Sexual Health Care Attitudes and Practices of Nurses Caring for Patients with Cancer

Young Hee Chae; Young Ok Song; Soon Tae Oh; Won Hee Lee; Young Mi Min; Hyang Mi Kim; Seung A Lee; Young Sin Choi

doi:10.5388/aon.2015.15.1.28

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Chae, Song, Oh, Lee, Min, Kim, Lee, and Choi: Sexual Health Care Attitudes and Practices of Nurses Caring for Patients with Cancer

Original Article

Asian Oncology Nursing 2015; 15(1): 28-36.

Published online: 31 March 2015

DOI: https://doi.org/10.5388/aon.2015.15.1.28

Sexual Health Care Attitudes and Practices of Nurses Caring for Patients with Cancer

Young Hee Chae, Young Ok Song, Soon Tae Oh, Won Hee Lee, Young Mi Min, Hyang Mi Kim, Seung A Lee, Young Sin Choi

Nursing Services, Kyungpook National University Medical Center, Daegu, Korea.

Address reprint requests to: Chae, Young Hee. Nursing Services, Kyungpook National University Medical Center, 807 Hoguk-ro, Buk-gu, Daegu 702-210, Korea. Tel: +82-53-200-3011, Fax: +82-53-200-3029, chae1214@hanmail.net

Received 12 December 2014 Revised 5 January 2015 Accepted 25 January 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to examine nurses' sexual health care attitude and practice while caring for cancer patients.

Methods

Data were collected using a structured questionnaire from 236 nurses caring for patients with cancer from June 30, 2014 to July 6, 2014 at a University Hospital in Daegu, Korea.

Results

The mean score for sexual health care attitude of nurses caring for patients with cancer was 27.75±6.45 of a possible range 17 to 51 and the mean score for a sexual health care practice of nurses was 3.67±3.30 of a possible range 0 to 21. The scores of a sexual health care attitude and practice were significantly different by age, education, department, experience in gynecology or urology departments, and position. Sexual health care attitude and practice had a significantly positive correlation (r=.16, p=.015).

Conclusion

The nurses caring for patients with cancer recognize the importance of sexual health care, but their sexual health care practice rate was very low. Therefore specific and differentiated nurse education programs designed to increase sexual health care practice are required for young nurses and staff nurses that are not practicing sexual health care often.

Keywords: Nurses, Neoplasms, Sexual Health, Attitude, Practice

Figures and Tables

Table 1

General and Work-related Characteristics (N=236)

Characteristics	Categories	n (%)	M ± SD
Gender	Male	13 (5.5)
Gender	Female	223 (94.5)
Age (year)	≤ 25	39 (16.5)	30.2 ± 6.27
	26~30	128 (54.3)
	31~35	38 (16.1)
	≥ 36	31 (13.1)
Martial status	Single	168 (71.2)
Martial status	Married	68 (28.8)
Education	Diploma	77 (32.6)
	Bachelor	142 (60.2)
	≥ Master	17 (7.2)
Religion	Protestantism	32 (13.6)
	Catholicism	26 (11.0)
	Buddhism	45 (19.1)
	Others	2 (0.8)
	None	131 (55.5)
Department	Ward	159 (67.4)
	ICU	22 (9.3)
	ER	14 (5.9)
	Chemotherapy unit	11 (4.7)
	OPD	30 (12.7)
Clinical experience (year)	≤ 1	21 (8.9)	6.30 ± 6.49
	> 1~ ≤ 5	119 (50.4)
	> 5~ ≤ 10	61 (25.9)
	> 10	35 (14.8)
Working experience of gynecology or urology	Yes	60 (25.4)
Working experience of gynecology or urology	No	176 (74.6)
Position	Staff nurse	222 (94.1)
Position	Head nurse	14 (5.9)
Experience of sexual health education	Yes	27 (11.4)
Experience of sexual health education	No	209 (88.6)

Table 2

Degrees of Sexual Health Care Attitude (N=236)

Items	Agree	Don't know	Disagree	M±SD
Items	n (%)	n (%)	n (%)	M±SD
1. It is uncomfortable to discuss sexual issues with patients.	122 (51.7)	65 (27.5)	49 (20.8)	1.69 ± 0.79
2. I am reluctant to discuss sex with patients of the opposite sex.	148 (62.7)	48 (20.3)	40 (17.0)	1.54 ± 0.77
3. I feel uncomfortable discussing specific sexual activities with patients.	194 (82.2)	34 (14.4)	8 (3.4)	1.21 ± 0.49
4. I feel uncomfortable discussing sex with patients.	154 (65.2)	41 (17.4)	41 (17.4)	1.52 ± 0.77
5. I am not ready to talk about sexual issues with patients.	114 (48.3)	88 (37.3)	34 (14.4)	1.66 ± 0.72
6. Discussing sex is a difficult thing to do.	157 (66.5)	55 (23.3)	24 (10.2)	1.44 ± 0.67
7. I may be embarrassed if patients broach sexual issues.	104 (44.1)	71 (30.1)	61 (25.8)	1.82 ± 0.82
8. Patients would be uncomfortable if I broached sexual issues.	141 (59.7)	79 (33.5)	16 (6.8)	1.47 ± 0.62
9. I am afraid patients would feel their privacy was invaded if I asked specific questions about sex.	164 (69.5)	50 (21.2)	22 (9.3)	1.40 ± 0.65
10. I am afraid patients would be offended if I broached sexual issues.	124 (52.5)	79 (33.5)	33 (14.0)	1.61 ± 0.72
11. I am afraid conversation about sex with patients would bring about a distance between me and them.	64 (27.1)	82 (34.8)	90 (38.1)	2.11 ± 0.80
12. I am too busy to deal with sexual issues.	164 (69.5)	45 (19.1)	27 (11.4)	1.42 ± 0.69
13. It is hard to find a proper place where I can talk about sexual issues with patients.	179 (75.8)	33 (14.0)	24 (10.2)	1.34 ± 0.66
14. I do not have enough time to talk about sexual issues with patients.	184 (78.0)	36 (15.2)	16 (6.8)	1.29 ± 0.58
15. I am afraid my fellows would think it is unusual that I deal with patients sexual issues.	59 (25.0)	77 (32.6)	100 (42.4)	2.17 ± 0.80
16. I am afraid my fellows would feel uncomfortable dealing with patients sexual issues.	59 (25.0)	91 (38.6)	86 (36.4)	2.11 ± 0.78
17. My fellows also seem to be reluctant to talk about sex with cancer patients.	66 (28.0)	119 (50.4)	51 (21.6)	1.93 ± 0.70
Total (17 Items)				27.75 ± 6.45

Table 3

Degrees of Sexual Health Care Practice (N=236)

Items	Performed	Didn't perform	Not applicable	M±SD
Items	n (%)	n (%)	n (%)	M±SD
1. Counseling and education for a decrease in sexual satisfaction	3 (1.3)	161 (68.2)	72 (30.5)	0.01 ± 0.11
2. Counseling and education for a decrease in sexual desire	1 (0.4)	165 (69.9)	70 (29.7)	0.00 ± 0.66
3. Assessment of a decrease in sexual satisfaction	3 (1.3)	161 (68.2)	72 (30.5)	0.01 ± 0.11
4. Assessment of vaginal dryness and dyspareunia	9 (3.8)	157 (66.5)	70 (29.7)	0.38 ± 0.19
5. Assessment of erectile dysfunction	13 (5.5)	150 (63.6)	73 (30.9)	0.55 ± 0.23
6. Counseling and education for vaginal dryness and dyspareunia	15 (6.4)	149 (63.1)	72 (30.5)	0.64 ± 0.24
7. Assessment of a decrease in sexual desire	4 (1.7)	158 (66.9)	74 (31.4)	0.17 ± 0.13
8. Counseling and education for erectile dysfunction	9 (3.8)	155 (65.7)	72 (30.5)	0.38 ± 0.19
9. Assessment of depression	125 (53.0)	84 (35.6)	27 (11.4)	0.53 ± 0.50
10. Counseling for depression	94 (39.9)	115 (48.7)	27 (11.4)	0.40 ± 0.19
11. Assessment of changes in body image	112 (47.5)	99 (41.9)	25 (10.6)	0.47 ± 0.50
12. Counseling for changes in body image	94 (39.8)	117 (49.6)	25 (10.6)	0.40 ± 0.49
13. Assessment of handling stress	131 (55.5)	82 (34.8)	23 (9.7)	0.56 ± 0.50
14. Counseling and education for handling stress	102 (43.2)	110 (46.6)	24 (10.2)	0.43 ± 0.50
15. Assessment of the intimacy between patient and partner	33 (14.0)	156 (66.1)	47 (19.9)	0.14 ± 0.35
16. Assessment of communication between patient and partner	48 (20.3)	141 (59.8)	47 (19.9)	0.20 ± 0.40
17. Refer to experts when needed	14 (5.9)	170 (72.1)	52 (22.0)	0.06 ± 0.27
18. Nursing records of patients' sexual issues	3 (1.3)	176 (74.6)	57 (24.1)	0.01 ± 0.11
19. Counseling and education for sterility during treatment	15 (6.4)	149 (63.1)	72 (30.5)	0.64 ± 0.24
20. Counseling and education for resuming sex life and contraception	15 (6.4)	154 (65.2)	67 (28.4)	0.64 ± 0.24
21. Counseling and education for menopause during treatment	24 (10.2)	145 (61.4)	67 (28.4)	0.10 ± 0.30
Total (21 Items)				3.67 ± 3.30

Table 4

Differences of Sexual Health Care Attitude and Sexual Health Care Practice according to Characteristics (N=236)

Characteristics	Categories	Sexual health care attitude		Sexual health care practice
Characteristics	Categories	M ± SD	t or F (p) Scheffé	M ± SD	t or F (p) Scheffé
Gender	Male	30.31 ± 6.71	1.48 (.142)	4.85 ± 3.29	1.32 (.188)
Gender	Female	27.60 ± 6.42	1.48 (.142)	3.61 ± 3.29	1.32 (.188)
Age (year)	≤ 25^a	27.46 ± 6.79	3.87 (.010) b<d	2.90 ± 3.12	3.39 (.019) a<d
	26~30^b	26.93 ± 5.75		3.76 ± 3.12
	31~35^c	27.97 ± 6.15		3.00 ± 3.05
	≥ 36^d	31.23 ± 8.07		5.13 ± 4.07
Martial status	Single	27.50 ± 6.12	- 0.94 (.350)	3.29 ± 2.98	- 2.59 (.011)
Martial status	Married	28.37 ± 7.21	- 0.94 (.350)	4.63 ± 3.84	- 2.59 (.011)
Education	Diploma^a	27.38 ± 6.38	4.57 (.011) a,b<c	3.12 ± 3.23	12.58 (<.001) a,b<c
	Bachelor^b	27.42 ± 6.21		3.54 ± 3.01
	≥ Master^c	32.24 ± 7.39		7.29 ± 3.87
Religion	Protestantism	27.06 ± 7.37	0.78 (.548)	3.19 ± 3.19	1.14 (.337)
	Catholicism	28.08 ± 7.49		3.69 ± 3.00
	Buddhism	28.40 ± 7.80		4.53 ± 3.80
	Others	21.00 ± 1.41		2.00 ± 2.83
	None	27.73 ± 5.46		3.52 ± 3.19
Department	Ward^a	27.28 ± 6.22	4.03 (.004) a,b,d<e	4.02 ± 3.07	5.21 (<.001) a,d,e>c
	ICU^b	25.64 ± 3.82		2.32 ± 2.82
	Er^c	28.07 ± 6.29		0.57 ± 1.65
	Chemotherapy unit^d	27.27 ± 7.36		4.91 ± 4.55
	OPD^e	31.83 ± 7.55		3.83 ± 3.91
Clinical experience (year)	≤ 1	28.29 ± 6.09	1.79 (.151)	2.29 ± 3.20	2.47 (.063)
	> 1~ ≤ 5	26.98 ± 6.26		3.55 ± 3.00
	> 5~ ≤ 10	27.90 ± 5.88		3.80 ± 3.24
	> 10	29.77 ± 7.86		4.69 ± 4.13
Working experience of gynecology or urology	Yes	29.28 ± 7.07	2.15 (.033)	5.02 ± 3.62	3.75 (<.001)
Working experience of gynecology or urology	No	27.23 ± 6.16	2.15 (.033)	3.22 ± 3.06	3.75 (<.001)
Position	Staff nurse	27.46 ± 6.20	- 2.84 (.005)	3.50 ± 3.19	- 3.20 (.002)
Position	Head nurse	32.43 ± 6.86	- 2.84 (.005)	6.36 ± 3.89	- 3.20 (.002)
Experience of sexual health education	Yes	28.85 ± 6.61	0.94 (.347)	3.67 ± 3.67	- 0.12 (.991)
Experience of sexual health education	No	27.61 ± 6.43	0.94 (.347)	3.67 ± 3.26	- 0.12 (.991)

Table 5

Correlation between Sexual Health Care Attitude and Sexual Health Care Practice (N=236)

Variable	Sexual health care attitude
Variable	r	p
Sexual health care practice	.16	.015

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