General Practitioners' approach to sexuality over 60: a mixed study.

Maxime Pautrat

Keywords: Sexuality ; Elderly ; Health communication ; General practitioners

Background:

The sexuality of the elderly is the focus of recently research, but still rarely discussed during primary care consultations.

Research questions:

The aim of this study was to describe the practice of general practitioners (GPs) and to explore what GPs think about communicating about the sexuality of elderly people (EP).

Method:

Mixed study included quantitative and qualitative study, carried out between June 2021 and June 2022 among GPs. The quantitative study included a descriptive analysis, based on anonymous questionnaire designed by the investigators and distributed by mailing via professional structures. It included the usual demographic data completed with questions about sexuality. The qualitative study was an inductive analysis inspired by grounded theory. Its aim was to conceptualize the representations of GPs recruited by a snowball effect, based on individual semi-directed interviews.

Results:

105 questionnaires were analysed. There was a significant link between male gender and comfort (p<0.05). GPs who were "at ease" were significantly older than those who were "not at ease" (p<0.05). 12 GPs were interviewed. During the interviews, they reaffirmed their role as being "in the best place" while expressing their "discomfort". A patient-centred approach was favoured, with a " trusting " approach that went beyond " Judeo-Christian modesty ". The GPs reported a transference phenomenon linked to their personal and professional experience. "Resistance, it's simple, it's always on the doctor's side" testified to their reflexivity.

Conclusions:

GPs' perceptions of how to deal with the sexuality of EP led to the emergence of new proposals, such as not limiting sexuality to coitus, combating societal taboos, and promoting mutual support in peer groups. This study opens up other avenues for reflection, such as screening for even old cases of violence and sexually transmitted infections, which are often overlooked in the over-60s.

Points for discussion:

How can intimate questions be included in daily EBM practice?

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