Seksuele disfunctie en relatieproblemen na prostaatkankerbehandeling: De gewenste zorg vanuit het oogpunt van patiënt en partner

Erectile dysfunction (ED) is one of the most common side effects of prostate cancer (PC) treatment and may lead to changes in a relationship. The aim of this study was to identify sexual and/or relational problems and to investigate what kind of supportive care is preferred by patients and their partners. A cross-sectional survey was performed among men diagnosed with PC enrolled in active surveillance or treated with laparoscopic radical prostatectomy, brachytherapy, intensity-modulated radiotherapy or hormonal therapy. If possible, partners were included as well. Out of 250 patients, 80,5% suffered from moderate to severe erectile complaints. Half of them (53,7%) was treated for ED and a great part was partially (30,7%) up to not satisfied (25,7%). Out of 168 partners, 50,6% found it difficult to cope with changes around sexuality. The majority of men (74,7%) preferred a standard consultation with a urologist-sexologist three months after treatment to discuss sexuality

Knowledge and attitude of nursing students regarding older adults' sexuality: A cross-sectional study.

CC-BY     Gepubliceerd in Nurse Education Today, January 2021 https://www.sciencedirect.com/science/article/pii/S0260691720314933 Background: Although older adults are sexual, sexuality is infrequently discussed with them by health care professionals. Nursing students, as future professionals, can make an important contribution by developing competences in discussing intimacy and sexuality with older adults to increase quality of life and to prevent sexual problems. In order to improve these competences, current levels of knowledge and attitude need to be explored. Objectives: To investigate i) knowledge and attitudes of nursing students regarding intimacy and sexuality of older adults, ii) the difference in knowledge and attitudes of nursing students in different years of study and iii) frequency of discussing intimacy and sexuality with older adults. Design: Cross-sectional. Settings: A University of Applied Sciences in the Netherlands. Participants: Nursing students, ≥16 years who were able to read and write in Dutch. Methods: The Ageing Sexual Knowledge and Attitudes Scale was used among nursing students. Furthermore, demographic information and frequencies were collected. Data was analyzed using SPSS. Results: In total, 732 students participated. The mean knowledge-score was 43.9 (SD = 8.9), the mean attitude-score 64.3 (SD = 16.0). Unlike attitude, the level of knowledge differed significantly per year of study: first year students had the lowest and third year students the highest knowledge. Most students stated they ‘never’ (54.1%) or ‘once’ (13.2%) discussed intimacy and sexuality with older adults. Reasons to avoid talking about intimacy and sexuality were feelings of ‘not being the right person’ (17.3%) and ‘incompetence’ (14.0%). Conclusions: Nursing students had moderate knowledge and positive attitudes toward older adults’ intimacy and sexuality. The knowledge-level differed per year of study, the attitude level did not. Only a minority discussed intimacy and sexuality with older adults. Moderate knowledge and positive attitudes do not mean that intimacy and sexuality is discussed. To ensure students feel responsible and competent, interventions should focus on continuous knowledge dissemination, role clarification and role modelling

Patient with two secondary somatic-type malignancies in a late recurrence of a testicular non-seminoma: Illustration of potential and flaw of the cancer stem cell therapy concept

Here, we report the case of a patient with a non-seminoma of the left testicle, with an intestinal-type adenocarcinoma and a low grade leiomyosarcoma in a late recurrence 19 years after initial diagnosis. The history of the patient, alive w

Discussing sexuality with patients with Parkinson's disease: a survey among Dutch neurologists

Sexual functioning is often impaired in patientswith Parkinson’s disease (PD) and may affect quality oflife of patients and their spouse. However, little is knownabout the practice patterns of neurologists with regard todiscussing sexuality in this field. The aim of this cross-sectional study was to evaluate to what extent neurologistsdiscuss sexuality with PD patients. A 22-item questionnairewas sent to 139 neurologists specializing in PD. The surveycontained questions about their attitudes, knowledge, andpractice patterns with respect to sexual dysfunction (SD) inpatients with PD. The response rate of the survey was66.9%. Most participants (56.8%) stated that they addresssexuality in less than half of their PD patients. High age ofpatients (42.0%), insufficient consultation time (37.5%),and a lack of patients’ initiative to raise the topic them-selves (36.4%) were frequently reported barriers towardsdiscussing sexuality. The majority of participants consid-ered that discussing sexuality is a responsibility that laywith neurologists (85.2%), nurses (73.9%), and patients(72.7%). One quarter of the neurologists reported to haveinsufficient or no knowledge on SD. The majority of par-ticipants regarded screening for SD important or slightlyimportant (85.2%). A large proportion of Dutch neurolo-gists specializing in PD do not routinely discuss sexualitywith their PD patients. Sexual healthcare in PD patientsmay benefit from time-efficient tools and agreements onwho is responsible for discussing SD. Furthermore, rec-ommendations in PD guidelines on screening and manag-ing SD should be adapted to fit everyday practicehttps://creativecommons.org/licenses/by/4.0/ CC BY 4.0https://creativecommons.org/licenses/by/4.0

What is the role of nephrologists and nurses of the dialysis department in providing fertility care to CKD patients?: A questionnaire study among care providers.mong Dutch neurologists

Purpose This study evaluated current fertility care for CKD patients by assessing the perspectives of nephrolo- gists and nurses in the dialysis department. Methods Two different surveys were distributed for this cross-sectional study among Dutch nephrologists (N=312) and dialysis nurses (N=1211).   Results Response rates were 50.9% (nephrologists) and 45.4% (nurses). Guidelines on fertility care were present in the departments of 9.0% of the nephrologists and 15.6% of the nurses. 61.7% of the nephrologists and 23.6% of the nurses informed ≥50% of their patients on potential changes in fertility due to a decline in renal function. Fertility subjects discussed by nephrologists included “wish to have children” (91.2%), “risk of pregnancy for patients’ health” (85.8%), and “inheritance of the disease” (81.4%). Barriers withholding nurses from discussing FD were based on “the age of the patient” (62.6%), “insufficient training” (55.2%), and “language and ethnicity” (51.6%). 29.2% of the nurses felt competent in discussing fertility, 8.3% had sufficient knowledge about fertility, and 75.7% needed to expand their knowledge. More knowledge and competence were associated with providing fertility health care (p< 0.01).   Conclusions In most nephrology departments, the guide- lines to appoint which care provider should provide fertil- ity care to CKD patients are absent. Fertility counseling is routinely provided by most nephrologists, nurses often skip this part of care mainly due to insufficiencies in self- imposed competence and knowledge and barriers based on cultural diversity. The outcomes identified a need for fer- tility guidelines in the nephrology department and training and education for nurses on providing fertility care.   CC BY 4.0 https://creativecommons.org/licenses/by/4.0

Unravelling current sexual care in chronic kidney disease: perspective of social workers

Background: Fifty to eighty percent of patients suffering from chronic kidney disease (CKD) experience a form of sexual dysfunction (SD), even after renal transplantation. Despite this, inquiring about SD is often not included in the daily practice of renal care providers. Objectives: This paper explores the perspectives of renal social workers regarding sexual care for patients and evaluates their practice,attitude towards responsibility and knowledge of SD. Design: A cross-sectional study was conducted using a 41-item online survey. Participants: Seventy-nine members of the Dutch Federation of Social Workers Nephrology. Results: It was revealed that 60% of respondents discussed SD with a fifth of their patients. Frequency of discussion was associated with experience (p¼0.049), knowledge (p¼0.001), supplementary education (p¼0.006), and the availability of protocols on sexual care (p¼0.007).Main barriers towards discussing SD consisted of ‘culture and religion’ (51.9%), ‘language and ethnicity’ (49.4%), and ‘presence of a third person’ (45.6%). Sufficient knowledge of SD was present in 28% of respondents. The responsibility for discussion was 96% nephrologists and 81% social workers. Conclusion: This study provides evidence that a part of Dutch nephrology social workers do not provide sexual care regularly, due to insufficient experience and sexual knowledge, absence of privacy and protocols and barriers based on cultural diversity. According to the respondents the responsibility for this aspect of care should be multidisciplinary. Recommendations include a need for further education on the topic, private opportunities to discuss SD and multidisciplinary guidelines on sexual car

Suitable sexual health care according to men with prostate cancer and their partners

Purpose:To determine which health care provider and what timing is considered most suitable to discuss sexual and relationalchanges after prostate cancer treatment according to the point of view of men and their partners. Methods A cross-sectional survey was conducted among men diagnosed with prostate cancer or treated after active surveillance, who received laparoscopic radical prostatectomy, brachytherapy, intensity-modulated radiotherapy, and/or hormonal therapy. If applicable, partners were included as well. Results In this survey, 253 men and 174 partners participated. Mean age of participating men was 69.3 years (SD 6.9, range 45–89). The majority (77.8%) was married and average length of relationship was 40.3 years (SD 14.1, range 2–64). Out of 250 men, 80.5% suffered from moderate to severe erectile dysfunction. Half of them(50.2%, n = 101) was treated for erectile dysfunction and great part was partially (30.7%, n = 31) up to not satisfied (25.7%, n = 26). Half of the partners (50.6%, n = 81) found it difficult to cope with sexual changes. A standard consultation with a urologist-sexologist to discuss altered sexuality is considered preferable by 74.7% (n = 183). Three months after treatment was the most suitable timing according to 47.6% (n = 49). Conclusions During follow-up consultations, little attention is paid to the impact of treatment-induced sexual dysfunction on the relationship of men with prostate cancer and their partners. A standard consultation with a urologistsexologist 3 months after treatment to discuss sexual and relational issues is considered as most preferable

Mysterious Habitats

Peter Argondizza performs Mysterious Habitats from his album "...from the hook to the hill" Composition by Dusan Bogdanovi