Discussing sexuality in health care: A systematic review

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.