Sexual Health Issues of Patients in the Primary Health Care Setting
Gott, M., Galena, E., Hinchliff, S. and Elford, H. (2004). “Opening a Can of Worms”: GP and Practice Nurse Barriers to Talking about Sexual Health in Primary Care. Family Practice, 21(5): 528-536. doi: 10.1093/fampra/cmh509.
Abstract
Several studies claim that some health professionals do not allow sexually related issues to be discussed for a long period of time during patient consultations hours under the primary care setting. The aim of this study is to determine the barriers perceived by general practitioners (GP) and practice nurses to inhibit the discussion of sexual health issues under primary care and to identify the strategies to develop the communication in this field. Participants include 22 GPs and 35 practice nurses from Sheffield. Findings from the semi-structured interviews indicate that the so-called “can of worms” reflects the problematic belief of sexually related issues under primary care. The issue is deemed sensitive, complex and it lacks time and experts to properly handle the situation. Gender preference, age, and ethnicity are some of the factors that affect the communication channel between medical practitioners and patients. And while there are some the key strategies such as information dissemination, role expansions and training of nurses that may break communication barriers, there are still several limitations involved. In conclusion, healthcare providers do not address sexual health issues in a proactive manner. Thus, further attention should be focused to expand the role of primary healthcare providers on sexual health management (Gott et al., 2004).
Gott, M. and Hinchliff, S. (2003). Barriers to Seeking Treatment for Sexual Problems in Primary Care: A Qualitative Study with Older People. Family Practice, 20: 690–695.
Seeking treatment for sexual problems has remained unexplored among older people who perceived that “asexuality” has lead them to being excluded in sexual health research. This study uses a qualitative approach (i.e. a semi-structured interview) to determine the barriers experienced by older people in treating their sexual problems in the primary health care setting. Twenty-two women and twenty-three men ages 50-92 years olds who are under the care of Sheffield general practice were included in this study. Some of the variables in the questionnaire included the following: attitude towards, and experiences in seeking help for sexual problems. Using a framework approach in analyzing the interviews, results indicate that the participants perceived the general practitioner (GP) as the main source of professional help in their sexual problems. Some of the communication barriers that were identified include the demography of the GP, attitudes on later life sexuality, “normal ageing,” shame or embarrassment and services. To conclude, many older people encounter sexual problems that they feel they could only relate to their GP. However, they cannot bring themselves to discuss such matter due to the aforementioned inhibiting factors (Gott and Hinchliff, 2003).
Stokes, T. and Mears, J. (2000). Sexual Health and the Practice Nurse: a Survey of Reported Practice and Attitudes. The British Journal of Family Planning, 26(2): 89-92.
Practice nurses play a significant role in providing sexual health training sessions in the general practice. This study aims to identify nursing practices and attitudes in sexual health and discuss the communication barriers related to sexual health discussions with patients. Survey questions were given to 298 nurse participants in Leicestershire, England. Only 234 nurses were successful in completing the survey. Results revealed that majority of the nurses routinely check patients (90%), provide pap smears (89%), conduct clinical task (83%), provides care to patients with urogenital symptoms (77%) and offer family planning counselling services (54%). The minority group (13%) provide clinical services involving teenage health. Sexual health discussions are always incorporated with family planning counselling (65%) and also discussed in patients with urogenital manifestations (58%). Sixty-two percent of the nurses took at least one sexual health management courses five years ago. Mann-Whitney test suggests the number of nurses taking training courses decrease significantly. Further analysis also indicates that nurses find it is easier to discuss about sexual health concerns with females and teenagers as compared to males and those with different gender preference. To conclude, it is important that practice nurses while offering a diverse array of services, also need to take into account the history of sexual health along with providing appropriate counselling. Some of the aspects that require improvement include providing sexual health counselling in the general practice with emphasis on service for teenagers (Stoke and Mears, 2000).
References
Gott, M., Galena, E., Hinchliff, S. and Elford, H. (2004). “Opening a Can of Worms”: GP and Practice Nurse Barriers to Talking about Sexual Health in Primary Care. Family Practice, 21(5): 528-536. doi: 10.1093/fampra/cmh509.
Gott, M. and Hinchliff, S. (2003). Barriers to Seeking Treatment for Sexual Problems in Primary Care: A Qualitative study with older people. Family Practice, 20: 690–695.
Stokes, T. and Mears, J. (2000). Sexual Health and the Practice Nurse: a Survey of Reported Practice and Attitudes. The British Journal of Family Planning, 26(2): 89-92.
