Facilitators and barriers for nurses in providing sexual education to myocardial-infarction patients: A qualitative systematic review

Background: Myocardial infarction (MI) greatly impacts an individual\u27s sexual health. It is reported that almost 40 to 80% population with MI are not able to resume their sexual routine after the illness due to organic or psychological sexual dysfunction. To reduce the prevalence of sexual dysfunction after MI, cardiac nurses are required to provide sexual counselling to their stable patients. However, this responsibility is seldom fulfilled by nurses due to several barriers. These barriers are not explicitly explored from the nurses\u27 perspective, which is necessary to understand in order to promote sexual counselling in cardiac health care settings. Objective: To explore the facilitators and barriers of cardiac nurses in providing sexual education to post-MI patients. Design and Method: A qualitative systematic review was undertaken by performing a systematic search from six databases along with search from reference lists of related studies. Findings: Four studies revealed 49 findings, which formed 10 categories and yielded four synthesised findings. These are: (1) Institutional Barriers such as lack of education, guidelines and material resources can prevent nurses from providing sexual education to MI patients; (2) Personal barriers such as uncertainty about the nurse\u27s role in sexual education, giving least priority to sexual counselling and lack of comfort with discussing sexuality can affect how nurses provide sexual education to MI patients; (3) Socio-cultural and religious barriers such as contradictory beliefs and gender differences can challenge nurses when providing sexual education to MI patients and (4) Nurses consider different strategies for addressing sexual education with MI patients, in individual or group settings. Conclusion: To promote sexual counselling, strategies are proposed by nurses, which can help in limiting barriers and facilitate in conducting counselling sessions. These strategies need to be validated from extensive research before implementing them into nursing practice