Development and evaluation of a prostate sexual rehabilitation clinic: a pilot project

OBJECTIVE: To evaluate a sexual rehabilitation service for men with prostate cancer and to use these results to inform the development of future care. PATIENTS AND METHODS: The study participants included 155 men with prostate cancer referred to a sexual rehabilitation clinic by their urologists or radiation oncologists, of whom the partners of 58 were in attendance. Questionnaires to measure sexual function and positive feelings towards the partner were completed before the clinic visit; and for satisfaction with the clinic service immediately after the appointment; and for sexual function, positive feelings towards the partner, and satisfaction with treatments at 4 months afterward. RESULTS: Ninety patients completed the 4-month evaluation, of whom 35 were couples. Enhancement of erection and understanding sexual changes related to treatment were the two main concerns of patients. Phosphodiesterase-5 inhibitors and intracavernosal injections were the treatments of choice. Compared with partners, patients had significantly greater positive feelings towards their partners at both measurement times and were more satisfied with their prescribed treatment. The total scores on sexual function were significantly higher at 4 months. CONCLUSIONS: These results support the need to include partners as a necessary part of these men's sexual rehabilitation. A structured follow-up is necessary to monitor the success of treatment and to document the quality of erection.     

A multimedia psychosocial support program for couples receiving infertility treatment: a feasibility study

OBJECTIVE: To develop and test the feasibility of a theory-driven, psychosocial support CD-ROM prototype for couples in infertility treatment. DESIGN: Focus group meetings with reproductive health experts, semistructured interviews with infertility patients, and content analysis of an infertility message board to determine content domains of the CD-ROM. Usability and acceptance testing of prototype CD-ROM based on predetermined feasibility criteria. SETTING: Private offices and fertility centers. PATIENT(S): Expert panel of 5 reproductive health specialists; interviews with 62 individuals with infertility (35 women, 27 men); feasibility study with 12 patients and 12 experts in reproductive medicine and infertility support. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Product usability/acceptance test. RESULT(S): Participant feedback and content analysis informed the development of a prototype patient education CD-ROM that uses audio, video, interactive tasks, and personalized feedback. Over 80% of participants successfully completed usability tasks, and over 90% rated prototype satisfaction as "good" to "excellent." Some areas were noted for improvement in navigation and refinement in delivery of instructions. Results strongly indicate an interest in an infertility multimedia support tool. CONCLUSION(S): Multimedia methods may serve as an effective, innovative psychosocial intervention for infertility patients and overcome barriers of limited local access to educational and support services.     

Intermittent human immunodeficiency type 1 virus (HIV-1) shedding in semen and efficiency of sperm processing despite high seminal HIV-1 RNA levels

To study seminal excretion of human immunodeficiency virus type 1 (HIV-1) during 4 years of follow-up in an HIV-1-infected patient, the relationship between high viral excretion and inflammatory status of semen, and the efficiency of sperm processing methods in obtaining spermatozoa with undetectable RNA and proviral DNA levels.Case report.University hospital and research group on human fertility.One HIV-1-infected patient.Paired blood and semen samples were obtained during 4 years of follow-up.CD4 cell count; blood and seminal plasma viral load; and HIV-1 RNA and proviral DNA in different cell fractions obtained during sperm processing, as measured by the density gradient method and the swim-up method; sperm parameters; and polymorphonuclear granulocyte count.Shedding of HIV-1 in semen was intermittent. The highest seminal viral loads were associated with a markedly increased polymorphonuclear granulocyte count, which reflects inflammation of the genital tract. Spermatozoa with undetectable levels of HIV-1 RNA or DNA were obtained regardless of the viral load in semen.In an HIV-1-infected man with intermittent seminal viral excretion, sperm processing was effective in obtaining spermatozoa without detectable HIV-1 genomes.     

Factors Affecting Abortion Decisions among Young Couples in Nepal

PurposeTo explore, using both survey data and case studies, factors that are associated with abortion decisions among young couples in the context of recently legalized abortion in Nepal.MethodsThis article draws primarily on data collected in detailed case histories of 30 participants selected from a sample of the respondents to a survey of 997 married women aged 15 to 24 years and 499 men aged 15 to 27 years collected in 2003. Bivariate analyses of the survey data are presented in summary form to provide some general contextual background, with the key themes that emerged from analysis of the case histories being described.ResultsAlmost half of the young women in the survey reported that they had ever experienced an unintended pregnancy. A considerable proportion of these couples thought about abortion but the majority of them did not take any action. Some of them had attempted abortion but only few had succeeded. Multiple factors, including socio-cultural beliefs, affect the decision-making phase, making the process dynamic and situation-specific. Husbands and health service providers play a major role in the decision-making process.ConclusionsThe study highlights the need to scale up family planning and abortion services to young couples, and emphasizes the importance of involving men and service providers in public education and advocacy campaigns against unsafe abortion. It also points to the need for wider education in the community about family planning and legal abortion services, as well as for the transparent pricing of services and greater efforts to enhance women’s decision-making capacities and control over their reproductive options.     

The heart of the meal: food preferences and habits among rural Australian couples

This article draws upon empirical data from a qualitative study investigating issues around the food choices and preferences of a group of 34 heterosexual cohabiting couples, with and without children living at home, in a rural region of Australia. It explores their everyday food habits and preferences, their notions of a healthy diet and their use of and attitudes towards takeaway food and dining out. The study found that the participants, for the most part, demonstrated a conservatism in their food preferences, lacking the desire for exotica and the gourmand sensibility that characterises members of the metropolitan middle class. The aspects of food they found most pleasurable and valuable were nostalgia, tradition, balance, health, family togetherness and sociality.     

Gender and Contraception: A Proposed Conceptual Model for Research and Practice

Unintended pregnancy and birth, frequently due to contraceptive non-use or misuse, continue to be important public health problems. A large body of literature has examined women's characteristics related to contraceptive use. However, much of what is known about men and contraception has been obtained or extrapolated from interviews with women. In this paper, we first present an overview of unintended pregnancy and the link with contraception. We explore gender considerations in contraceptive decision-making and discuss the literature of men's role in contraceptive attitudes and practices both in the developing countries and in the United States. Because individuals who make contraceptive decisions are actually part of couples, we examine the recent literature on couple communication and the role of partner influence on contraceptive practice. Finally, we propose a conceptual model that can be used for studying gender differences regarding factors that influence contraceptive use. The model is comprised of a variety of factors influencing contraceptive use that include; (1) knowledge of contraceptive methods, use, and effectiveness; (2) structural/access, institutional, and financial factors that may present barriers to contraceptive acquisition and use; and (3) socio-cultural factors. These sociocultural factors include: (a) attitude (beliefs, values, perceived risk of pregnancy, cognitive assessment/acceptability of pregnancy, masculinity ideology, self-esteem, and self-efficacy); (b) the influence of significant others, including partners, peers, and family; and (c) sociodemographic factors including age, ethnicity, marital status, education, and income. This model should be useful in identifying gender differences in knowledge, attitudes, and practices about contraception and pregnancy so that efforts to reduce unintended pregnancy can effectively target both women and men.     

Uncertainty in Illness and Optimism in Couples With Multiple Sclerosis

We examined relationships among uncertainty in illness, optimism, symptom severity, and depression in 18 individuals with Multiple Sclerosis (MS) and their partners. Participants are part of an ongoing study in which they complete assessments every 3 months for approximately 1 year. Preliminary analyses indicate some similarities as well as some differences in responses between individuals with MS and their partners. Specifically, results indicated a very strong positive correlation between patients' and partners' levels of uncertainty regarding the illness. Differences in responding were evident when comparing levels of depression with uncertainty. Levels of depression in patients positively related to levels of uncertainty in their partners. Preliminary results also suggest negative correlations between patients' levels of optimism and levels of uncertainty in both partners. Future analyses will focus on whether these relationships remain constant over time.     

Professional Identity and Coping Behaviors in Dual‐Career couples

Abstract: This qualitative study of 15 dual‐career couples examines the connection between partners’ professional identity and coping behaviors implemented in response to work and family stressors. The analysis provided evidence that dual‐career couples enact professional and family identities that rely on being competent and responsible in both work and family roles. Coping patterns fell into similar patterns across work and family domains, but strategy use was unique by domain and reflective of couples’ belief in the value of interdependent interactions.     

Pain Anxiety and Its Association With Pain Congruence Trajectories During the Cold Pressor Task

Incongruence of pain severity ratings among people experiencing pain and their observers has been linked to psychological distress. Previous studies have measured pain rating congruence through static self-report, involving a single rating of pain; however, this method does not capture changes in ratings over time. The present study examined the extent to which partners were congruent on multiple ratings of a participants' pain severity during the cold pressor task. Furthermore, 2 components of pain anxiety—pain catastrophizing and perceived threat—were examined as predictors of pain congruence. Undergraduate couples in a romantic relationship (N = 127 dyads) participated in this study. Both partners completed measures of pain catastrophizing and perceived threat before randomization to their cold pressor participant or observer roles. Participants and observers rated the participant's pain in writing several times over the course of the task. On average, observers rated participants' pain as less severe than participants' rated their own pain. In addition, congruence between partners increased over time because of observers' ratings becoming more similar to participant's ratings. Finally, pain catastrophizing and perceived threat independently and jointly influenced the degree to which partners similarly rated the participant's pain.