Is women's sexual function impaired by an abnormal pap smear?

OBJECTIVE: Although the stressful psychological impact on women of an abnormal Pap smear is well documented, little research has been undertaken on its sexual impact. Our objective was to assess the impact of an abnormal Pap smear on the sexual function of affected women. METHODS: A prospective study compared the sexual function of 48 women with an abnormal Pap smear (case group) with that of 48 women with a normal Pap smear (control group). Sexual function was assessed using the Female Sexual Function Index and the Hospital Anxiety Depression Scale. The questionnaires were mailed to the participants. RESULTS: Surprisingly, the risk of sexual dysfunction was comparable between women with and without an abnormal Pap smear (odds ratio [OR] 0.7; p = 0.4). The OR remained statistically non-significant after adjustment for risk factors. Multivariable analysis showed that only older age at first intercourse, depression and anxiety were identified as factors significantly associated with sexual dysfunction. CONCLUSION: Contrary to our clinical experience, female sexual function is not impaired by an abnormal Pap smear. Further research is needed to better understand how sexuality in women with abnormal Pap smears may be affected.

[How to address sexual issues in oncology : Challenges and perspectives]. / Prise en charge de la sexualité en oncologie : enjeux et pistes de réflexions.

One of the most problematic aspects of patients' quality of life after cancer is often the impacts on sexuality. Among the health care professionals (hcp) involved in care process, the important role that nurses could play, alongside with doctors, in dealing with these issues has been emphasized. However, it seems that hcp still struggling to broach this subject. The aim of this paper is to examine, based on current knowledge and, more specifically on a Swiss study, nurses' representations and practices facing such an issue in oncology. Findings highlighted that hcp were unequipped due to a lack of training and hampered by structural and personal constraints. Practical perspectives are suggested to allow future adjustments.

Les répercussions sur la sexualité constituent souvent l'un des aspects les plus problématiques de la qualité de vie après un cancer. Parmi les professionnel·le·s de santé impliqué·e·s dans le parcours de soins, il a été souligné le rôle central que pourraient tenir les infirmier·ère·s, aux côtés des médecins, dans la prise en charge de ces questions. Or, il semble qu'ils-elles peinent à aborder ce sujet. L'objectif de cet article est d'examiner, sur la base des connaissances actuelles et, plus particulièrement, d'une étude menée en Suisse, les représentations et pratiques des infirmier·ère·s face à l'abord d'un tel sujet dans le champ du cancer. Les résultats relèvent que ces soignant·e·s sont démuni·e·s du fait d'un manque de formation et entravé·e·s par des contraintes structurelles et personnelles. Des pistes permettant des ajustements sont suggérées.

[The introduction of sexuality during gynaecological consultation]. / L'abord de la sexualité en consultation gynécologique.

Many health organisms recommended to gynaecologists to actively address sexuality issues during consultation. However, physicians do not take systematically sexual history from their patients into account. The objective of this paper is to examine, on the basis of current knowledge and, more specifically on a Swiss study, gynaecologists' perceived obstacles and also patients' expectations with regard to sexuality issues. Findings highlighted a lack of training in sexology within medical programs. Moreover, it emphasized important mismatches on perceptions between gynaecologists and patients concerning the gynaecologist's role ; intimacy and even on the way of introducing sexuality topics. Practical perspectives are suggested to allow futur adjustments.

De nombreux organismes de santé recommandent aux gynécologues d'aborder activement la sexualité en consultation. Or, il semble que peu de médecins intègrent systématiquement des questions de sexualité dans leur anamnèse. L'objectif de cet article est d'examiner, sur la base des connaissances actuelles, et plus particulièrement d'une étude menée en Suisse, les obstacles perçus par les gynécologues, ainsi que les attentes des patientes en la matière. Les résultats relèvent non seulement des lacunes dans le cursus universitaire de médecine en matière de sexualité, mais également d'importantes discordances entre gynécologues et patientes concernant le rôle du gynécologue, la perception de l'intime ainsi que sur la manière même d'introduire le sujet. Des pistes permettant des ajustements futurs sont suggérées.

Interprofessional collaboration and diabetes care in Switzerland: A mixed-methods study.

To face the increasing prevalence of diabetes in Switzerland, a cantonal programme has been implemented. One of its goals is to promote collaborative approaches among healthcare professionals (HCPs). The objectives of the current study were to examine HCPs' perceptions about the collaboration they experience in diabetes care and to determine whether perceptions differed among professional groups. A mixed-methods study was conducted. First, a total of 332 HCPs comprising diabetes specialists and non-specialists participated by completing a questionnaire on interprofessional collaboration. Focus groups were then led in order to deepen the understanding and complement the interpretation of quantitative results. Quantitative results showed a perception of a moderate level of collaboration. Mean scores for specialists were systematically worse than those of non-specialists and more prominently in the "level of conflict dimension," which means that specialists generally perceived a lower level of collaboration and a higher level of possible conflict associated with it. Qualitative results highlighted the vagueness in role definition and emphasised a form of reluctance by general physicians to collaborate with specialists, as the physicians felt that they were losing their responsibilities. The findings suggest that it is not the need to collaborate that encourages HCPs involved in collaborative schemes to desire or to know how to successfully initiate, promote, or conduct interprofessional collaboration. This study highlights the important perceptions about collaboration that could be taken into account when planning future collaborative programmes.

Adolescents with a smartphone sleep less than their peers.

Many studies have shown that the use of electronic media is related to sleep disturbance, but few have examined the impact of smartphones. The objective of this study was to assess longitudinally whether acquiring a smartphone had an effect on adolescents' sleeping duration. The study included 591 adolescents observed at baseline (T0, Spring 2012; mean age 14.3 years, 288 females) and 2 years later (T1). They were divided into owners (those owning a smartphone at T0 and T1; N = 383), new owners (those owning a smartphone at T1 but not at T0; N = 153), and non-owners (those not owning a smartphone at any time-point; N = 55). Groups were compared on sleep duration, sleep problems, and sociodemographic variables. Overall, all three groups decreased their sleeping time between T0 and T1. At T0, owners of a smartphone were found to sleep significantly less than non-owners and new-owners, especially on school days, and to report significantly more sleeping problems. At T1, new-owners and owners showed no differences on sleep duration or sleeping problems. CONCLUSION: The results emphasize that owning a smartphone tends to entail sleep disturbance. Therefore, adolescents and parents should be informed about the potential consequences of smartphone use on sleep and health. What is Known: • The use of electronic media plays an important role in the life of adolescents. • Smartphone use is increasing among young people and allows them to be connected almost anytime anywhere. What is New : • Adolescents owning a smartphone sleep less hours on school days than their peers. • Smartphones seem to have an important impact on youths' sleep duration.

Including sustainability issues in nurse education: A comparative study of first year student nurses' attitudes in four European countries.

INTRODUCTION: Education in sustainable development is a goal recognised by a large number of countries and a vital concept in healthcare. It is therefore important that nurse education incorporates elements of sustainable development into nursing education curricula. However, there is limited research on student nurses' attitudes towards sustainability and no comparison of attitudes towards sustainability and its inclusion in the nursing curriculum across Europe. AIM: This project aims to assess student nurses' attitudes towards sustainability, its relevance to nursing and its inclusion in the nursing curricula. 1. To assess base-line attitudes at the start of nursing and midwifery training; 2. To compare sustainability awareness between students participating in training in a number of European universities. DESIGN: A comparative survey design using the Sustainability Attitudes in Nursing Survey (SANS_2) questionnaire. SETTINGS: Nursing classes of Universities and Nursing Schools in four European countries were investigated using a questionnaire consisting of five sustainability-related items. PARTICIPANTS: 916 nursing students (UK: 450, Germany: 196, Spain: 124, Switzerland: 146). DATA ANALYSIS: Standard descriptive and inferential statistical methods were used to establish psychometric quality (Principal Components Analysis, Cronbach's alpha, Pearson correlations) and compare student nurses from the four countries. RESULTS: The reliability of SANS_2 was good (Cronbach's alpha=.82) and the five items loaded on a single factor which explained 58% of variance. ANOVA of the SANS_2 total score showed significant differences between countries with German nursing students showing more sustainability awareness than students from the UK and Spain. CONCLUSIONS: SANS_2 is a reliable instrument to assess nursing students' sustainability awareness; there are significant differences in sustainability awareness of students of different European countries. Limitations of the study include non-random sampling, possible method effects and social desirability effects. RELEVANCE TO CLINICAL PRACTICE: Sustainability will become increasingly important in clinical practice; greater knowledge about the attitudes of nurses towards sustainability can support the development and testing of sustainability-focused teaching and learning materials.

Integrating sexuality into gynaecological consultations: gynaecologists' perspectives.

There are currently few studies exploring doctors' personal perspectives on integrating sexuality into medical consultations. This study focuses on the views of gynaecologists on introducing, or not introducing, sexuality into their work. A total of 30 semi-structured interviews were conducted with gynaecologists in the French-speaking part of Switzerland. The thematic content analysis and computer-assisted lexical analysis (Alceste) on the interview transcripts highlighted four categories: perceptions and description of sexuality, patient's sexological history, training in sexology and perceived difficulties. It is observed that, above all, the 'medical dimension' characterises gynaecologists' perceptions. Of greater interest is our observation of disparities in gynaecologists' discussion of their practice, which is often the product of lay knowledge based on common sense and/or personal experience. Finally, the decision to integrate questions relating to sexuality seems to depend on non-medical factors such as the personal experience, interest or gender of the doctor.