Understanding the current sexual health service provision for mental health consumers by nurses in mental health settings: Findings from a Survey in Australia and England

Quinn, Chris; Platania‐Phung, Chris; Bale, Christopher; Happell, Brenda; Hughes, Elizabeth

doi:10.1111/inm.12452

Cited by 26 publications

(28 citation statements)

References 23 publications

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“…( M = 14.9)Routine practice.ServiceCommon reference to: sexual function assessment, psychotropic side-effects, patient embarrassment, and pros and cons of information. Sexual side effects recognised as impacting on medication adherence but most did not discuss it with patients.Quinn et al [60] [Not stated]Uk & AustraliaCross-sectional survey. Sexual health care/Purpose-designed survey questionnaire.…”

Section: Resultsmentioning

confidence: 99%

Mental health nurses’ attitudes, experience, and knowledge regarding routine physical healthcare: systematic, integrative review of studies involving 7,549 nurses working in mental health settings

et al. 2019

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Background There has been a recent growth in research addressing mental health nurses’ routine physical healthcare knowledge and attitudes. We aimed to systematically review the empirical evidence about i) mental health nurses’ knowledge, attitudes, and experiences of physical healthcare for mental health patients, and ii) the effectiveness of any interventions to improve these aspects of their work. Methods Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Multiple electronic databases were searched using comprehensive terms. Inclusion criteria: English language papers recounting empirical studies about: i) mental health nurses’ routine physical healthcare-related knowledge, skills, experience, attitudes, or training needs; and ii) the effectiveness of interventions to improve any outcome related to mental health nurses’ delivery of routine physical health care for mental health patients. Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative, narrative synthesis of study findings was conducted. Results Fifty-one papers covering studies from 41 unique samples including 7549 mental health nurses in 14 countries met inclusion criteria. Forty-two (82.4%) papers were published since 2010. Eleven were intervention studies; 40 were cross-sectional. Observational and qualitative studies were generally of good quality and establish a baseline picture of the issue. Intervention studies were prone to bias due to lack of randomisation and control groups but produced some large effect sizes for targeted education innovations. Comparisons of international data from studies using the Physical Health Attitudes Scale for Mental Health Nursing revealed differences across the world which may have implications for different models of student nurse preparation. Conclusions Mental health nurses’ ability and increasing enthusiasm for routine physical healthcare has been highlighted in recent years. Contemporary literature provides a base for future research which must now concentrate on determining the effectiveness of nurse preparation for providing physical health care for people with mental disorder, determining the appropriate content for such preparation, and evaluating the effectiveness both in terms of nurse and patient- related outcomes. At the same time, developments are needed which are congruent with the needs and wants of patients. Electronic supplementary material The online version of this article (10.1186/s12912-019-0339-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Mental health nurses’ attitudes, experience, and knowledge regarding routine physical healthcare: systematic, integrative review of studies involving 7,549 nurses working in mental health settings

et al. 2019

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“…Byers 2011;Nnaji & Friedman 2008;Reissing & Di Giulio 2010;Rele & Wylie 2007). Reported barriers to addressing sexuality in mental health settings also appear to be consistent across nursing, psychology, and psychiatry; these include discomfort with the topic, a lack of time to address sexual concerns, and a dearth of appropriate pre-registration and continuing education (e.g., Hendry et al 2018;Quinn et al 2018;Reissing & Di Giulio 2010).…”

Section: Introductionmentioning

confidence: 95%

“…), do not routinely include aspects of sexuality in their work (Quinn et al . ), and inadvertently engage a range of strategies to silence sexuality within the therapeutic encounter (Higgins et al . ).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, such conversations are 'often constructive, informative, and safe', yet clinicians rarely initiate these conversations within the therapeutic encounter (McCann et al 2019, p. 92). Clinician-based research reflects this, consistently demonstrating, for example that mental health nurses avoid discussing or addressing sexuality across settings (Quinn & Happell 2015;Quinn et al 2011), do not routinely include aspects of sexuality in their work (Quinn et al 2018), and inadvertently engage a range of strategies to silence sexuality within the therapeutic encounter (Higgins et al 2008).…”

Section: Introductionmentioning

confidence: 99%

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‘It's just a peripheral issue’: A qualitative analysis of mental health clinicians’ accounts of (not) addressing sexuality in their work

Urry

Chur‐Hansen

Khaw

2019

Int J Mental Health Nurs

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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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“…These findings were echoed in a survey of mental health staff in England and Australia about sexual health provision. 25 Participants from both countries reported that very limited sexual health work was being undertaken in routine practice but they did see it as part of their role. Therefore, in order to address this issue, mental health staff require training and guidance in relation to sexual health issues in SMI and in how to engage people in conversations about sexual behaviour, and offer advice about where to access help for contraception and sexual health concerns.…”

Section: Mental Health Service Response To Sexual Healthmentioning

confidence: 99%

Sexual health promotion in people with severe mental illness: the RESPECT feasibility RCT

Hughes

Mitchell

Gascoyne

et al. 2019

Health Technol Assess

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Background People with serious mental illness have sexual health needs, but there is limited evidence regarding effective interventions to promote their sexual health. Objectives To develop a sexual health promotion intervention for people with serious mental illness, and to conduct a feasibility trial in order to establish the acceptability and parameters for a fully powered trial. Design A two-armed randomised controlled, open feasibility study comparing usual care alone with usual care plus the adjunctive intervention. Setting Five community mental health providers in Leeds, Barnsley, Brighton and London. Participants Adults aged ≥ 18 years with serious mental illness and receiving care from community mental health teams. Interventions A remote, web-based computer randomisation system allocated participants to usual care plus the RESPECT (Randomised Evaluation of Sexual health Promotion Effectiveness informing Care and Treatment) intervention (three sessions of 1 hour) (intervention arm) or usual care only (control arm). The intervention was an interactive manualised package of exercises, quizzes and discussion topics focusing on knowledge, motivation and behavioural intentions to adopt safer sexual behaviours. Main outcome measures Feasibility parameters including establishing the percentage of people who were eligible, consented and were retained in each arm of the trial, retention for the intervention, as well as the completeness of the data collection. Data were collected on knowledge, motivation to adopt safer sexual behaviour, sexual behaviour, sexual stigma, sexual health service use and quality of life. Data were collected at baseline and then at 3 months and 6 months post randomisation. Results Of a target of 100 participants, 72 people participated in the trial over 12 months. Of the 36 participants randomised to the intervention arm, 27 received some of the intervention (75.0%). At 3 months, 59 of the 72 participants completed follow-up questionnaires (81.9%) (30 participants from the intervention arm and 29 participants from the control arm). Only the first 38 participants were followed up at 6 months. However, data were collected on 29 out of 38 participants (76.3% retention): 13 in the intervention arm and 16 in the control arm. No adverse events were reported. Participant feedback confirmed that both the design and the intervention were acceptable. The economic analysis indicated high completion rates and completeness of data among participants who continued the trial. Conclusions Despite the limitations, the findings suggest that it is both acceptable and feasible to undertake a sexual health promotion study for people with serious mental illness. Future work A fully powered randomised controlled trial would be required to establish the clinical effectiveness of the intervention. Trial registration Current Controlled Trials ISRCTN15747739. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 65. See the NIHR Journals Library website for further project information.

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Understanding the current sexual health service provision for mental health consumers by nurses in mental health settings: Findings from a Survey in Australia and England

Cited by 26 publications

References 23 publications

Mental health nurses’ attitudes, experience, and knowledge regarding routine physical healthcare: systematic, integrative review of studies involving 7,549 nurses working in mental health settings

Mental health nurses’ attitudes, experience, and knowledge regarding routine physical healthcare: systematic, integrative review of studies involving 7,549 nurses working in mental health settings

‘It's just a peripheral issue’: A qualitative analysis of mental health clinicians’ accounts of (not) addressing sexuality in their work

Sexual health promotion in people with severe mental illness: the RESPECT feasibility RCT

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