Victoria Mosack

Sexual Counseling for Individuals With Cardiovascular Disease and Their Partners A Consensus Document From the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP)

Sexual counseling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP)

Screening for depression among pregnant and postpartum women.

The purpose of this study was to examine the screening of depression among pregnant and postpartum participants in a community-based program. This cross-sectional study used archival data from 98 women participating in a community-based visiting nurse program in a midwestern U.S. city. Depression screening was accomplished using the Center for Epidemiologic Studies Depression scale (CES-D) and Edinburgh Postnatal Depression scale (EPDS); both instruments ask respondents to answer questions regarding their mood during the past week. The CES-D identified more pregnant and postpartum women as depressed than did the EPDS. A standard regression analysis using previous pregnancies, history of depression, married versus nonmarried, presence of support, and breast-feeding as predictor variables did not produce statistically significant findings for predicting depression among the pregnant and postpartum women in this study. This finding underscores the value of brief depression screening instruments for nurses working with pregnant and postpartum women.

Progress in sexual counseling by cardiac nurses, 1994 to 2009

OBJECTIVE To examine trends in the practice of sexual counseling by cardiac nurses. METHODS A non-experimental descriptive design was used to analyze survey data collected at 2 time points: 1994 (n = 171) and 2009 (n = 288). RESULTS Nurses in the 2009 sample reported more conservative values (P < .001) and greater sense of responsibility for providing sexual counseling (P < .0001) than those in the 1994 sample. Although sexual activities (cuddling, kissing, fondling, masturbation, oral sex) were discussed more frequently by nurses in the 1994 survey (P < .001), improvements in the specific discussion of myocardial infarction-related sexual activity and counseling were noted in the 2009 sample, including by patient age and gender (P < .0001). CONCLUSION Comparison of the 2 data samples suggests an improving trend in provision of sexual counseling by cardiac nurses, which can be reinforced by including sexual counseling information and role-play opportunities in continuing education courses.

Risk factors as predictors of sexual activity in heart failure.

Patients with heart failure (HF) often have concerns about sexual activity while living with HF. Little is known about factors that contribute to sexual activity and sexual dysfunction in HF. This study examined selected risk factors and demographic variables as predictors of sexual activity in HF patients. The sample (N = 97) was mostly male and white and had some college education. Four risk factors, tobacco use, alcohol use, having diabetes, and number of medications, were statistically significant in showing decreased odds of being sexually active, when controlling for age, sex, education, and body mass index. Nonexercisers and hypertension were not significant predictors of sexual activity. Among cardiac medication classes, there were no statistically significant differences between those HF patients who were and were not sexually active. Health professionals need to be mindful of these predictive factors as they provide sexual counseling to patients with HF.

Genetics of Depression: An Overview of the Current Science

Most psychiatric disorders, including major depressive disorder (MDD), are known to involve complex interactions between genetic and environmental influences that impact the development and severity of symptomatology. Health care practitioner competencies have been expanded to include application of genetic knowledge in mental health. Yet this information is difficult to decipher and apply. To assist with these challenges, this article synthesizes recent literature related to the genetics of MDD and illustrates the genetic pathways for major depression.

A Social-Cognitive Sexual Counseling Intervention Post-MI—Development and Pilot Testing

PURPOSE Individuals experiencing myocardial infarction (MI) report anxiety, depression, diminished quality of life (QOL), and reduced sexual activity. DESIGN AND METHODS We examined return to sexual activity post-MI, and pilot tested a comprehensive sexual counseling intervention based on social-cognitive theory. The intervention in this pretest/posttest preexperimental study used an informational video, newsletters, and telephone counseling, with cardiac patients (N = 10) and partners (N = 3). Measures included QOL; knowledge; sexual anxiety, depression, self-efficacy, and satisfaction. FINDINGS At 8 weeks, only 60% had returned to sexual activity, with low QOL and sexual satisfaction for patients and partners. PRACTICE IMPLICATIONS Supportive interventions by nurses are needed to assist MI patients and partners return to sexual activity.

Sexual self-perception and adjustment of cardiac patients: a psychometric analysis

The psychological impact of a cardiac event includes anxiety and depression, poor sexual quality, and diminished sexual satisfaction. Few measures capture psychosexual recovery following a cardiac event. This study evaluated the reliability and validity of the Sexual Self-Perception and Adjustment Questionnaire (SSPAQ) among cardiac patients (N = 128), measuring sexual anxiety, depression, self-efficacy, and satisfaction. Scale-level content validity was 0.97. After item analysis, 28 items were retained; Cronbach’s alpha is >0.90, indicating item appropriateness for the combined scale (0.97). A four-factor model was supported with each of the subscale items accounting for at least 64% of the variance. Construct validity comparing sexually active to inactive showed those inactive had significantly lower sexual self-perception. The SSPAQ is a cohesive measure of sexual self-perception, and findings suggest each subscale can be used independently for measures of sexual anxiety, sexual depression, sexual self-efficacy, and sexual satisfaction, and may be useful in research and clinical settings.

Effects of depression on sexual activity and sexual satisfaction in heart failure.

Patients with heart failure often suffer from depression. However, little is known about the influence of depression on sexual activity and satisfaction. This secondary analysis of descriptive cross-sectional data study examines the role of depression on sexual activity and sexual satisfaction in heart failure. Results highlight the need for acute care nurses to routinely screen for depression and sexual concerns in HF.

Changes in myocardial infarction-specific sexual counseling by cardiac nurses

It is largely unknown if changes in the practice of sexual counseling of myocardial infarction (MI) patients by cardiac nurses have occurred over time. Therefore, the purpose of this study was to examine changes in the practice of MI-specific sexual counseling by cardiac nurses, comparing the years 1994 and 2009. Based on these results, suggestions for sexual counseling of MI patients are provided.

Medication use and predictors of sexual activity in men and women with CVD

Purpose:To examine the influence of cardiac and noncardiac medications on sexual activity by drug classification and generation of the drug, among men and women with cardiovascular disease. Data sources:This study was a subanalysis (n = 224) of survey data from a cross‐sectional sample of 336 cardiac patients. Self‐reported medications were categorized by generic drug name, classification, and subclass and/or generation of the drug. Sexual activity was the presence or absence of current sexual activity in the last 2 months. Conclusions:Patients taking generation one beta blockers, particularly men; diuretics as a class; and loop diuretics, were significantly less likely to be sexually active, with diuretics negatively influencing sexual activity in women, but not men. Certain antidepressant medications positively influenced sexual function, particularly for women. Nearly 20% of the variances in sexual activity were explained by younger age, fewer number of medications, higher education, and having a sexual partner. Implications for practice:A new finding meriting further study was that loop diuretics negatively impacted sexual activity, particularly for women; and further studies of women overall are clearly needed. Advance practice nurses play an important role in evaluating medications, proactively choosing drugs within a class or subclass less likely to cause sexual problems, and in promoting sexual quality of life of cardiac patients.