Sunday, 23 August 2009

the sexual history taking

http://www.youtube.com/watch?v=V5ouk1SJbOs

click on this youtube link to see sexual history taking clip 
(embeding disabled)
we live in a culture that is , on one hand, charcaterized by lack of 
information and secrecy about sex and on the other, by sexually explicit 
entertainment and advertising.

despite its importance, most of us find "sexual history taking" is a
difficult topic to discuss with the patient.

to begin the patient's sexual history, use introductory statement 
and transparency whic ease the transition to difficult topic.
example:
"I always include questions about sexual problems in my
routine history because the are so common, have you had any 

if you find that you need to know more, i.e suspecting a sexually 
transmitted disease, you need to find more about:
1-sexual oreintation.
2-number and regularity of sexual partners.
3-weather they are from same or opposite sex.
4-if the partner have any STD's.

"I need to know more about your sexual relationship in order to 
understand your risk for certain disorder,..."

techniques for sexual history:
* use simple screening question to determine how much you
need to know.
*delaying this part of the interview until you know something about 
you patient as a person.
*ensuring that you and your patient are using words that have the same
meaning.
*proceed from less intimate to more intimate questions.
*sequencing your questions from open-end to close-end depending
on the degree of details you need.
*using introductory and transparent statment to help the patient 
understand why you are asking what might otherwise be interpreted as
intrusive question.

from:the medical interview by J L Coulehan and M R Block

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