Discussing sexuality in health care: A systematic review

Abstract

Aims and objectives: Using the PRISMA guidelines, a systematic literature review was conducted to explore current and relevant evidence regarding factors that influence nurses' provision of sexual healthcare education to patients. Background: The World Health Organization and Healthy People 2020 emphasise the importance of sexual health care. Although the nursing profession has the ability to develop a competent level of sexuality education, sexual health care is often ignored in nursing care and education. Many nurses are failing to engage in meaningful conversations about sexual health with patients, and this could lead to negative health events. However, patients would like reliable and nonjudgmental access to education about sexual health. Design: Electronic databases were searched for articles published between 2012-2017. Studies of nurses providing sexual health education in healthcare settings were included. The Melnyk and Fineout-Overholt (2015, Evidence-based practice in nursing & healthcare, Philadelphia, PA: Walters Kluwer) quality assessment framework was used. The researchers independently reviewed 532 studies and agreed upon ten to include in this review. Results: Findings from this systematic review suggest that nurses' provision of sexual health education to patients is influenced by four factors: (a) a lack of knowledge about sexual health, (b) nurses' attitudes and beliefs that sexual health care is private and not a priority, (c) nurses' comfort discussing sexual health, and (d) perceived barriers related to time, responsibility and organisational support. Conclusion:The ten articles reviewed were all Level VI descriptive and qualitative studies, as defined by Melnyk and Fineout-Overholt (2015). It is evident that sexual healthcare information is not being widely addressed. To reduce stigma, the positive aspects of sexual health care must be promoted on multiple levels.Relevance to clinical practice: Leaders in professional and community-based organizations should be on the forefront of making recommendations for nurses and practitioners, so they could improve their ability to provide sexual healthcare information to their patients. K E Y W O R D Shealth promotion, nursing education, patient teaching, sexual health, sexuality, teacher

Attitudes and beliefs of nurses and physicians about managing sexual health in primary care: A multi‐site cross‐sectional comparative study

“…For example, more often than physicians, the nurses in this study felt safer discussing sexual matters with patients, reported more sufficient knowledge to address questions, and believed they can effectively manage issues with either men or women. A systematic review of sexuality in health care determined sexual health care is not viewed by physicians as a medical problem (Fennell & Grant, 2019). Similarly, in addressing sexual health, Klaeson et al (2017) (Ha & Longnecker, 2010;Patel et al, 2019), including a lack of instruction for psychosocial concerns such as sexual health (Dennis & Elstein, 1980;Wagner, 2005).…”

“…The same authors also reported 65% of the adolescents received consultation or content related to sexual health during their visit, but the mean time was 36 s. Other studies have similarly reported sexual health conversations during primary care visits are low frequency with minimal depth (Donaldson et al., 2013; Klein & Wilson, 2002). Although sexual health is a historically important area for evidence‐based practice (Reynolds & Magnan, 2005), sexual health is often neglected by nurses and physicians (East & Hutchinson, 2013; Fennell & Grant, 2019; Tsimtsiou et al., 2006). Initiating sexual health discussions with patients has been described as opening a “can of worms” by Gott et al.…”

Using ICF and ICHI to promote sexual health

“…Sexual health care and rehabilitation is an important but often neglected field in health and welfare practice, which may lead to decreased quality of life (Fennell & Grant, 2019;Haesler et al, 2016;Wang et al, 2018). Health care professionals often describe being insufficiently educated and feeling insecure when addressing sexual health in clinical practice (Fennell & Grant, 2019;Wang et al, 2018).…”

“…Sexual health care and rehabilitation is an important but often neglected field in health and welfare practice, which may lead to decreased quality of life (Fennell & Grant, 2019;Haesler et al, 2016;Wang et al, 2018). Health care professionals often describe being insufficiently educated and feeling insecure when addressing sexual health in clinical practice (Fennell & Grant, 2019;Wang et al, 2018). In this article, we present how the International Classification of Functioning, Disability and Health (ICF) and the International Classification of Health Interventions (ICHI) can be used together in the health care process as well as in structured documentation in a health information system such as the electronic health record (EHR) to promote sexual health and related care.…”

Comparing App-based and Lecture-based Methods of Sexual Satisfaction Education: A Randomized Controlled Trial

“…Sexual health care is often overlooked in nursing (26). This seems to be true in Iranian society because, in the Iranian culture, sexual issues have long been known as taboos (27).…”