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Lu MJ, Li JB, Wu CY, Huong PTT, Hsu PC, Chang CR. Effectiveness of a Sexual Health Care Training to Enhance Psychiatric Nurses' Knowledge, Attitude, and Self-Efficacy: A Quasi-Experimental Study in Southern Taiwan. J Am Psychiatr Nurses Assoc 2024; 30:17-29. [PMID: 34533070 DOI: 10.1177/10783903211045733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sexual health is a taboo issue in some societies. Limited assessments were conducted during nursing care in mental health services. It is unknown whether psychiatric nurses' competencies would be enhanced through short training courses. AIMS The present study employed a quasi-experimental design to evaluate the effectiveness of an 8-hour sexual health care training for psychiatric nurses to improve sexual health knowledge, attitude, and self-efficacy in a teaching psychiatric hospital in southern Taiwan. METHOD Volunteered psychiatric nurses were randomly assigned to the experimental or control group. The 8-hour training program contained sexual health knowledge and attitudes, case discussion, role play, and sexual identity or harassment issues. Each nurse received a pretest and a posttest in the 1-month period between August and September 2019. Descriptive and multivariate statistical analyses were used to evaluate the effects. RESULTS Among the 75 psychiatric nurses, 43 were in the control group and 32 were in the experimental group. The two groups were not significantly different in the working year, gender, education, marriage, and other psychosocial variables. After the training, the overall performance of sexual health care knowledge, attitudes, and self-efficacy of the experimental group improved significantly than the controls. CONCLUSIONS The sexual health care training program enhanced psychiatric nurses' confidence and generally improved their sexual knowledge and attitudes. It is suggested that sexual health care needs to be highlighted during in-job training to augment the well-being and life quality of psychiatric patients.
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Affiliation(s)
- Mei-Jou Lu
- Mei-Jou Lu, MSc, RN, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung; Fooyin University, Kaohsiung, Taiwan
| | - Jin-Biau Li
- Jin-Biau Li, PhD, RN, Cardinal Tien Junior College of Healthcare and Management
| | - Chia-Yi Wu
- Chia-Yi Wu, PhD, RN, School of Nursing, National Taiwan University College of Medicine, Taipei; Department of Nursing, National Taiwan University Hospital, Taipei; Taiwan Suicide Prevention Center, Taipei
| | - Pham Thi Thu Huong
- Pham Thi Thu Huong, PhD Candidate, MSN, RN, School of nursing, National Taiwan University College of Medicine, Taipei, Taiwan; Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam; National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Pei-Chen Hsu
- Pei-Chen Hsu, RN, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chiou-Rong Chang
- Chiou-Rong Chang, RN, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
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2
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Krogh HB, Vinberg M, Mortensen GL, Skakke D, Nielsen D, Giraldi A. Bipolar disorder and sexuality: a preliminary qualitative pilot study. Int J Bipolar Disord 2023; 11:5. [PMID: 36735118 PMCID: PMC9898481 DOI: 10.1186/s40345-023-00285-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Individuals with mental health disorders have a higher risk of sexual problems impacting intimate relations and quality of life. For individuals with bipolar disorder (BD) the mood shifts might to a particular degree affect their sexual function with possible hypersexual interest during manic episodes and low sexual interest during depressive episodes. The diagnosis is often given in late adolescence, which may impact sexual identity and development. Only a few studies have looked at BD and sexual life, with no qualitative research on the topic. We conducted a qualitative pilot study exploring sexuality in connection to mood swings in five participants with BD. RESULTS Thematic content analysis revealed five themes: (1) sexual drive and impulses, (2) sexual behavior, (3) thoughts and feelings in relation to sexual issues, (4) intimate relationships, and (5) sexuality and identity. During manic episodes the participants described having a higher sexual drive, leading for some to more sexual interactions. During depressed episodes, the sexual drive in the three female participants was low, however, in the two men, rather than a reduced sexual drive, a more self-destructive way of engaging in sex prevailed. The sexual outgoing behavior during manic phases was described as joyful, with no feelings of shame connected to it. However, the shifts in sexual drive connected to mood shifts affected the participants' relationships negatively. Further, all the participants described having outgoing sexual behavior in their youth. CONCLUSIONS Overall, changes in sexual drive may act as a trigger or early warning symptoms of new episodes, pinpointing the clinical relevance of addressing sexuality in individuals with BD. In general, sexual drive followed affective episodes. However, during depressive episodes sex could be, instead of reduced drive, associated with negative feelings. All participants described having an outgoing sexual behavior in their youth before the onset of BD, which might be essential to consider if there is a clinical suspension of BD in an individual.
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Affiliation(s)
- Helle B. Krogh
- grid.4973.90000 0004 0646 7373Sexological Clinic, Mental Health Center Copenhagen, Copenhagen University Hospital, Ole Maaloes 14, 2100 Copenhagen, Denmark
| | - Maj Vinberg
- grid.4973.90000 0004 0646 7373Mental Health Center, Northern Zealand, Copenhagen University Hospital, Mental Health Services CPH, Hillerød, Denmark ,grid.475435.4Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark
| | | | - Ditte Skakke
- grid.4973.90000 0004 0646 7373Sexological Clinic, Mental Health Center Copenhagen, Copenhagen University Hospital, Ole Maaloes 14, 2100 Copenhagen, Denmark
| | - Dorthe Nielsen
- grid.7143.10000 0004 0512 5013Odense University Hospital, Odense, Denmark
| | - Annamaria Giraldi
- grid.4973.90000 0004 0646 7373Sexological Clinic, Mental Health Center Copenhagen, Copenhagen University Hospital, Ole Maaloes 14, 2100 Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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3
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Brand E, Tham C, Ratsch A, Heffernan E. Sexual knowledge of Queensland forensic mental health patients: A cross-sectional quantitative study. Front Psychiatry 2023; 14:1160277. [PMID: 37113546 PMCID: PMC10126372 DOI: 10.3389/fpsyt.2023.1160277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Forensic patients with serious mental illnesses (SMI) encounter significant challenges including active symptomatology, associated social and interpersonal impairments, psychotropic medication side effects and institutionalization, all of which negatively affect sexual functioning and possibly their acquirement of sexual knowledge. Evidence shows an increased prevalence of high-risk sexual behavior by this group however, there is an absence of literature examining the sexual knowledge of forensic patients. This quantitative cross-sectional study enrolled N = 50 patients currently under the treatment requirements of a Forensic Order and utilized the validated General Sexual Knowledge Questionnaire (GSKQ) to quantify the participants' sexual knowledge over the domains of physiology, sexual intercourse, pregnancy, contraception, sexually transmitted diseases, and sexuality. Male forensic patients scored lower than females on all domains of sexual knowledge. All participants had reasonable knowledge of physiology, sexual intercourse and sexuality; of concern were poor scores on pregnancy, contraception and sexually transmitted diseases. Thirty-five (70%) of the respondents indicated that they had some limited sex education, mostly at school. Only six (12%) received any sexual education from a health professional despite extensive contact with the forensic mental health services across many years. There is a need to assess the deficit in sexual knowledge of forensic patients in order to develop sexual health education, intervention and rehabilitative programmes that cater to the specific needs of this group to improve their sexual knowledge, encourage safe and positive sexual experiences, and enhance their quality of life.
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Affiliation(s)
- Elnike Brand
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- *Correspondence: Elnike Brand,
| | - Ching Tham
- Metro South Hospital and Health Services, Queensland Health, Brisbane, QLD, Australia
| | - Angela Ratsch
- Wide Bay Hospital and Health Service, Research Services, Hervey Bay Hospital, Hervey Bay, QLD, Australia
- Rural Clinical School, The University of Queensland, Brisbane, QLD, Australia
| | - Edward Heffernan
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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4
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Brand E, Ratsch A, Nagaraj D, Heffernan E. The sexuality and sexual experiences of forensic mental health patients: An integrative review of the literature. Front Psychiatry 2022; 13:975577. [PMID: 36226109 PMCID: PMC9548579 DOI: 10.3389/fpsyt.2022.975577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Sexuality is an integral aspect of the human experience that defines an individual. Robust research, substantiated by the World Health Organization, demonstrates that healthy sexuality improves mental health and quality of life. Despite this level of global advocacy and clinical evidence, sexuality and sexual health as determinants of health have been largely overlooked in the mental healthcare of patients being treated under the requirements of a forensic order (forensic patients). In this review, the authors have evaluated the literature related to the sexual development, sexual health, sexual knowledge and risks, sexual experiences, sexual behavior and sexual desires of forensic patients to inform policy and clinical practice. Furthermore, the review explored how forensic patients' sexual healthcare needs are managed within a forensic mental healthcare framework. The paper concludes with recommendations for service providers to ensure that sexual health and sexuality are components of mental health policy frameworks and clinical care. Methods An integrative review was utilized to summarize empirical and theoretical literature to provide a greater comprehensive understanding of the sexuality and sexual experiences of forensic patients. This included identifying original qualitative, quantitative, or mixed-method research, case reports, case series and published doctoral thesis pertaining to the research topic. Results Twenty-one articles were selected for review. We grouped the review findings into three main themes: 1) Forensic patient themes, 2) Forensic mental health staff themes and 3) Forensic mental health organization themes. The review demonstrated scant information on the sexual healthcare needs of forensic patients or how health services manage these needs while the patient is in a hospital or reintegrating into the community. Conclusion There is a dearth of evidence-based, individualized or group approaches which clinicians can utilize to assist forensic patients to achieve a healthy sexual life and it is recommended that such services be developed. Before that however, it is essential to have a clear understanding of the sexual healthcare needs of forensic patients to identify areas where this vulnerable population can be supported in achieving optimal sexual health. Urgent changes to clinical assessment are required to incorporate sexual healthcare as a component of routine mental healthcare.
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Affiliation(s)
- Elnike Brand
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Angela Ratsch
- Wide Bay Hospital and Health Service, Research Services, Hervey Bay Hospital, Hervey Bay, QLD, Australia
- Rural Clinical School, The University of Queensland, Brisbane, QLD, Australia
| | - Dinesh Nagaraj
- Community Mental Health and Addiction Services, Waikato District Health Board, Hamilton, New Zealand
| | - Edward Heffernan
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Urry K, Chur-Hansen A, Khaw C. 'It's Not Really a Part of Standard Practice': Institutional Silencing of Sexuality Within Australian Mental Health Settings. QUALITATIVE HEALTH RESEARCH 2022; 32:543-555. [PMID: 34904865 DOI: 10.1177/10497323211061340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Research seeking to understand and improve sexuality-related practice in mental health settings has paid little attention to the institutional context in which clinicians' practice is embedded. Through a social constructionist lens, we used thematic analysis to examine how 22 Australian mental health clinicians implicated the wider institutional context when discussing and making sense of sexuality-related silence within their work. Interviews were part of a study exploring participants' perceptions of sexuality and sexual health in their work more generally. Broader silences that shaped and reinforced participants' perceptions and practice choices were situated in professional education; workplace cultures; and the tools, procedures and policies that directed clinical practice. We argue that sexuality-related silence in mental health settings is located in the institutional context in which clinicians learn and work, and discuss how orienting to this broader context will benefit research and interventions to improve sexuality-related practice across health settings.
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Affiliation(s)
- Kristi Urry
- School of Psychology, Faculty of Health and Medical Sciences, 1066University of Adelaide, Adelaide, SA, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, 1066University of Adelaide, Adelaide, SA, Australia
| | - Carole Khaw
- School of Medicine, Faculty of Health and Medical Sciences, 1066University of Adelaide, Adelaide, SA, Australia
- Adelaide Sexual Health Centre, Infectious Disease UnitRoyal Adelaide Hospital, Adelaide, SA, Australia
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6
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Hortal-Mas R, Moreno-Poyato AR, Granel-Giménez N, Roviralta-Vilella M, Watson-Badia C, Gómez-Ibáñez R, Aguayo-González MP, Giménez-Díez D, Bernabeu-Tamayo MD, Leyva-Moral JM. Sexuality in people living with a serious mental illness: A meta-synthesis of qualitative evidence. J Psychiatr Ment Health Nurs 2022; 29:130-146. [PMID: 33047434 DOI: 10.1111/jpm.12700] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/17/2020] [Accepted: 09/03/2020] [Indexed: 01/31/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT A serious mental illness influences sexual life and people affected have worries about their sexual health. People living with a serious mental illness can and want to participate in interventions related to sexual health. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE People who suffer a serious mental illness are interested in maintaining an active sex life. People who suffer a serious mental illness experience rejection when they open up and they lose intimate relationships or possibilities of meeting other people because of ignorance and prejudices surrounding mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE Mental health services must respond to this need, that is including sexual needs assessment among routine standard practices or training nurses on sexual education to allow them to advise patients and their families and friends. Health systems should promote awareness programmes and reduce the stigma surrounding mental health and sexuality. ABSTRACT INTRODUCTION: Sexuality-related nursing care is scarce and mainly focuses on biological issues. There is also a lack of knowledge about how serious mental illnesses affect sexuality. AIM To explain how people with a serious mental illness perceive and experience their sexuality. METHOD A meta-synthesis was conducted to integrate qualitative studies. Four databases were used to perform the search, focused in the last ten years. Nine articles were included, and their results analysed thematically. RESULTS Four categories were identified: "Pathologized sexuality," which explains how the disorder and treatment affect sexuality; "Not my sexuality anymore," which describes feelings emerging from the perceived limitations and the role of self-acceptance; "Learning to manage intimate relationships," which explains the desire to establish intimate personal relationships and define their meaning; and "Reconstructing my sexuality," which elucidates the influence of the environment on sexuality. DISCUSSION Sexuality is influenced by several factors, the main ones being: the clinical complications, the side effects of drug treatment, the social support, the relationship with the health sector and stigma. IMPLICATIONS FOR PRACTICE Having a serious mental illness affects sexuality and can provoke suffering and social isolation. Mental health services should address this issue and carry out community interventions to reduce stigma.
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Affiliation(s)
- Roger Hortal-Mas
- Psychiatric Rehabilitation Area, Hermanas Hospitalarias - Hospital Sagrat Cor, Martorell, Catalonia, Spain
| | - Antonio Rafael Moreno-Poyato
- Department of Public Health, Mental Health and Perinatal Nursing, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Hospital del Mar Institute for Medical Research (IMIM), Barcelona, Catalonia, Spain
| | - Nina Granel-Giménez
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Maria Roviralta-Vilella
- Institut de Neuropisquiatria i Addiccions, Parc de Salut Mar de Barcelona, Barcelona, Catalonia, Spain
| | - Carolina Watson-Badia
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.,Knowledge Management Department, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Rebeca Gómez-Ibáñez
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Mariela Patricia Aguayo-González
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - David Giménez-Díez
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.,Partial Home Care Unit, CPB Serveis de Salut Mental, Barcelona, Catalonia, Spain
| | - Maria Dolores Bernabeu-Tamayo
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Juan Manuel Leyva-Moral
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.,Centre for Health Sciences Research, Universidad María Auxiliadora, Lima, Peru.,Evidence-Based Health Care South America: A Joanna Briggs Institute Affiliated Group, Universidad Norbert Wiener, Lima, Peru
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7
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Brand E, Nagaraj D, Ratsch A, Heffernan E. A Qualitative Study on Sexuality and Sexual Experiences in Community Forensic Mental Health Patients in Queensland, Australia. Front Psychiatry 2022; 13:832139. [PMID: 35432027 PMCID: PMC9008211 DOI: 10.3389/fpsyt.2022.832139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/09/2022] [Indexed: 11/23/2022] Open
Abstract
This qualitative study reports on the sexuality and sexual experiences of community-based forensic mental health participants. The findings indicate that these participants feel the need for intimacy and want to engage in sexual activity more often than their neurotypical Australian peers. Participants identified their mental health and the side effects of compliance with prescribed psychotropic medications were barriers to achieving their desired level of sexual activity. Participants supported the notion that mental health teams were positioned to assist patients navigate the psychological, cultural, education and physical barriers to achieving sexual health and wellbeing. We propose several interventions to support these participants and other community forensic mental health patients in attaining healthy relationships, understanding their sexual health, and gaining more fulfilling sexual experiences. These interventions, which include sex education, upskilling in socialization and communication, and regular medication reviews, could be delivered as part of the holistic care provided by mental health teams. Mental health clinicians should be offered appropriate training to assess patients and have discussions related to sexuality, sexual experiences and sexual health needs.
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Affiliation(s)
- Elnike Brand
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Dinesh Nagaraj
- Community Mental Health and Addiction Services, Waikato District Health Board, Hamilton, New Zealand
| | - Angela Ratsch
- Wide Bay Hospital and Health Service, Research Services, Hervey Bay Hospital, Hervey Bay, QLD, Australia.,Rural Clinical School, The University of Queensland, Brisbane, QLD, Australia
| | - Edward Heffernan
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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8
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Gombert M, Ballester P, Segura A, Peiró AM. Introducing sexual dysfunction in mental care. Expert Opin Drug Saf 2020; 20:69-79. [PMID: 33191796 DOI: 10.1080/14740338.2020.1849135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction: People with any psychiatric disorder tend to have difficulties in responding sexually. However,sexual dysfunction (SD) is usually under-recognized, even the tightly hormonal and neuronal common connexions through the brain-sex axis. Multiple sources of resistance to SD assessment and intervention persist. Areas covered: The present review aims to underline the feasibility to introduce SD evaluation in patients with any psychiatric disorders, evaluating the potential mutual benefits of their management. Expert opinion: Women and men living with mental disorders frequently display sexual difficulties; however, some of them consider sexuality as a relevant parameter of their quality of life. In fact, SD as a side effect is a frequent reason for stopping the intake of medication. What is more, a holistic approach integrating sexual function could foster a better understanding of mental pathologies due to a common origin of pathogenesis. This could improve care quality, in keeping with the global tendency toward the development of personalized medicine. Consistently, the integration of SD assessment is highly recommended in mental health, all the more so when a psychotropic drug is prescribed. An expected consequence would be a reconstruction of the healthcare professional's consideration for the sexuality of people experiencing mental disorders.
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Affiliation(s)
- Marie Gombert
- Department of Paediatrics, Obstetrics and Gynecology, University of Valencia , Valencia, Spain
| | - Pura Ballester
- Department of Pharmacology, Paediatrics and Organic Chemistry , Alicante, Spain.,Neuropharmacology on Pain (NED) Group, Alicante Institute for Health and Biomedical Research (ISABIAL) , Alicante, Spain
| | - Ana Segura
- Andrology Unit, Department of Health of Alicante - General Hospital, Alicante, Spain.,Clinical Pharmacology Unit, Department of Health of Alicante - General Hospital, Alicante, Spain
| | - Ana M Peiró
- Department of Pharmacology, Paediatrics and Organic Chemistry , Alicante, Spain.,Clinical Pharmacology Unit, Department of Health of Alicante - General Hospital, Alicante, Spain
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Landi G, Marchi M, Ettalibi MY, Mattei G, Pingani L, Sacchi V, Galeazzi GM. Affective and Sexual Needs of Residents in Psychiatric Facilities: A Qualitative Approach. Behav Sci (Basel) 2020; 10:E125. [PMID: 32756442 PMCID: PMC7464764 DOI: 10.3390/bs10080125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The affective and sexual needs of psychiatric patients are often under-considered, although they contribute significantly to their general well-being. Such topics are critical for Residential Psychiatric Facilities Users (RPFUs), whose daily life is paced by therapeutic settings. The aim of this paper is to better understand how sexuality and affectivity are expressed by the RPFUs at the Mental Health Department of Modena, within psychiatric residential settings. METHODS Adult RPFUs took part into two audio recorded focus groups. Digital transcripts were analyzed using MAXQDA software in order to perform qualitative narrative analysis, so as to develop a hierarchical code system a posteriori (derived from the data). RESULTS Eleven participants (eight RPFUs and three investigators) attended the first focus group, and eight participants (5 RPFUs and 3 investigators) attended the second focus group. 175 interventions were analyzed and coded under seven thematic areas: (a) contraception and sexually transmitted disease prevention (N = 17); (b) affective needs (N = 11); (c) personal experiences (N = 61); (d) regulation of sexual relations (N = 18); (e) Mental Health Professionals' (MHPs) openness towards the topic (N = 17); (f) MHPs' responses to RPFUs' sexual behaviors (N = 33); and (g) RPFUs proposals (N = 18). The highlighted topics suggest that affective and sexual relations commonly occur within residential psychiatric facilities, even if mental health services often fail to recognize and address RPFUs' affective and sexual needs as well as to provide effective solutions to manage them. CONCLUSIONS RPFUs expressed a request for support to fulfill their affective and sexual needs and dedicated spaces for sexual activities to relieve their discomfort, while MHPs highlighted a need for awareness, training, and shared problem-solving strategies.
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Affiliation(s)
- Giulia Landi
- Department of Mental Health and Drug Abuse, AUSL Modena, Via San Giovanni del Cantone, 23–41121 Modena, Italy;
| | - Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287–41125 Modena, Italy; (M.M.); (L.P.); (V.S.)
| | | | - Giorgio Mattei
- Department of Economics & Marco Biagi Foundation, University of Modena and Reggio Emilia, Via J. Berengario, 51–41121 Modena, Italy;
| | - Luca Pingani
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287–41125 Modena, Italy; (M.M.); (L.P.); (V.S.)
| | - Valentina Sacchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287–41125 Modena, Italy; (M.M.); (L.P.); (V.S.)
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287–41125 Modena, Italy; (M.M.); (L.P.); (V.S.)
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10
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Kazour F, Obeid S, Hallit S. Sexual desire and emotional reactivity in chronically hospitalized Lebanese patients with schizophrenia. Perspect Psychiatr Care 2020; 56:502-507. [PMID: 31750549 DOI: 10.1111/ppc.12455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/11/2019] [Accepted: 11/15/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To study the level of emotional reactivity of Lebanese patients with schizophrenia who have a high level of sexual desire. DESIGN/METHODS It is a cross-sectional study, enrolling 30 men and 30 women, between April and June 2017. The sexual behavior questionnaire (SBQ) was used to explore the desire, sexual arousal, orgasm, ejaculation, pleasure, and satisfaction with sexuality. FINDINGS A significantly higher mean emotional score, higher cognitive functioning score, higher motivation score, higher motor deficit score, higher sensory perception score, higher SBQ score, and higher emotional reactivity were found in patients who masturbate compared with those who did not. PRACTICE IMPLICATIONS All these improvements in patients who masturbate might be associated with better social relations, which might improve patient integration in society. KEY POINTS Sustained sexual activity of patients with schizophrenia is associated with improved emotional and cognitive functioning. The same applies to higher levels of motivation, motor skills, and sensoriality. Sustained sexual activity of patients who have schizophrenia would indicate a better prognosis of schizophrenia.
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Affiliation(s)
- Francois Kazour
- Departments of Psychiatry, Psychology and Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Arts and Science, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.,INSERM U930, François Rabelais University, Tours, France
| | - Sahar Obeid
- Departments of Psychiatry, Psychology and Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Arts and Science, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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11
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Evcili F, Demirel G, Bekar M, Guler H. Effectiveness of postpartum sexual health education programme structured according to Levine's conservation model: An interventional study. Int J Nurs Pract 2020; 26:e12855. [PMID: 32510741 DOI: 10.1111/ijn.12855] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 03/18/2020] [Accepted: 05/01/2020] [Indexed: 01/29/2023]
Abstract
AIM This study aimed to determine the effects of a postpartum sexual health education programme structured according to Levine's conservation model on postpartum women. METHODS The interventional study was completed with 67 postpartum women. The intervention group was given the postpartum sexual health education programme structured according to Levine's conservation model. The control group received routine discharge training. The data were collected using a personal information form, The Index of Female Sexual Function, Arizona Sexual Experience Scale and Golombok-Rust Inventory of Sexual Satisfaction. RESULTS It has been determined that the decrease in sexual arousal and desire is the first among postpartum sexual problems experienced by women. This study demonstrated that sexual function, sexual satisfaction and sexual response were higher in nonbreastfeeding women, women who had sexual intercourse one to three times a week and women who could talk to health care professionals on sexual matters. After the programme, the intervention group had more adequate sexual function, and they developed a strong, easy and satisfactory sexual response than the control group (p < 0.05). CONCLUSION This programme was effective in increasing the sexual functions and satisfaction of the postpartum women. Models provide guidance to nurses for provision of care in a systematic manner.
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Affiliation(s)
- Funda Evcili
- Vocational School of Health Care Services, Cumhuriyet University, Sivas, Turkey
| | - Gulbahtiyar Demirel
- Faculty of Health Sciences, Midwifery Department, Cumhuriyet University, Sivas, Turkey
| | - Mine Bekar
- Faculty of Health Sciences, Midwifery Department, Cumhuriyet University, Sivas, Turkey
| | - Handan Guler
- Faculty of Health Sciences, Midwifery Department, Cumhuriyet University, Sivas, Turkey
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Mitchell A, Hill B. Physical health assessment for people with a severe mental illness. ACTA ACUST UNITED AC 2020; 29:553-556. [PMID: 32463746 DOI: 10.12968/bjon.2020.29.10.553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Aby Mitchell
- Senior Lecturer, Adult Nursing, University of West London
| | - Barry Hill
- Director of Employability (Nursing, Midwifery and Health), and Programme Leader, BSc (Hons) Nursing Science (Adult), Northumbria University, Newcastle
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13
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Luby R. Using the STARTER model to talk about sex in mental health nursing practice. ACTA ACUST UNITED AC 2020. [DOI: 10.7748/mhp.2020.e1457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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14
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Abdelatti SI, Ismail RM, Hamed RA. Sexual dysfunctions in a sample of male psychiatric patients compared to medically ill patients. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00022-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Many of the psychiatric disorders and other medical conditions may affect the sexual function of the patients. The present study aims to investigate the frequency of sexual dysfunctions in male psychiatric patients compared to other medically ill patients.
Results
Sexual dysfunction among psychiatric patients (51.2%) was significantly higher than among other medical patients (21%). Among the psychiatric patients, those with schizophrenia (75%) had the highest prevalence rate of sexual dysfunctions. The patients with bipolar disorders, depressive disorders, and anxiety disorders had the following rates respectively: 55%, 45%, and 30%. Among the other medical patients, those with the cardiac diseases (35%) had the highest prevalence rate of sexual dysfunctions. The patients with hepatic diseases, diabetes, urologic diseases, and respiratory diseases had the following rates respectively: 25%, 20%, 15%, and 10%. Prolactin level among psychiatric patients was significantly higher than among the other medical patients, while there was no significant difference between the psychiatric and other medical patients regarding total testosterone level.
Conclusion
Considering the significant relative frequency of sexual dysfunctions in psychiatric patients, more emphasis is recommended to be placed on the prevention and proper treatment of these disorders.
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Wainberg ML, McKinnon K, Cournos F. Learning from #MeToo: a Call to Action in the Training of Psychiatric Faculty and Residents to Discuss Sexuality as a Health and Mental Health Issue. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2020; 44:16-20. [PMID: 30924109 DOI: 10.1007/s40596-019-01051-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/08/2019] [Indexed: 06/09/2023]
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16
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Urry K, Chur-Hansen A, Khaw C. 'It's just a peripheral issue': A qualitative analysis of mental health clinicians' accounts of (not) addressing sexuality in their work. Int J Ment Health Nurs 2019; 28:1278-1287. [PMID: 31353790 DOI: 10.1111/inm.12633] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2019] [Indexed: 02/05/2023]
Abstract
Sexuality, relationships, and intimacy are integral parts of many peoples' lives, not negated by mental distress and illness. Yet typically, these needs are not addressed adequately in mental health settings. In-depth interviews were conducted with mental health clinicians with an aim of exploring their perceptions and understandings of sexuality and sexual concerns within mental health settings. Participants were 22 mental health nurses, psychologists, and psychiatrists working with people across a range of settings in four Australian cities. Sexuality or aspects of this were often not addressed in clinical practice, and this was common across participants' accounts. A critical thematic analysis was conducted to explore how participants made sense of or explained this silence in relation to sexuality. Two key themes were 'Sexuality is hard to talk about' and 'Sexuality is a "peripheral issue"'. In positioning sexuality as a peripheral issue, participants drew on three key explanations (sub-themes): that sexuality rarely 'comes up', that it is not pragmatic to address sexuality, and that addressing sexuality is not part of participants' roles or skill sets. A third theme captured the contrasting perception that 'Sexuality could be better addressed' in mental health settings. This analysis indicates that, beyond anticipated embarrassment, mental health clinicians from three disciplines account for omissions of sexuality from clinical practice in similar ways. Moreover, these accounts serve to peripheralize sexuality in mental health settings. We consider these results within the context of espoused holistic and recovery-oriented principles in mental health settings.
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Affiliation(s)
- Kristi Urry
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Anna Chur-Hansen
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Carole Khaw
- Adelaide Sexual Health Centre, Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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17
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Urry K, Chur-Hansen A. Who decides when people can have sex? Australian mental health clinicians' perceptions of sexuality and autonomy. J Health Psychol 2018; 25:2188-2199. [PMID: 30035634 DOI: 10.1177/1359105318790026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Sexuality is a central aspect of human experience but there is evidence that this is largely constrained, pathologised or ignored in mental health settings. We conducted in-depth interviews with 22 psychologists, psychiatrists and mental health nurses working across a variety of settings in four Australian cities. Sexuality was most often perceived as relevant in the mental health setting when it was simultaneously constructed as dangerous. Participants located this danger in sexual expression itself or within individuals who, because of mental illness, lacked the autonomy required to successfully engage in 'safe' sex. We discuss these findings and their implications for research and professional practice.
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18
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Hendry A, Snowden A, Brown M. When holistic care is not holistic enough: The role of sexual health in mental health settings. J Clin Nurs 2017; 27:1015-1027. [DOI: 10.1111/jocn.14085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Avril Hendry
- Mental Health; School of Health and Social care; Edinburgh Napier University; Edinburgh UK
| | - Austyn Snowden
- Mental Health; School of Health and Social care; Edinburgh Napier University; Edinburgh UK
| | - Michael Brown
- Health & Social Care Research; School of Health & Social Care; Edinburgh Napier University; Edinburgh UK
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19
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Corbett R, Elsom S, Sands N, Prematunga R. An exploratory investigation of sexual health screening in the first 12 weeks of case management in populations with severe mental illness. Int J Ment Health Nurs 2017; 26:160-169. [PMID: 27616654 DOI: 10.1111/inm.12257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2016] [Indexed: 11/27/2022]
Abstract
The sexual health of people with mental illness is commonly overlooked, neglected or inadequately addressed in mental health care, despite evidence showing that people with severe mental illness are more vulnerable to sexually transmitted infections (including HIV), sexual side-effects, and sexual dysfunction than the general population. This article reports a study that investigated sexual health screening in five community mental health clinics within a large a regional health service in Victoria, Australia. The aim of the study was to examine the extent to which sexual health screening is currently undertaken on newly admitted case-managed consumers, and to identify the types of screening undertaken. An exploratory design using retrospective file audit was used in the study. A total of 186 medical records met the study inclusion criteria. The study found that less than 40% of consumers were provided with sexual health screening during their first 12 weeks of case management. The study also found that sexual side-effects, issues of fertility, sexual self-esteem, safe sexual practices, and sexual dysfunction were rarely screened for. Poor sexual health screening has implications for the safety and quality of mental health care and requires targeted research to improve understandings and approaches to care.
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Affiliation(s)
- Rebecca Corbett
- Mental Health, Drugs and Alcohol Education Team, Barwon Health, Geelong, Victoria, Australia
| | - Stephen Elsom
- Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | - Natisha Sands
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Roshani Prematunga
- Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, Victoria, Australia
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20
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Sung SC, Jiang HH, Chen RR, Chao JK. Bridging the gap in sexual healthcare in nursing practice: implementing a sexual healthcare training programme to improve outcomes. J Clin Nurs 2016; 25:2989-3000. [DOI: 10.1111/jocn.13441] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Su-Ching Sung
- Graduate Institute of Health Care; Chang Gung University of Science and Technology; Taoyuan City Taiwan
| | - Huey-Hwa Jiang
- Department of Nursing; Taipei Veterans General Hospital Yuli Branch; Yuli Township Hualian County Taiwan
| | - Ru-Rong Chen
- Medication & Health Center; Banqiao Veterans Home; Veterans Affairs Council; New Taipei City Taiwan
| | - Jian-Kang Chao
- Department of Psychiatry; Pingtung Branch; Kaohsiung Veterans General Hospital; Pingtung Taiwan
- Department of Health Administration; Tzu Chi
University of Science and Technology; Hualien County Taiwan
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21
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Macleod C, Nhamo-Murire M. The emancipatory potential of nursing practice in relation to sexuality: a systematic literature review of nursing research 2009-2014. Nurs Inq 2016; 23:253-66. [PMID: 27147132 DOI: 10.1111/nin.12131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2015] [Indexed: 11/28/2022]
Abstract
Nurses play a key role in the provision of services in relation to sexuality in both primary and sexual and reproductive health-care. Given the intersection of sexualities with a range of social injustices, this study reviews research on nursing practice concerning sexuality from an emancipatory/social justice perspective. A systematic review of English articles published in nursing journals appearing on the Web of Science database from 2009 to 2014 was conducted. Thirty-eight articles met the inclusion criteria. Analysis consisted of a descriptive phase (types and location of studies, aspects of sexualities focused on, target health users and aspects of nursing practice focused on) and a critical/emancipatory phase. In terms of practice, our analysis revealed that: barriers exist to the integration of issues relating to sexuality in nursing practice; the social location of nurses and their personal feelings regarding sexuality influence their practice; content that addresses gendered norms and media that assist in communication underpin some emancipatory practices. Few studies locate analyses of nursing practice within gendered, cultural and social norms; consider advocacy as part of the practice of nurses; or analyse the promotion of health user participation in health services and structures. The implications for emancipatory practice are drawn out.
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Affiliation(s)
- Catriona Macleod
- Psychology Department, Critical Studies of Sexualities and Reproduction (CSSR), Rhodes University, Grahamstown, South Africa
| | - Mercy Nhamo-Murire
- Psychology Department, Critical Studies of Sexualities and Reproduction (CSSR), Rhodes University, Grahamstown, South Africa
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22
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Assessment of Sexual Fantasies in Psychiatric Inpatients With Mood and Psychotic Disorders and Comorbid Personality Disorder Traits. J Sex Med 2016; 13:262-9. [PMID: 26803456 DOI: 10.1016/j.jsxm.2015.12.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 12/16/2015] [Accepted: 12/21/2015] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Sexuality is an important aspect of quality of life and sexual fantasies comprise a normal part of human sexuality. However, the nature of sexuality and sexual fantasies of patients with mental illness remains an understudied area. AIM To investigate the nature and frequency of sexual fantasies in psychiatric patients, the present study compared the frequency of four types of sexual fantasies across four different mood and psychotic diagnoses and three personality disorder clusters. METHODS Study participants included 133 psychiatric inpatients recruited from an urban hospital. Sexual fantasies were compared across patients with schizophrenia, bipolar disorder, schizoaffective disorder, major depressive disorder and three nonclinical samples from the literature and then correlated with personality cluster scores. MAIN OUTCOME MEASURES Subjects were administered the Structured Clinical Interview for DSM-IV for Axis I and for Axis II Disorders. Sexual fantasies were assessed by the Wilson Sexual Fantasies Questionnaire, which measures four types of sexual fantasies (exploratory, intimate, impersonal, and sadomasochistic). RESULTS Within the entire sample, there were significant differences across sexual fantasy types, with subjects scoring highest on intimate sexual fantasies and then exploratory, impersonal, and sadomasochistic. There were no significant differences across mood and psychotic diagnostic groups for any of the sexual fantasy scales and the scores were within the normative range of nonclinical samples. Patients with high cluster B scores scored significantly higher on all four fantasy scales than those without. Patients with high cluster A scores scored lower on intimate fantasies, but there was no association between cluster C scores and sexual fantasies. The association between cluster B and sexual fantasies remained consistent across Structured Clinical Interview for DSM-IV for Axis I diagnoses (no interaction effect). CONCLUSION Patients with severe mental illness report sexual fantasies that are largely affiliative in nature and consistent with normative patterns. This suggests that assessment and treatment of sexual issues in the mentally ill should be part of the clinical routine as it is in healthy individuals.
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Ahmadzadeh G, Shahin A. Sexual dysfunctions in the patients hospitalized in psychiatric wards compared to other specialized wards in Isfahan, Iran, in 2012. Adv Biomed Res 2015; 4:225. [PMID: 26623400 PMCID: PMC4638051 DOI: 10.4103/2277-9175.166648] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Accepted: 08/07/2013] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Having pleasurable sexual intercourses plays a major role in marital life satisfaction. Many of the medical and psychiatric disorders may affect the sexual function of the patients. The present study aims to investigate the relative frequency of sexual dysfunctions in the patients hospitalized in psychiatric wards and that of the patients in other specialized wards. MATERIALS AND METHODS This study is a descriptive-analytical, cross-sectional one, carried out on 900 patients hospitalized in psychiatric, cardiac, orthopedic, ophthalmology, and dermatology and plastic surgery wards of 5 hospitals in Isfahan. Data collection tools included demographic questionnaire and Arizona Sexual Experiences Scale (ASEX). RESULTS Sexual dysfunction in the patients hospitalized in psychiatric wards (38%) was significantly higher than in the patients in other wards (27%), (P = 0.00). Among the patients hospitalized in psychiatric wards, those with bipolar disorder (37.3%) had the highest prevalence rate of sexual dysfunction. The patients with schizophrenia, major depression, substance abuse, and anxiety disorders had the following rates respectively. Among the patients in non-psychiatric wards, those in cardiac wards (37.1%) had the highest prevalence rate of sexual dysfunction. There was a significant relationship between the drug uses, mostly psychiatric drugs especially anti-psychotics, and the occurrence of sexual dysfunction. CONCLUSION Considering the significant relative frequency of sexual dysfunction in psychiatric patients and undesired effects of simultaneous occurrence of both of these disorders in the patients, more emphasis is recommended to be placed on the prevention and proper treatment of these disorders in the patients.
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Affiliation(s)
- Gholamhossain Ahmadzadeh
- Department of Psychiatry, Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Shahin
- Department of School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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24
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Rodolpho JRC, Hoga LAK, Reis-Queiroz J, Jamas MT. Experiences and daily life attitudes of women with severe mental disorders: integrative review of associated factors. Arch Psychiatr Nurs 2015; 29:223-35. [PMID: 26165977 DOI: 10.1016/j.apnu.2015.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/10/2015] [Accepted: 03/21/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective is to identify the factors that influence the experiences and daily life attitudes of women with severe mental disorders (SMD). METHOD A search for studies published from 2000 to 2014 was conducted in electronic databases. All relevant primary studies were screened using integrative methods. Findings were synthesized thereafter. RESULTS Fifteen articles were included. A total of 21 factors were identified as being associated with experiences and daily life attitudes of women with SMD. These factors consisted of the following five categories: strengths and limitations regarding self-care behavior and healthcare delivery, unmet healthcare needs, psychosocial vulnerabilities underlying SMD, gains and challenges of motherhood, and adoption of coping strategies. CONCLUSIONS Healthcare providers can greatly contribute to improving the quality of healthcare for women with SMD, but several barriers need to be overcome.
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Affiliation(s)
| | | | - Jéssica Reis-Queiroz
- University of São Paulo, School of Nursing, Cerqueira Cesar, São Paulo, SP, Brazil.
| | - Milena Temer Jamas
- São Paulo State University, Faculty of Medicine of Botucatu, Department of Nursing.
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25
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Oskay U, Can G, Basgol S. Discussing sexuality with cancer patients: oncology nurses attitudes and views. Asian Pac J Cancer Prev 2015; 15:7321-6. [PMID: 25227836 DOI: 10.7314/apjcp.2014.15.17.7321] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sexual health and function frequently are overlooked by healthcare professionals despite being identified as an essential aspect of patient care. Patients with cancer have identified sexuality issues as being of equal importance to other quality-of-life issues. OBJECTIVES The aim of this study was to determine the views and attitudes of oncology nurses caring for cancer patients regarding sexual counseling. PARTICIPANTS AND METHODS A descriptive cross-sectional study was conducted on the web site of the Turkish Oncology Nurses Association. With the participation of 87 nurses from oncology departments, the study determined that most nurses do not evaluate and counsel patients regarding their sexual problems and many difficulties prevent them from focussing on sexual health. The most important reasons for ignoring sexual counseling were the absence of routine regarding sexual counseling in oncology departments, the belief that the patient may become ashamed and the nurses' self-evaluation that they have insufficient skills and education to counsel in this subject. CONCLUSIONS The most important variables in sexual evaluation and counseling are long years of service in the profession and a postgraduate degree.
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Affiliation(s)
- Umran Oskay
- Department of Gynecologic and Obstetrics Nursing, Florence Nightingale Nursing Faculty, Istanbul University, Istanbul, Turkey E-mail :
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26
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'You just lose the people you know': relationship loss and mental illness. Arch Psychiatr Nurs 2015; 29:96-101. [PMID: 25858201 DOI: 10.1016/j.apnu.2014.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 11/05/2014] [Accepted: 11/27/2014] [Indexed: 11/21/2022]
Abstract
The purpose of this qualitative study was to explore the nature, scope and consequences of losses resulting from mental illness. This paper presents findings from a key theme of this study-the loss of relationships. Thematic analysis revealed two categories: loss of intimate relationships, which included subcategories of (i) spouses/partners, (ii) children/parenthood, (iii) family, and (iv) friends; and (2) people within the community, such as people at church and support groups. Relationships are seen as one of the most crucial yet challenging elements to recovery and wellbeing for people affected by mental illness.
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Tennille J, Solomon P, Bohrman C. Using the FIELD Model to Prepare Social Work Students and Field Instructors on Sexuality and Intimacy for Persons with Psychiatric Disabilities. SEXUALITY AND DISABILITY 2014. [DOI: 10.1007/s11195-014-9380-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Browne G, Hurley J, Lakeman R. Mental health nursing: what difference does it make? J Psychiatr Ment Health Nurs 2014; 21:558-63. [PMID: 25080944 DOI: 10.1111/jpm.12162] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- G Browne
- School of Nursing and Midwifery, Newcastle University, Port Macquarie, NSW, Australia
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29
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Maasoumi R, Moridi M, Farhadi F, Moshfeghi Z. Sexual Function in Women With Rheumatoid Arthritis. WOMEN’S HEALTH BULLETIN 2014. [DOI: 10.17795/whb-20098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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de Visser RO, Badcock PB, Simpson JM, Grulich AE, Smith AMA, Richters J, Rissel C. Attitudes toward sex and relationships: the Second Australian Study of Health and Relationships. Sex Health 2014; 11:397-405. [DOI: 10.1071/sh14099] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/23/2014] [Indexed: 11/23/2022]
Abstract
Background
Attitudes towards sex and relationships influence laws about what is and is not permissible and social sanctions against behaviours considered unacceptable. They are an important focus for research given their links to sexual behaviour. The aim of the present study was to describe attitudes towards sex and relationships, to identify correlates of scores on a scale of sexual liberalism and to examine responses to jealousy-evoking scenarios among Australian adults. Methods: Computer-assisted landline and mobile telephone interviews were completed by a population-representative sample of 20 094 men and women aged 16–69 years. The overall participation rate among eligible people was 66.2%. Respondents expressed their agreement with 11 attitude statements, five of which formed a valid scale of liberalism, and also responded to a jealousy-evoking scenario. Results: There was general agreement that premarital sex was acceptable (87%), that sex was important for wellbeing (83%) and that sex outside a committed relationship was unacceptable (83%). Respondents were accepting of homosexual behaviour and abortion and few believed that sex education encouraged earlier sexual activity. More liberal attitudes were associated with: being female; speaking English at home; homosexual or bisexual identity; not being religious; greater education; and higher incomes. Respondents who expressed more liberal attitudes had more diverse patterns of sexual experience. Predicted sex differences were found in response to the jealousy-evoking scenario — men were more jealous of a partner having sex with someone else and women were more jealous of a partner forming an emotional attachment — but responses varied with age. Conclusion: Sexual attitudes of Australians largely support a permissive but monogamous paradigm. Since 2002, there has been a shift to less tolerance of sex outside a committed relationship, but greater acceptance of homosexual behaviour.
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Abstract
PURPOSE To explore nurses' perceptions of how consumers of mental health services have responded to mental health nurses discussing sexuality with them. DESIGN AND METHODS Qualitative exploratory design including in-depth individual interviews with 14 mental health nurses in Australia on two occasions. Nurse participants were taught the BETTER model in the first interview and were asked to use this in their practice. FINDINGS In the second interview nurse participants described the model as useful and consumer responses as very positive. PRACTICE IMPLICATIONS The findings suggest the BETTER model is a simple and effective intervention that can assist mental health nurses to include sexuality as part of nursing care.
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Affiliation(s)
- Chris Quinn
- Institute of Health and Social Science Research and School of Nursing and Midwifery, CQ University Australia, Rockhampton, Queensland, Australia
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32
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Quinn C, Happell B, Welch A. The 5-As framework for including sexual concerns in mental health nursing practice. Issues Ment Health Nurs 2013; 34:17-24. [PMID: 23301565 DOI: 10.3109/01612840.2012.711433] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Available evidence informs us that sexual health concerns of consumers are commonly avoided within mental health services. This paper describes the findings of a qualitative exploratory research project. This research was conducted in three stages, all involving in-depth interviews with 14 nurses working in a mental health setting. Stage 1 involved an exploration of participants' views about including sexual concerns in their practice and included an educational intervention designed to encourage sexual inclusivity in practice. Stage 2 involved follow up interviews 4-6 weeks later to discuss the effectiveness of the intervention and whether practice change had resulted. Stage 3 was conducted two years later with the aim of determining the extent to which practice changes had been sustained. The themes emerging throughout the research emphasised five main stages in the nurses' experience: avoidance; awareness; applying; approval; and acknowledgement. Avoidance of the topic was commonly noted in the early stages of the research. The education program led to awareness raising of sexual concerns and approval towards the importance of this area to which lead to applying it to practice. This ultimately resulted in acknowledgement of the need for sexual concerns to become part of mental health nursing practice. These five stages are represented in the Five A's for including sexual concerns in mental health nursing practice, the framework developed by the first author.
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Affiliation(s)
- Chris Quinn
- Central Queensland University Australia, Institute of Health and Social Sciences Research, Rockhampton, Australia
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Billington T. Issues of patient sexuality in nurse education. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2012; 21:1109. [PMID: 23123846 DOI: 10.12968/bjon.2012.21.18.1109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Tracey Billington is a substance misuse nurse and a part-time MSc student at Northumbria University. Here, she reflects on her experiences as a trainee nurse dealing with the complexities of patient sexual health and the need for this area to be taken more seriously by the nursing profession, beginning with its inclusion and emphasis in the nurse education curriculum.
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34
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Werner S. Needs assessment of individuals with serious mental illness: can it help in promoting recovery? Community Ment Health J 2012; 48:568-73. [PMID: 22138851 DOI: 10.1007/s10597-011-9478-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
Abstract
Needs of individuals with serious mental illness (SMI) must be understood in order to promote recovery. This study examined the needs of 206 individuals with SMI and compared their perceptions with those of their professional caregivers. Needs were reported in the areas of accommodations, psychotic symptoms, daytime activity, intimate relationships, and psychological distress. Caregivers reported more met needs, while individuals themselves reported more unmet needs. Results suggest that in order to promote recovery, services for persons with SMI should be developed in accordance with patients' most prominent needs, specifically in the social and personal areas of intimate and sexual relationships.
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Affiliation(s)
- Shirli Werner
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, 91905, Mount Scopus, Israel.
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35
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Quinn C, Happell B. Getting BETTER: breaking the ice and warming to the inclusion of sexuality in mental health nursing care. Int J Ment Health Nurs 2012; 21:154-62. [PMID: 22145637 DOI: 10.1111/j.1447-0349.2011.00783.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Discussing sexual issues with consumers is considered a nursing role, yet it is commonly avoided. Research suggests that sexual issues and difficulties are particularly evident in mental health settings, and failure to address these issues represents a significant gap in care and treatment. Specific models for raising sexual issues have been used in oncology and cardiac care settings to assist clinicians. A descriptive, exploratory study was conducted with mental health nurses from Queensland, Australia. The aim of this research was to explore whether a specific model, the BETTER model (bring up, explain, tell, time, educate, record) was useful in assisting mental health nurses in raising the topic of sexuality with consumers. In-depth interviews explored participants' attitudes and experiences of discussing sexuality. Participants were introduced to the BETTER model, and were asked to trial the approach with consumers. They were then interviewed a second time. Two main themes emerged: greater awareness and becoming part of practice. Participants described a transformation of their practice from one of avoiding issues of sexuality with consumers, to a position of inclusion, which became embedded within practice. Participants did not tend to use the model in a structured way, and it appears that knowledge and awareness were more useful than the model itself.
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Affiliation(s)
- Chris Quinn
- Institute for Health and Social Science Research and School of Nursing and Midwifery, CQUniversity Australia, Rockhampton, QLD.
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Quinn C, Happell B, Browne G. Opportunity lost? Psychiatric medications and problems with sexual function: a role for nurses in mental health. J Clin Nurs 2011; 21:415-23. [PMID: 22172200 DOI: 10.1111/j.1365-2702.2011.03908.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To explore patients' non-adherence to psychiatric medication with mental health nurses. BACKGROUND The ability of consumers to maintain normal sexual behaviours is complicated by abnormally high incidence of sexual problems arising from the medications they are prescribed. Sexual side effects of psychiatric medications are identified as a major reason for non-adherence to psychiatric medication regimes yet it remains an issue mental health nurses tend to avoid in their practice with consumers. DESIGN An exploratory, descriptive qualitative approach. METHOD Individual interviews were conducted with 14 nurses currently working with adult consumers of mental health services. Data analysis followed the framework approach developed by Ritchie and Spencer as the process for identification of the main themes. RESULTS Problems with sexual function in relation to psychiatric medication issues was one major theme to emerge from this research. More specifically the participants referred to: assessment of sexual function, the side effects of psychiatric medication, consumer embarrassment, and, the pros and cons of information. Participants recognised that sexual side effects were likely to have an impact on adherence to medication and that this was an important consideration but most did not discuss this issue with consumers. Consumer embarrassment and the belief that knowledge itself might cause non-adherence were the two main reasons for not discussing this topic. CONCLUSIONS Problems with sexual function of consumers presents an important practice consideration for nurses working in mental health settings. There is an urgent need for strategies to enhance awareness and confidence among nurses in exploring this topic with consumers. RELEVANCE TO CLINICAL PRACTICE Mental health nurses can adopt a leadership role in recognising the relevance of sexuality in care and treatment for consumers of mental health services. Strategies to assist in developing skill and confidence in this domain are required as a matter of priority.
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Affiliation(s)
- Chris Quinn
- Institute of Health and Social Science Research and School of Nursing and Midwifery, CQUniversity Australia, Rockhampton, Qld., Australia
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Sexual health care for women with dyspareunia. Taiwan J Obstet Gynecol 2011; 50:268-74. [DOI: 10.1016/j.tjog.2011.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2011] [Indexed: 11/21/2022] Open
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Frauenfelder F, Müller-Staub M, Needham I, Van Achterberg T. Nursing phenomena in inpatient psychiatry. J Psychiatr Ment Health Nurs 2011; 18:221-35. [PMID: 21395914 DOI: 10.1111/j.1365-2850.2010.01659.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Little is known about the question if the nursing diagnosis classification of North American Nursing Association-International (NANDA-I) describes the adult inpatient psychiatric nursing care. The present study aimed to identify nursing phenomena mentioned in journal articles about the psychiatric inpatient nursing care and to compare these phenomena with the labels and the definitions of the nursing diagnoses to elucidate how well this classification covers these phenomena. A search of journal articles took place in the databases MedLine, PsychInfo, Cochrane and CINAHL. A qualitative content analysis approach was used to identify nursing phenomena in the articles. Various phenomena were found in the articles. The study demonstrated that NANDA-I describes essential phenomena for the adult inpatient psychiatry on the level of labels and definitions. However, some apparently important nursing phenomena are not covered by the labels or definitions of NANDA-I. Other phenomena are assigned as defining characteristics or as related factors to construct nursing diagnoses. The further development of the classification NANDA-I will strengthen the application in the daily work of psychiatric nurses and enhance the quality of nursing care in the inpatient setting.
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Affiliation(s)
- F Frauenfelder
- Centre of Psychiatry, Department of Education, Consulting and Development, Rheinau, Switzerland.
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Quinn C, Happell B, Browne G. Talking or avoiding? Mental health nurses' views about discussing sexual health with consumers. Int J Ment Health Nurs 2011; 20:21-8. [PMID: 21199241 DOI: 10.1111/j.1447-0349.2010.00705.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Mental health consumers are sexual beings; however, their sexual desire, capacity, and ability to maintain previous sexual patterns can be altered by their illness or by the effects and side-effects of medications. The sexuality of consumers has been poorly addressed, and the limited evidence suggests that mental health nurses remain ambivalent to including sexuality in their care. This paper presents the findings of a research project investigating the practices of mental health nurses in assessing and supporting the sexuality of consumers. A qualitative, exploratory approach underpinned individual interviews with 14 mental health nurses from inpatient and community settings. The participants acknowledged the importance of sexuality; however, most were reluctant to enquire about consumer concerns and tended to either ignore the issue or refer it to another clinician. Four themes were identified: talking about or avoiding sexuality concerns with consumers; sexuality is not an important priority; refer to others, as talking about sexuality is not 'my' job; and sexuality is poorly addressed by others. It is important that barriers to the assessment and discussion of sexuality are identified, and measures are taken to overcome them.
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Affiliation(s)
- Chris Quinn
- Institute of Health and Social Science Research School of Nursing and Midwifery, Central Queensland University, Rockhampton Gold Coast Mental Health and ATOD Service, Gold Coast, Queensland, Australia
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Quinn C, Happell B, Browne G. Sexuality and consumers of mental health services: the impact of gender and boundary issues. Issues Ment Health Nurs 2011; 32:170-6. [PMID: 21341951 DOI: 10.3109/01612840.2010.531518] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The importance of sexuality to humanity is clearly acknowledged. However, for consumers of mental health services, it tends to be a neglected topic. Although nurses are at the forefront of mental health service delivery, evidence suggests they are reluctant to include sexuality as part of their care. This article describes the findings from a qualitative exploratory research project that examined mental health nurses' attitudes to discussing sexuality with consumers. Fourteen mental health nurses from a service in Queensland participated in this study. Data analysis revealed two main themes: the impact of gender, and professional boundary issues. In terms of gender, participants referred to the impact of sexual dysfunction experienced by young adult male consumers. For female consumers the discussion centred on vulnerability to sexual exploitation and the need to exercise protective measures to ensure safety. Participants indicated concerns about being professionally compromised when discussing sexuality with consumers of the opposite sex. These findings highlight the need for further exploration of mental health nurses' attitudes towards discussing sexuality with consumers as part of their practice.
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Affiliation(s)
- Chris Quinn
- Central Queensland University Australia, Institute of Health and Social Sciences Research, Rockhampton, Australia
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Abstract
Sexuality is a complex and fundamental aspect of a person's health and mental well-being, yet mental health professionals generally seem reluctant to discuss sexuality related issues and few research studies have specifically explored the sexuality of women with enduring mental illness. The aim of this qualitative research was to gain a deeper understanding about the sexuality experiences of this group of women. Eight women were interviewed individually, and then together as a focus group. Working from a feminist theoretical perspective, the interview transcripts were analysed thematically. All the women considered sexuality an essential component of their identity. However, powerful interlocking systems controlled and influenced how the women expressed their sexuality, often marginalizing, and positioning them as 'Other', and rendering their sexuality hidden and unseen. The experiences of this group of women highlight the need for mental health professionals to recognize sexuality as an important aspect of a person's care and recovery, and to create a culture that is supportive of a person's sexuality and sexual expression. Incorporating sexuality related issues into clinical practice offers mental health professionals a significant opportunity to make a positive difference.
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Affiliation(s)
- Joanna Davison
- Bachelor of Nursing Programme, Whitireia Community Polytechnic, Porirua, New Zealand.
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Akkuş Y, Nakas D, Kalyoncu U. Factors Affecting the Sexual Satisfaction of Patients with Rheumatoid Arthritis and Ankylosing Spondylitis. SEXUALITY AND DISABILITY 2010. [DOI: 10.1007/s11195-010-9162-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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