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      Acceptability of Health Professionals’ Address of Sexuality and Erectile Dysfunction - A Qualitative Interview Study with Men in Cardiac Rehabilitation

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          Abstract

          Introduction

          In the developing phase of the complex health intervention: Physical Activity to reduce Vascular Erectile Dysfunction (PAVED), it is crucial to explore whether men can accept the communicative component regarding information that regular aerobe Physical Activity can reduce Erectile Dysfunction (i-PAVED). This information is provided by health professionals (HPs) in cardiac rehabilitation, where sexuality issues such as erectile dysfunction (ED) are otherwise rarely addressed.

          Aim

          To explore how acceptance of cardiac HPs’ address of sexuality, ED, and i-PAVED can be identified in men's narratives.

          Methods

          In this descriptive qualitative study, we conducted semi-structured individual interviews with 20 men (range 48-78 years of age) attending municipal cardiac secondary prevention and rehabilitation programmes on their acceptance of HPs’ address of sexuality, ED, and i-PAVED. The Theoretical Framework of Acceptability components (affective attitude, burden, ethicality, intervention coherence, perceived effectiveness, opportunity costs and self-efficacy) and three temporal perspectives (retrospective, concurrent and prospective) were used in the concept-driven first step of a content analysis, which was followed by a thematically data-driven second step.

          Main Outcome Measures

          Men anticipated and experiential acceptance was identified in six out of seven components of Theoretical Framework of Acceptability.

          Results

          Men acceptance was identified as “expression of interest,” “addressing sexuality,” “attitudes and values,” “understandable and meaningful,” “insights” and “motivation,” whereas no narratives were identified in relation to the component of opportunity costs.

          Conclusion

          As an aspect of the development of the complex cardiovascular health care intervention PAVED, this qualitative study showed that men attending cardiac secondary prevention and rehabilitation seemed to prospectively accept the communicative component of PAVED being HPs’ address of sexuality, ED, and i-PAVED, if the HPs are professional, educated and competent in the field of sexual health. Gerbild H, Areskoug-Josefsson K, Larsen CM, et al. Acceptability of Health Professionals’ Address of Sexuality and Erectile Dysfunction - A Qualitative Interview Study with Men in Cardiac Rehabilitation. Sex Med 2021;9:100369.

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          Most cited references49

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

            Qualitative content analysis as described in published literature shows conflicting opinions and unsolved issues regarding meaning and use of concepts, procedures and interpretation. This paper provides an overview of important concepts (manifest and latent content, unit of analysis, meaning unit, condensation, abstraction, content area, code, category and theme) related to qualitative content analysis; illustrates the use of concepts related to the research procedure; and proposes measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure. Interpretation in qualitative content analysis is discussed in light of Watzlawick et al.'s [Pragmatics of Human Communication. A Study of Interactional Patterns, Pathologies and Paradoxes. W.W. Norton & Company, New York, London] theory of communication.
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              Code Saturation Versus Meaning Saturation: How Many Interviews Are Enough?

              Saturation is a core guiding principle to determine sample sizes in qualitative research, yet little methodological research exists on parameters that influence saturation. Our study compared two approaches to assessing saturation: code saturation and meaning saturation. We examined sample sizes needed to reach saturation in each approach, what saturation meant, and how to assess saturation. Examining 25 in-depth interviews, we found that code saturation was reached at nine interviews, whereby the range of thematic issues was identified. However, 16 to 24 interviews were needed to reach meaning saturation where we developed a richly textured understanding of issues. Thus, code saturation may indicate when researchers have "heard it all," but meaning saturation is needed to "understand it all." We used our results to develop parameters that influence saturation, which may be used to estimate sample sizes for qualitative research proposals or to document in publications the grounds on which saturation was achieved.
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                Author and article information

                Contributors
                Journal
                Sex Med
                Sex Med
                Sexual Medicine
                Elsevier
                2050-1161
                01 June 2021
                June 2021
                01 June 2021
                : 9
                : 3
                : 100369
                Affiliations
                [1 ]Health Sciences Research Centre, UCL University College, Odense, Denmark
                [2 ]Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
                [3 ]Faculty of Health Science, VID Specialized University, Sandnes, Norway
                [4 ]School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
                [5 ]Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
                [6 ]Department of Sports Science and Clinical Biomechanics; University of Southern Denmark, Odense, Denmark
                [7 ]Clinical Nursing Research Unit, Aalborg University hospital, Denmark
                Author notes
                [* ] Corresponding Author: Helle Gerbild PT, Health Science Research Centre, UCL University College, Niels Bohrs Alle’ 1, 5230 Odense M, Denmark heng@ 123456ucl.dk
                Article
                S2050-1161(21)00049-0 100369
                10.1016/j.esxm.2021.100369
                8240334
                34087535
                4ebe20f2-e7ea-4500-b71d-35dc5a86b89f
                Copyright © 2021 The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 11 January 2021
                : 23 March 2021
                Categories
                Original Research
                Evaluation

                acceptability,cardiovascular diseases,communication,erectile dysfunction,interview,physical activity

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