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The Experience of Indonesian Men Living with Type-2 Diabetes Mellitus and Erectile Dysfunction: A Semi-structured Interview Study

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Abstract

Background

Erectile dysfunction (ED) in men living with Type-2 Diabetes Mellitus (T2DM) in Indonesia is rarely discussed. This study explored the lived experiences of young- to middle-aged Indonesian men living with T2DM and ED to identify the related healthcare support they received from their local public health center.

Methods

A qualitative-descriptive approach was used to elicit the experiences of twelve men with T2DM who were recruited from a public health center in Surabaya. Using guiding questions, individual interviews were audio recorded, transcribed verbatim, translated to English and then thematically analyzed.

Results

Most men in this study experienced ED, with participants’ responses to ED ranging from acceptance to feeling afraid to acknowledge ED to their wife or displaying anger towards their wife. Despite reporting they needed information about ED related to T2DM, participants reported an absence of discussion about ED with health professionals during regular T2DM appointments. Men reported not raising the issue themselves as they felt ashamed or embarrassed. Some men engaged in high-risk self-management behaviors, such as using off-street medications to try and fix their ED while others sought other forms of intimacy with their wife.

Conclusion

This study’s findings present previously unreported healthcare experiences of Indonesian men with T2DM and ED. Although routinely visiting healthcare professionals in public health settings for T2DM management, the men in this study did not receive assessment or healthcare around ED. The men would have appreciated the opportunity to discuss their ED and explore treatment options. Future studies are recommended to explore how men with T2DM and ED, and their wives, can be supported by healthcare professionals to improve health and wellbeing outcomes.

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Availability of Data and Materials

All data have been deidentified and cleaned prior to analysis and further presentation. Raw data is stored in password protected electronic storage and access to raw data is limited to the corresponding author. The data and material will be destroyed in line with the HREC approval that underpinned the study.

Code Availability

All data was analysed using NVivo® 12 and MS Excel; and access to the document is via the corresponding author.

Notes

  1. Puskesmas are government-mandated public health centers located across Indonesia and staffed with multi-disciplinary teams of medical doctors, nurses, dentists, pharmacists, public health personnel and health administrations. [27]

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Acknowledgements

We would like to thank Professor Lisa McKenna (Head of School of Nursing and Midwifery) and Professor Timothy Skinner (Director University Department of Rural Health) at La Trobe University for their kind assistance. We appreciate Universitas Airlangga, the Directorate General of Higher Education (DIKTI) of the Ministry of Education and Culture of the Republic of Indonesia, the head of the Puskesmas, and all research assistants.

Funding

This research was originally funded by The Universitas Airlangga under the Grant Number 886/UN3/2018 and the continuing study was supported by the Directorate General of Higher Education (DIKTI) of the Ministry of Education and Culture of the Republic of Indonesia.

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Authors and Affiliations

  1. Faculty of Nursing, Universitas Airlangga Indonesia, Kampus C Jln Mulyorejo, 60115, Surabaya, East Java, Indonesia

    Setho Hadisuyatmana, Ferry Efendi, Eka Mishbahatul Marah Has & Sylvia Dwi Wahyuni

  2. School of Psychology and Public Health, La Trobe University of Australia, Kingsbury Drive, Bundoora, VIC, 3086, Australia

    Setho Hadisuyatmana & James H. Boyd

  3. Australian Centre for Evidence Based Aged Care, College of Science Health and Engineering, La Trobe University of Australia, Kingsbury Drive, Bundoora, VIC, 3086, Australia

    Michael Bauer

  4. School of Nursing & Midwifery, College of Science Health and Engineering, La Trobe University of Australia, Kingsbury Drive, Bundoora, VIC, 3086, Australia

    Sonia Reisenhofer

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  1. Setho Hadisuyatmana
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Contributions

Authors’ contributions to the present manuscript are explained following the Australian Code for the Responsible Conduct of Research: Conception and design of project: SH, EMMH, SDW; Conception and design of output: SH, EMMH, MB; Acquisition of research data: SH, SDW; Contribution of knowledge JHB, SR, FE, Research data interpretation and analysis: SH, SR, MB; Drafting for publication: SH, MB, FE, JHB; Review, editing and supervision JHB, SR, FE, MB.

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Correspondence to Setho Hadisuyatmana.

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All authors declare no conflicting interests that could influence the work reported in this paper.

Ethics Approval

Approvals to conduct the study were obtained from accredited human research ethic committees (HREC) in Indonesia and in Australia.

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Written informed consent was obtained from each participant prior to the interview commencing.

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All authors consented to submit the present work to the Sexuality and Disability with no conflicting interests.

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Hadisuyatmana, S., Efendi, F., Has, E.M.M. et al. The Experience of Indonesian Men Living with Type-2 Diabetes Mellitus and Erectile Dysfunction: A Semi-structured Interview Study. Sex Disabil 39, 245–260 (2021). https://doi.org/10.1007/s11195-021-09687-y

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