Talking about sex: a qualitative study on the physician’s inner experience

Titolo Rivista RIVISTA DI SESSUOLOGIA CLINICA
Autori/Curatori Daniela Leone, Ivan Fossati, Edoardo Pescatori, Elena Vegni
Anno di pubblicazione 2017 Fascicolo 2017/2
Lingua Inglese Numero pagine 19 P. 51-69 Dimensione file 258 KB
DOI 10.3280/RSC2017-002004
Il DOI è il codice a barre della proprietà intellettuale: per saperne di più clicca qui

Qui sotto puoi vedere in anteprima la prima pagina di questo articolo.

Se questo articolo ti interessa, lo puoi acquistare (e scaricare in formato pdf) seguendo le facili indicazioni per acquistare il download credit. Acquista Download Credits per scaricare questo Articolo in formato PDF

Anteprima articolo

FrancoAngeli è membro della Publishers International Linking Association, Inc (PILA)associazione indipendente e non profit per facilitare (attraverso i servizi tecnologici implementati da CrossRef.org) l’accesso degli studiosi ai contenuti digitali nelle pubblicazioni professionali e scientifiche

The study aimed to explore clinicians’ subjective difficulties related to talking with patients about sexuality. Forty-four physicians were recruited during a one-day congress about erectile dysfunction, where they were asked to write a narrative about an episode in which they found themselves in difficulty talking with a patient about sex. Narratives were analyzed using Interpretative Phenomenological Analysis. Four main issues with sub-issues arose from the data: 1. What: cognitive contents and emotions; 2. How: talking about sex, the problem of language; 3. As if: the metaphoric view of the profession; 4. Who: me as a man. Clinical and educational implications are discussed.

L’obiettivo del presente lavoro è quello di esplorare le difficoltà dei clinici nel par-lare con i pazienti di tematiche riguardanti la sessualità. Quarantaquattro medici sono stati reclutati durante una giornata di congresso sulla disfunzione erettile, du-rante la quale è stato chiesto loro di scrivere una narrazione su un episodio in cui si sono trovati in difficoltà a parlare di sesso con il paziente. Le narrazioni sono state analizzate utilizzando l’Analisi Interpretativa Fenomenologica. Dall’analisi dei dati sono emerse quattro tematiche principali, con relative sotto-tematiche: 1. Cosa: contenuti cognitivi ed emozioni; 2. Come: parlare di sesso, il problema del linguaggio; 3. Come se: la prospettiva metaforica della professione; 4. Chi: io come uomo. Le implicazioni cliniche e formative dei risultati sono state infine discusse.

Keywords:Analisi Interpretativo Fenomenologica; disfunzione erettile; mondo interno del medico; parlare di sesso; relazione medico-paziente; ricerca qualitativa.

  1. Åsbring P., Närvänen A.L. (2003). Ideal versus reality: physicians perspectives on patients with chronic fatigue syndrome (CFS) and fibromyalgia. Social Science & Medicine, 57 (4):711-720. DOI: 10.1016/S0277-9536(02)00420-
  2. Brandenburg U., Bitzer J. (2009). The challenge of talking about sex: The importance of patient–physician interaction. Maturitas, 63 (2):124-127.
  3. Browning D.M., Meyer E.C., Truog R.D., Solomon M.Z. (2007). Difficult conver-sations in health care: Cultivating relational learning to address the hidden cur-riculum. Academic Medicine, 82 (9):905-913.
  4. Brunner J.S. (1986). Actual minds, possible worlds. Cambridge, MA, USA: Har-vard University Press.
  5. Burd I.D., Nevadunsky N., Bachmann G. (2006). Impact of Physician Gender on Sexual History Taking in a Multispecialty Practice. The Journal of Sexual Med-icine, 3 (2):194-200.
  6. Derenne J., Roberts L. (2010). Psychiatry’s role in teaching medical students, psychiatric residents, and colleague physicians about human sexuality. Academic Psychiatry, 34 (5):321-4.
  7. Diamond E.L., Grauer K. (1986). The physician’s reactions to patients with chronic pain. American Family Physician, 34 (3):117-122.
  8. Dunn K.M., Croft P.R., Hackett G.I. (1998). Sexual problems: a study of the prevalence and need for health care in the general population. Family Prac-tice, 15 (6):519-524.
  9. Engel G.L. (1981). The clinical application of the biopsychosocial model. Journal of Medicine and Philosophy, 6 (2):101-124.
  10. Gabbard G.O., Nadelson C. (1995). Professional boundaries in the physician-patient relationship. Jama, 273 (18):1445-1449.
  11. Gott M., Galena E., Hinchliff S., Elford, H. (2004). “Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care. Family Practice, 21 (5):528-536.
  12. Greenhalgh T., Hurwitz B. (1999). Why study narrative. British Medical Journal, 318 (7175):48-50.
  13. Haboubi N.H.J., Lincoln N. (2003). Views of health professionals on discussing sexual issues with patients. Disability and Rehabilitation, 25 (6):291-296. DOI: 10.1080/096382802100003118
  14. Hirooka N., Lapp D.P. (2012). Erectile dysfunction as an initial presentation of diabetes discovered by taking sexual history. BMJ Case Reports, bcr1220115289.
  15. Kennedy J.S. (2002). Physicians’ feelings about themselves and their patients. JAMA, 287 (9):1113-1114.
  16. Lamiani G., Meyer E.C., Rider E.A., Browning D.M., Vegni E., Mauri E., Moja E., Truog R.D. (2008). Assumptions and blind spots in patient‐centredness: action research between American and Italian health care professionals. Medical Education, 42(7):712-720.
  17. Leone D., Anania S., Fossati I., Cassardo C., Zagonel V., Vegni E. (2012). Meeting a cancer patient in pain: Stories of difficulties. Neuropsychological Trends, 12: 99-106. Testo disponibile al sito: http://www.ledonline.It/lneuro-psychologicaltrends.
  18. Levine R.B., Kern D.E., Wright S.M. (2008). The impact of prompted narrative writing during internship on reflective practice: a qualitative study. Advances in Health Sciences Education, 13 (5):723-733.
  19. Lewis C.E. (1990). Sexual practices: are physicians addressing the issues?. Journal of General Internal Medicine, (5 Suppl.):S78-81.
  20. Mauri E., Vegni E., Lozza E., Parker P.A., Moja E.A. (2009). An exploratory study on the Italian patients’ preferences regarding how they would like to be told about their cancer. Supportive Care in Cancer, 17 (12):1523-1530.
  21. Meier D.E., Back A.L., Morrison R.S. (2001). The inner life of physicians and care of the seriously ill. JAMA, 286 (23):3007-3014.
  22. Morse J.M., Barrett M., Mayan M., Olson K., Spiers J. (2008). Verification strategies for establishing reliability and validity in qualitative research. International Journal of Qualitative Methods, 1 (2):13-22. DOI: 10.1177/16094069020010020
  23. Moskowitz M.A. (2000). The challenges of diagnosing erectile dysfunction in the primary care setting. The Nurse Practitioner, 25 (suppl.):1-3. DOI: 10.1097/00006205-200003001-0000
  24. Nicolosi A., Glasser D.B., Kim S.C., Marumo K., Laumann, E.O. (2005). Sexual behaviour and dysfunction and help‐seeking patterns in adults aged 40-80 years in the urban population of Asian countries. BJU International, 95 (4):609-614.
  25. Pinchera A., Jannini E.A., Lenzi A. (2002). Research and academic education in medical sexology. Journal of Endocrinological Investigation, 26 (3 suppl..):13-14.
  26. Platano G., Margraf J., Alder,J., Bitzer J. (2008). Frequency and Focus of Sexual History Taking in Male Patients—A Pilot Study Conducted among Swiss General Practitioners and Urologists. The Journal of Sexual Medicine, 5 (1):47-59.
  27. Rosen R., Kountz D., Post H.,Zwicker T., Leiblum S., Wiegel M. (2006). Sexual Communication Skills in Residency Training: The Robert Wood Johnson Mod-el. The journal of Sexual Medicine, 3 (1):37-46.
  28. Sarkadi A., Rosenqvist U. (2001). Contradictions in the medical encounter: female sexual dysfunction in primary care contacts. Family Practice, 18 (2):161-166.
  29. Skelton J.R., Matthews P.M. (2001). Teaching sexual history taking to health care professionals in primary care. Medical Education, 35 (6):603-608.
  30. Smith J.A., Flowers P. and Larkin M. (2009). Interpretative Phenomenological Analysis: Theory Method and Research. London: Sage.
  31. Smythe E.A., Ironside P.M., Sims S.L., Swenson M.M., Spence D.G. (2008). Doing Heideggerian hermeneutic research: A discussion paper. International Journal of Nursing Studies, 45 (9):1389-1397.
  32. Tomlinson J. (1998). ABC of sexual health: taking a sexual history. BMJ: British Medical Journal, 317 (7172):1573.
  33. Tsimtsiou Z., Hatzimouratidis K., Nakopoulou E., Kyrana E., Salpigidis G., Hatzichristou D. (2006). Predictors of physicians’ involvement in addressing sexual health issues. The Journal of Sexual Medicine, 3 (4):583-588.
  34. Vegni E., Zannini L., Visioli S., Moja E. (2001). Giving bad news: a GPs’ narrative perspective. Supportive Care in Cancer, 9 (5):390-396.
  35. Wylie K., Rudolph E., Boffard C. (2013). Sexual History Taking. In: Kirana P.S., Tripodi F., Reisman Y., Porst H. (eds.), The EFS and ESSM syllabus of clinical sexology (pp. 398-409). Amsterdam: Medix.

Daniela Leone, Ivan Fossati, Edoardo Pescatori, Elena Vegni, Talking about sex: a qualitative study on the physician’s inner experience in "RIVISTA DI SESSUOLOGIA CLINICA" 2/2017, pp 51-69, DOI: 10.3280/RSC2017-002004