General Internist Communication about Sexual Function with Cancer Survivors
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Sexual dysfunction is an important issue that affects many cancer survivors who are increasingly being cared for by internists.
To examine the attitudes and reported practices of internists regarding survivorship care as it pertains to sexual dysfunction.
Surveys were sent to 406 physicians affiliated with the Department of Internal Medicine at the University of Colorado Denver School of Medicine. Of the 319 eligibles, 227 were returned (71% RR).
Of the 227 responders, 46% were “somewhat/very” likely to initiate a conversation about sexual dysfunction; 62% “never/rarely” addressed sexual dysfunction. Each additional weekly hour spent in patient care was associated with a 2% increase in the likelihood of sexual dysfunction being addressed or discussions about sexual dysfunction being initiated. Reported inadequate preparation/formal training around survivorship issues was associated with sexual dysfunction being addressed less often (odds ratio [OR] = 0.45). Perception of patient anxiety or fears about health was associated with sexual dysfunction being addressed more often (OR = 2.38). Perceived preparedness to evaluate long-term effects was associated with a greater likelihood of physicians initiating discussions about sexual functioning (OR = 2.49).
Cancer survivors receive their long-term care from internists. Our results suggest that sexual dysfunction is often not addressed during their follow-up care. Additional training is needed to prepare physicians to negotiate this difficult issue.
KEY WORDSgeneral internist survivorship sexuality communication
We are grateful to the Swim Across America Foundation and the American Cancer Society for supporting this work. We thank Sowmya Rao, PhD, for her statistical assistance. We would like to acknowledge and thank Monica Rothwell, Laura Fox, and Jennifer Pandiscio for their assistance with preparation of these data and the manuscript.
Conflicts of Interest
Drs. Bober, Campbell, Recklitis, and Diller have no conflicts of interest to disclose. Dr. Park reports that Pfizer has supplied medication for a pilot smoking cessation trial. Dr. Kutner reports receiving honoraria from 1) the Ovations Professional Advisory Committee (United Health Care) and 2) for a talk for Anthem/Wellpoint; she also reports receiving royalties from McGraw-Hill for authorship of “Practice Guidelines in Primary Care.”
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