Thursday, July 12, 2007
This presentation is part of : Health Promotion Issues
Trends in Sexual Concerns After Myocardial Infarction, 1995-2002
Elaine E. Steinke, PhD, RN and Victoria Mosack, PhD, RN. School of Nursing, Wichita State University, Wichita, KS, USA
Learning Objective #1: describe the Concept of Sexual Integrity as it applies to sexual concerns of myocardial infarction patients.
Learning Objective #2: discuss three nursing strategies for addressing sexual concerns after myocardial infarction.

Background: Anxiety and sexual concerns are common after a myocardial infarction (MI), often persisting during recovery.  As society has more openly discussed sexual issues, MI patients may receive more information on resuming sexual activity.  It is unknown to what extent sexual concerns of MI patients have persisted or changed in the last decade. 

Objective: Examine trends in sexual concerns of MI patients using qualitative analysis of patient comments from 1995 to 2002, and identify trends in concerns early, middle, and later in recovery post-MI.

Methods:  Qualitative analysis of narrative comments from three separate samples of MI patients was performed, encompassing time periods of 1995, 1997, and 2000 to 2002.  Data were coded using McFarlane & Rubenfeld’s Concept of Sexual Integrity; major concepts were self-identity, communication, and environment.  Data were reviewed independently by two researchers to reach agreement on classification of data for analysis. Units of analysis using sentences and phrases were coded independently by the researchers for one major concept and sub-concept of the model. Codes were compared, and when discrepancies occurred, codes discussed until agreement was reached.  A total of 342 units were coded and interrater agreement was 94%. 

Results:  Themes over the 8-years period included alterations in self-identity, specifically related to health state (physical and psychological), and role adjustment.  Communication concerns involved predominantly a lack of sexual information.  Both sexual concerns and positive expressions of intimacy were noted in later data, and partner-related concerns were often expressed as environmental concerns.  Trends across early, middle, and later MI recovery periods were similar to findings across the 8-year period.

Conclusions:  MI patients express concerns regarding sexual activity.  Health providers must provide sexual counseling, and by addressing the educational needs and concerns of patients will serve to enhance patient sexual integrity.  Partner needs have been neglected and should be further addressed.