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Abstract
Objectives: Despite improvements in many domains of functioning, sexual quality of life often remains impaired following coronary artery bypass graft (CABG) surgery. This study examined associations among sexual quality of life, fear of sexual activity and receiving information from providers about sexual activity in CABG patients.
Methods: Participants completed a survey assessing sexual activity, mental health and physical health at baseline (3–5-day post-surgery; n = 60) and 2-month post-surgery (n = 42).
Results: Sexual quality of life showed moderate difficulties at baseline and did not improve by follow-up (p values ≥0.09). At follow-up, greater patient fear was associated with lower sexual quality of life in some domains; receiving information was related to lower fear (p values ≤0.03) and greater sexual satisfaction and interest (p values ≤0.04). Suggestive of mediation, there was a significant indirect effect of information on patient fear and of patient fear on sexual interest (p = 0.05).
Conclusions: Though data were cross-sectional, findings suggest that fears of sexual activity may play a role in lowering CABG patients’ motivation for sexual activity and that receiving information from a medical provider may assist in hastening sexual rehabilitation. Prospective and intervention studies are needed to support findings.
Acknowledgements
No financial relationships exist between the authors and the organisations sponsoring this research and the authors have no conflicts of interest to report. Original funding was from National Institute of Mental Health B/START Program, #1R03MH53848-01, awarded to Kathryn L. Taylor, PhD. The writing of this manuscript was partially supported by Grant PF-09-154-01-CPPB from the American Cancer Society awarded to Jennifer Barsky Reese, PhD.
Notes
Notes
1. Because more than one-third of the sample reported no sexual activity at baseline, we recoded sexual activity as ‘no sexual activity’ versus ‘any sexual activity’ and conducted a McNemar test comparing scores at baseline and 2-month follow-up. Results were not significant (p = 0.73). Difficulty becoming aroused was also skewed at baseline, with 58.2% of patients reporting that difficulty becoming aroused did not limit their sexual activity. We conducted a McNemar test comparing scores from baseline to 2-month follow-up on this measure which was also non-significant (p = 0.39). Lack of change does not seem to be a result of the skewed distribution of these variables. We also conducted logistic regressions using the dichotomous versions of the sexual activity and difficulty becoming aroused variables and found the same results. Patient fear of sexual activity still significantly predicted frequency of sexual activity (p = 0.05, OR = 0.24) while it did not predict difficulty becoming aroused. Neither partner fear nor information from providers significantly predicted the dichotomous variables of frequency of sexual activity and difficulty becoming aroused.
2. In order to assess whether the loss of significance in these associations was due to missing data for some participants at follow-up, we ran the correlations at follow-up using only data from participants who had both baseline and follow-up data and obtained similar results.
3. We conducted separate analyses comparing male and female participants on all sexual quality of life variables at baseline and 2-month follow-up and found no significant differences across genders. Because of this, and the small sample size leading to a limited number of possible control variables, we conducted the regression analyses using the full sample including both genders and did not control for gender in regression analyses. In addition, considering the small number of women in the sample, we conducted all analyses in men only to determine if including the women changed the results and the results remained the same. Thus, we chose to keep women in the final sample.
4. In order to assess whether findings would differ if the sexual satisfaction items were entered separately rather than as a combined scale, we conducted analyses and found largely similar results. Patient fear was not associated with satisfaction with sex life, while there was a trend for the association between patient fear and satisfaction with frequency of sex (β = −0.31, p = 0.07). While partner fear was not significantly associated with satisfaction with frequency of sex, there was a trend for the association between partner fear and satisfaction with sex life (β = −0.31, p = 0.06).
5. In the regression analyses with the two sexual satisfaction items entered separately, receiving information was significantly associated with satisfaction with sex life (β = 0.44, p = 0.01), while there was a trend towards an association between receiving information and satisfaction with frequency of sexual activity (β = 0.34, p = 0.07).