Department of Urology, Leiden University Medical Center, The Netherlands.
Department of Medical Decision Making, Leiden University Medical Center, The Netherlands.
J Adv Nurs. 2018 Jan;74(1):128-136. doi: 10.1111/jan.13386. Epub 2017 Aug 8.
To explore the role of nurses in the dialysis department in providing sexual care to patients receiving dialysis.
Sexual health is not self-evident for patients undergoing dialysis; 70% experience sexual dysfunction. Nevertheless, sexual care is often not provided.
A national cross-sectional survey.
Questionnaires (n = 1211) were sent to employees of 34 dialysis centres from January-May 2016. Descriptive statistics and statistical tests were used to describe and interpret data.
The response rate was 45.6%. Three-quarter of nurses discussed sexual dysfunction with less than half of their patients. Main barriers for discussing were based on language and ethnicity (57.3%), culture and religion (54.1%) and the older age of the patient (49.7%). Eighteen per cent of nurses had sufficient knowledge on sexual dysfunction, competence was present in 51.2% of nurses and 68.3% indicated a need for training. Forty-three per cent knew about guidelines on sexual care by renal care providers. Nurses who rated their knowledge or competence higher or who were aware of guidelines discussed sexuality more often. The accountability for discussing sexuality was appointed to nephrologists (82.8%) and their own group of professionals (66.3%). Nurses referred 1.16% of their patients to sexual care providers.
Dialysis nurses do not consistently address patients' sexuality, although they feel accountable to do so. This seems due to self-imposed insufficient knowledge, cultural barriers and organizational problems. Study findings imply that current situation could benefit from guidelines, additional training, a private moment to discuss sexual dysfunction and adequate referral systems to specialized care providers.
探讨透析科护士在为透析患者提供性护理方面的作用。
接受透析的患者的性健康并非不言而喻;70%的患者经历性功能障碍。然而,通常不提供性护理。
全国横断面调查。
2016 年 1 月至 5 月,向 34 个透析中心的员工发送了问卷(n=1211)。使用描述性统计和统计检验来描述和解释数据。
回应率为 45.6%。四分之三的护士与不到一半的患者讨论了性功能障碍。讨论的主要障碍基于语言和种族(57.3%)、文化和宗教(54.1%)以及患者年龄较大(49.7%)。18%的护士对性功能障碍有足够的了解,51.2%的护士有能力,68.3%的护士表示需要培训。43%的护士了解肾脏护理提供者的性护理指南。对自己的知识或能力评价较高或了解指南的护士更经常讨论性问题。讨论性问题的责任由肾病学家(82.8%)和他们自己的专业人员(66.3%)承担。护士将 1.16%的患者转介给性护理提供者。
透析护士并没有始终如一地解决患者的性问题,尽管他们觉得有责任这样做。这似乎是由于自我认为知识不足、文化障碍和组织问题。研究结果表明,当前的情况可能受益于指南、额外的培训、私下讨论性功能障碍的机会以及适当的转介系统到专门的护理提供者。