关于性前期的注意事项Talking about sex in primary care.ppt

Summary Ask permission Assume the initiative Use “language” that fits a particular situation Convey a sense of trust and confidentiality Use form of questioning that providing information followed by a question Display as attitude of non judgmentalism Delay inquiry into obviously sensitive areas Provide information by way of explanation Ask questions about feeling in addition to experiences Promote an optimistic attitude Epidemiology of sexual problems in Primary care A study used questionnaire that contained items concerning dysfunctions and difficulties 152 patients, almost did so (93%) 56% identified at least one sexual problem Moore JT, Goldstein Y: Sexual problems among family medicine patients, J Fam Prac 10:243-247, 1980 Multiple reasons for discrepancy The physician did not ask relevant questions The patient did not spontaneously report problems The physician did not record the information in the patient’s chart Moore JT, Goldstein Y: Sexual problems among family medicine patients, J Fam Prac 10:243-247, 1980 Sexual “Difficulties” ; Partner chooses inconvenient time Inability to relax Attraction(s) to persons other than mate Disinterest Attraction(s) to persons of the same sex Different sexual practices or habits “Turned off” Too little foreplay before intercourse Too little “tenderness” after intercourse Partner chooses inconvenient time Inability to relax Attraction(s) to persons other than mate Disinterest Attraction(s) to persons of the same sex Different sexual practices or habits “Turned off” Too little foreplay before intercourse Too little “tenderness” after intercourse Screening for sexual problems ; Given the immense numbers of patients with sexual problems, the need becomes obvious for triage system. The nature of problem and its impact can be evaluated and proper action taken Further assessment and treatment Referral Screening Criteria ; Useful screening questions should observe at least 4 rules Screening questions should encompass a wide sp