By William L. Maurice MD FRCP(C), Majorie A. Bowman MD MPA
A realistic advisor to interviewing sufferers approximately sexual issues with instructed questions, instructions for the review and therapy of universal sexual difficulties, and instructions for referral. It contains pattern questions and case histories for a extra medical focus.
* contains case histories all through, guiding you thru history-taking and the actual examination. * includes particular inquiries to ask whilst a sufferer unearths an issue (and particular suggestions to take advantage of with sufferers who look reluctant to talk). * offers updated details on instructed remedies, together with Viagra.
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Extra resources for Sexual Medicine In Primary Care
3. Treatments such as surgery64 or drugs65 can interrupt sexual function. A health professional should inquire about drug side effects (see Chapter 8 and Appendix III). 4. Inquiry into past sexual events may be essential to understand the nature of a disorder in the present. 66 5. The observation that “. 67 The aging of the population translates into increasing expectations by many patients regarding sexual function. These hopes may conflict with the difficulty that many young health professionals experience in discussing sexual matters with older people.
Chapter 8 reviews the many issues and questions that an interviewer must address concerning medical, psychiatric, and sexual disorders (apart from dysfunctions). Chapter 8 completes the PART I focus on general aspects of talking to people about sexual matters. REFERENCES 1. Copland A: What to listen for in music, New York, 1967, McGraw-Hill. 2. Chandler & Co: PBS/KCTS, April 11, 1996. 3. The Globe and Mail, Adacity, C 1, June 7,1997. Laumann et al: The social organization of sexuality: sexual practices in the United States, Chicago, 1994, The University of Chicago Press.
Where (in a health professional history) Should Questions Be Asked About Sex? Sometimes, a patient spontaneously indicates that a sexual concern is the principal reason for the visit. When this occurs, the sexual problem obviously has priority. However, such information usually has to be elicited carefully. In a medical setting, three different circumstances (not mutually exclusive) exist in which this could happen: 1. The prime location in a medical history for asking about sex-related information is within a Review of Systems (ROS [sometimes referred to as a The lowering of defenses during a physiFunctional Inquiry]; see “Permission” in Chapter 2 for an exam- cal examination can be hazardous to the ple).