Patient-Centered Outcomes and Treatment Preferences Regarding Sexual Problems: A Qualitative Study Among Midlife Women.
Patient-Centered Outcomes and Treatment Preferences Regarding Sexual Problems: A Qualitative Study Among Midlife Women.
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关于性问题的以患者为中心的结果和治疗偏好：中年女性的定性研究。
DOI：
10.1016/j.jsxm.2017.05.014
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Thurston,RebeccaC
中科院分区：
文献类型：
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作者：
Thomas,HollyN;Hamm,Megan;Hess,Rachel;Borrero,Sonya;Thurston,RebeccaC
背景性功能障碍在中年女性中很常见，会对生活质量产生重大的负面影响。尽管存在治疗方法，但关于中年女性喜欢哪种性功能结果和治疗的研究很少。目的是通过个人访谈和焦点小组更好地了解对性活跃女性最重要的性功能结果以及她们更喜欢的治疗类型。方法20 次个人访谈和三个焦点小组 (N = 39) 由训练有素的主持人主持，进行音频录制和转录。两名研究人员开发了密码本，主要研究人员对所有数据进行了编码。第二位调查员对五次随机选择的采访进行了编码，以确保编码器的可靠性。检查与结果和治疗偏好相关的代码以确定中心主题。结果平均年龄为 52.8 岁（范围 = 45-59）。当被问及她们想要性功能障碍治疗的目的时，女性寻求针对特定性问题的解决方案：性欲低下、阴道疼痛和干燥、性唤起或达到性高潮的能力下降。然而，当被问及性生活中最重要的方面时，大多数女性表示情感结果对她们来说最重要，例如与伴侣的亲密关系。大多数女性出于对副作用的担忧，更喜欢行为治疗而不是药物治疗。这些女性认为行为治疗可能更适合解决性问题的生理和心理方面。临床意义这项研究强调了在评估和治疗中年女性性功能障碍时不仅考虑身体结果而且考虑情感结果的重要性。它还强调了除药物治疗之外发展行为治疗的重要性。优点和局限性通过使用定性方法，这项研究让女性有时间和空间讲述自己在中年时的性经历。此外，还代表了不同的种族和族裔群体以及更年期状况。局限性包括普遍性有限，对于大多数定性研究来说都是如此。此外，虽然大多数女性确实认可性问题，但我们并不排除没有性投诉的女性。结论中年女性重视与性功能有关的身体和情感结果。该样本中的许多中年女性表示，在治疗性功能障碍方面，更倾向于行为方法而不是药物方法。
BackgroundSexual dysfunction is common in midlife women and can have a significant negative impact on quality of life. Although treatments exist, there is little research on which sexual function outcomes and treatments midlife women prefer.AimTo better understand the sexual function outcomes that were most important to sexually active women 45 to 60 years old and the types of treatments they would prefer from individual interviews and focus groups.MethodsTwenty individual interviews and three focus groups (N = 39) were led by a trained facilitator, audio recorded, and transcribed. Two investigators developed a codebook, and the primary investigator coded all data. A second investigator coded five randomly selected interviews to ensure intercoder reliability. Codes relating to outcomes and treatment preferences were examined to identify central themes.ResultsThe mean age was 52.8 years (range = 45–59). When asked what they would want a sexual dysfunction treatment to do, women sought solutions to specific sexual problems: low desire, vaginal pain and dryness, and decreased arousal or ability to achieve orgasm. However, when asked about the most important aspect of their sex life, most women indicated emotional outcomes, such as enhanced intimacy with their partner, were most important to them. Most women preferred behavioral over pharmaceutical treatments, citing concerns about side effects. These women felt that behavioral treatments might be better equipped to address physical and psychological aspects of sexual problems.Clinical implicationsThis study highlights the importance of considering not only physical but also emotional outcomes when evaluating and treating sexual dysfunction in midlife women. It also emphasizes the importance of developing behavioral treatments in addition to pharmaceutical treatments.Strengths and LimitationsBy using a qualitative approach, this study allowed women the time and space to speak their own words about their experiences with sexuality at midlife. In addition, different racial and ethnic groups and menopausal statuses were represented. Limitations include limited generalizability, as is true for most qualitative research. In addition, although most women did endorse sexual problems, we did not exclude women with no sexual complaints.ConclusionsMidlife women value physical and emotional outcomes with regard to sexual function. Many midlife women in this sample expressed a preference for behavioral approaches over pharmaceutical approaches for the treatment of sexual dysfunction.