Steinke 2004.

Methods	Study design: randomised controlled trial (RCT) with 2 groups. Data collection timepoints: 4 data collection timepoints: Time 1, Pretest, during patients' hospital stay; Time 2, 1 month post myocardial infarction; Time 3, 3 months post myocardial infarction; T4 5 months post myocardial infarction.
Participants	Setting: cardiac rehabilitation programme which is part of a large medical centre in the Midwest USA. Inclusion criteria: patients were identified and referred for inclusion by manager of cardiac rehabilitation. Inclusion criteria included a diagnosis of myocardial infarction; ability to read, write and speak English; over 30 years of age; sexually active. Exclusion criteria: previous psychiatric problems; discharged to a nursing home; complex, multiple problems. Participants randomised: 115 participants in total; 92 men and 23 women. 64 assigned to intervention condition and 51 assigned to the control condition.
Interventions	Control: usual care, which involved receiving standard verbal and written instructions provided by the cardiac rehabilitation staff about resuming sexual activity following a myocardial infarction. This contained brief guidelines about resuming sexual activity. "Verbal discussion on resuming sexual activities varied depending on time constraints and comfort with the topic by the cardiac rehabilitation nurse". Intervention: usual care, plus a 15‐minute video. The video was developed by Steinke and reviewed by clinical experts. The intervention contained content on: the effect of the heart attack on sexuality and sexual function, communicating with the partner, the impact of cardiac risk factors on sexual function, specific suggestions on when and how to resume sexual activity, and the effects of various medications on sexual function.
Outcomes	Outcomes relevant to this review Anxiety: Speilbergers State Trait Anxiety Inventory. Quality of Life: Ferrans & Powers Quality of Life Index (QLI) – Cardiac Version III. Knowledge: 25‐item Sex After myocardial infarction Knowledge Test. Sexual function: The Watts Sexual Function Questionnaire (WSFQ) with 4 subscales: sexual desire; arousal; orgasm; and satisfaction. Return to sexual activity: 2 questions: was the patient sexually active and when they had returned to sexual activity.
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Random assignment to groups was accomplished by a coin toss.
Allocation concealment (selection bias)	Unclear risk	The trial gave no details on the process.
Blinding of participants and personnel (performance bias) All outcomes	High risk	There was no blinding of participants and study personnel, which may have had an impact on outcomes.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	The trial gave no details.
Incomplete outcome data (attrition bias) All outcomes	High risk	45% attrition rate in intervention group, and 27% in the control group.
Selective reporting (reporting bias)	Low risk	The trial authors reported all variables in the results section.
Other bias	High risk	Threat to external validity. The manager of cardiac rehabilitation identified and referred participants. Therefore participants are unlikely to be representative of the general population. It was largely a white, married, educated sample.

Abbreviations: CABG: coronary artery bypass grafting; RCT: randomised controlled trials; MI: myocardial infarction.