Sexual counseling for people with acute coronary syndrome: educational video development

Andrade, Laura Rizardi dos Santos; Anjos, Lanay Dourado dos; Aguiar, Ana Paula Freitas; Lima, Edvone Alves de; Abuchaim, Erika de Sá Vieira; Lopes, Juliana de Lima; Lopes, Camila Tákao; Santos, Vinicius Batista

doi:10.1590/0034-7167-2023-0416

Laura Rizardi dos Santos Andrade Corresponding author: Laura Rizardi dos Santos AndradeI , E-mail: laura.rizardi@unifesp.br

study design

data analysis

interpretation

article writing

critical review of relevant intellectual content

approval of the final version to be published

Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0001-9357-1512

Lanay Dourado dos Anjos

study design

data analysis

interpretation

article writing

critical review of relevant intellectual content

approval of the final version to be published

Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil

Hospital Sírio-Libanês. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0002-1383-4472

Ana Paula Freitas Aguiar

study design

data analysis

interpretation

article writing

critical review of relevant intellectual content

approval of the final version to be published

Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil

Hospital Universitário São Paulo, Unidade de Cardiologia. São Paulo, São Paulo, Brazil

https://orcid.org/0009-0004-9191-2714

Edvone Alves de Lima

study design

data analysis

interpretation

article writing

critical review of relevant intellectual content

approval of the final version to be published

Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil

Hospital Israelita Albert Einstein. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0002-4314-2784

Erika de Sá Vieira Abuchaim

study design

data analysis

interpretation

article writing

critical review of relevant intellectual content

approval of the final version to be published

Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0002-1881-4016

Juliana de Lima Lopes

study design

data analysis

interpretation

article writing

critical review of relevant intellectual content

approval of the final version to be published

Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0001-6915-6781

Camila Tákao Lopes

study design

data analysis

interpretation

article writing

critical review of relevant intellectual content

approval of the final version to be published

Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0002-6243-6497

Vinicius Batista Santos

study design

data analysis

interpretation

article writing

critical review of relevant intellectual content

approval of the final version to be published

Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0001-5130-5523

Corresponding author: Laura Rizardi dos Santos AndradeI , E-mail: laura.rizardi@unifesp.br

EDITOR IN CHIEF: Antonio José de Almeida Filho

ASSOCIATE EDITOR: Hugo Fernandes

Ref	Study objective and design	Research findings and types of counseling
27	Provide essential information for healthcare professionals to initiate practical and applicable sexual counseling for men and women with CVD. Review study	Medication: establish a good relationship with patient, guide medication adherence, assess the root of the dysfunction and possibilities for changing or adjusting the dose; Environment: comfortable and familiar to minimize cardiac stress; Warning signs: advise reporting any signs and symptoms; Physical training: exercising regularly to reduce the risk of cardiac events; Intensity and energy consumption: dependent on physical capacity and being well rested before sexual activity; Positions: must allow comfort and facilitate breathing.
28	Provide practical, evidence-based approaches to enable healthcare professionals to discuss sexual counseling, illustrated by various case scenarios. Review study	Medications: advise reporting any side effects and not stop after one appears; Environment: comfortable and familiar, rest before sexual activities, avoid heavy meals and excessive alcohol consumption before sexual intercourse; Position that provides better comfort; Warning signs: chest pain, extreme shortness of breath, elevated or irregular heart rate, fatigue the day after sexual activity, dizziness or insomnia; Activity: regular physical activity as tolerated; Resumption of sexual activity: start with activities that require less intensity/energy expenditure, such as hugs, kisses, caresses.
29	Describe the latest guidelines published by the American Heart Association on sexual activity in patients with heart disease as well as treatment options for sexual dysfunction. Review study	Clinical assessment (low risk of cardiac complications); Decompensated patients should abstain from sexual activity until stabilization; If any type of sexual dysfunction is noted due to medications, they should not be suspended and complaints should be assessed to rule out other sources; Be rested before sexual activity, avoid unfamiliar places and sexual partners to reduce stress; Avoid heavy food and alcohol; Preference for positions that facilitate inspiration.
30	Present a comprehensive literature review describing the sexual problems of women after myocardial infarction. Review study	Lack of knowledge among professionals, low prevalence of guidance on sexual function; Educational programs for sexual therapy: patient education, cognitive restructuring, emotional support, medical guidance, increase frequency and quality of sexual activities after myocardial infarction; Psychological factors (such as anxiety) worsened during physiological changes during sex.

Content	Cla	The	Pra
Let’s talk a little about Pedro’s concerns about sexual activity after leaving the hospital	1.0	1.0	1.0
At a gathering of friends	1.0	1.0	1.0
Friend: My friend Pedro, how are you feeling after leaving the hospital?	1.0	1.0	1.0
Pedro: I’m fine, but can I have sex again?	1.0	1.0	1.0
Friend: I think you should talk to a professional about this at your next appointment and wait to have sex again.	1.0	1.0	1.0
Pedro: I think I’ll wait and ask at my next appointment.	1.0	1.0	1.0
On the day of the appointment	1.0	1.0	1.0
Nurse: Good morning, Pedro! I’m nurse Júlia. Nice seeing you again. How are you?	1.0	1.0	1.0
Pedro: I’m doing well. Taking all the medicines the doctor prescribed for me.	1.0	1.0	1.0
Pedro: I started walking 30 minutes in the morning every day. I’m feeling great.	1.0	1.0	1.0
Pedro: And I’m also eating low-salt foods, avoiding fried foods and eating more fruits and vegetables.	1.0	1.0	1.0
Pedro: But there’s something I’d really like to ask and I don’t know how.	1.0	1.0	1.0
Nurse: Pedro, remember that I’m here to help you get back to your life safely after your heart attack.	1.0	1.0	1.0
Pedro: I’m scared of having sex again. What should I do?	1.0	1.0	1.0
Nurse: Look, Pedro, this is a subject that we can talk about calmly and clearly, without judgment or anything like that.	1.0	1.0	0.8
Nurse: It is recommended that you wait at least seven days after discharge to resume sexual activities.	1.0	1.0	1.0
Nurse: It’s important that you start slowly with touching, kissing and other forms of pleasure that you enjoy that use less energy. This foreplay can increase sexual desire for both you and the person you are with.	1.0	1.0	1.0
Nurse: An alternative to spending less energy is to stay in a position where you move less, i.e., prefer to stay underneath.	0.8	0.8	0.8
Nurse: It doesn’t matter what sex you are. See in the photos that the colorful person is the one who had the heart attack. So, it is recommended that you stay underneath.	1.0	1.0	1.0
Nurse: We also need to know how to recognize, in our own body, what the warning signs are.	1.0	1.0	1.0
Nurse: Be aware if you feel very tired, chest pain, and shortness of breath during or after sexual activity.	1.0	1.0	1.0
Nurse: If you experience these symptoms and they improve after sexual intercourse, you should see the doctor or nurse who is taking care of you as soon as possible.	1.0	1.0	1.0
Nurse: And try to reduce efforts during sexual intercourse until you talk to these professionals.	1.0	1.0	1.0
Nurse: But if you don’t improve after rest, go to the emergency room immediately.	1.0	1.0	1.0
Nurse: We have other tips that are also important. Write it down, Mr. Pedro:	1.0	1.0	1.0
Nurse: To improve your sexual relationship: choose a quiet and calm environment; try to be relaxed and rested beforehand; have a light diet before sexual intercourse; and look for positions that use less energy.	1.0	1.0	1.0
Nurse: The doctor will prescribe several important medications for you, and some may have some bad side effects, such as	1.0	1.0	1.0
Nurse: Lack of desire to have sexual intercourse, difficulty keeping the penis hard and little lubrication in the vagina.	1.0	1.0	1.0
Nurse: But don’t stop following treatment, and if there is a problem, just tell the nurse or doctor who takes care of you.	1.0	1.0	1.0
Nurse: For those who need it, lubricants can help with vaginal dryness and also with pleasure itself.	1.0	1.0	1.0
Nurse: There are some medicines that can help the penis get hard, but these medicines can be dangerous if used without a doctor’s approval.	1.0	1.0	1.0
Pedro: Ah, after this information, I feel calmer, thank you for everything.	1.0	1.0	1.0
Nurse: That’s right, Pedro! You are doing great and taking the best care of yourself.	1.0	1.0	1.0
For more information, visit the website: www.educacor.unifesp.br	1.0	1.0	1.0

[1] Corresponding author: Laura Rizardi dos Santos AndradeI , E-mail: laura.rizardi@unifesp.br

Brasil

Brasil

Sexual counseling for people with acute coronary syndrome: educational video development

Consejería sexual para personas con síndrome coronario agudo: desarrollo de video educativo

ABSTRACT

Objective:

Method:

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Conclusion: