Authors/Year Country	Sample	Barriers	Sexual health assessment promotion activities
Kim, (2010) [35] Korean	310 nurses Descriptive study	Nurses competencies in term of knowledge, communication skills and training	Development educational program. Patient-centered sexual health curriculum. Improves nurses’ communication skills
Jaarsma et al., (2010) [24] Sweden	157 cardiac nurses Descriptive survey	Nurses beliefs that patients may be upset, embarrassed or anxious if they were asked about sexual health Insufficient knowledge to answer patients’ questions	Providing nurses with knowledge and practical training increases their comfort in discussion patients’ sexual health
Saunamaki et al., (2010) [36] Sweden	100 nurses Correlative Comparative design	Nurseslack confident and did not make time to address patients’ sexual concerns	Education sessions to improve nurses’ positive attitudes and confident in addressing sexual health concerns
Altıok and Yılmaz, (2011) [37] Turkish	32 patients with MI descriptive and qualitative design Semi-structured interviews	Patients consider sex a private issues that can be discussed with others due to the cultural perspectives of Turkish society	Provide appropriate settings where patients can express their sexual problems comfortably Consider sexual assessment in patient care planning and during patient education. Patients with MI have to contact health care providers and seek for treatment. Referral of patients to experts and resource. Establishing centers for sexual counseling Activate nurses’ roles in sexual counseling centers
Hoekstra et al., (2012) [5] Netherlands	122 Nurses Descriptive survey	Lack of organizational policy Lack of training Cultural, Religion, Language and Ethnicity issues Age of the patient The patient is too ill to address sexual health Sexuality is not problem by the patient Patients did not initiate subject Lack of knowledge in general and how to initiate the topic. Nurses feel uncomfortable	Investigating barriers that prevent nurses from discussing sexual health Select an appropriate time and setting during follow up visits or during review of medications at cardiac clinic