Decreased sexual function in partners after patients' first-time myocardial infarction.

BACKGROUND: A myocardial infarction event affects not only patients but also partners, although how it affects the partners' sexual function is not studied. AIM: The purpose of this study was to describe and compare how partners experienced their sexual function one year before with one year after first-time myocardial infarction of their partner. METHODS: A longitudinal and comparative design was used. Self-reported data on Watts Sexual Function Questionnaire was collected retrospectively at two occasions from 123 partners (87 women and 36 men), measuring the year prior to the first-time myocardial infarction and the year after. Data were analysed using descriptive and inferential statistics. RESULTS: The total score for Watts Sexual Function Questionnaire showed a significant decrease over time. In all four subscales a decrease was found, which were statistically significant in three out of the four subscales (sexual desire, 19.39 vs 18.61; p<0.001, orgasm, 14.11 vs 13.64; p=0.027 and satisfaction, 12.61 vs 12.31; p=0.042). Twenty-six partners reported that their intercourse frequencies decreased over time, while six partners reported an increased intercourse frequency. CONCLUSIONS: Partners' sexual function decreased after patients' first-time myocardial infarction. It is important for health personnel to offer information and discussion about sexual function and concerns with both patients and partners after a first-time myocardial infarction.

Perceptions of intimate relationships in partners before and after a patient's myocardial infarction.

AIMS AND OBJECTIVES: To describe and explore how partners rate their intimate relationship before and after the patients' first myocardial infarction. A further aim was to investigate the association between partners' rating of their intimate relationship and self-rated health. BACKGROUND: To date, information on how partners experience the intimate relationship before and after a patient's myocardial infarction is sparse. DESIGN: A descriptive and exploratory design with longitudinal data collection. METHODS: The study comprised 127 partners, aged 34-87 years. Data collection included self-reported information on socio-demographic data, intimate relationship and self-rated health one year before and one year after patients' first myocardial infarction. Intimate relationship was assessed by the Swedish version of the Relationship Assessment Scale. Self-rated health was evaluated by the EuroQoL visual analogue scale. RESULTS: In general, partners reported high satisfaction with their intimate relationship both before and after the patients' myocardial infarction. Women reported somewhat lower ratings in their intimate relationship than men before the myocardial infarction. Women increased their ratings after one year, while men on average decreased their ratings. Partners with higher education reported lower ratings for intimate relationship after one year. Those with children living at home rated intimate relationship lower than those without children living at home after one year. Partners' self-rated health status was stable over time. No significant association between intimate relationship and self-rated health was found. CONCLUSIONS: This study provides important insights regarding couples' relationships from the perspective of the partner. Socio-demographic factors such as sex, educational level, having children living at home and employment status may influence how the relationship, from the partners' perspective, is affected by a myocardial infarction event. RELEVANCE TO CLINICAL PRACTICE: This study provides insight into how partners rate their intimate relationship and self-rated health over time before and after patients' myocardial infarction.

The female partners' experiences of intimate relationship after a first myocardial infarction.

AIM: This study aimed to explore and describe women's experience of intimate relationships in connection to and after their partner's first myocardial infarction. BACKGROUND: Support from partners is important for recovery, but little is known about partners' experience of intimate relationships after myocardial infarction. DESIGN: The study used an explorative, qualitative design. METHODS: The first author interviewed 20 women having a partner who had suffered a first myocardial infarction during the preceding year. Qualitative content analysis was used to analyse the data. FINDINGS: Three themes emerged: 'limited life space', 'sense of life lost' and 'another dimension of life'. The women described how their self-assumed responsibility led to a more stifling and limited life. Their sense of life lost was described in terms of deficits and feeling the loss. The women also described experiencing another dimension of life characterised by three subthemes: 'uncertainty of life', 'certain of relationship' and 'share life more'. CONCLUSIONS: The partners' myocardial infarction had an impact on the interviewees' intimate relationships; they suffered a major loss and missed their 'former' partner, both emotionally and sexually. They struggled with the new asymmetry in their intimate relationship and felt compelled to adapt to their partners' lack of sexual desire or function. Also, their partner controlled them, which lead towards a stifling, more limited life space. RELEVANCE TO CLINICAL PRACTICE: Caregivers in hospital and primary care settings could apply the findings in their efforts to help couples recover or maintain intimate relationships following myocardial infarction.

The male partners' experiences of the intimate relationships after a first myocardial infarction.

BACKGROUND: Stress in the intimate relationship is found to worsen the prognosis in women suffering from myocardial infarction (MI). Little is known about how male spouses experience the intimate relationship. AIM: This study aimed to explore and describe the experience of men's intimate relationships in connection to and after their female partner's first MI. METHODS: An explorative and qualitative design was used. Interviews were conducted with 16 men having a partner who the year before had suffered a first MI. The data were analysed with qualitative content analysis. RESULTS: Three themes emerged: masculine image challenged; life takes another direction; and life remains unchanged. The men were forced to deal with an altered image of themselves as men, and as sexual beings. They were hesitant to approach their spouse in the same way as before the MI because they viewed her to be more fragile. The event also caused them to consider their own lifestyle, changing towards healthier dietary and exercise habits. CONCLUSIONS: After their spouse's MI, men experienced a challenge to their masculine image. They viewed their spouse as being more fragile, which led the men to be gentler in sexual intimacy and more hesitant to invite sexual activity. This knowledge about how male spouses experience the intimate relationship could be helpful for health personnel in hospitals and primary care when they interact with couples where the woman suffers from cardiac disease or other chronic disorders.

Validity and reliability of a Swedish version of the Relationship Assessment Scale (RAS): a pilot study.

BACKGROUND: There is a need for a short and easily administered scale, in the Swedish language, for assessing partner relationships in the health care of persons with cardiac disease. PURPOSE: To establish the reliability and validity of the Swedish version of the Relationship Assessment Scale (RAS). DESIGN: The present pilot study has a methodological design. FINDINGS: Content validity has been tested for relevance, clarity and readability. The scale was tested for construct validity with explorative factor analysis. The reliability was tested by internal consistency and test-retest analysis. The result showed a two-factor solution, which does not correspond to the original proposed one-factor solution. The factor analyses revealed two quite distinct factors of RAS, labelled "Relationship built on expectations and satisfaction of needs" and "Relationship built on love and devotion". CONCLUSIONS: The scale has satisfactory psychometric properties in terms of content validity, construct validity, homogeneity and stability in a population of persons with cardiac disease. Wider evaluations of the RAS for other populations and settings are recommended.

Evaluation of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) in persons with heart disease: a pilot study.

BACKGROUND: As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required. AIMS: The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease. METHODS: A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions. RESULTS: Two separate factor analyses each revealed a two-factor structure on both occasions: "Sexual appetite" and "Sexual expectations" with gender-neutral questions and "Sexual sensitiveness" and "Sexual ability" with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test-retest values for all but one question exceeded 0.70. CONCLUSIONS: The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.