VINCENT B. FARRELL MSN MBA RN FNP-C Chamberlain College of Nursing

Size: px

Start display at page:

Download "VINCENT B. FARRELL MSN MBA RN FNP-C Chamberlain College of Nursing"

Hollie Doyle
5 years ago
Views:

1 VINCENT B. FARRELL MSN MBA RN FNP-C Chamberlain College of Nursing 1

2 This program has been developed solely for the purposes of describing knowledge regarding barriers and facilitators for providers discussing sexual issues in primary care with men screened for erectile dysfunction, before and after participation in an online educational intervention with a one-month practice-change follow-up. The program is posted as a part of this project s educational intervention and is intended only for such use. The study has been approved for this purpose by the Chamberlain College of Nursing Institutional Review Board. Please find the link to return to the survey at the end of the slides.

3 Discern perceived barriers to ED discussion in the areas of: Knowledge Comfort Environment Patient variables Other barriers Describe perceived facilitators to ED discussion Determine practice change factors that might improve healthcare for patients with ED 3

4 The need for addressing barriers and facilitators for providers discussing sexual issues in primary care with men screened for erectile dysfunction has been established in the nursing literature (Martinez- Piedrola, Castro-Molina, & Saez-Crespo, 2005). However, increasing evidence reveals that there is a lack of knowledge regarding best practices in relation to the treatment of erectile dysfunction (Abdulmohsen, et al., 2004; Wilbanks, 2008; Wilbanks, 2009). Given emerging recommendations for evaluation, treatment, and management of erectile dysfunction, updates in primary care provider knowledge is warranted (Albersen, Mwamukonda, Shindel, & Lue, 2011; Barnett, Robleda-Gomez, & Pachana, 2012; Nehra et al., 2012; Perelman, 2011). 4

5 ED ED Erectile Dysfunction (ED) affects millions of men worldwide with implications that go far beyond sexual activity Recognized as an early marker of cardiovascular disease, diabetes mellitus (DM) and depression Commonly missed when evaluating male patients in clinic setting Missed due to embarrassment on the part of the patient and the clinician 5

6 Sedentary Lifestyle Obesity Smoking Drug and Alcohol Use Untreated Hypertension and Hyperlipidemia Metabobolic Syndrome HYPERTENSION Not controlled or treated can lead to Stroke, Heart Attack Peripheral Vascular Disease (PVD), & Erectile Dysfunction 6

Concerns in talking to one s partner about sexual function or future sexual relationships Body image How to

7 THE INABILITY TO DISCUSS ED ISSUES WITH PROVIDERS Misinterpretation of questions asked by provider to patient Options in ED management Concerns about ED treatment Impact of treatment on pt s sexual function Concerns in talking to one s partner about sexual function or future sexual relationships Body image How to carry out a testicular exam Impact of impotence Impact of ED outcomes Options of prosthesis Ejaculatory difficulties 7

8 Misinterpretation of the intentions of the provider Concerns for treatment and management Verbal interactions Couple sex counselling Body image Testicular self exams Monthly, after warm shower, in front of a mirror Impact of ED outcomes Ejaculatory difficulties Early, Delayed & Retrograde ejaculation 8

9 9

10 Lack of private environment Lack of services to refer pts Heavy workload lack of time Too short encounter window to discuss sexual issues Sexual concerns too sensitive to document in health record Lack of support from colleagues and management 10

11 ED is when men have trouble getting or keeping an erection ED becomes more common as you get older Male sexual dysfunction is not a natural part of aging (Grant & Jackson, 2013). ED can be a sign of health problems Blood vessels are clogged and one may have nerve damage from diabetes ED problem will go untreated if a man does not see his doctor or healthcare provider (Harvard Men s Health Watch, 2013). 11

12 Pt with mental health issues Different culture Different Religion Younger than me Older than me Different Gender Different Sexual Orientation Is single 12

Embarrassed/offended if provider initiated conversation Family member or relative present Prefer nurses wait until pt raises own concerns

want female provider to talk about sexual concerns Does not want to talk to a female provider about sexual concerns Colleague thinks it is

13 Embarrassed/offended if provider initiated conversation Family member or relative present Prefer nurses wait until pt raises own concerns Believes that the impact of ED is the role of the provider Becomes emotionally distressed Does not want to talk about sexual issues Does not want female provider to talk about sexual concerns Does not want to talk to a female provider about sexual concerns Colleague thinks it is infringing on pt s right to privacy about sexual issues Might interpret questions as sexual advance or seductive gesture Refuses to answer questions 13

Knowledge of sexual ED difficulties Having private environment Sufficient time to talk to pt Being told by another provider that pt has sexual concerns Communication

14 Knowledge of sexual ED difficulties Having private environment Sufficient time to talk to pt Being told by another provider that pt has sexual concerns Communication Workshop Role Play Clinical Policies/Procedures on how to address sexual issues Knowing pt to establish a rapport Have colleagues talk to pt Being prompted in EMR 14

15 Regardless of our gender, medical providers need to have confidence for our clients to make them feel comfortable to discuss any medical topic and comfort to accept our suggestions and treatment recommendations. Our goal should be to help our clients to change from this or this.to this 15

16 Abdulmohsen, M., Abdulrahman, I., Al-Khadra, A., Bahnassy, A., Taha, S., Kamal, B., &... Al- Elq, A. (2004). Physicians' knowledge, attitude and practice towards erectile dysfunction in Saudi Arabia. Eastern Mediterranean Health Journal, 10(4/5), Albersen, M., Mwamukonda, K., Shindel, A., & Lue, T. (2011). Evaluation and treatment of erectile dysfunction. Medical Clinics of North America, 95(1), Barnett, Z., Robleda-Gomez, S., & Pachana, N. (2012). Viagra: The little blue pill with big repercussions. Aging & Mental Health, 16(1), Martinez-Piedrola, M., Castro-Molina, M., & Saez-Crespo, A. (2005). Erectile dysfunction: Objectives and interventions in the nursing consultation. Enfermeria Clinica, 15(1), Moore, A., Higgins, A., & Sharek, D. (2013). Barriers and facilitators for oncology nurses discussing sexual issues with men diagnosed with testicular cancer. European Journal of Oncology Nursing, 17(4), Nehra, A., Jackson, G., Miner, M., Billups, K., Burnett, A., Buvat, J., &... Wu, F. (2012). The Princeton III consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clinic Proceedings, 87(8), Perelman, M. (2011). Erectile dysfunction and depression: Screening and treatment. Urologic Clinics of North America, 38(2), Wilbanks, S. (2008). Test your knowledge: Erectile dysfunction. Journal for Nurse Practitioners, 4(10), 800. Wilbanks, S. (2009). Test your knowledge... answer key for erectile dysfunction crossword. Journal for Nurse Practitioners, 5(1),

17 Thank you for participating in this project! Please slowly drag your mouse over the live link below to activate and then click on the URL to return to the post-test (you may need to wait briefly for the link to connect):

Priapism and Sickle Cell Disease

Priapism and Sickle Cell Disease Information for patients with sickle cell disease Read this brochure to learn about: What causes priapism What treatments can help Who to contact for more information Please