggest the utility of the STD-KQ to assess STI knowledge among older adults. However, the consistently low knowledge scores highlight the need for educational interventions among this population.

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“…Moreover, higher levels of ageist attitudes were found to be directed towards older women compared to older men [12]. Older men and women are often afraid to involve physicians in their sexual problems and therefore choose to deal with these problems alone or to ignore them [13–18]. When family physicians raise sexual issues, it usually occurs with older men, rather than with older women [10], despite studies, which indicate a higher sexual dysfunction rate among older women [3].…”

Section: Introductionmentioning

confidence: 99%

When sex meets age: Family physicians’ perspectives about sexual dysfunction among older men and women: A qualitative study from Israel

Levkovich

Gewirtz‐Meydan

Karkabi

et al. 2019

European Journal of General Practice

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Background: Gender differences in relation to sexual functioning among older adults have received very little research attention, although the ageing process is likely to be characterized by difficulties in sexual functioning among both women and men. Objectives: The purpose of this qualitative research is to examine and understand the perceptions of family physicians, and the differences in their attitudes regarding male and female patients. Method: Qualitative interviews with family physicians were conducted between August 2017 and December 2017. Sixteen family physicians participated in the study, aged 36–64; most were born in Israel and half of them were women. Twelve physicians were Jewish, two were Christian and two were Muslim. Nine work in rural practices and seven work in urban practices. We used in-depth, semi-structured, face-to-face interviews. The interviews were recorded, transcribed and analysed by three researchers using content analysis. Results: The analysis of the interviews revealed two main themes: (1) Differences as perceived by family physicians: men are perceived as being interested in engaging in full sexual relations, including penetration, while among women, the main need is focused on the relationship and intimacy. (2) Gender differences regarding seeking a solution through the family physician. Family physicians reported that most of the patients who seek solutions regarding sexual dysfunction in old age are men with impotence problems. Family physicians perceived that women seek out solutions less frequently, some because they are afraid their relationship will suffer if they do not continue having sex with their partners. Conclusion: Men and women were seen as having different motivations for engaging in sex and different needs from physicians.

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Promoting a discussion on later life sexuality: Lessons from sexologist physicians

Cited by 12 publications

References 51 publications

“Why not ask the doctor?” Barriers in help-seeking for sexual problems among older adults in Poland

“Why not ask the doctor?” Barriers in help-seeking for sexual problems among older adults in Poland

Sexually Transmitted Infection Knowledge among Older Adults: Psychometrics and Test–Retest Reliability

When sex meets age: Family physicians’ perspectives about sexual dysfunction among older men and women: A qualitative study from Israel

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