J Menopausal Med.  2018 Dec;24(3):210-216. 10.6118/jmm.2018.24.3.210.

Cultural Barriers Influencing Midwives' Sexual Conversation with Menopausal Women

• Khadivzadeh T
• Ghazanfarpour M
• Latifnejad Roudsari R

• KMID: 2455896
• DOI: http://doi.org/10.6118/jmm.2018.24.3.210

Abstract

OBJECTIVES
The present study aimed to determine the barriers influencing the sexual conversation.
METHODS
In this descriptive cross-sectional study, 200 midwives were selected through convenience sampling method from private and public clinics in Mashhad, North East of Iran. A self-structured questionnaire was used to collect the study data.
RESULTS
The mean age of subjects was 39.58 ± 8.12 years with 13.49 ± 7.59 years of work experience. A number of cultural conditions act as an inhibitory force for the midwives to address sexual issues with menopausal women. Menopausal women visit a doctor at the acute stage when emotional and physical problems make sexual discussion difficult for the midwives (86.5%). Other related causes for not having proper sexual conversation were insufficient knowledge (51.4%), inadequate education provided via public media through health providers (83.5%), midwives or their patient's shame (51.5%), and attempt to get help from traditional healers, friends, relatives and supplicants instead of midwifery staff (78.5%). Also, we found that sexual workshops, communication workshops, and work experiences had a significant influence in changing the views of midwives.
CONCLUSIONS
Cultural barriers prevent the patients and providers from communicating effectively with each other, thus highlighting the need for sexual and communication workshops for the health care providers.

Keyword

Culture; Menopause; Sexual behavior; Sexuality

MeSH Terms

Cross-Sectional Studies
Education
Female
Friends
Health Personnel
Humans
Iran
Menopause
Methods
Midwifery
Sexual Behavior
Sexuality
Shame

Reference

1. Pauls RN, Kleeman SD, Segal JL, Silva WA, Goldenhar LM, Karram MM. Practice patterns of physician members of the American Urogynecologic Society regarding female sexual dysfunction: results of a national survey. Int Urogynecol J Pelvic Floor Dysfunct. 2005; 16:460–467.

2. Dyer K, das Nair R. Why don't healthcare professionals talk about sex? A systematic review of recent qualitative studies conducted in the United kingdom. J Sex Med. 2013; 10:2658–2670.

3. Rashidian M, Minichiello V, Knutsen SF, Ghamsary M. Barriers to sexual health care: a survey of Iranian-American physicians in California, USA. BMC Health Serv Res. 2016; 16:263.

4. Stead ML, Brown JM, Fallowfield L, Selby P. Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues. Br J Cancer. 2003; 88:666–671.

5. Salehian R, Naserbakht M, Mazaheri A, Karvandi M. Perceived barriers to addressing sexual issues among cardiovascular patients. Iran J Psychiatry Behav Sci. 2017; 11:e7223.

6. Ghazanfarpour M, Khadivzadeh T, Latifnejad Roudsari R, Mehdi Hazavehei SM. Obstacles to the discussion of sexual problems in menopausal women: a qualitative study of healthcare providers. J Obstet Gynaecol. 2017; 37:660–666.

7. Kushner M, Solorio MR. The STI and HIV testing practices of primary care providers. J Natl Med Assoc. 2007; 99:258–263.

8. Magnan MA, Reynolds K. Barriers to addressing patient sexuality concerns across five areas of specialization. Clin Nurse Spec. 2006; 20:285–292.

9. Ghazanfarpour M, Khadivzadeh T, Roudsari RL. Sexual disharmony in menopausal women and their husband: A qualitative study of reasons, strategies, and ramifications. J Menopausal Med. 2018; 24:41–49.

10. Kottmel A, Ruether-Wolf KV, Bitzer J. Do gynecologists talk about sexual dysfunction with their patients? J Sex Med. 2014; 11:2048–2054.

11. Yoshany N, Morowatisharifabad MA, Mihanpour H, Bahri N, Jadgal KM. The effect of husbands' education regarding menopausal health on marital satisfaction of their wives. J Menopausal Med. 2017; 23:15–24.

12. Heidari M, Ghodusi M, Rafiei H. Sexual self-concept and its relationship to depression, stress and anxiety in postmenopausal women. J Menopausal Med. 2017; 23:42–48.

13. Ozgoli G, Sheikhan Z, Dolatian M, Valaee N. The survey of obstacle and essentiality health providers for sexual health evaluation in women referring to health centers related of Shahid Beheshti University of Medical Sciences. Pejouhandeh. 2014; 19:175–183.

14. Guthrie C. Nurses' perceptions of sexuality relating to patient care. J Clin Nurs. 1999; 8:313–321.

15. Hordern A, Grainger M, Hegarty S, Jefford M, White V, Sutherland G. Discussing sexuality in the clinical setting: The impact of a brief training program for oncology health professionals to enhance communication about sexuality. Asia Pac J Clin Oncol. 2009; 5:270–277.

16. Humphery S, Nazareth I. GPs' views on their management of sexual dysfunction. Fam Pract. 2001; 18:516–518.

17. Steinke EE, Jaarsma T, Barnason SA, Byrne M, Doherty S, Dougherty CM, et al. Sexual counselling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP). Eur Heart J. 2013; 34:3217–3235.