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Mckie AL, Saito A, Green T, Bonner A. Understanding nurses' perceptions of sexual health and function in people requiring haemodialysis. J Ren Care 2024. [PMID: 39148447 DOI: 10.1111/jorc.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/07/2024] [Accepted: 07/26/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Sexual dysfunction is common for adults receiving chronic haemodialysis; however, renal nurses seldom discuss this topic with patients. OBJECTIVES This study aimed to identify renal nurses' attitudes towards providing sexual healthcare and to determine their confidence in discussing sexual dysfunction with adults who are receiving haemodialysis. DESIGN An online cross-sectional study. PARTICIPANTS Renal nurses across Australia and New Zealand (n = 65) who were members of the Renal Society of Australasia provided direct care to adults receiving haemodialysis. MEASUREMENTS Two questionnaires measuring (1) the frequency of sexual health discussions, levels of knowledge and competence, barriers to discussing sexual dysfunction and views on accountability (Van Ek survey) and (2) communication, practical knowledge, and attitude (sexual health educator for professionals scale) were used. Demographic characteristics were also collected. RESULTS Most participants were females (60%) with postgraduate qualifications (61.4%). The average nephrology nursing experience was 13.10 ± 9.14 years. Most renal nurses identified as having positive attitudes (77.2%) about providing sexual healthcare and were confident in communicating with patients about sexual concerns (42.9%), although many nurses (64.35%) rarely did so. Less than one-half (48.6%) indicated feeling competent to discuss sexual dysfunction, and less than one-third (30%) had sufficient knowledge about sexual dysfunction. Barriers were lack of practical training (74.2%) and insufficient time (57.1%). Younger nurses (≤45 years old) and male nurses were significantly more confident in discussing sexual health matters. CONCLUSIONS Overall, renal nurses had positive attitudes towards discussing sexual health concerns with patients however they rarely did so.
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Affiliation(s)
- Amanda L Mckie
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
- School of Nursing and Midwifery, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Amornrat Saito
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
| | - Theresa Green
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
| | - Ann Bonner
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
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Horne M, Youell J, Brown Wilson C, Brown L, Simpson P, Dickinson T. Using participatory research to co-produce an education and training e-resource to support care home staff to meet the sexuality, intimacy and relationship needs of care home residents with and without dementia. FRONTIERS IN DEMENTIA 2023; 2:1235517. [PMID: 39081975 PMCID: PMC11285635 DOI: 10.3389/frdem.2023.1235517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/24/2023] [Indexed: 08/02/2024]
Abstract
Aim To present the methodological approach and research methods chosen in a research study designed to enable the collaborative creation of an education and training e-resource designed to facilitate and support care home staff to address the sexuality, intimacy and relationship needs of older care home residents. Design Co-production using community-based participatory approach. Methods Four participatory workshops with care home staff, residents and their significant others. Results Workshops 1 and 2 identified and developed real-world case scenarios related to sexuality, intimacy and relationship needs and identified care staff training needs in this area. Then workshop 3 provided valuable feedback on the prototype training e-resource, and the final workshop identified care home staff engagement with and implementation of the e-resource in practice. Conclusion The findings provide evidence that using participatory approaches, such as co-production, to develop education and training resources in a sensitive subject area with care home residents, significant others, carers and care home staff, was a useful approach in engaging a vulnerable population group, in a sensitive area. However, this approach is not without challenges in care home communities.
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Affiliation(s)
- Maria Horne
- Faculty of Medicine and Health, School of Healthcare, University of Leeds, Leeds, United Kingdom
| | - Jane Youell
- Faculty of Medicine and Health, School of Healthcare, University of Leeds, Leeds, United Kingdom
| | | | - Laura Brown
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Paul Simpson
- School of Social Sciences, University of Manchester, Manchester, United Kingdom
| | - Tommy Dickinson
- Department of Mental Health Nursing, Kings College London, London, United Kingdom
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Rodríguez-Mora Á, Barrilaro L, García-Rojas AD, Hernando-Gómez Á. [Attitudes, knowledge and perceptions of care staff in long-term care homes about residents' sexual expressions. Systematic review]. Rev Int Androl 2023; 21:100368. [PMID: 37399729 DOI: 10.1016/j.androl.2023.100368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/07/2022] [Accepted: 09/06/2022] [Indexed: 07/05/2023]
Abstract
The sexual manifestations of residents in long-term care facilities are often overlooked and even discouraged by care staff. The aim of this study was to conduct a systematic review of caregivers' attitudes, knowledge and perceptions of sexual expression. After consulting different databases, ten scientific articles published between 2012 and 2022 met the inclusion criteria to form part of this review. This work has made it possible to identify and structure the insufficient scientific literature on this specific area of sexuality in older adults. It is concluded that there is scarce scientific literature and that the areas reviewed are determinant in the daily care of institutionalised older adults. Expanding in this field of study will allow the creation of training programmes and the creation of programmes for the care staff to deal with the sexual behaviour of institutionalised older adults.
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Affiliation(s)
- Álvaro Rodríguez-Mora
- Departamento de Psicología, Instituto Universitario de Investigación para el Desarrollo Social Sostenible (INDESS), Universidad de Cádiz, Cádiz, España.
| | - Laura Barrilaro
- Servicio de Atención Psicológica y Psicopedagógica (SAP), Universidad de Cádiz, Cádiz, España
| | | | - Ángel Hernando-Gómez
- Departamento de Psicología Social, Evolutiva y de la Educación, Universidad de Huelva, Huelva, España
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Faccio E, Aquili L, Bombieri M, Rocelli M. Is falling in love within the mental health system a problem? How to turn it into a chance for the care relationship. J Psychiatr Ment Health Nurs 2022; 30:286-294. [PMID: 36461642 DOI: 10.1111/jpm.12888] [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: 04/30/2022] [Revised: 10/11/2022] [Accepted: 11/30/2022] [Indexed: 12/04/2022]
Abstract
UNLABELLED WHAT IS KNOWN ABOUT THE SUBJECT?: In the context of health and social care, situations at the limit or beyond the role of the professional, such as falling in love and physical attraction between a client and a nurse, are very common events. In residential contexts, the construction of the professional relationship is made more complex than in other care contexts since sharing daily life, routine, constant contact and isolation contribute to making relationships more intense from an emotional point of view. Moreover, the same elements that promote the therapeutic process (interpersonal closeness, self-disclosure, trust) are also sources of role ambivalence and possible emotional misunderstandings. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: In contrast to what is usually proposed in the literature for the management of similar situations, such as supervision by experts external to the team, this paper proposes a strategy of supervision between peers (called in literature "intervision") and of taking charge of the situation by the entire team and the group of service users. WHAT ARE THE IMPLICATIONS FOR MENTAL HEALTH NURSING?: The story here presented offers a key example that may be of interest not only to residential centres for substance users but also to all residential mental health communities. It shows not only that one can fall in love, but that this event can generate new opportunities for the therapeutic pathway. The risks associated with not addressing these situations are discussed. These include the restriction of the feeling of falling in love within the canons of error; the attribution of what happened to personal characteristics and the assumption of guilt for such occurrences. ABSTRACT INTRODUCTION: The care pathway within a mental health service can create situations of strong emotional impact, including physical attraction and falling in love. This may evolve in moments of impasse for the staff and sometimes compromise the success of therapeutic treatment. AIM/QUESTION This article offers some evidence about how intervene in a situation such as a client falling in love with a nurse, avoiding transforming it into a problem. The fear of the nurse, maybe already inclined to blame themselves for what has happened, when he/she asks for supervision, is to feel judged also by the supervisor. This story teaches that to refer to figures from outside the team, as would usually be the case with supervision, may be replaced by enhancing the role composition already available in the residential community as a resource. METHOD The story was listened and enhanced thankyou to an exchange between M. and the community manager. From the analysis of the narratives co-produced by M., the former substance user, and the community manager, the elements that made it possible to transform a feeling of falling in love into an interaction of extended trust emerged. RESULTS AND DISCUSSION The non-judgmental and confidential context, but above all the training in interpersonal exchange, facilitated the client sharing very intimate and private experiences, which are usually hidden or denied. This made it possible to make the community responsible for the individual's experiences and to overcome the role impasse and the related identity dilemma. IMPLICATIONS FOR PRACTICE Neither nurses nor clients should be held accountable or blamed when these episodes occur. The strongest resource is sharing in the group and putting one's own experiences into play. Following the M. story, a targeted confrontation between team members and clients is an accessible and effective resource to respond to situations of strong emotional impact, falling in love being just one example; however, it can be effectively activated only through a collective taking charge of the individual's difficulties has already been implemented.
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Affiliation(s)
- Elena Faccio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padua, Italy
| | - Ludovica Aquili
- Ph.D Student in Social Science, Interactions, Communication, Cultural Constructions, Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padua, Italy
| | - Marco Bombieri
- Community for Drug Addicts Arcobaleno, Strada comunale Montotto Secondo, Fermo, Italy
| | - Michele Rocelli
- Ph.D Student in Social Science, Interactions, Communication, Cultural Constructions, Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padua, Italy.,Ex-psychologist in Charge of the Community for Drug Addicts Arcobaleno, Strada comunale Montotto Secondo, Fermo, Italy
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Horne M, Youell J, Brown L, Brown-Wilson C, Dickinson T, Simpson P. Feasibility and acceptability of an education and training e-resource to support the sexuality, intimacy and relationship needs of older care home residents: a mixed methods study. Age Ageing 2022; 51:6776176. [PMID: 36309975 PMCID: PMC9618283 DOI: 10.1093/ageing/afac221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/01/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND sexuality, intimacy and relationship needs are often a neglected aspect of the care of older adults in residential care facilities. Improving awareness, knowledge and improving attitudes about these needs among care staff could enhance quality of care and lead to better outcomes for residents. OBJECTIVE to evaluate the feasibility and acceptability of a co-designed education and training e-resource to help care staff support their residents' sexuality, intimacy and relationship needs. METHODS we delivered the education and training e-resource to five UK care homes over a 6-month period in a pre-post mixed methods study using surveys, focus groups and individual interviews. RESULTS fifty-nine members of staff from participating care homes undertook the education and training e-resource. 18/59 (31%) of participants completed all six modules and the pre-post surveys. Eleven participants participated in focus groups/interviews to explore experiences of using the e-resource. The e-resource was successfully implemented in the study homes and found to be acceptable. We found preliminary evidence of positive changes in staff attitudes. Factors that facilitated implementation included support from the care home manager. Barriers identified included IT infrastructure and technology. CONCLUSIONS the findings provide initial evidence that a co-designed education and training e-resource raised awareness of, and improved attitudes towards, older adults' sexuality and intimacy needs. This work provides the foundation for a next phase to establish the effectiveness of the e-resource on staff practice and resident outcomes.
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Affiliation(s)
- Maria Horne
- Address correspondence to: Maria Horne, Faculty of Medicine and Health, School of Healthcare, University of Leeds, Leeds LS1 9JT, UK.
| | - Jane Youell
- Faculty of Medicine and Health, School of Healthcare, University of Leeds, Leeds, UK
| | - Laura Brown
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Tommy Dickinson
- Department of Mental Health Nursing, King’s College London University, London, UK
| | - Paul Simpson
- School of Social Sciences, University of Manchester, Manchester, UK
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Thomas P, Calvez M, Gouriou L, Hazif-Thomas C. [The right of elderly people in old people's homes to have a fulfilling emotional and sexual life]. SOINS. GERONTOLOGIE 2022; 27:13-22. [PMID: 35926968 DOI: 10.1016/j.sger.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The sexual life of elderly people living in residential institutions for the dependent elderly (Ehpad) is a sensitive subject that is rarely discussed. Particular difficulties sometimes arise when they have cognitive problems. Affectivity and sexuality in old people's homes must be approached with tact and maturity by the carers. Sexuality belongs to private life, but its excesses are difficult to reconcile with collective life. Some proposals can be made on ethical issues and on the relationship with residents and their families.
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Affiliation(s)
- Philippe Thomas
- Centre de recherches sémiotiques (CeReS), EA 3648, Université de Limoges, 39 rue Camille-Guérin, 87000 Limoges, France.
| | - Marine Calvez
- Ehpad de Kerlaouéna, 34 rue Camille-Vallaux, 29480 Le Relecq-Kerhuon, France
| | - Laurence Gouriou
- Ehpad de Kerlaouéna, 34 rue Camille-Vallaux, 29480 Le Relecq-Kerhuon, France
| | - Cyril Hazif-Thomas
- Service de psychiatrie du sujet âgé (Soins primaires, santé publique, registre des cancers de Bretagne occidentale, EA 7479), centre hospitalier régional universitaire de Brest, route de Ploudalmézeau, 29820 Bohars, France
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McBride K, Carlson M, Everett B. Using the Intersectionality-Based Policy Analysis Framework to Evaluate a Policy Supporting Sexual Health and Intimacy in Long-Term Care, Assisted Living, Group Homes & Supported Housing. J Appl Gerontol 2022; 41:1992-2001. [PMID: 35623344 DOI: 10.1177/07334648221099728] [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: 11/16/2022] Open
Abstract
Sexuality is an integral part of being human throughout life. This does not change when moving into long-term care (LTC). However, the sexual health of persons living in LTC is often overlooked. This paper presents an analysis of the recently released health organizational policy: Supporting Sexual Health and Intimacy in Long-Term Care, Assisted Living, Group Homes & Supported Housing. The Intersectionality-Based Policy Analysis Framework is used to outline the policy problem, examine how this policy was developed, and evaluate its potential to address the problem. Key findings are that both the development process and the policy constructs align with principles of intersectionality, such as equity, reflexivity, and diverse knowledges. In conclusion, this analysis suggests this policy is feasible, equitable and could effectively address sexual health for persons living in LTC, while leading to an improved workplace for staff. We recommend that this policy be more widely adopted across Canada.
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Affiliation(s)
- Kate McBride
- Clinical Education Lead, Provincial Perinatal Substance Use Program, 8145Provincial Health Services Authority (PHSA), Vancouver, BC, Canada
| | - Marie Carlson
- Sexual Health Clinician, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Bethan Everett
- Senior Leader Ethicist, Vancouver Coastal Health, Vancouver, BC, Canada
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Nilsson ML, Annersten Gershater M, Bengtsson M. Registered Nurses' experiences of caring for persons with dementia expressing their sexuality. Nurs Open 2022; 9:1723-1730. [PMID: 35170245 PMCID: PMC8994936 DOI: 10.1002/nop2.1197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 12/22/2021] [Accepted: 01/30/2022] [Indexed: 12/02/2022] Open
Abstract
Background Sexuality is an integral part of human beings and persons living with dementia still perceive negative attitudes from caregivers in this regard. Aim This study aimed to explore registered nurses' experiences of caring for persons with dementia living in nursing homes and expressing their sexuality. Methods A qualitative inductive design was adopted; data were collected through semi‐structured interviews and analysed through content analysis. Results The analysis reflected three categories. (1) Dealing with different reactions and responding to nursing staff and relatives: The registered nurses experienced discomfort, insecurity, frustration, distress and embarrassment when confronted with sexual expressions in people with dementia. (2) Caring with a focus on the person: The registered nurses expressed the importance of protecting the integrity of the person and consequently their right to sexual expressions. (3) Needing more competence development: The registered nurses expressed the need to educate and inform not only themselves but also the nursing staff and relatives.
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Affiliation(s)
- Mari-Louise Nilsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | | | - Mariette Bengtsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
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Ho PJ, Goh YS. Health care professionals and care staff challenges and experiences of managing sexual expression among older adults ≥60 years in long-term care facilities: a qualitative review and meta-synthesis. Age Ageing 2022; 51:6430097. [PMID: 34850812 DOI: 10.1093/ageing/afab230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 08/12/2021] [Indexed: 11/13/2022] Open
Abstract
Long-term care (LTC) facilities, in which older adults are institutionalised, have the responsibility to address their residents' rights, privacy and comfort in expressing themselves sexually in an acceptable manner. However, many older adults have reported barriers in their sexual expression, which is often a result of the care staff's attitudes in the facilities. This review synthesis evidence from qualitative studies on the challenges faced by care staff when supporting sexual expression of older residents in LTC facilities. The systematic review and meta-synthesis is reported according to the Enhanced Transparency in Reporting the Synthesis of Qualitative Research Statement. A systematic literature search for peer-reviewed studies was conducted on PubMed, Cochrane Library, EMBASE, Scopus, Web of Science, PsycINFO, CINAHL and ProQuest Theses and Dissertations from inception until December 2020. Sandelowski and Barroso's two-step approach was used to synthesise the evidence. Seventeen qualitative studies published between 2004 and 2020 were included. This review encapsulated the experiences and challenges of 4,387 care staff whose age ranged from 18 to 69 years. Through the meta-synthesis, four themes were identified: varying manifestations of sexual expression and situations encountered, a spectrum of care staff's attitudes, setting boundaries in dementia care and workplace support. Managing sexual expression can be challenging for the care staff, given the complex interplay between personal beliefs, social contexts, moral dilemmas, practical barriers and the lack of clear policies. This review highlighted the need to equip them with knowledge, skills and confidence in managing sexuality in LTC facilities.
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Affiliation(s)
- Pei Juan Ho
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yong Shian Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Alice Lee Centre for Nursing Studies, National University Health System, Singapore
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Peisah C, Ayalon L, Verbeek H, Benbow SM, Wiskerke E, Rabheru K, Sorinmade O. Sexuality and the Human Rights of Persons With Dementia. Am J Geriatr Psychiatry 2021; 29:1021-1026. [PMID: 34183238 DOI: 10.1016/j.jagp.2021.05.016] [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: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 10/21/2022]
Abstract
We explore barriers to enjoyment of human rights to sexuality of persons with dementia and remedies for addressing these. Enjoyment of sexuality is contingent upon actualization of rights to dignity, autonomy, respect for will and preferences, abuse safeguarding and equitable access to highest standards of sexual health. Persons with dementia living at home or in care face systemic barriers to enjoyment of sexuality fueled by ageism, apathy and ignorance, compounded by complex legal barriers in relation to consent. Such challenges can be tackled with awareness raising and education of care staff, families and physicians, including training for capacity assessment with dimensional, noncategorical conceptualization of capacity, leaving room for supported decision-making. These measures, together with strengthened legislative and human rights frameworks to cater to the specific needs of older people, may allow people to live well with dementia and exercise their human rights to enjoy sexuality in a safe and lawful manner.
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Affiliation(s)
- Carmelle Peisah
- School of Psychiatry, Faculty Medicine & Ageing Futures Institute, University of New South Wales, Capacity Australia (CP), Sydney, Australia.
| | - Liat Ayalon
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University (LA), Ramat Gan, Israel
| | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University (HV), Maastricht, the Netherlands
| | - Susan Mary Benbow
- Centre for Ageing & Mental Health, University of Chester (SMB), Chester, United Kingdom
| | | | - Kiran Rabheru
- University of University of Ottawa (KR), Ottawa, Ontario, Canada
| | - Oluwatoyin Sorinmade
- Old Age Psychiatry, Kent and Medway NHS and Social Care Partnership Trust (OS), Kent, UK
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Uslu E, Buldukoglu K. The gray zone of patient-nurse communication: Inappropriate sexual behavior. Perspect Psychiatr Care 2021; 57:948-952. [PMID: 32730666 DOI: 10.1111/ppc.12591] [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: 05/11/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This review was written to examine the incidences of inappropriate sexual behavior (ISB) and to study the responsibilities of nurses in the management of ISB. CONCLUSIONS When nurses experience ISB, they tend to describe this situation as harassment. However, the use of the phrase "harassment" indicates inadequate professionalism because although disturbing, not every incidence of ISB is an expression of adult sexuality. Some patients are also likely to use this type of behavior to mask their existing life stress. As a result, nurses have difficulty interpreting and managing behavior that falls in this gray zone. PRACTICE IMPLICATIONS To support nurses, we recommended that studies that define ISB, determine its prevalence, evaluate it, and guide nurses in the management of ISB should be carried out.
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Affiliation(s)
- Esra Uslu
- Department of Psychiatric Nursing, Faculty of Health Science, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Kadriye Buldukoglu
- Department of Psychiatric Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Henrickson M, Cook CM, MacDonald S, Atefi N, Schouten V. Not in the Brochure: Porneia and Residential Aged Care. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2021; 19:588-598. [PMID: 33815627 PMCID: PMC8010488 DOI: 10.1007/s13178-021-00573-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Sexuality and intimacy in residential aged care (RAC) are receiving increased research attention. In this article, porneia refers to access to sex workers, as well as online pornography, and masturbation by residents in RAC. Sex work is legal and regulated in Aotearoa New Zealand. METHODS The present study was a two-arm mixed-method cross-sectional study using a concurrent triangulation design. A validated survey tool was developed. Data were collected in 2018-2019: 433 staff surveys were collected from 35 RAC across the country; 61 interviews were carried out with 77 staff, residents, and family members. RESULTS Staff opinions about sex work and pornography were inconclusive. Nevertheless, access to sex workers occurs in many RAC facilities across the country. Interviews demonstrated a diversity of responses among the three groups; staff attitudes are paramount. CONCLUSIONS Some staff are prepared for resident requests for sex workers; others continue to look to policies and management for guidance, but such policies are often lacking. Most staff have adopted the language of needs vs. rights which dominates the literature. POLICY IMPLICATIONS Staff education on sexuality and facility policy is essential; education for residents and their families is also desirable. Facilities often over-notify third parties. Discourse about sexuality needs to move towards a person-centred, salutogenic approach.
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Affiliation(s)
- Mark Henrickson
- School of Social Work, Massey University, Private Bag 102904, North Shore MSC, Auckland, 0745 New Zealand
| | - Catherine M Cook
- School of Clinical Sciences, Nursing Department, AUT University, Auckland, New Zealand
| | - Sandra MacDonald
- School of Nursing, Manukau Institute of Technology, Auckland, New Zealand
| | - Narges Atefi
- School of Social Work, Massey University, Auckland, New Zealand
| | - Vanessa Schouten
- School of Humanities, Massey University, Palmerston North, New Zealand
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Wilschut VFC, Pianosi B, van Os-Medendorp H, Elzevier HW, Jukema JS, den Ouden MEM. Knowledge and attitude of nursing students regarding older adults' sexuality: A cross-sectional study. NURSE EDUCATION TODAY 2021; 96:104643. [PMID: 33152640 DOI: 10.1016/j.nedt.2020.104643] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 10/05/2020] [Accepted: 10/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although older adults are sexual, sexuality is infrequently discussed with them by health care professionals. Nursing students, as future professionals, can make an important contribution by developing competences in discussing intimacy and sexuality with older adults to increase quality of life and to prevent sexual problems. In order to improve these competences, current levels of knowledge and attitude need to be explored. OBJECTIVES To investigate i) knowledge and attitudes of nursing students regarding intimacy and sexuality of older adults, ii) the difference in knowledge and attitudes of nursing students in different years of study and iii) frequency of discussing intimacy and sexuality with older adults. DESIGN Cross-sectional. SETTINGS A University of Applied Sciences in the Netherlands. PARTICIPANTS Nursing students, ≥16 years who were able to read and write in Dutch. METHODS The Ageing Sexual Knowledge and Attitudes Scale was used among nursing students. Furthermore, demographic information and frequencies were collected. Data was analyzed using SPSS. RESULTS In total, 732 students participated. The mean knowledge-score was 43.9 (SD = 8.9), the mean attitude-score 64.3 (SD = 16.0). Unlike attitude, the level of knowledge differed significantly per year of study: first year students had the lowest and third year students the highest knowledge. Most students stated they 'never' (54.1%) or 'once' (13.2%) discussed intimacy and sexuality with older adults. Reasons to avoid talking about intimacy and sexuality were feelings of 'not being the right person' (17.3%) and 'incompetence' (14.0%). CONCLUSIONS Nursing students had moderate knowledge and positive attitudes toward older adults' intimacy and sexuality. The knowledge-level differed per year of study, the attitude level did not. Only a minority discussed intimacy and sexuality with older adults. Moderate knowledge and positive attitudes do not mean that intimacy and sexuality is discussed. To ensure students feel responsible and competent, interventions should focus on continuous knowledge dissemination, role clarification and role modelling.
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Affiliation(s)
- Vivian F C Wilschut
- Health Sciences, University Utrecht, Utrecht, the Netherlands; Center of Nursing, Saxion, University of Applied Sciences, Deventer/Enschede, the Netherlands
| | - Birgit Pianosi
- Gerontology Department, Huntington University, Sudbury, Canada
| | | | - Henk W Elzevier
- Department of Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands
| | - Jan S Jukema
- Center of Nursing, Saxion, University of Applied Sciences, Deventer/Enschede, the Netherlands
| | - Marjolein E M den Ouden
- Center for Technology, Health & Care, Saxion University of Applied Sciences, Deventer/Enschede, the Netherlands; Center for Health and Technology, ROC of Twente, Hengelo, the Netherlands.
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Ricoy-Cano AJ, Obrero-Gaitán E, Caravaca-Sánchez F, Fuente-Robles YMDL. Factors Conditioning Sexual Behavior in Older Adults: A Systematic Review of Qualitative Studies. J Clin Med 2020; 9:jcm9061716. [PMID: 32503157 PMCID: PMC7356633 DOI: 10.3390/jcm9061716] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 12/18/2022] Open
Abstract
The sexual behavior of older adults, especially women, has undergone changes in recent years, though there are still certain stereotypes today related to pathophysiology, beliefs, culture and tradition that negatively affect older adults’ sexual activity. The aim of our review is to present the main qualitative studies analyzing how physiological and psychosocial factors affect sexual behavior in older adults. A systematic review of these qualitative studies was carried out. All stages of this review were carried out peer-to-peer in order to guarantee minimized bias. A bibliographical search was completed between February and April 2019, in Web of Science, Scopus, PubMed Medline, PsycINFO ProQuest and CINAHL. To analyze the findings of the selected qualitative studies, a “Thematic Synthesis Analysis” was performed, using Eppi-Reviewer 4 software (UCL Institute of Education, University of London, UK). The quality of the studies was assessed with a CASP-Qualitative-Checklist. A total of 16,608 references were screened and 18 qualitative studies were included in this review. The studies involved 2603 participants across seven countries, most being women (approximately 80%). We identified a wide variety of physiological and psychological factors that can influence the sexual behavior of older adults, such as the presence of pathologies (erectile dysfunction and menopause), the strength of spiritual beliefs, and patriarchal roles upheld by upbringings conveying that women’s role is to provide men with sexual pleasure. Biological age in relation to stereotypical models of sexual behavior, emphasized as a risk factor in the contraction of sexual diseases, seems to play a relevant role as a factor limiting sexual behavior in older adults.
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Affiliation(s)
- Adrián Jesús Ricoy-Cano
- Social Work Department, University of Jaén, 23071 Jaén, Spain; (A.J.R.-C.); (F.C.-S.); (Y.M.D.L.F.-R.)
| | - Esteban Obrero-Gaitán
- Physiotherapy Area, Department. of Health Sciences, University of Jaén, 23071 Jaén, Spain
- Correspondence: ; Tel.: +34-953212381
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