Psychological Distress is Correlated with Erectile Dysfunction Among Patients Receiving Methadone Maintenance in Taiwan.

OBJECTIVE: Although erectile dysfunction (ED) is prevalent in patients receiving long-term methadone maintenance, studies in Chinese culture exploring the relationship between psychological distress and ED are scarce. METHODS: One hundred eighty-seven male patients in methadone maintenance treatment were assessed in this cross-sectional study. Instruments included the Opiate Treatment Index (OTI) to evaluate the health-related consequences of methadone treatment and the Chinese Health Questionnaire-12 (CHQ-12) for the assessment of psychological distress, respectively. ED was defined by the International Index of Erectile Function 15. Quality of life was measured using the European Quality of Life-5 Dimensions. We constructed a multiple linear regression model to examine the associations between the determinants and ED. RESULTS: The CHQ-12 score had a significant relationship with the severity of ED after controlling for all important variables. The social functioning domain of the OTI and methadone dose was also significantly correlated with ED. CONCLUSIONS: The strong relationship between psychological distress and ED emphasized the importance of both diagnosis and management of ED among methadone patients receiving long-term maintenance treatment. The etiological relationship between methadone dose and ED require further investigation.

A survey of obesity and erectile dysfunction of men conscripted into the military in Taiwan.

INTRODUCTION: Obesity is receiving growing research attention. However, investigations concerning the potential impact of obesity and testosterone on erectile dysfunction (ED) in young men have not been completely clarified. AIM: To identify the relationship between ED, serum testosterone level, and obesity in draftees in Taiwan. METHODS: Data were obtained from a baseline survey of 364 young adult military conscripts (19-24 years old). Their demographic data, body mass index (BMI), serum testosterone, and ED status were assessed. Sixty-four subjects had ED, and 300 comprised the normal control group. MAIN OUTCOME MEASURES: The International Index of Erectile Function-5 (IIEF-5), Sexual Desire Inventory, and Sexual Behavior Scale were used to assess ED, sexual desire, and sexual function. RESULTS: Three hundred sixty-four men were available for analysis. The mean age of the sample was 21.66 ± 0.92 years (19-24 years). The IIEF total score had a mean of 21.99 ± 2.34 and median of 23; 64 (17.6%) subjects had ED, although mild. The results showed an increased risk of ED among obese men and subjects with lower serum testosterone. Among the predictors of ED, obesity (odds ratio =83.97, 95% CI = 16.17-436.03, degrees of freedom [d.f.] = 1, P < 0.001) and lower serum testosterone (odds ratio = 679.84, 95% CI = 108.48-4,260.58, d.f. = 1, P < 0.001) were significantly independent factors. Testosterone levels were lower in subjects with obesity (P < 0.001). CONCLUSION: This study supports the idea that BMI and serum testosterone may provide warning signs of ED and, at the same time, an opportunity for early intervention in young men.

Relationship among sexual desire, sexual satisfaction, and quality of life in middle-aged and older adults.

The authors examined the association among sexual desire, sexual satisfaction, and quality of life in a sample of community participants. They predicted that quality of life would be positivity correlated with sexual satisfaction and that sexual desire would indirectly influence quality of life. This research showed that elderly adults' sexual desire and sexual satisfaction decrease with age and that nearly 40% of the interviewees still had sexual activity one or more times every month. The results revealed that sexual desire does not directly influence quality of life, but it does have a direct effect on sexual satisfaction; hence, sexual satisfaction will indirectly affect quality of life.

Long-term outcomes of lateral tunneled transposed brachiobasilic arteriovenous fistulas in elderly hemodialysis patient.

BACKGROUND: Arteriovenous fistula is recommended for the general dialysis population, but its use remains controversial in the elderly population. We evaluated the long-term outcomes of lateral tunneled transposed brachiobasilic arteriovenous fistulas in older patients who underwent hemodialysis. METHODS: In this retrospective cohort study, we included patients who received a two-stage transposed brachiobasilic arteriovenous fistula in a medical center from May 2005 to January 2014. The patients were followed up from the fistula placement date until any intervention, death, failure, January 2015, or the end of the sixth year. Death and arteriovenous fistula failure during the observation period were considered as adverse outcomes, and the cause of death was identified. The cumulative patency rate was calculated using the Kaplan-Meier approach to reveal the long-term outcomes of this procedure. RESULTS: Among the 66 patients who underwent surgery, the average age was 65.8 ± 13.5 years and the majority were females (62.1%). After a median follow-up of 20.6 months, 19 patients died, 12 (18.2%) received vascular intervention, and 3 experienced fistula failure. No significant difference was observed in the 6-year cumulative patency rates between younger and older adults (96.3% vs 80.3%, p = 0.58). None of the deaths during the observation period were related to bloodstream infection. CONCLUSION: A two-stage lateral tunneled transposed brachiobasilic arteriovenous fistula can be applied to patients undergoing hemodialysis, regardless of age.

A study of masturbatory knowledge and attitudes and related factors among Taiwan adolescents.

The main purpose of this study was to investigate the relationship between masturbatory knowledge and masturbatory attitudes among Taiwan adolescents. This study was based on a structured questionnaire survey that used the Adolescent Masturbatory Knowledge Inventory (AMKI) and the Adolescent Negative Attitude toward Masturbation Inventory (ANAMI). Subjects were recruited from the third grade of high school and vocational school students aged 17-18 living in Kaohsiung (southern Taiwan) using stratified and cluster sampling approaches. Seven hundred and eighty questionnaires were sent out, with a 96.8% response rate. A total of 95.3% of male subjects and 30.3% of female subjects reported having masturbation experience. Masturbatory knowledge was significantly related to the variables "school system", "frequency of viewing pornographic media", "status of being sexually active", and "conversation about sex with friends". Masturbatory attitudes were significantly associated with the same variables as well as with gender and masturbatory behavior. Masturbatory attitudes were positively correlated with masturbatory knowledge. The school system explained 15.4% of masturbatory knowledge variance. Masturbatory knowledge, masturbatory behavior, frequency of viewing pornographic media and status of being sexually active explained 39.5% of masturbatory attitude variance. In conclusion, adolescents in Taiwan hold positive attitudes toward masturbation and reported having insufficient knowledge regarding masturbation. Results can assist school staffs and parents to gain a deeper understanding of adolescents' knowledge about and attitudes toward masturbation.

[An exploratory study of psychiatric patients' needs and nurses' current practices related to sexual counseling].

The purpose of this study was to explore psychiatric patient needs and current nursing practice with regard to sexual counseling and to understand differences in individual patient characteristics. A total of 182 psychiatric patients and 44 psychiatric nurses were purposively selected from a mental hospital in northern Taiwan. Results revealed that 63.2% of subjects had not been given sexuality information and 81.9% had not been approached by nurses to discuss such issues. While 35.2% of study patients treated sexual issues as psychological or private issues that should only be discussed with psychologists, 33.5% expressed a desire to discuss issues related to sexuality with nurses. Even so, most subjects preferred to discuss sexual issues in a private way, and asked for assistance from same-gender professionals. Also, patients with higher education levels placed greater attention on the counseling topics of how to express sexual needs and the impacts of mental illness on sexuality. With regard to nurses participating in the study, female nurses had a generally more conservative attitude toward sexual values than males. Those who were married, older, or had received continuing sexuality education were more comfortable with conducting sexual counseling. Those with clinical experience and continuing sexuality education were able to take more responsibility and a more professional role in sexual counseling. Data collected on the specific subject groups in order to provide effective comparisons can be employed to refine current sexual counseling training programs for nurses in order to improve patient care.

Study on alcohol dependence and factors related to erectile dysfunction among aborigines in Taiwan.

Relatively few studies have addressed the risk factors of erectile dysfunction (ED) in Taiwanese- most have described ED and medical problems in the general population. In this study, the cardiovascular risk factors of ED among aborigines in Taiwan were investigated. However, alcohol dependence (AD) was prevalent in Taiwan's aborigine population. So this study also focused on the relationship among AD, the cardiovascular risk factors and ED. A cross-sectional study was conducted, and data was obtained from a baseline survey of 192 aboriginal adults (35-75 years of age). The participants' demographic data, AD, markers of endothelial function, serum testosterone, and ED status were assessed. Ninety-four (49%) of the 192 participants had a history of alcoholism and 79 (84%) of those with alcoholism had ED. The study reported that AD and hyperlipidemia, metabolic syndrome (MetS), ED, abnormality of testosterone, and high-sensitivity C-reactive protein are highly prevalent among the aborigines. Factors that may affect ED included age, AD, central obesity, diabetes mellitus, hyperlipidemia, hypertension, MetS, and testosterone. ED is highly prevalent among aborigines with the risk factors of AD, MetS, old age, and abnormal testosterone serum level. MetS, atherosclerosis, and ED are risk factors for cardiovascular diseases. Hence, an increased focus on Taiwanese aborigines with ED is necessary.

Effectiveness of the sexual healthcare education in nursing students' knowledge, attitude, and self-efficacy on sexual healthcare.

Few researchers and curricula have experimentally tested sexual healthcare education on nursing students' knowledge, attitudes and self-efficacy improvement towards sexual healthcare - a gap in the nursing evidence-base that this study was designed to address. A quasi-experimental design was used to evaluate the effectiveness of the sexual healthcare education on nursing students' knowledge, attitude, and self-efficacy related to sexual healthcare. The experimental group (95 subjects) received the 12-week program, but the control group (95 subjects) didn't. The hierarchical linear model (HLM) was used to analyze the longitudinal changes. The results revealed that the students in the experimental group showed significant improvements over those in the control group on knowledge (ß=-0.27, P<0.001), attitude (ß=-0.38, P<0.001), and self-efficacy (ß=-0.90, P<0.001). This study demonstrates that the sexual healthcare education can help nursing students enhance their knowledge and explore their own values as well as feelings on patient sexuality, and play an important role in preparing students to meet future challenges related to sexual health.

Female sexual dysfunction: definition, classification, and debates.

Sexual dysfunction refers to difficulties that occur during the sexual response cycle that prevent the individual from experiencing satisfaction from sexual activity. It is relatively difficult to estimate the prevalence of female sexual dysfunction (FSD), because the definition and diagnostic criteria are still controversial and under development. These difficulties reveal our insufficient understanding of the basis of FSD. This review was conducted in an effort to deal with this complicated clinical issue, by examining the most updated clinical criteria of FSD under the context of a redefined female sexual response model.

Sexual health care for women with dyspareunia.

Female dyspareunia is a serious impairment with a prevalence of up to 39.5%, imposing a significant burden on women's health, relationship, and quality of life. Because the causes of female dyspareunia are associated with multiple biological, medical, psychological, sociocultural, and interpersonal dimensions, all members of the health team should help fill this gap in the total care of the patient. The nurse is an ideal member of the health team to counsel patients in the sensitive and highly charged area of human sexuality. The purpose of this article was to explore the essential components of female dyspareunia from nursing care perspective to help women suffering from dyspareunia. The article provides a set of tools, including description and clinical presentation, obtaining a history and clinical data for the evaluation of dyspareunia, and a counseling tool of the Permission, Limited Information, Specific Suggestions, and Intensive Therapy model; suggestions are also provided for health care professionals during the treatment process.

Sexual cognitive predictors of sexual communication in junior college adolescents: medical student perspectives.

BACKGROUND: Further understanding the relationship between sexual cognition and sexual communication in adolescents may facilitate sexual health promotion in this population. PURPOSE: This study was designed to investigate associations between sexual cognitive variables and sexual communication in adolescents. METHODS: This study used a cross-sectional research design with conventional sampling. Data were collected from one medical college in central Taiwan. A total of 900 questionnaires were dispatched, with 748 copies returned, giving a response rate of 83.1%. Structural questionnaires were designed to collect demographic data, sexual self-concept inventory, sexual risk cognition, sexual self-efficacy, and sexual communication scale. This study applied statistical methods, including descriptive statistics, Pearson product-moment correlation, and multiple regression analysis. RESULTS: Major findings revealed that (a) adolescents talked about sexual activity and sexual issues with their parents at a moderate level (mean = 2.52, SD = 1.24), (b) all sexual cognitive variables (sexual self-concept, sexual risk cognitions, and sexual self-efficacy) correlated positively with sexual communication, and (c) predictors of sexual communication were supported by demographic data (having heterosexual friends, satisfaction with heterosexual friends, and duration of relationships with heterosexual friends) and sexual cognitive variables, which accounted for 62.0% of variance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Study results can contribute to the development of safe sexual health programs and improve healthcare provider knowledge of sexual communication among adolescents. More sexual communication between adolescents and their parents is encouraged. Moreover, sexual health programs must give increased focus on the issue of adolescent sexual cognition to help encourage increased discussion between adolescents and their parents regarding sexual activity and issues.