Exploring the provision of sexual health education for adults with acute coronary syndrome in cardiac rehabilitation programs
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Abstract
Annually, acute coronary syndrome (ACS) is diagnosed in 63,000 Canadians, and 73% survive. Although practice guidelines and scientific statements clearly identify the importance of providing sexual health education to ACS survivors, it is not routinely provided. By not including sexual health education to ACS survivors, this patient population may experience higher rates of fear, depression, and anxiety. There is a paucity of research literature about the successful provision of sexual health education post-ACS. The purpose of this thesis was to provide an overview of the current state of the literature related to sexual health education to inform health care providers about factors shaping sexual health education for ACS survivors and explore healthcare providers’ experiences providing sexual health education to ACS survivors. A scoping review was completed, which identified the limited provision of sexual health education along with macro, meso, and micro-level factors influencing the provision of sexual health education. A gap in the literature was noted related to the lack of use of a sex positive lens when investigating the provision of sexual health education to ACS survivors. An interpretive descriptive study was then completed using a strengths-based approach and guided by sex positivity. Semi-structured, digitally recorded interviews were conducted with eight healthcare providers, half of whom were nurses. Additional data sources were a sociodemographic form and a reflective journal. Data were analysed using open, axial, then selective coding and constant comparative analysis. Key barriers and facilitators were identified and categorized according to sex and sexuality, the individual, and the institution. The findings may offer effective strategies to healthcare providers for use in their practice and provide a foundation to revisit and revise policy and programs in cardiac rehabilitation. Successfully providing sexual health education may reduce fear, depression, and anxiety as well as increase the return to sexual activity among ACS survivors. Ultimately, consciously providing sexual health education to ACS survivors may improve their quality of life.