Sexuality is one of the determinants of human health and has positive effects on physical and mental health . Sexual problems are widely effective in quality of life and can have adverse impacts on emotional health and interpersonal relationships . Sexual health is a state of physical, mental, and social well-being in relation to sexuality 
Myocardial infarction, due to its debilitating nature, has many negative effects on different aspects of patients ‘lives, including their sexual activity [4, 5]. People with myocardial infarction experience many sexual concerns , and a large number of them limit or stop their sexual activity for fear of re-myocardial infarction or sudden death [7, 8]. Returning to sexual activity after a myocardial infarction and reaching sexual satisfaction are major challenges for patients and their spouses . Given the positive effects of treatment for sexual problems, especially an increase of quality of life, early detection, and timely treatment of sexual issues should be a priority of the healthcare team . It should be considered as educational-counseling programs and a part of routine care for cardiovascular patients [4, 9].
Sexual counseling as an important component of patient care, and healthcare providers should strive to better understand the principles, application, and consequences of sexual counseling. Sexual counseling involves interaction with the patient to obtain information about sexual concerns and safe return to sexuality. Sexual counseling also includes evaluating, supporting, and providing specific advice on psychosexual problems, sometimes referred to as psychosexual counseling [11, 12]. Nurses, through close communication with patients, have the opportunity to interact with patients and their spouses during counseling, and to meet their basic needs for optimal well-being , because their spouses are also among important components of cardiac rehabilitation . Although nurses play a key role in providing sexual counseling for cardiac patients , they do not consider the exchange of information about sexual concerns of the patients with myocardial infarction as their essential role . Most nurses reportedly do not consider cardiac patients' sexual needs as an essential part of their assessment, do not routinely evaluate their sexual problems, and are reluctant to do so [16, 17].
Given the importance of nurses' role in providing counseling, many barriers are available، especially in training sexuality to patients with myocardial infarction .The researchers reported a lack of organizational policies and nurses’ lack of knowledge of the current barriers . A study also identified lack of time, lack of knowledge or education, type of attitude, and uncertain beliefs in sexuality, irresponsibility, and problems related to the disease . Another researchers categorized barriers into four categories of patient, nurse, organization, and value related ones . some nurses believe that sexual evaluation is unethical .
Since sexuality is influenced by the culture, beliefs, and thoughts of society and families, the Iranian community, especially in southeastern Iran, considers talking about sexual issues as taboo. Therefore, the current study aimed to investigate the barriers to sexual counseling for patients with myocardial infarction from the perspectives of nurses working in cardiac care units in hospitals located in southeastern Iran.