Sexual medicine education in Finland – Opinions of general practitioners, medical students, and midwifery students on their sexual medicine competence and education

Sexual problems are common, and the likelihood of experiencing them increases with age and various chronic diseases. Therefore, healthcare professionals should be able to bring up sexual issues with their patients. The present thesis aimed to evaluate the barriers experienced by Finnish general practitioners (GPs) and final-year medical students and midwifery students to bringing up sexual issues with their patients. Further, it set out to determine GPs’ self-reported inquiries about sexual problems when dealing with patients with chronic diseases as well as GPs’ awareness of medications inducing sexual problems. Additionally, it assesses the knowledge of and educational interest in sexual medicine of medical and midwifery students. The study of GPs collected data from a random sample of 1,000 Finnish GPs. For the study of students, all final-year medical and midwifery students graduating between December 2018 and May 2019 in Finland were enrolled. Web-based questionnaires were utilized. Although the GPs and both the medical and midwifery students reported a good competence in discussing sexual issues with patients, several barriers emerged that hindered them from bringing up such issues in patient encounters. In addition, the majority of the GPs considered that sexual problems are often side effects of medications prescribed for other pathologies. Nevertheless, the GPs self-reported that they seldom followed up on whether the medications, once prescribed, caused side effects in sexual functions. The majority of the GPs reported that the sexual medicine education they had received in medical school was insufficient. The midwifery and, in particular, the medical students reported a lack of knowledge in several fields of sexual medicine. Additionally, the majority of medical students and approximately half the midwifery students reported receiving too little sexual medicine education during their studies. The results of the present thesis highlight the importance of increasing sexual medicine education in both medical and midwifery education.Seksuaalilääketieteen opetus Suomessa - Terveyskeskuslääkärien, lääketieteen opiskelijoiden ja kätilöopiskelijoiden mielipiteitä seksuaalilääketieteellisestä osaamisestaan ja opetuksesta Seksuaaliongelmat ovat yleisiä ja niiden esiintyvyys kasvaa ikääntyessä sekä erilaisten kroonisten sairauksien myötä. Sen vuoksi on tärkeää, että terveydenhuollon ammattilaiset osaavat ottaa seksuaaliasiat puheeksi potilastilanteissa. Tässä väitöskirjatutkimuksessa selvitettiin, mitkä tekijät estävät suomalaisia terveyskeskuslääkäreitä sekä viimeisen vuoden lääketieteen opiskelijoita ja kätilöopiskelijoita ottamasta seksuaaliasioita puheeksi potilaidensa kanssa. Lisäksi selvitettiin terveyskeskuslääkärien tietoisuutta kroonisten sairauksien ja niiden lääkitysten aiheuttamista seksuaaliongelmista ja sitä, kartoittavatko he mahdollisia seksuaaliongelmia potilailta, joilla on jokin krooninen sairaus. Edelleen selvitettiin lääketieteen opiskelijoiden ja kätilöopiskelijoiden tietämystä ja kiinnostusta seksuaalilääketiedettä kohtaan. Aineisto kerättiin satunnaisotannalla valitulta tuhannelta suomalaiselta terveyskeskuslääkäriltä sekä kaikilta joulukuun 2018 ja toukokuun 2019 välisenä aikana Suomessa valmistuneilta lääketieteen opiskelijoilta ja kätilöopiskelijoilta. Käytössä oli sähköinen kyselylomake. Sekä terveyskeskuslääkärit että lääketieteen opiskelijat ja kätilöopiskelijat raportoivat, että heillä on hyvä osaaminen koskien seksuaaliasioista keskustelemista. Esiin nousi kuitenkin useita seksuaaliasioiden puheeksi ottamisen esteitä. Kroonisten sairauksien ja seksuaaliongelmien yhteyksien tutkimuksessa, suurin osa terveyskeskuslääkäreistä piti seksuaaliongelmia usein muihin sairauksiin määrättyjen lääkkeiden sivuvaikutuksina. Siitä huolimatta vain harvat raportoivat kysyvänsä mahdollisia lääkitysten sivuvaikutuksina ilmenneitä seksuaaliongelmia. Suurin osa terveyskeskuslääkäreistä koki opintojensa aikana saamansa seksuaalilääketieteen opetuksen riittämättömäksi. Sekä lääketieteen opiskelijat että kätilöopiskelijat raportoivat tiedon puutetta useilla seksuaalilääketieteen osa-alueilla. Lisäksi suurin osa lääketieteen opiskelijoista ja noin puolet kätilöopiskelijoista koki saaneensa liian vähän seksuaalilääketieteen opetusta. Tämän väitöskirjatutkimuksen tulokset korostavat seksuaalilääketieteen opetuksen lisäämisen tärkeyttä niin lääketieteen kuin kätilöopinnoissakin

Lääketieteen opiskelijat tarvitsevat seksuaalilääketieteen opetusta

Lähtökohdat Seksuaaliongelmista kärsiviä potilaita tavataan useilla eri lääketieteen erikoisaloilla. Tutkimuksemme tarkoituksena oli selvittää Suomen lääketieteellisissä tiedekunnissa annettavaa seksuaalilääketieteen opetusta.Menetelmät Viimeisen vuoden opiskelijoille (n = 562, syksy 2018 – kevät 2019) lähetettiin kysely, johon 233 vastasi (41,5 %).Tulokset Yli puolet opiskelijoista oli kiinnostuneita seksuaalilääketieteen opetuksesta, mutta 71 % piti tiedekunnassaan annettua opetusta liian vähäisenä. Seksuaalilääketieteen opetusta annettiin eniten synnytys- ja naistentautiopin kurssilla, mutta jossain määrin myös psykiatrian, yleislääketieteen, iho- ja sukupuolitautien sekä kirurgian kursseilla. Sekä erillistä seksuaalilääketieteen kurssia että integroitua opetusta pidettiin hyvinä opetusmetodeina, paitsi Tampereen yliopistossa, jossa lähes kaikki vastaajat pitivät integroitua opetusta parempana.Päätelmät Seksuaalilääketieteen opetusta tulisi lisätä ja kehittää lääketieteen perusopetuksessa. Opetus voitaisiin toteuttaa joko integroituna muuhun opetukseen tai omana kurssinaan. Lisäksi eri lääketieteellisissä tiedekunnissa annettua seksuaalilääketieteen opetusta tulisi yhtenäistää</p

Patients with chronic diseases: Is sexual health brought up by general practitioners during appointments? A web-based study

ObjectivesMany chronic diseases and their medications may induce sexual problems. This study aimed to evaluate whether general practitioners (GPs) raise sexual health issues during appointments with patients who have chronic diseases.Study designA web-based questionnaire was distributed to a random sample of 1,000 GPs in Finland.Main outcome measuresThe study aim was to determine GPs’ self-reported inquiry into sexual problems with patients who have chronic diseases and GPs’ awareness of medications inducing sexual problems.ResultsOnly 16.2% of the GPs inquired about sexual health issues, typically during appointments dealing with reproductive organs. A majority (66.9%) considered sexual problems to be side-effects of medications, but only 17.9% followed up about them. Compared to male GPs, female GPs were more likely to inquire about gynecologic patients’ sexual issues (OR 1.77, 95% CI 1.05–2.99), but less likely to ask about them with urologic (OR 0.56, 95% CI 0.35–0.91) and neurologic patients (OR 0.35, 95% CI 0.17–0.72). The GPs aged 40–49 and 50–65 were more likely than those aged 27–39 to inquire about sexual health issues among patients with cardiovascular (OR 2.87, 95% CI 1.11–7.44, OR 2.89, 95% CI 1.16–7.19) and neurologic (OR 4.63, 95% CI 1.45–14.82, OR 5.68, 95% CI 1.87–17.23) diseases.ConclusionsGPs seldom inquire about sexual problems with patients who have chronic diseases or after prescribing medications for these conditions, which may lead to underdiagnosis and undertreatment of sexual problems.</p

General practitioners' self-reported competence in the management of sexual health issues - a web-based questionnaire study from Finland

Objective Although sexual problems are common, they are rarely brought up in appointments with general practitioners (GPs). We aimed to assess the barriers that hinder GPs from bringing up sexual health issues and to evaluate the need for education on sexual medicine. Design A web-based questionnaire was used. Setting Four fields were included: A) the self-reported competence in discussing sexual health and treating patients with these issues, B) the barriers to bringing up patients' sexual health problems, C) the source of education on sexual medicine and D) the need for education on sexual medicine. Subjects A random sample of 1000 GPs in Finland (a response rate of 43.5%, n = 402). Main outcome measures GPs' self-assessed competence in discussing and treating sexual health issues, related barriers to bringing up the topic and the reported need for education. Results The main reasons reported for not bringing up sexual health issues were shortness of the appointment time (85.6%), a lack of knowledge (83.6%) and a lack of experience with sexual medicine (81.8%). The male GPs reported better competence in discussing the issues and treating male patients, whereas the female GPs reported better competence in discussing the issues with female patients. No differences emerged between genders regarding treating female patients. Nearly 90% of the GPs expressed needing more education about sexual medicine. Conclusions Although the GPs reported good competence in discussing sexual health issues with their patients, several barriers to bringing up sexual health issues emerged. Continuing education was desired and could lessen these barriers.</p

Medical and midwifery students need increased sexual medicine education to overcome barriers hindering bringing up sexual health issues - A national study of final-year medical and midwifery students in Finland

Objectives: Physicians and midwives meet patients with sexual health issues regularly; however, they may have limited sexual medicine education. The study's aim was to evaluate the self-reported competence of medical and midwifery students to bring up sexual health issues with their patients and to assess the barriers that hinder these discussions. The need for additional education was also evaluated.Study design: A web-based questionnaire was sent to the last-year medical and midwifery students graduating between December 2018 and May 2019 in Finland. In total, 233 medical students and 131 midwifery students participated in the study. Three fields were evaluated: the self-reported competence in discussing sexual health issues and treating patients with these issues, the barriers to bringing up sexual problems, and the need for education in sexual medicine.Results: The students self-reported better competence in discussing sexual health issues than in treating patients' sexual problems. For the medical students, the most important barriers hindering bringing up sexual health issues were lack of i) time (89.2 %), ii) experience with sexual medicine (88.1 %), and iii) knowledge (82.1 %). For the midwifery students, the most important barriers were i) lack of experience with sexual medicine (73.3 %), ii) fear of failing to respond to patients' sexual health issues (64.9 %), and iii) lack of knowledge (62.5 %). A higher percentage of the midwifery students (96.2 %) reported an interest in sexual medicine education compared to the medical students (55.4 %) (OR 13.89, 95 % CI 5.32-35.71, P Conclusions: Both student groups reported several barriers hindering bringing up sexual health issues with their patients and expressed a need for more education, particularly the medical students.</p

Let's talk about sexuality - A web-based survey of self-reported competence in sexual problems among obstetrician-gynecologists in Finland

Introduction: Sexual health is an important aspect of quality of life, yet both healthcare professionals and patients might hesitate to bring up the topic during appointments. Our study investigated obstetrician-gynecologists' (OB/GYNs') self-reported competences in discussing and treating sexual problems, as well as the barriers to bringing up the subject. An additional aim was to evaluate the need for continuing education in sexual medicine.Material and methods: A web-based questionnaire was sent to the members of The Finnish Society of Obstetrics and Gynecology (n = 1212). The survey was completed by 328 respondents (275 specialists and 53 OB/GYN residents). Their background information (gender, age, education, occupational status, daily number of patients, and daily number of patients with sexual health issues) was assessed. The questionnaire included four fields: (A) self-reported competence in discussing and treating patients with sexual problems (three questions), (B) the barriers to bringing up sexual problems with patients (nine questions), (C) the source of education in sexual medicine (two questions), and (D) the need for education in sexual medicine (two questions).Results: Most of the OB/GYNs self-reported their competence to be good in discussing sexual problems, but poor in treating patients' sexual problems. The male OB/GYNs reported better competence than did the females. Several barriers were identified-most frequently, "shortness of the appointment time" (76%), "lack of knowledge about sexual medicine" (75%), and "lack of experience with sexual medicine" (74%). Older OB/GYNs and male OB/GYNs reported fewer barriers. The majority of the respondents considered their previous education in sexual medicine to be insufficient, especially in medical school (95%), but also in residency (83%), and they reported a need for additional education.Conclusions: Our study indicated several barriers that hindered OB/GYNs from assessing sexual problems during appointments. Although OB/GYNs reported a good competence in discussing sexual problems, they reported a poor competence in treating them. Their previous education in sexual medicine was rated as insufficient, and continuing education was desired. The information provided by our study can be used for improving and organizing education in sexual medicine, which is crucial for diminishing the barriers to discussing and treating sexual problems.</p

Patterns in airborne pollen and other primary biological aerosol particles (PBAP), and their contribution to aerosol mass and number in a boreal forest

We studied variation in concentrations of airborne pollen and other particles of biological origin in a boreal forest in Finland during 2003–2004. The highest concentrations of pollen were observed in late spring and early summer, whereas the peak concentrations of other particles of biological origin (including e.g. fungal spores) occurred in August–September. Although the patterns in concentrations in 2003 and 2004 were similar, the concentration levels were significantly different between the years. The contribution of pollen and other particles of biological origin led to an increase in the measured particulate matter (PM) mass during the pollen season (mass of pollen and other particles of biological origin 5.9 and 0.4 μg m–3, respectively, in respect to PMtotal mass of 9.9 μg m–3) but the effect on total particle number was negligible. The other particles of biological origin constituted the largest fraction of measured primary biological aerosol particle (PBAP) numbers (~99%), whereas pollen showed a higher relative mass fraction (~97%) of PBAP. These results underline the important contribution of PBAP to coarse atmospheric particle mass providing up to 65% of the total mass during the peak pollen season

Finnish Centre of Excellence in Physics, Chemistry, Biology and Meteorology of Atmospheric Composition and Climate Change : summary and outlook

Peer reviewe

Hoitohenkilöstön täydennyskoulutuksen kehittäminen

Tämän kehittämishankkeen perimmäisenä tarkoituksena on, että Turun yliopistollisen keskussairaalan naistenklinikan hoitohenkilökunta on osaavaa ja saa riittävästi tarvitsemaansa täydennyskoulutusta ylläpitääkseen ammattitaitonsa sekä pystyäkseen kehittämään elinikäistä oppimistaan. Osaamiskartoituksen avulla selvitettiin naistenklinikan hoitohenkilökunnan ammatillista osaamista heiltä itseltään saatavan tiedon avulla. Lisäksi selvitettiin heidän täydennyskoulutustarvetta. Kohderyhmän muodostivat Turun yliopistollisen keskussairaalan naistenklinikan hoitohenkilökunta (n=124). Kyselyn vastausprosentti oli 69%. Tutkimusaineisto kerättiin tätä kehittämishanketta varten kehitetyllä kyselylomakkeella. Mittari sisälsi 47 muuttujaa, joista muodostettiin kahdeksan summamuuttujaa. Kyselylomakkeessa oli lisäksi avoimia kysymyksiä, joilla selvitettiin vastaajien täydennyskoulutustarvetta. Tutkimusaineisto analysoitiin tilastollisesti lukuun ottamatta avoimia kysymyksiä. Aineistoa kuvailtiin tarkastelemalla frekvenssejä, keskiarvoja ja hajontoja. Tilastollisena testinä käytettiin parametritonta Kruskall-Wallis –testiä. Avoimet kysymykset analysoitiin käyttämällä sisällön analyysimenetelmää. Osaamiskartoituksen tulokset osoittivat, että naistenklinikan hoitohenkilöstön itsearvioima ammatillinen osaaminen oli hyvä. Hoitohenkilöstö arvioi ammatillisen osaamisensa parhaimmaksi yhteistyöosaamisen osa-alueella. Hoitohenkilöstön ammatillinen osaaminen oli heikointa monikulttuurisen hoitotyön osaamisen osa-alueella. Tilastollisesti merkitsevä yhteys hoitohenkilöstön ammatilliseen osaamiseen oli ammattinimikkeellä, työkokemuksen määrällä ja täydennyskoulutuspäivien lukumäärällä. Hoitohenkilöstön täydennyskoulutustarpeista täydennyskoulutuksen sisällölliset toiveet liittyivät eniten kliinisen osaamisen sekä monikulttuurisen hoitotyön osaamisen osa-alueille. Täydennyskoulutuksen toteuttamismuotona toivottiin eniten luentoja ja käytännön harjoituksia. Osaamiskartoituksen tulosten pohjalta laadittiin täydennyskoulutussuunnitelma naistenklinikan hoitohenkilökunnalle.The main purpose of this development project was that there is competent nursing staff working at Turku University hospital´s women´s clinic and that they receive the kind of continuing professional education they need to be able to keep up with their professional competence and develop their lifelong learning. The professional competence of the nursing staff working at women´s clinic was determined in this study. Also the nursing staff´s need for continuing education was determined. The target group was the nursing staff on women´s clinic (n=124). The response rate was 69%. The data were collected by structured questionnaire which was developed for this development project. The questionnaire had also open-ended questions which were used to determine the need for continuing professional education of the target group. The research data excluding open-ended questions were analyzed by using statistical methods. Statistical methods used to describe the data were frequencies, percentages and deviations. Nonparametric Kruskall-Wallis –test was used as statistical test. The open-ended questions were analyzed by using content analysis. The results of the study showed that the nursing staff of women´s clinic evaluated their level of professional competence as good. The nursing staff evaluated their competence being best in co-operation skills area. Their competence was weakest in area of multicultural nursing skills. Their occupation, the amount of working experi-ence and the number of continuing education days had correlation with their compe-tence. The biggest need for continuing education as the target group self estimated was in the area of clinical skills and multicultural nursing skills. The ways of organ-izing continuing professional education as the target group hoped for were lectures and exercises. A continuing professional education plan was made for the nursing staff of women´s clinic based on the findings of this study. The results of this devel-opment project can be utilized when planning continuing professional education for nursing staff and to support their professional competence