Skip to main content

Advertisement

SpringerLink
Log in

Nurses and Midwives Role in Patient Sexual Health Assessment: A Cross-Sectional Study

  • Original Paper
  • Published:
Sexuality and Disability Aims and scope Submit manuscript

Abstract

A cross-sectional exploratory study was conducted to assess nurses and midwives’ attitudes and beliefs towards addressing patients' sexual health. A convenient sample of 305 nurses and midwives (professionals and students) were recruited from University Hospitals in Lebanon. The Sexuality Attitude and Belief Survey (SABS) was used and data about barriers to sexual assessment, sexual education and sociodemographic characteristics were collected. The sample included nursing students, 30.1%, staff nurses, 61.2%, and midwives, 8.6%. The mean age was 26.8 years, and 83.7% were females. Only 28.4% of the total sample received sexual health education, and 12.5% reported taking patients' sexual history. The total SABS score was 48.4, which is relatively high. Most nurses and midwives (72.2%) stated that they do not spend time discussing patients' sexual concerns, viewing sexuality as 'too private an issue to discuss' (68.9%). In parallel, a minority had the belief that patients expect nurses to ask about their sexual concerns (32.7%) and felt confident in their abilities to address patients' sexual issues (30.3%). SABS score was significantly associated with the participants' gender, status, care unit, sexual health education and history taking. This study provided a preliminary appraisal of Lebanese nurses' and midwives' approaches towards patients' sexual health assessment and highlighted the obstacles that hinder appropriate sexual health practice. Based on the findings, there is a need for initiatives at the level of education and practice to develop nurses and midwives' competence and improve patient outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. WHO: Sexual Health. https://www.who.int/health-topics/sexual-health#tab=tab 1 (2017). Accessed 10 July 2021

  2. Hogben, M., Harper, C., Habel, M.A., Brookmeyer, K., Friedman, A.: Attitudes to sexual health in the United States: Results from a national survey of youth aged 15–25 years. Sex. Health 14, 540–547 (2017)

    Article  Google Scholar 

  3. Lusti-Narasimhan, M., Beard, J.R.: Sexual health in older women. B. World Health Organ. 91, 707–709 (2013)

    Article  Google Scholar 

  4. Mick, J.M.: Sexuality assessment: 10 strategies for improvement. Clin J Oncol Nurs. 11, 671–675 (2007)

    Article  Google Scholar 

  5. Carrillo González, G.M., Sánchez Herrera, B., Chaparro Díaz, L.: Chronic disease and sexuality. Investigación y Educación en Enfermería. 31, 295–304 (2013)

    Google Scholar 

  6. Bdair, I.A., Maribbay, G.L.: Perceived knowledge, practices, attitudes and beliefs of jordanian nurses toward sexual health assessment of patients with coronary artery diseases. Sex. Disabil. (2020). https://doi.org/10.1007/s11195-020-09639-y

    Article  Google Scholar 

  7. Merghati-Khoei, E., Pirak, A., Yazdkhasti, M., Rezasoltani, P.: Sexuality and elderly with chronic diseases: A review of the existing literature. J Res. Med.Sci: Off. J Isfahan Univ. Med. Sci. 21(1), 136 (2016). https://doi.org/10.4103/1735-1995.196618

    Article  Google Scholar 

  8. Irfan, M., Hussain, N.H.N., Noor, N.M., Mohamed, M., Sidi, H., Ismail, S.B.: Epidemiology of male sexual dysfunction in Asian and European regions: a systematic review. Am J Mens Health 14, 1557988320937200 (2020)

    PubMed  PubMed Central  Google Scholar 

  9. McCool, M.E., Zuelke, A., Theurich, M.A., Knuettel, H., Ricci, C., Apfelbacher, C.: Prevalence of female sexual dysfunction among premenopausal women: A systematic review and meta-analysis of observational studies. Sex. Med. Rev. (2016). https://doi.org/10.1016/j.sxmr.2016.03.002

    Article  PubMed  Google Scholar 

  10. Zeleke, B.M., Bell, R.J., Billah, B., Davis, S.R.: Hypoactive sexual desire dysfunction in community-dwelling older women. Menopause 24, 391–399 (2017)

    Article  Google Scholar 

  11. Zahlan, L., Khauli, N., Khoury, B.: Sexual health services in the Arab region: availability, access, and utilisation. Glob. Publ. Health 15, 485–496 (2020)

    Article  Google Scholar 

  12. Wagner, G.J., Aunon, F.M., Kaplan, R.L., Karam, R., Khouri, D., Tohme, J., Mokhbat, J.: Sexual stigma, psychological wellbeing and social engagement among men who have sex with men in Beirut. Lebanon. Cult. Health Sex. (2013). https://doi.org/10.1080/13691058.2013.775345

    Article  PubMed  Google Scholar 

  13. Mgopa, L.R., Rosser, B.R.S., Ross, M.W., Lukumay, G.G., Mohammed, I., Massae, A.F., Leshabari, S., Mkonyi, E., Mushy, S.E., Mwakawanga, D.L., Trent, M., Wadley, J., Bonilla, Z.E.: Cultural and clinical challenges in sexual health care provision to men who have sex with men in Tanzania: a qualitative study of health professionals’ experiences and health students’ perspectives. BMC Publ. Health (2021). https://doi.org/10.1186/s12889-021-10696-x

    Article  Google Scholar 

  14. Fennell, R., Grant, B.: Discussing sexuality in health care: A systematic review. J. Clin. Nurs. (2019). https://doi.org/10.1111/jocn.14900

    Article  PubMed  Google Scholar 

  15. Santa Maria, D., Guilamo-Ramos, V., Jemmott, L.S., Derouin, A., Villarruel, A.: Nurses on the front lines: Improving adolescent sexual and reproductive health across health care settings. Am. J. Nurs. (2017). https://doi.org/10.1097/01.NAJ.0000511566.12446.45

    Article  PubMed  Google Scholar 

  16. Sung, S.C., Jiang, H.H., Chen, R.R., Chao, J.K.: Bridging the gap in sexual healthcare in nursing practice: implementing a sexual healthcare training programme to improve outcomes. J. Clin. Nurs. 25, 2989–3000 (2016)

    Article  Google Scholar 

  17. Jonsdottir, J.I., Zoëga, S., Saevarsdottir, T., Sverrisdottir, A., Thorsdottir, T., Einarsson, G.V., Gunnarsdottir, S., Fridriksdottir, N.: Changes in attitudes, practices and barriers among oncology health care professionals regarding sexual health care: Outcomes from a 2-year educational intervention at a University Hospital. Eur. J Oncol Nurs. 21, 24–30 (2016)

    Article  Google Scholar 

  18. Yingling, C.T., Cotler, K., Hughes, T.L.: Building nurses’ capacity to address health inequities: incorporating lesbian, gay, bisexual and transgender health content in a family nurse practitioner programme. J. Clin Nurs. 26, 2807–2817 (2017)

    Article  Google Scholar 

  19. Ford, J.V., Barnes, R., Rompalo, A., Hook, E.W.: Sexual health training and education in the US. Public Health Rep. 128, 96–101 (2013)

    Article  Google Scholar 

  20. Nanda International Nursing Diagnoses List 2020–21. https://www.publichealth.com.ng/nanda-international-nursing-diagnosis-list-2020-2021/ (2020). Accessed Aug 8 2021

  21. Wang, P., Ai, J., Davidson, P.M., Slater, T., Du, R., Chen, C.: Nurses’ attitudes, beliefs and practices on sexuality for cardiovascular care: A cross-sectional study. J. Clin. Nurs. (2019). https://doi.org/10.1111/jocn.14692

    Article  PubMed  Google Scholar 

  22. McKie, A.L., Green, T., Bonner, A.: Nurse’s practices and attitudes toward sexual health, wellbeing, and function in people receiving haemodialysis: A scoping review. J. Ren. Care. (2021). https://doi.org/10.1111/jorc.12360

    Article  PubMed  Google Scholar 

  23. Krouwel, E.M., Nicolai, M.P.J., Van Steijn-van Tol, A.Q.M.J., Putter, H., Osanto, S., Pelger, R.C.M., Elzevier, H.W.: Addressing changed sexual functioning in cancer patients: a cross-sectional survey among Dutch oncology nurses. Eur J Oncol Nurs. 19(6), 707–715 (2015)

  24. Saunamäki, N., Engström, M.: Registered nurses’ reflections on discussing sexuality with patients: responsibilities, doubts and fears. J. Clin. Nurs. 23, 531–540 (2014)

    Article  Google Scholar 

  25. Bal, M.D., Sahiner, N.C.: Turkish nursing students' attitudes and beliefs regarding sexual health. Sex. Disabil. https://doi.org/10.1007/s11195-014-9388-y

  26. O'Regan, K.: Breaking taboos: Can Lebanon be honest about sexual health? https://www.middleeasteye.net/discover/lebanon-sexual-health-lgbtq (2019). Accessed July 31 2020

  27. Azar, M., Kroll, T., Bradbury-Jones, C.: Lebanese women and sexuality: A qualitative inquiry. Sex. Reprod. Healthc. 8, 13–18 (2016)

    Article  Google Scholar 

  28. Aouad, N., Abed, D.: Queer community in crisis: trauma, inequality and vulnerability. OXFAM International. https://www.oxfam.org/en/research/queer-community-crisis-trauma-inequality-and-vulnerability (2021). Accessed Aug 5 2021

  29. Porter, L.: Tackling Lebanon's blushes about sex. Al Jazeera.

  30. https://www.aljazeera.com/features/2017/4/24/tackling-lebanons-blushes-about-sex (2017). Accessed Aug 5 2020

  31. Hamdanieh, M., Ftouni, L., Al Jardali, B., Ftouni, R., Rawas, C., Ghotmi, M., El Zein, M.H., Ghazi, S., Malas, S.: Assessment of sexual and reproductive health knowledge and awareness among single unmarried women living in Lebanon: A cross-sectional study. Reprod. Health. (2021). https://doi.org/10.1186/s12978-021-01079-x

    Article  PubMed  PubMed Central  Google Scholar 

  32. El-Kak, F., Jurdi, R., Kaddour, A., Zurayk, H.: Gender and sexual health in clinical practice in Lebanon. Int. J. Gynecol. Obstet. (2004). https://doi.org/10.1016/j.ijgo.2004.09.002

    Article  Google Scholar 

  33. Obermeyer, C.M., Reher, D., Saliba, M.: Symptoms, menopause status, and country differences: a comparative analysis from DAMES. Menopause 14, 788–797 (2007)

    Article  Google Scholar 

  34. Azar, M., Bradbury-Jones, C., Kroll, T.: Middle-aged Lebanese women’s interpretation of sexual difficulties: a qualitative inquiry. BMC womens health 21, 1–11 (2021)

    Article  Google Scholar 

  35. Azar, M., Azar, N., Kroll, T., Bradbury-Jones, C.: Should i seek help for sexual difficulties? Middle-aged lebanese women’s views. J. Sex. Marital Ther. (2021). https://doi.org/10.1080/0092623X.2021.1934208

    Article  PubMed  Google Scholar 

  36. Reynolds, K.E., Magnan, M.A.: Nursing attitudes and beliefs toward human sexuality. Collaborative research promoting evidence-based practice. Clin. Nurse Spec. 19(5), 255–260 (2005)

  37. Doherty, S., Byrne, M., Murphy, A.W., McGee, H.M.: Cardiac rehabilitation staff views about discussing sexual issues with coronary heart disease patients: a national survey in Ireland. Eur. J. Cardiovasc. Nurs. 10, 101–107 (2011)

    Article  Google Scholar 

  38. Arikan, F., Meydanlioglu, A., Ozcan, K., Ozer, Z.C.: Attitudes and beliefs of nurses regarding discussion of sexual concerns of patients during hospitalisation. Sex. Disabil. 33, 327–337 (2015)

    Article  Google Scholar 

  39. Julien, J.O., Thom, B., Kline, N.E.: Identification of barriers to sexual health assessment in oncology nursing practice. Oncol. Nurs. Forum, 37, (2010)

  40. Magnan, M.A., Reynolds, K.E., Galvin, E.A.: Barriers to addressing patient sexuality in nursing practice. Medsurg. Nurs. 14, 282–289 (2005)

    PubMed  Google Scholar 

  41. Ören, B., Zengin, N., Yazıcı, S., Akıncı, A.Ç.: Attitudes, beliefs and comfort levels of midwifery students regarding sexual counselling in Turkey. Midwifery 56, 152–157 (2018)

    Article  Google Scholar 

  42. Ozan, Y.D., Duman, M., Çiçek, Ö.: Nursing students’ experiences on assessing the sexuality of patients: a mixed-method study. Sex Disabil. 37, 613–623 (2019)

    Article  Google Scholar 

  43. Senturk Erenel, A., Cicek Ozdemir, S.: Attitude and behaviors of senior nursing students in the assessment of sexual health. Sex. Disabil. 38, 503–514 (2020)

    Article  Google Scholar 

  44. Asefa, A., Nigussie, T., Henok, A., Mamo, Y.: Prevalence of sexual dysfunction and related factors among diabetes mellitus patients in Southwest Ethiopia. BMC Endocr. Disord. 19, 1–8 (2019)

    Article  Google Scholar 

  45. Susan Bohnenkamp, M.S.: Sexual side effects and prostate cancer. Medsurg. Nurs. 29, 216–218 (2020)

    Google Scholar 

  46. Thakurta, R.G., Singh, O.P., Bhattacharya, A., Mallick, A.K., Ray, P., Sen, S., Das, R.: Nature of sexual dysfunctions in major depressive disorder and its impact on quality of life. Indian J. Psychol. Med. 34, 365–370 (2012)

    Article  Google Scholar 

  47. Jaarsma, T., Strömberg, A., Fridlund, B., De Geest, S., Mårtensson, J., Moons, P., Norekval, T.M., Smith, K., Steinke, E., Thompson, D.R.: Sexual counselling of cardiac patients: nurses’ perception of practice, responsibility and confidence. Eur. J. Cardiovasc. Nurs. 9, 24–29 (2010)

    Article  Google Scholar 

  48. Evcili, F., Demirel, G.: Patient’s sexual health and nursing: a neglected area. Int. J. Caring Sci. 11, 1282–1288 (2018)

    Google Scholar 

  49. Zeng, Y.C., Li, Q., Wang, N., Ching, S.S., Loke, A.Y.: Chinese nurses’ attitudes and beliefs toward sexuality care in cancer patients. Cancer Nurs. 34, E14–E20 (2011)

    Article  Google Scholar 

  50. Magnan, M.A., Reynolds, K.: Barriers to addressing patient sexuality concerns across five areas of specialisation. Clin. Nurse Spec. 20, 285–292 (2006)

    Article  Google Scholar 

  51. International Confederation of Midwives/ICM. https://mana.org/pdfs/ICM13-1.1GlobalStandardsMidwiferyRegulation.pdf (2011) Accessed 26 June 2021

  52. Tugut, N., Golbasi, Z.: Sexuality assessment knowledge, attitude, and skill of nursing students: an experimental study with a control group. Int. J. Nurs. Knowl. 8, 123–130 (2016)

    Google Scholar 

  53. Saunamäki, N., Andersson, M., Engström, M.: Discussing sexuality with patients: Nurses’ attitudes and beliefs. J. Adv. Nurs. (2010). https://doi.org/10.1111/j.1365-2648.2010.05260.x

    Article  PubMed  Google Scholar 

Download references

Funding

This research was funded by Balamand Internal Research Grants [BIRG], University of Balamand, Lebanon.

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, University of Balamand, Dekouaneh Beirut: Rond Point Saloumeh Sin El Fil, P.O. Box: 55251, Dekouaneh, Beirut, Lebanon

    Mathilde Azar, Hiba Chakhtoura & Vicky Gebran

  2. School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland

    Thilo Kroll

  3. American University of Beirut, Hariri School of Nursing, Beirut, Lebanon

    Silva Dakessian Sailian

Authors
  1. Mathilde Azar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thilo Kroll
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hiba Chakhtoura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vicky Gebran
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Silva Dakessian Sailian
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mathilde Azar.

Ethics declarations

Conflict of interest

There is no conflict of interest related to this study.

Ethics approval

An Internal Review Board/IRB ethics approval was obtained from the University of Balamand and Saint George Hospital University Medical Center. All participants signed an informed consent that guarantees their autonomous participation in the study and the anonymity and confidentiality of data that will be accessible to the authors only.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Azar, M., Kroll, T., Chakhtoura, H. et al. Nurses and Midwives Role in Patient Sexual Health Assessment: A Cross-Sectional Study. Sex Disabil 40, 583–598 (2022). https://doi.org/10.1007/s11195-022-09739-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11195-022-09739-x

Keywords

Search

Navigation