Psychosocial and Relationship Issues in Men With Erectile Dysfunction

Patrick J. DiMeo, BSN, RN, OCN

Disclosures

Urol Nurs. 2006;26(6):442-446. 

In This Article

Nursing Responsibilities

Clinic Visit

ED is a topic that neither the patient nor clinician tends to bring up in the clinic setting. Feelings of embarrassment and uncomfortableness are two of the reasons cited (Baldwin, Ginsberg, & Harkaway, 2000). Health care clinicians need to establish an atmosphere of comfortableness and openness for the patient. Clinicians also need to encourage a patient to involve his partner in the clinic visit and treatment decision process. In that way, discussion of mutual fears and anxieties can be addressed. Once communication channels are opened, then they can make the best decision for them as a couple. This gives them the greatest chance of treatment success (Roy & Allen, 2004). In our clinic, we use the following outlined practices to involve the patient and partner and to make them feel comfortable at their visit.

Medical History

The room set-up should be conducive to the situation so that the patient does not feel inferior but as an equal participate in the clinician-patient interaction. The clinician needs to introduce him or herself to the patient/partner and explain that a medical, sexual, and psychosocial history will be taken. Based upon that information, treatment options will be discussed. Explaining your medical background to the patient/partner can be helpful and possibly put them more at ease.

A thorough medical history (see Table 2 ), including medications, drug allergies, and any alternative therapies is an essential first step. This will help and guide the clinician on identifying and recognizing the problem (Albaugh & Lewis, 2005). The role of nonprescription drugs and over-the-counter (OTC) drugs may factor into the patient's self-treatment of ED. Obtaining a thorough history of these medications is vital in the medical assessment. This part of the visit can be more comfortable for the patient because the topic may be less threatening. If agreeable to the patient, the partner may be able to add additional information on the patient's past medical history.

Sexual/Psychosocial History

When obtaining a sexual/psychosocial history, it is imperative that the clinician make the patient feel relaxed, welcomed, and not rushed in the conversation. Gaining the patient's trust and projecting an open and honest approach may minimize possible embarrassment or discomfort during the visit. Some patients feel more comfortable with their partner present while others feel more comfortable by themselves. This decision should be supported by the clinician. But the clinician should explain that bringing a partner can be very beneficial at the appointment. Table 3 provides examples of specific psychosocial questions used in the author's practice that may be used to expand on relationship issues and guide the conversation. The experienced clinician may be able to assess the type of relationship the patient has with his partner from the responses. The status of the partner relationship can play a pivotal role in how the patient copes with his ED. The trust level that the patient has and develops with the clinician will determine the openness of his answers and what he is willing to discuss. The clinician needs to be sensitive and respectful of the patient's situation and offer encouragement as the patient relates his concerns. Health care clinicians have a knack of reading what is happening with patients because of the skill set that has been acquired with experience. Letting the patient know that he is not alone in this situation and informing him of some statistics is helpful in a man's mindset. Discussing with the patient some of the medical reasons he is experiencing ED or how a relationship issue, home, or work is affecting him can put him more at ease.

As the visit proceeds, the patient will be asked specific questions about the quality and frequency of his erections (see Table 4 ). In our clinical practice, these questions are effective as part of the assessment. If the clinician-patient trust level has been established, patient embarrassment is generally not an issue at this point.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....