CPI Flashcards
How to overcome barriers in sexual consultation
- training
- providing patient info (enable patients to initiate)
- expand role of GP
Barriers in talking about sexual issues with particular patient groups
- gender (opposite gender sexualize)
- ethnicity (difference in attitudes)
- age (esp older)
- non-heterosexual partner
Issues after radical prostatectomy
- becoming a changed man
- striving to gain a sense of control in a new life situation
- managing a new life situation
- striving to become reconciled in a new life situation
Reasons for not seeking help for ED
- lack of support
- fear/denial
- barriers they put in front of themselves
How to decrease risk of ED
- low-fat, low-chol diet
- exercise regularly
- avoid tobacco and excessive alcohol
- avoid activities prone to penile pain
- ensure proper evaluation and management of other problems (diabetes/HT)
Reasons to screen for depression
- reduced appetite and weight loss
- recent significant loss
- cognitive problems
- fatigue and reduced energy
- preoccupation with somatic complaints
Importance of regular screening for mood disorders
- very prevalent in primary care level
- costly (distress, morbidity, direct and indirect medical costs)
- commonly neglected and missed (stigma)
- complex (multiple causation, no biochem marker)
- easily treated
- dramatically affects quality of life and co-morbid recovery
- can affect adherence
Importance of considering patient’s sexuality when providing health care
- sexual behaviors contribute to well being
- contribute to possibility of illness
- discomfort about discussing can damage practitioners access to patient info
- weak knowledge leads to patients seeking dubious sources of assistance
- link between reproductive and sexual health (has medical and public health implications - HIV)
Ethnographic approach
- how patients identify
- what is at stake
- illness narrative
- pschosocial support and stresses that could affect health
- recognition of health practitioners culture (stereotyping)
- problems of cultural competency
Effects of ED
- changes in identity
- feelings of dissatisfaction
- emotional effect
- stress in intimate relationship
- occupational function
Diagnosing depression
- depressed mood
- diminished interest or pleasure in activities
- significant weight loss or gain without explanation
- insomnia or hypersonic every day
- psychomotor agitation or retardation
- fatigue or loss of energy
- feelings of worthlessness
- dismissed ability to think or concencrate
- recurrent thoughts about death (suicidality)
Risky drinking
More than 4 units a day, more than 5 days a week
Questions to screen for alcohol abuse
- ever felt you should cut down?
- ever felt annoyed when others criticized
- ever felt guilty?
- ever had drink first thing in the morning to steady your nerves?
Effects of alcohol consumption that lead to sexual risk taking behavior
- compromised reasoning skills
- increased sexual arousal
- increased sexual desire
- decreased inhibitions
- reduced judgement
- reduced sense of responsibility
2 key components of the attachment process
- provision of nurturing environment of basic trust and security (allowing for development if secure base)
- development of individuation and autonomy
3 critical elements of attachment process
- holding
- containment
- provision of space
Definition of holding
Involves staying in the situation by experiencing, acknowledging and comforting a child in distress
Definition of containment
An active process involving feeling, thinking and acting to distill distress into a tolerable form
Definition of provision of space
Process of allowing and encouraging exploration of nearby environment
How stigma can affect psychosocial functioning
- people around may not want close contact
- increased expenditure of health costs
- reduced self esteem
- reduced social status
- reduced confidence in social settings
- discrimination is terms of employment
- discrimination in terms of social activities
- difficulty in meeting a partner/making friends
Factors that may discourage a man from consulting GP about prostate cancer
- embarrassment about sexual/erectile dysfunction
- embarrassment about urinary leakage
- has become used to symptoms as they developed gradually
- fear of diagnosis of cancer
- fear of treatment
- diminished sexual activity
- cultural or religious background
- old age (life stage)
Phases of pscho-physiological response of male arousal
- desire
- excitement
- orgasm
- resolution
3 main categories of sexual dysfunction
- physical
- psychological
- substances (alcohol, cannabis)
