Andrist L C
Graduate Program in Nursing, MGH Institute of Health Professions, Boston, Massachusetts.
Nurs Clin North Am. 1988 Dec;23(4):959-73.
The importance for taking a sexual history cannot be overstated. In the general patient population, the goal of the history is to assess the impact of illness on a client's sexual health. This information provides the nurse with a baseline for educating the client about his or her sexual adaptation to illness or surgery. Further, the sexual history is a part of the holistic nursing framework for patient care. Nurses working in settings in which they routinely care for clients with STDs have the additional responsibility of utilizing data from the history to educate clients regarding risk factors, re-evaluation of lifestyle behaviors, and preventative measures. Education of clients is crucial to decreasing the incidence of STDs. Nurses need to confront their own values and attitudes regarding sexuality as the first step to overcoming barriers in discussing sexuality with their clients. Additionally, education regarding human sexual behavior is important in expanding nurses' knowledge in this area. I have outlined interview techniques that can be helpful in eliciting the sexual history, emphasizing open-ended questions and ubiquitous statements. These techniques can be useful in both ambulatory and in-patient settings. The format for taking a sexual history has been addressed, with specific questions relevant to clients exposed to STDs. I have pointed to the need for considering the sexual history within the context of the client's life situation and suggested that information regarding sexuality be thoughtfully gathered, taking into account variables such as culture and sexual preference. Finally, this article addresses educating clients for safe sexual practices and emphasizes the need for nurses to counsel all sexually active clients concerning the risk factors for STDs. As the incidence of STDs continue to increase, and particularly as AIDS becomes increasingly widespread, nurses must be in the forefront of educating the public. As a health care profession advocating caring and commitment to holistic care, nursing can contribute to health promotion activities through addressing clients' sexual health.
获取性病史的重要性无论如何强调都不为过。在普通患者群体中，病史采集的目的是评估疾病对患者性健康的影响。这些信息为护士向患者传授其对疾病或手术的性适应情况提供了基线。此外，性病史是患者整体护理框架的一部分。在常规护理性传播疾病患者的环境中工作的护士，还有额外的责任利用病史数据对患者进行有关危险因素、生活方式行为重新评估及预防措施的教育。对患者进行教育对于降低性传播疾病的发病率至关重要。护士首先需要正视自己对性的价值观和态度，以此作为克服与患者讨论性问题时的障碍的第一步。此外，关于人类性行为的教育对于拓宽护士在这一领域的知识很重要。我概述了一些有助于引出性病史的访谈技巧，强调开放式问题和普遍适用的陈述。这些技巧在门诊和住院环境中都可能有用。文中讨论了获取性病史的形式，以及与接触性传播疾病的患者相关的具体问题。我指出了在患者生活状况背景下考虑性病史的必要性，并建议在收集有关性方面的信息时要深思熟虑，同时考虑文化和性取向等变量。最后，本文论述了对患者进行安全性行为教育的问题，并强调护士有必要就性传播疾病的危险因素向所有有性行为的患者提供咨询。随着性传播疾病的发病率持续上升，尤其是艾滋病日益蔓延，护士必须站在公众教育的前沿。作为倡导关爱和致力于整体护理的医疗保健专业，护理可以通过关注患者的性健康为健康促进活动做出贡献。
