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Related Experiment Videos

Why doctors have difficulty with sex histories.

J M Merrill1, L F Laux, J I Thornby

  • 1Department of Community Medicine, Baylor College of Medicine, Houston, TX 77030.

Southern Medical Journal
|June 1, 1990
PubMed
Summary

Physicians often struggle with taking sexual histories, impacting sexually transmitted disease (STD) detection. Key barriers include embarrassment, perceived irrelevance, and inadequate training, which are linked to personal traits like anxiety and low self-esteem.

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Area of Science:

  • Medical Education
  • Public Health
  • Psychology

Background:

  • Physician performance in detecting sexually transmitted diseases (STDs) and counseling patients on transmission requires improvement.
  • The ongoing AIDS pandemic highlights the critical need to understand barriers in taking patient sexual histories.
  • Existing research indicates challenges in physicians' ability to effectively gather sexual history information.

Purpose of the Study:

  • To identify and quantify the primary reasons physicians cite for their colleagues' inadequate sexual history-taking.
  • To develop and validate scales measuring physician-reported barriers: embarrassment, perceived irrelevance of sexual history, and inadequate training.
  • To explore personal attributes correlating with these barriers among medical students.

Main Methods:

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  • Physician beliefs regarding barriers to sexual history-taking were identified.
  • Scales were developed to measure embarrassment, perceived relevance, and training adequacy.
  • 350 senior medical students were surveyed, and personal attributes were correlated with scale scores.

Main Results:

  • 50% of students felt poorly trained, and 25% felt embarrassed asking sexual history questions, despite 93% deeming it important.
  • Shyness and social anxiety predicted embarrassment; a nonsympathetic view of psychosocial issues correlated with perceived irrelevance.
  • Homophobia, authoritarianism, and fear of AIDS were linked to the belief that sexual history is unimportant; low self-esteem correlated with feeling inadequately trained.

Conclusions:

  • Physician embarrassment, perceived irrelevance of sexual history, and inadequate training are significant barriers to effective STD risk assessment.
  • Personal traits such as shyness, social anxiety, nonsympathetic attitudes, homophobia, authoritarianism, fear of AIDS, and low self-esteem influence these barriers.
  • Addressing these barriers through targeted interventions is crucial for improving patient care and STD prevention.