La anamnesis en la historia clínica en salud sexual: habilidades y actitudes / The medical history taking in sexual health: skills and attitudes

Una vida sexual satisfactoria repercute de manera favorable en la calidad de vida, existiendo evidencia de que previene múltiples procesos orgánicos y de que las disfunciones sexuales constituyen a menudo un signo precoz de enfermedad orgánica oculta (cardiovascular, endocrinológica o neurológica). Existen dificultades para realizar la anamnesis sexual por parte del profesional, del paciente o del sistema de salud, sin embargo, dada su importancia, es necesario que el médico adopte una actitud de búsqueda activa, sobre todo entre la población de riesgo. Para realizarla es necesario que la situación sea propicia (sentido de la oportunidad), preservando la confidencialidad del encuentro, y se llevará a cabo con naturalidad, empatía, adoptando una actitud de escucha activa, cuidando el lenguaje no verbal, sin emitir juicios de valor y recurriendo a la asertividad para superar las resistencias. En esta publicación se propone una pauta para realizarla adecuadamente (AU)

A sexual satisfactory life favourably affects quality of life, there being evidence that shows there are multiple organic processes of which sexual dysfunction is often a precocious sign of underlying organic disease (cardiovascular, endocrinological or neurological). Difficulties exist in recording the sexual anamnesis on the part of the professional, the patient, or by the health system. Nevertheless, given its importance, it is necessary for the doctor to adopt an attitude of active search, especially among the population of risk. To do this, it is necessary that the situation is propitious (sense of the opportunity), preserving the confidentiality of the meeting, and it will be carried out naturally and with empathy, adopting a listening attitude, taking into account the non-verbal language, without issuing valued judgments, and resorting to assertivity to overcome the resistances. This article proposes guidelines to perform an anamnesis adequately (AU)

[The medical history taking in sexual health: skills and attitudes]. / La anamnesis en la historia clínica en salud sexual: habilidades y actitudes.

A sexual satisfactory life favourably affects quality of life, there being evidence that shows there are multiple organic processes of which sexual dysfunction is often a precocious sign of underlying organic disease (cardiovascular, endocrinological or neurological). Difficulties exist in recording the sexual anamnesis on the part of the professional, the patient, or by the health system. Nevertheless, given its importance, it is necessary for the doctor to adopt an attitude of active search, especially among the population of risk. To do this, it is necessary that the situation is propitious (sense of the opportunity), preserving the confidentiality of the meeting, and it will be carried out naturally and with empathy, adopting a listening attitude, taking into account the non-verbal language, without issuing valued judgments, and resorting to assertivity to overcome the resistances. This article proposes guidelines to perform an anamnesis adequately.

Estudio del burnout mediante el test CUBO (cuestionario urgente de Burnout). Análisis de fiabilidad / Study of burnout with the CUBO test (urgent questionnaire of burnout). Analysis if realibility

Se presenta el “cuestionario urgente de burnout” (CUBO), desarrollado para medir de forma rápida el síndrome de estar “quemado”. El cuestionario fue aplicado a 245 adultos (169 mujeres y 76 varones), con diversas profesiones y distintos ámbitos laborales, agrupándolos en dos sectores profesionales (sanitarios y enseñanza). El análisis psicométrico de los datos, estudio de fiabilidad, reveló que el cuestionario muestra índices adecuados de fiabilidad, consistencia interna (coeficiente alfa 0,68) y fiabilidad como estabilidad temporal de las puntuaciones (técnica dos mitades, r de Pearson 0,68 y corrección de Sperman-Brown 0,81). A partir de estos índices, nos proponemos seguir estudiando el cuestionario y más concretamente la validez, correlacionando los resultados de la prueba con criterios externos o con otras pruebas de reconocida validez, que midan iguales aspectos

This article presents The “Urgent Questionnaire of Burnout” (CUBO), developed to measure of fast formthe syndrome to be “burned”. The questionnaire was applied to 245 adults (169 women and 76 men), with diverse professions and different labor scopes, grouping them in two professional sectors (sanitary and education).The psychometric analysis of the data, study of reliability, revealed that the questionnaire shows suitable indexes of reliability, internal consistency (coefficient alpha 0.68) and reliability like temporary stability of the scores (technical two halves, r of Pearson 0,68 and correction of Sperman-Brown 0.81). Starting from these indexes, we set out to continue studying the questionnaire more concretely and the validity, correlating the test results with external criteria or other tests of recognized validity, that they measure equal aspects

Core document on erectile dysfunction: key aspects in the care of a patient with erectile dysfunction.

The aim of this Core Document of the Spanish Consensus on Erectile dysfunction (ED) is to offer guidance to the nonspecialist physician in the management of patients with ED. ED is one of the most frequent chronic health problems in men older than 40 y of age and may also act as a sentinel symptom for other important underlying diseases. Its etiology can be classified into organic, psychogenic, or mixed. In most cases, the underlying cause of ED is usually a chronic health problem (such as diabetes, hypertension, atherosclerosis, and so on) or an adverse drug effect. The initial step in the management is to assess erectile function in patients with risk factors for ED. Once ED has been established, a detailed sexual, medical, and social history, including a review of medications used, is the most important aspect of a patient's assessment. Generally, examination should be limited to the cardiovascular, neurological, and urogenital systems. Fasting glucose and blood lipid profile should be performed in every man with ED, and free testosterone levels in men older than 50 y or if hypogonadism is suspected; other diagnostic tests are optional and should be requested on an individualized basis. In many cases, the most likely cause of ED can be identified based on the above information. Therapeutic intervention should be patient-oriented and based on the expectations and wishes of the patient and his partner, who should be included in discussions whenever possible. Basic interventions common to any type of ED include sexual counseling, lifestyle modifications, treatment of associated medical conditions, and switching to alternative drugs with lower risk of ED. In certain cases, an etiologic treatment may be performed (sex therapy, revascularization surgery, and hormonal therapy). Most patients with ED will benefit from symptomatic treatments; first-line therapy may be prescribed by physicians who are not specialists in ED, and includes oral agents such as inhibitors of phosphodiesterase type 5, currently considered the drugs of choice for initial treatment of ED. Intracavernous drugs are the second-line therapy, and surgical treatments, such as implantation of penile prostheses, are reserved for urologists/andrologists who specialize in ED. Referral may be appropriate where indicated by age, clinical findings, or the patient's request.

Specific aspects of erectile dysfunction in sexology.

The sexology of erectile dysfunction (ED) is approached from a perspective that integrates medical, psychological, and social aspects. This article reviews the clinical intervention in sexology beginning with the diagnostic evaluation, where the organic and psychological factors (predisposing, precipitating, and perpetuating) contributing to ED are determined. A description of the differential diagnosis process follows, which establishes the relevance of organic factors in order to organize therapeutic strategies. There are three possible treatment processes: psychological intervention with the patient, intervention on the partner relationship, or intervention with the partner. Referral criteria are also described, such as when patients with ED should be referred to a sexologist, and to whom sexologists should refer patients with ED.