Sexual function

性功能
  • 文章类型: Systematic Review
    背景:子宫内膜异位症患者的性功能应通过患者报告的结果指标(PROMs)进行评估,该指标具有较高的信度和效度。目的是研究用于评估子宫内膜异位症患者性功能的PROM,以改善他们对研究和临床实践的选择。
    方法:我们从2000年1月至2023年9月进行了系统的文献综述。检索所有研究,包括确诊子宫内膜异位症的女性,并评估性生活质量或性功能或性困扰。根据基于Consensus的健康测量仪器选择标准(COSMIN)建议,评估了用于性功能障碍的PROM的不同特性。评估的特性是:结构有效性,内部一致性,跨文化有效性,可靠性,测量误差,标准有效性,构造效度,和响应性。该文献综述在Prospero上注册为2018CRD42018102278。
    结果:纳入74篇评估性功能的文章。在25个评估性功能的PROM中,女性性功能指数(FSFI)是最常用的(34/74[45.9%]项),其次是女性性困扰量表(9/74[12.2%]项)和性活动问卷(SAQ)(8/74[10.8%]项)。最常用的测量属性是“假设检验”和“响应性”。具有这两种测量特性的高水平证据的PROM是FSFI,SAQ,短性功能量表,女性性满意度量表,性生活质量-女性,女性性功能简介,和女性问卷中的性健康结果。FSFI问卷似乎更适合评估药物治疗,和用于评估手术治疗的SAQ。只有一种仪器是子宫内膜异位症特有的(视力障碍量表[SIDI]的主观影响)。
    结论:在这篇关于子宫内膜异位症性功能评估问卷的系统文献综述中,根据COSMIN标准,FSFI和SAQ问卷具有最佳的测量特性。FSFI问卷似乎适合评估医疗,和SAQ进行手术治疗。SIDI是唯一的具体问卷,但其响应性仍有待定义。
    BACKGROUND: Sexual function of patients with endometriosis should be assessed by patient-reported outcome measures (PROMs) that present high reliability and validity. The objective was to study the PROMs used to assess sexual function for patients with endometriosis to improve their selection for research and clinical practice.
    METHODS: We performed a systematic literature review from January 2000 to September 2023. All studies including women with confirmed endometriosis and assessing sexual quality of life or sexual function or sexual distress were retrieved. Different properties of PROMs used for sexual dysfunction were assessed according to the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) recommendations. Properties evaluated were: structural validity, internal consistency, cross-cultural validity, reliability, measurement error, criterion validity, construct validity, and responsiveness. This literature review was registered on Prospero as 2018 CRD42018102278.
    RESULTS: Seventy-four articles with evaluation of sexual function were included. Of the 25 PROMs assessing sexual function, the Female Sexual Function Index (FSFI) was the most frequently used (34/74 [45.9%] items), followed by the Female Sexual Distress Scale (9/74 [12.2%] items) and the Sexual Activity Questionnaire (SAQ) (8/74 [10.8%] items). The most commonly used measurement properties were \"hypothesis testing\" and \"responsiveness\". The PROMs with a high level of evidence for these two measurement properties were the FSFI, the SAQ, the Short Sexual Functioning Scale, the Sexual Satisfaction Scale for Women, Sexual Quality of Life-Female, the Brief Profile of Female Sexual Function, and the Sexual Health Outcomes in Women Questionnaire. The FSFI questionnaire appeared to be more relevant for evaluating medical treatment, and the SAQ for evaluating surgical treatment. Only one instrument was specific to endometriosis (the Subjective Impact of Dyspareunia Inventory [SIDI]).
    CONCLUSIONS: In this systematic literature review of sexual function assessment questionnaires in endometriosis, the FSFI and the SAQ questionnaires emerged as having the best measurement properties according to the COSMIN criteria. The FSFI questionnaire appears to be suited for evaluating medical treatment, and the SAQ for surgical treatment. The SIDI is the only specific questionnaire, but its responsiveness remains to be defined.
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  • 文章类型: Journal Article
    在35至45岁之间,对患有卵巢癌的高遗传风险妇女进行降低风险的输卵管卵巢切除术(RRSO)。虽然有可能挽救生命,RRSO可能会引起对生活质量产生负面影响并损害长期健康的症状。RRSO后的临床护理通常是次优的。本范围审查描述了RRSO如何影响短期和长期健康,并为从术前咨询到长期疾病预防的护理提供了基于证据的国际共识建议。这包括激素和非激素治疗血管舒缩症状的疗效和安全性,睡眠障碍和性功能障碍以及预防骨骼和心血管疾病的有效方法。
    Women at high inherited risk of ovarian cancer are offered risk-reducing salpingo-oophorectomy (RRSO) from age 35 to 45 years. Although potentially life-saving, RRSO may induce symptoms that negatively affect quality of life and impair long-term health. Clinical care following RRSO is often suboptimal. This scoping review describes how RRSO affects short- and long-term health and provides evidence-based international consensus recommendations for care from preoperative counselling to long-term disease prevention. This includes the efficacy and safety of hormonal and non-hormonal treatments for vasomotor symptoms, sleep disturbance and sexual dysfunction and effective approaches to prevent bone and cardiovascular disease.
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  • 文章类型: Journal Article
    目标:在穿透之前或之后不久射精的男性,没有控制感,经历与这种情况有关的痛苦的人可能会被诊断为早泄(PE),而难以达到性高潮的男性可能会被诊断为射精延迟(DE)。许多临床医生的经验表明,这些问题并不罕见,可能会给患者带来相当大的尴尬和不满。临床医生在管理PE和DE中的作用是进行适当的调查,提供教育,并提供合理且基于可靠科学数据的可用治疗方法。
    方法:用于告知本指南的系统评价是由西北太平洋循证实践中心的方法学团队进行的。研究馆员在OvidMEDLINE(1946年至2019年3月1日)中进行了搜索,Cochrane中央对照试验登记册(至2019年1月)和Cochrane系统评价数据库(至2019年3月1日)。更新搜索于2019年9月5日进行。数据库搜索产生了1,851篇潜在相关文章。在对摘要和标题进行双重审查之后,选择223篇系统综述和个别研究进行全文双重综述,8项系统评价和59项单独研究被确定为符合纳入标准,并被纳入评价.
    结果:几个心理健康,行为,PE和DE都存在药物治疗选择;然而,这些药物治疗方案均未获得美国食品和药物管理局的批准,它们在PE和DE治疗中的使用被认为是标签外的.
    结论:射精时间的紊乱会严重阻碍男性及其伴侣的性享受。小组建议,共同决策是射精障碍管理的基础;性伴侣参与决策,如果可能,可以优化结果。
    OBJECTIVE: Men who ejaculate before or shortly after penetration, without a sense of control, and who experience distress related to this condition may be diagnosed with premature ejaculation (PE), while men who experience difficulty achieving sexual climax may be diagnosed with delayed ejaculation (DE). The experience of many clinicians suggest that these problems are not rare and can be a source of considerable embarrassment and dissatisfaction for patients. The role of the clinician in managing PE and DE is to conduct appropriate investigation, to provide education, and to offer available treatments that are rational and based on sound scientific data.
    METHODS: The systematic review utilized to inform this guideline was conducted by a methodology team at the Pacific Northwest Evidence-based Practice Center. A research librarian conducted searches in Ovid MEDLINE (1946 to March 1, 2019), the Cochrane Central Register of Controlled Trials (through January 2019) and the Cochrane Database of Systematic Reviews (through March 1, 2019). An update search was conducted on September 5, 2019. Database searches resulted in 1,851 potentially relevant articles. After dual review of abstracts and titles, 223 systematic reviews and individual studies were selected for full-text dual review, and 8 systematic reviews and 59 individual studies were determined to meet inclusion criteria and were included in the review.
    RESULTS: Several psychological health, behavioral, and pharmacotherapy options exist for both PE and DE; however, none of these pharmacotherapy options have achieved approval from the United States Food and Drug Administration and their use in the treatment of PE and DE is considered off-label.
    CONCLUSIONS: Disturbances of the timing of ejaculation can pose a substantial impediment to sexual enjoyment for men and their partners. The Panel recommends shared decision-making as fundamental in the management of disorders of ejaculation; involvement of sexual partner(s) in decision making, when possible, may allow for optimization of outcomes.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    建立国家准则,以评估妇女的性健康问题并为妇女提供性保健。
    通过搜索PubMed检索已发表的文献,CINAHL,和2010年5月至10月的Cochrane图书馆,使用适当的受控词汇(例如,性,“性功能障碍,\"\"生理,“性交困难)和关键词(例如,性功能障碍,性治疗,anorgasmia).结果受到限制,在可能的情况下,对于系统审查,随机对照试验/对照临床试验,和观察性研究。没有语言限制。搜索定期更新,并在2010年12月之前纳入指南。通过搜索卫生技术评估和卫生技术评估相关机构的网站,确定了灰色(未发表)文献,临床实践指南收集,临床试验登记处,以及国家和国际医学专业协会。每篇文章都经过相关性筛选,如果确定相关,则获得全文。加拿大妇产科医师协会成立的专家工作组成员对获得的证据进行了审查和评估。
    使用加拿大预防保健工作组描述的标准对证据质量进行了评估和建议(表)。
    To establish national guidelines for the assessment of women\'s sexual health concerns and the provision of sexual health care for women.
    Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library from May to October 2010, using appropriate controlled vocabulary (e.g., sexuality, \"sexual dysfunction,\" \"physiological,\" dyspareunia) and key words (e.g., sexual dysfunction, sex therapy, anorgasmia). Results were restricted, where possible, to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Each article was screened for relevance and the full text acquired if determined to be relevant. The evidence obtained was reviewed and evaluated by the members of the Expert Workgroup established by The Society of Obstetricians and Gynaecologists of Canada.
    The quality of evidence was evaluated and recommendations made using the use of criteria described by the Canadian Task Force on Preventive Health Care (Table).
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  • 文章类型: Consensus Development Conference
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  • 文章类型: Journal Article
    OBJECTIVE: To establish national guidelines for the assessment of women\'s sexual health concerns and the provision of sexual health care for women.
    METHODS: Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library from May to October 2010, using appropriate controlled vocabulary (e .g., sexuality, \"sexual dysfunction,\" \"physiological,\" dyspareunia) and key words (e .g ., sexual dysfunction, sex therapy, anorgasmia). Results were restricted, where possible, to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Each article was screened for relevance and the full text acquired if determined to be relevant. The evidence obtained was reviewed and evaluated by the members of the Expert Workgroup established by The Society of Obstetricians and Gynaecologists of Canada.
    METHODS: The quality of evidence was evaluated and recommendations made using the use of criteria described by the Canadian Task Force on Preventive Health Care (Table).
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  • 文章类型: Journal Article
    性功能受损对生活质量有显著影响。各种患者报告的结果测量(PROM)可用于评估性功能。用于神经系统患者的PROM的质量仍然未知。
    系统回顾哪些验证的PROM可用于评估神经系统患者的性功能,并严格评估每个已确定的PROM的验证研究和测量特性的质量。
    根据系统评价和荟萃分析报表的首选报告项目进行系统评价。根据基于共识的健康测量仪器选择标准清单对纳入的出版物进行评估。
    针对以下患者组确定了21项有关性功能的PROM研究:脊髓损伤(11项研究),多发性硬化症(MS;6项研究),帕金森病(2项研究),创伤性脑损伤(1项研究),癫痫(1项研究)。发现PROM质量的证据是可变的,71%的研究缺乏对测量特性的总体评估。在任何出版物中都没有研究测量误差和响应性。
    已经确定了几种PROM来评估神经系统患者的性功能。只有针对MS患者的多发性硬化亲密关系和性行为问卷-15和多发性硬化亲密关系和性行为问卷-19的有力证据,尽管某些测量特性也缺乏证据。未来的研究应侧重于确定相关的PROM,并在具有高方法学质量的研究中为所有测量特性建立足够的质量。
    对神经科患者性功能的患者报告结果测量(PROMs)进行质量评估。发现的良好PROM的证据有限。需要具有高方法学质量的研究来提高PROM的质量,以评估神经系统患者的性功能。
    Impaired sexual function has a significant effect on quality of life. Various patient-reported outcome measures (PROMs) are available to evaluate sexual function. The quality of the PROMs to be used for neurologic patients remains unknown.
    To systematically review which validated PROMs are available to evaluate sexual function in neurologic patients and to critically assess the quality of the validation studies and measurement properties for each identified PROM.
    A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. The included publications were assessed according to the Consensus-Based Standards for the Selection of Health Measurement Instruments checklist.
    Twenty-one studies for PROMs regarding sexual function were identified for the following patient groups: spinal cord injury (11 studies), multiple sclerosis (MS; 6 studies), Parkinson\'s disease (2 studies), traumatic brain injury (1 study), and epilepsy (1 study). The evidence for the quality of PROMs was found to be variable, and overall evaluation of measurement properties was lacking in 71% of the studies. The measurement error and responsiveness were not studied in any of the publications.
    Several PROMs have been identified to evaluate sexual function in neurologic patients. Strong evidence was found only for the Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 and Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 for patients with MS, although evidence was lacking for certain measurement properties as well. Future research should focus on identifying relevant PROMs and establishing adequate quality for all measurement properties in studies with high methodological quality.
    A quality assessment of patient-reported outcome measures (PROMs) for sexual function in neurologic patients was made. The evidence found for good PROMs was limited. Studies with high methodological quality are needed to improve the quality of PROMs to evaluate sexual function in neurologic patients.
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  • 文章类型: Journal Article
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