Factors influencing sexual activity among patients with heart failure in Thailand

Abstract

In patients with heart failure (HF), sexual activity (SA) is influenced by physiological, psychological, and relational factors. These issues are often overlooked, despite the significant impact they have on quality of life. Research on this topic is extensive worldwide, however there remains a significant lack of data specifically focused on the Thai population. Moreover, sexual health is an underreported problem in patients with HF, necessitating the identification of predictors of SA to develop the best nursing care. Addressing this gap is important, as establishing a clear baseline in Thailand can serve as a vital reference point for developing further studies conducted within and outside of Asia. Therefore, the study aimed to identify predictors of SA among patients with HF, specifically metabolic equivalents (METs), age, mental health, and partner communication. The study used a cross-sectional observational design, recruiting a sample of 144 married Thai patients with HF from two tertiary care facilities. Data was collected between August and October 2024. Participants completed questionnaires on demographics, METs (Duke Activity Status Index), mental health status (DASS-21), and partner communication (Dyadic Sexual Communication Scale). Before beginning the research, all instruments were validated and assessed for reliability using appropriate psychometric methods. Binary logistic regression was used to analyze the predictive value of variables. The finding indicated that most participants reported fewer and shorter episodes of SA on a daily basis. Furthermore, they also identified a lack of professional guidance during this period. Significant predictors of SA included lower METs (OR=0.362), depression (OR=0.002), and effective partner communication (OR=1.156). Age, anxiety, and stress were not significant predictors of the outcome. The study concludes that lower METs, higher levels of depression, and effective partner communication are associated with reduced SA. Given the impact of METs and mental health, it is essential for nurses to integrate physical activity assessments and mental health screenings into HF care protocols.