The CHARMS Study: cardiac patients’ experiences of sexual problems following cardiac rehabilitation

Abstract

Background: Sexual problems are common among cardiac patients. Further information is required on patients' experiences of sexuality, and preferences for, sexual counselling.Aim: To characterise sexual dysfunction and related factors among patients following cardiac rehabilitation and examine related treatment delivery.Methods: Telephone interviews with 382 patients (32% response rate) recruited from six hospital rehabilitation centres.Results: Seventy-nine percent were male; average age was 64 years (SD 9.8). Forty-seven percent of the total sample reported no sexual relations in the previous year, and nearly a half of sexually active respondents reported at least one sexual problem. Erectile dysfunction (reported by 33%) and lack of interest in sex (reported by 10%) were the most common problems for men and women respectively. Twenty-three percent reported that sex had deteriorated for them since their cardiac event, and for half of these, this was considered a serious problem. In logistic regression analysis, higher anxiety (HADS) and being male were associated with reporting a sexual problem (χ 2 = 37.85, p<0.001). Sixty-six percent reported that sex was never discussed by a health professional and satisfaction with this aspect of care was low. Patients wanted these issues to be addressed and the majority (63%) claimed they would find it easy to discuss sexual problems with a health professional.Conclusions: Sexual inactivity and sexual problems are common in this group. Health professionals should address sexual issues with their patients, ideally in a private setting and within the broader context of addressing psychological wellbeing.

Barriers and Promoting Strategies to Sexual Health Assessment for Patients with Coronary Artery Diseases in Nursing Practice: A Literature Review

“…The rates of sexual health problems vary based on a variety of related factors such as patient's age, severity of disease and co-morbidities that range between 20% [17] and 70% [18]. About half (46%) of 382 patients with CADs in six rehabilitation centers reported sexual problems [19]. In one study conducted in Jordan (N = 124), about three quarters of patients with heart diseases reported that their sexual health is being altered [20].…”

“…For example, patients may need to know how their sexual health is being affected by the illness, by medications and associated side effects, when can they resume their sexual activities, what are the warning signs reportable to the physician, what sex enhancing medications can they use and what preparations are available to aid in resuming sexual activities. Byrne and colleagues reported that about half of 382 cardiac patients preferred the opportunity of addressing their sexual health concerns by health care providers [19].…”

“…These materials play an important role in improving patients' knowledge and encourage patients to express their sexual health concerns [19].…”

Advanced heart failure: an appraisal of the potential of levosimendan in this end-stage scenario and some related ethical considerations

“…Health-related quality of life is substantially undermined owing to reduced strength and capacity for physical activity, compromised sleep, and emotional components ( Figure 1). Additional factors associated with erosion of health-related quality of life in advanced heart failure include sleep-disordered breathing (including, but not limited to, obstructive sleep apnea), which may also be detrimental to prognosis [4], depression (which has been associated with, but not causally linked to, marked increases in mortality) [5,6], anxiety [5], and extensive reporting of sexual dysfunction and dissatisfaction [7,8].…”

Sexual function and cardiovascular disease: what the general cardiologist needs to know

“…Patients are often reluctant to seek medical advice regarding ED, necessitating proactive enquiry. The Cardiac Health and Relationship Management and Sexuality study (CHARMS) assessed cardiac rehabilitation patients; ED was associated with increased anxiety and depression, with 12% classing the deterioration of sexual lives following diagnosis/coronary event a serious problem 33. The multifactorial causes of ED require recognition to allow incorporation into rehabilitation programmes.…”