{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:19:41Z","timestamp":1761844781180},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2017,6,1]],"date-time":"2017-06-01T00:00:00Z","timestamp":1496275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2017,6,1]],"date-time":"2017-06-01T00:00:00Z","timestamp":1496275200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Ischemic heart disease and heart failure often lead to sexual difficulties in men, but little is known about the sexual difficulties in women and patients with other heart diagnoses or the level of information patients receive about the risk of sexual difficulties.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To investigate perceived sexual difficulties and associated factors in a mixed population of men and women newly diagnosed with heart disease and provide insight into sexual counseling and information given by health care professionals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This article reports on a cross-sectional, questionnaire study sent to a randomly selected sample of men and women newly diagnosed with heart failure, ischemic heart disease, atrial fibrillation, or heart valve surgery. Eligible patients were identified by diagnosis using the Danish National Patient Register, which contains all diagnoses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Sexual difficulties were self-reported using single-item questions, and factors associated with sexual difficulties were collected from the survey and national registers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study population consisted of 1,549 men and 807 women (35\u201398 years old) with heart failure (n\u00a0= 243), ischemic heart disease (n\u00a0= 1,036), heart valve surgery (n\u00a0= 375), and atrial fibrillation (n\u00a0= 702). Sexual difficulties were reported by 55% of men and 29% of women. In a multiple regression analysis, difficulties in men were associated with being older (\u226575 years old; odds ratio [OR]\u00a0= 1.97, 95% CI\u00a0= 1.13\u20133.43), having heart failure (OR\u00a0= 2.07, 95% CI\u00a0= 1.16\u20133.71), diabetes (OR\u00a0= 1.80, 95% CI\u00a0= 1.15\u20132.82), hypertension (OR\u00a0= 1.43, 95% CI\u00a0= 1.06\u20131.93), receiving \u03b2-blockers (OR\u00a0= 1.37, 95% CI\u00a0= 1.02\u20131.86), or having anxiety (OR\u00a0= 2.25, 95% CI\u00a0= 1.34\u20133.80) or depression (OR\u00a0= 2.74, 95% CI\u00a0= 1.38\u20135.43). In women, difficulties were significantly associated with anxiety (OR\u00a0= 3.00, 95% CI\u00a0= 1.51\u20135.95). A total of 48.6% of men and 58.8% of women did not feel informed about sexuality, and 18.1% of men and 10.3% of women were offered sexual counseling.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>Heart disease increases the risk of sexual difficulties and there is a need for improved information and counseling about sex and relationships for patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>This large nationwide survey of men and women combined a survey with administrative data from national registries. However, this study used non-validated single-item questions to assess sexual difficulties without addressing sexual distress.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>More than half the men and one fourth the women across common heart diagnoses had sexual difficulties. No difference was found among diagnoses, except heart failure in men. Despite guidelines recommending sexual counseling, sexual difficulties were not met by sufficient information and counseling.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2017.04.673","type":"journal-article","created":{"date-parts":[[2017,6,3]],"date-time":"2017-06-03T20:42:43Z","timestamp":1496522563000},"page":"785-796","update-policy":"http:\/\/dx.doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":15,"title":["Perceived Sexual Difficulties and Sexual Counseling in Men and Women Across Heart Diagnoses: A Nationwide Cross-Sectional Study"],"prefix":"10.1093","volume":"14","author":[{"given":"Lucas","family":"Rundblad","sequence":"first","affiliation":[{"name":"National Institute of Public Health, University of Southern Denmark , Copenhagen , Denmark"},{"name":"Danish Knowledge Center for Rehabilitation and Palliative Care, University of Southern Denmark and University Hospital Odense , Nyborg , Denmark"},{"name":"Sexological Clinic, Psychiatric Center Copenhagen, Rigshospitalet , Copenhagen , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann Dorthe","family":"Zwisler","sequence":"additional","affiliation":[{"name":"Danish Knowledge Center for Rehabilitation and Palliative Care, University of Southern Denmark and University Hospital Odense , Nyborg , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pernille Palm","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet , Copenhagen , Denmark"},{"name":"Department of Cardiology, Copenhagen University Hospital Bispebjerg and Frederiksberg , Copenhagen , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Holmberg","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, University of Southern Denmark , Copenhagen , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanna","family":"Schneekloth","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, University of Southern Denmark , Copenhagen , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamaria","family":"Giraldi","sequence":"additional","affiliation":[{"name":"Sexological Clinic, Psychiatric Center Copenhagen, Rigshospitalet , Copenhagen , Denmark"},{"name":"Institute of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2017,6,1]]},"reference":[{"key":"2023011111053418100_bib1","first-page":"2044","article-title":"Effect of sexual function on health-related quality of life mediated by depressive symptoms in cardiac rehabilitation. 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