General practitioner attitudes to discussing sexual health issues with older people

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Abstract

How health professionals perceive and manage later life sexual problems remains relatively unexplored and, in particular, little is known about the attitudes of GPs, who represent the first point of contact for most older people in the UK who experience sexual health concerns. This paper draws on qualitative data generated from in-depth interviews with 22 GPs working in demographically diverse primary care practices in Sheffield, UK. Analysis identified that GPs do not address sexual health proactively with older people and that, within primary care, sexual health is equated with younger people and not seen as a ‘legitimate’ topic for discussion with this age group. However, it was apparent that many beliefs held about the sexual attitudes and behaviours of older people were based on stereotyped views of ageing and sexuality, rather than personal experience of individual patients. The discussion considers the implications of these findings for primary care, particularly in relation to education and training.

Section snippets

Background

Sexuality and old age are typically seen as incompatible. Dominant images of sexuality revolve around the youthful, healthy, beautiful body and represent a marked contrast with those associated with old age, invoking as they do physical decline, decrepitude and sickness. As such, later life has tended to be characterised as asexual, both within the popular imagination and in research and policy agendas. However, one of the first qualitative studies to involve older people directly in

Recruitment and characteristics of participants

A qualitative approach was chosen because little is known about GP's perceptions of later life sexual health management and because of the complex attitudinal and experiential data we wished to capture. In-depth, semi-structured interviews were conducted with 22 GPs recruited from socio-economically diverse general practice surgeries in Sheffield in the North of England. Purposive sampling was used to maximise sample diversity, with the aim of recruiting approximately equal numbers of male and

What does ‘sexual health’ mean in primary care?

Initially, participants were asked to define sexual health from their perspective as GPs working within UK primary care practices, to provide a context for the subsequent discussion. The study participants interpreted the term ‘sexual health’ in varying ways. Although approximately one third adopted a strictly medical view of sexual health, the most common definition of the term also incorporated personal relationship issues, with a minority of participants not conceptualising sexual health

Discussion

This paper draws on the accounts of 22 GPs working in diverse practices in Sheffield, UK in order to explore how GPs perceive and manage the sexual health concerns of older people. Our findings support several conclusions. Overall it was evident that, despite recognition at a theoretical level that sexuality may remain important to people into later life, sexual health is not an issue proactively discussed by GPs with older patients. Reasons for this include, firstly that within primary care

Acknowledgements

We would like to thank all GPs who took part in the study for their time. This study was funded by an educational grant from Pfizer Ltd, Walton Oaks, Surrey, UK.

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