Australian health professionals’ perspectives on discussing sexual activity and intimacy with people who have had a heart attack: a qualitative study

Claire Moran; Kara Lilly; Anthony Leo Walsh; Rachelle Foreman; Jane Taylor

doi:10.1071/PY23119

RESEARCH ARTICLE (Open Access)

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Australian health professionals’ perspectives on discussing sexual activity and intimacy with people who have had a heart attack: a qualitative study

Claire Moran

^A ^B , Kara Lilly

^C , Anthony Leo Walsh

^D ^* , Rachelle Foreman ^E and Jane Taylor

^C

+ Author Affiliations

- Author Affiliations

^A True Relationships and Reproductive Health, Windsor, Qld 4030, Australia.

^B School of Psychology, University of Queensland, St Lucia, Qld 4072, Australia.

^C School of Health, University of the Sunshine Coast, Sippy Downs, Qld 4556, Australia.

^D Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Burwood, Vic. 3125, Australia.

^E Brisbane North Primary Health Network, Lutwyche, Qld 4030, Australia.

^* Correspondence to: anthony.walsh@deakin.edu.au

Australian Journal of Primary Health 30, PY23119 https://doi.org/10.1071/PY23119

Submitted: 22 June 2023 Accepted: 14 November 2023 Published: 12 December 2023

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY)

Abstract

Background

Sexual activity and intimacy contribute to wellbeing throughout adult life, including after a heart attack. Providing support and information about sexual activity and intimacy after a heart attack is recognised as part of a comprehensive approach to cardiac rehabilitation. Previous research shows that patients expect health professionals to initiate discussions about sexual activity and intimacy, but that this seldom occurs.

Methods

Drawing on qualitative survey responses from a range of Australian health professionals working in cardiac care and rehabilitation, this research examined their perspectives on discussing sexual activity and intimacy with their patients, and patients’ partners. Using a social constructionist approach, thematic analysis was used to identify themes expressed by participants.

Results

Discussions about sexual activity and intimacy after heart attack were perceived as nebulous and taboo. The predominance of an illness – rather than wellness – framing of these discussions and a tendency for health professionals to make judgement calls contributed to discussions not occurring. Health professionals also identified a range of intrapersonal, interpersonal and structural obstacles to discussions, including embarrassment, fear of patients’ embarrassment, a lack of role clarity, the absence of a clear protocol or training to guide practice, and a lack of time, privacy and patient resources.

Conclusions

Such discussions require normalisation, careful timing, sufficient time and adequate privacy. Staff training, a protocol and appropriate patient resources are needed to support health professionals to initiate discussions. Further research is required that investigates the impact of specific resources and training on health professionals’ practice and patient outcomes.

Keywords: cardiac rehabilitation, cardiovascular disease, health education, intimacy, qualitative research, sexual activity, sexual counselling, sexual health, social constructionist.

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