Gynaecological nursing: a compromising situation

Promoting teenage sexual health: an investigation into the knowledge, activities and perceptions of gynaecology nurses

AIM

This study was designed to investigate the teenage sexual health service provided by gynaecology nurses at Queen's Medical Centre, Nottingham, United Kingdom (UK), by assessing their knowledge, activities and perceptions in relation to teenage sexual health.

BACKGROUND

Part of a gynaecology nurse's work is caring for teenagers with sexual health problems, including unwanted pregnancies and sexually transmitted infections (STIs). Given the current national focus in the UK on improving teenage sexual health, there is clearly a role for gynaecology nurses to play, but this is rarely referred to in published literature and appears to be poorly defined.

METHOD

A cross sectional survey of all gynaecology nurses at Queen's Medical Centre was carried out, followed by semi-structured interviews with a small random subsample.

FINDINGS

Results indicated that, although 65% of nurses had worked on the gynaecology unit for more than 5 years, there was poor knowledge, an inconsistent pattern of nursing interventions and negative perceptions of the service offered. A majority of the nurses (87%) had not received any specific training in how to nurse teenagers with sexual health problems and 65% considered that the quality of sexual health service offered to teenagers was poor. Unexpected findings included poor general knowledge of local teenage sexual health services, the emotional effect on some nurses caring for young teenagers undergoing medical terminations of pregnancy (ToP), and the complete lack of training and protocols for taking a sexual history.

CONCLUSIONS

The nurses felt that the teenage sexual health service provided could be improved by better staff training, better information for teenagers and better organization. Recommendations have been made as a result of the study but the staff will need management support to ensure that changes are effective. Generalizations cannot be drawn from a study in one hospital but the results could reflect the low profile given to the teenage sexual health aspect of gynaecology nurses' work in the UK.

Analysing qualitative data: computerized and other approaches

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Purging the emotions: the lack of emotional expression in subfertility and in the care of the dying

The paper examines emotional expression by drawing on data from patients in two contrasting situations; interview data from couples attending fertility clinics, and audio-recorded conversations with terminally ill patients being cared for at home. Although the literature on subfertility and terminal illness frequently uses a bereavement model to argue for the importance of overt grieving, patients in these studies did not express a wish to discuss their feelings. This finding raises questions about how patients' needs are defined, and whether emotions may be created by discourse.

Time for a change: women's health education in Canadian university schools of nursing

As a group, women are the major users of the health care system, both directly, in terms of their own health, and indirectly, as the custodians of their family's health. In the past 10 years, there has been a growing awareness of the particular health concerns of women. One of the results of this increased awareness has been the development of courses that address these concerns. Most have been offered through Women's Studies programs. Recently, a growing awareness of these issues has developed among nurses and nurse educators. However, as Saunders and Taylor (1985) point out, "Nurse educators have been slow to develop courses that address women's health issues" (p. 25). My purpose in conducting this study was to survey university schools of nursing in Canada to discover if topics relating to women's health are incorporated into the nursing education curricula. I found that nursing education curricula tend to present women's health issues in a traditional, medically defined manner, focusing on childbearing and reproductive issues. The important problems of women and poverty, the social construction of diseases, and the social context of women's health were addressed much less frequently.

A study of nurses' knowledge and attitudes about sexuality in health care

This article discusses a questionnaire study carried out to investigate knowledge and attitudes towards sexuality among 50 trained nurses working in gynaecological and non-gynaecological wards in the U.K. Knowledge levels were low and attitudes were traditional, and the gynaecology nurses' scores showed them to be less knowledgeable and more conservative than other nurses. These findings match those of studies carried out in the U.S.A. in the 1970s. The implications of the study for nurse education are considered, bearing in mind some reservations concerning the research instruments used.

Professional and lay social support for hysterectomy patients

This paper describes a study of social support for women undergoing hysterectomy, and shows how original research plans had to be modified when early interviews revealed women's need for basic information and their desire to obtain this from the researcher. The modified design allowed comparisons between one group of women receiving information as part of the research interview and a second group receiving no such help. Post-hysterectomy follow-up at 3 months showed significant differences between the 2 groups, with the 'information group' being less hostile but more critical of their hospital treatment. The study also confirms previous findings by the same author of generally high levels of satisfaction, health and resumption of activities after hysterectomy. With regard to social support, it is suggested that full-time housewives are in particular need of support from nurses due to their relative isolation from other sources of support and information. However, all interviewees would have liked more information and support from health care professionals. Despite the acknowledged limitations of the study, some guidelines are offered for nurses attempting to increase levels of lay and professional support for their patients.