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Table 4 Categories of responses to the question: 'How do you think sexual problems should ideally be managed within primary care for patients with coronary heart disease?'

From: General practitioner views about discussing sexual issues with patients with coronary heart disease: a national survey in Ireland

Category

Illustrative quotation

More training/education needed for GPs

'The GP is the ideal first port of call for such issues, but we do need help in learning how to raise and deal with such issues'. GP030

GPs need to raise the issue during consultations

'We should bring it [sex] up....bringing it up may not reveal any problems at the time, but gives patients an opportunity to come back to it at a later date'. GP035

GPs need to provide the time and opportunity during consultations for patients to raise sexual issues

'Frequently in primary care when the subject is approached there can be a negative response from the patient - as if their privacy has been encroached upon - on occasions, a patient would leave the practice due to this incursion. Thus, if I seek an answer I will try to get the patient to initiate the discussion by discussing bodily function and effects of physical and emotional disturbance'. GP076

Guidelines/protocols need to be developed to guide GP behaviour

'A protocol for management ought to be developed for use by GPs'. GP052. 'If we are to raise the issue then some evidence-based guidelines would be helpful to guide management'. GP064

Hospital cardiac rehabilitation should play central role

'[Sexual issues] should be addressed specifically as part of hospital cardiac rehabilitation program at presentation'. GP131

Needs to be more awareness among GPs

'Erectile dysfunction is currently being highlighted - we must continue to raise awareness'. GP131

Resources should be developed, e.g. leaflets/DVDs to give to patients during consultations

'There should be patient information leaflets to give patients with coronary heart disease that discuss the sexual problems they may encounter. This would open up the issue for discussion'. GP225

Need other staff/services for referral

'If such issues are raised though we need to have some confidence in the availability of backup should we get out of our depth. Lack of such backup is also a very big issue.' GP030

  1. Note: Seventy percent (n = 43) of GPs provided a response to the question.