Views of Mexican outpatients with rheumatoid arthritis on sexual and reproductive health: A cross-sectional study

Abstract

Background Rheumatoid arthritis (RA) impacts sexual and reproductive health (SRH), which is a prominent component of a patient´s quality of life and highly influenced by the cultural background. The aim of the study was to explore the interest of Mexican outpatients with RA in SRH and to examine patient view on SRH. Methods This cross-sectional study surveyed 303 consecutive outpatients with RA on their perceptions of SRH importance, SRH satisfaction, access to SRH information, preferences regarding SRH communication with healthcare professionals, and understanding of SRH (qualitative open-ended descriptions). Descriptive statistics and inferential analysis were used. Patient knowledge of each dimension of SRH was rated based on pre-specified criteria. Two assessors assigned ten major themes to each patient´s description of both dimensions of SRH. Results Patients perceived their SRH as an important component of their general health and wished to address the topic, although few had access to such communication. Female patients assigned lesser importance to SRH, showed lesser degree of satisfaction with SRH, and expressed preference for a truthful physician. Age showed a linear association with individual survey responses, except for satisfaction with reproductive health dimension. There was a linear association between increased age and decreased years of formal education with a lower level of SRH knowledge. Ten major themes emerged for each of the two dimensions of the SRH construct, although most individual descriptions were assigned to one or two major themes. Conclusions Further education and assessment of SRH in Mexican patients with RA is warranted.

How Do Mexican Patients With Rheumatoid Arthritis Define Sexual and Reproductive Health? A Content Analysis Study

“…The theoretical framework was conceived on empirical theory of psychological processes applied at SRH conceptualization 1,21 and from the local experience of researchers that belonged to the medical discipline. 9 Finally, it should be highlighted that qualitative methods are suitable to investigate multifaceted phenomenon as experienced by individuals and to explore areas with limited knowledge. 22 Four relevant aspects derived from the CA that capture the core of patients' interpretation of SH and RH will be discussed herein.…”

“…The survey explored patients' interest in addressing SRH as part of their rheumatologic evaluation, which previously published results, 9 and patients' understanding of SH and RH. Briefly, a multidisciplinary committee proposed the survey content, which agreed on 11 items and their scales responses, distributed into 5 components.…”

“…The survey was distributed to 330 consecutive RA outpatients during the study period, and their characteristics had been previously described (9) and are summarized in Supplementary Table 1 (http:// links.lww.com/RHU/A457).…”

“…For each SRH construct, coders agreed on the same 10 major themes: information/knowledge, overall prevention-oriented patient care, family planning, overall health, well-being, relationships and couple relationships, biological aspects (primarily), psychological aspects (primarily), sexuality expression, and holistic concept. 9 Their distribution among the 219 and 223 definitions of SH and of RH, respectively, is summarized in Figure 1. Briefly, overall prevention-oriented patient care, overall health, and sexuality expression were the most frequently assigned themes to SH, whereas biological aspects (primarily), overall health, and overall prevention-oriented patient care were the most frequently assigned themes to RH.…”

“…Impaired sexual and reproductive functions have been observed in RA patients, and they derive from physical components related to the underlying rheumatic disease and to additional comorbid conditions, hormone imbalance, therapy-related effects, psychopathological comorbidities, and personal choices 4–7 . Despite the impact of SRH on the quality of life, issues of sexuality and related to reproductive life are often neglected by both rheumatologists and their RA patients 8,9 …”