Watch today’s video to learn,
1. How to explore the sexual history sensitively in CSA.
2. How to have a structured approach to the sexual history.
3. How to assess the STI risk and then offer tests as appropriate to get more marks.
4. How to be proactive in addressing child protection issues, pregnancy risk etc.
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Here you go!
Importance of Detailed Sexual History in Medical Consultations.
Get the full transcript below.
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Transcript – Consultation Skills Tips
Importance of Detailed Sexual History in Medical Consultations
Thank you for joining me.
Please share with your friends!
I am Hema, the founder of csasmartgroup.com, a website designed to help GP registrars pass CSA with flying colours.
Exploring the sexual history of a patient is an essential part of that success.
Without it, the chance of addressing an STI risk could be missed and so could your chance of passing.
For example, if a female patient had unprotected intercourse with four partners in six months and her current partner had unprotected sex with five casual male partners in five months, their sexual risk behaviour must influence your diagnosis.
Here is some useful general advice to follow.
Ensure confidentiality, be open-minded, be non-judgemental, put the patient at ease, be aware of your own body language, gestures and posture, maintain eye contact, explain why discussing sexual history is relevant, look out for subtle non-verbal cues from the patient and promote good sexual health.
Another crucial consideration is the issue of child protection – an on-call team can be referred to if necessary.
Also, consider safeguarding issues for vulnerable adults and remember a sensitive approach is needed for sexual assault victims.
Practicing these scenarios with your trainer or senior colleague, whilst familiarising yourself with local referral pathways, will give you confidence.
Tips to think about on the day itself include setting the agenda, gaining consent, informing the patient you will be asking personal questions, pre-empting any discomfort, using simple language and defining what the patient actually means by “sex”.
Never assume anything and ask unfamiliar jargon to be explained.
A structured approach to sexual history should cover:
when, where, gender, casual or regular partners, nationality, ethnicity, the nature of sexual activity, protection (condom or contraception), active or passive relationships, symptoms, other partners, previous STIs, previous check-ups, drug use, HIV, hepatitis or syphilis tests and hepatitis B vaccinations.
Assess the risk and then offer tests as appropriate.
Also, relate to the risk of pregnancy when asking about the last menstrual period in gynaecological history.
Don’t take the heterosexuality of previous partners for granted.
Ask both men and women who their former relationships were with and whether previous partners were gay or bisexual.
And it’s crucial to empathise throughout and remain patient-centred.
See below for a consultation video example of how to gather information about sexual history competently.
Here, the patient is worried he may have contracted an STD.
It’s important for the GP to enquire about the patient’s risk behaviour sensitively and then negotiate a plan forward.
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Dr. Hema