Center on Aging, Kansas State University, Manhattan.
Center for Research Methods and Data Analysis, University of Kansas, Lawrence.
Gerontologist. 2020 May 15;60(4):725-734. doi: 10.1093/geront/gnz016.
Approaches to sexual expression in nursing homes are often devoid of person-centered components, such as resident choice. Little is known about residents' preferences for sexual and intimate expression across different situations. To evaluate future resident preferences, a convenience sample of 389 midlife and older adults in the United States were assessed for their perceptions of appropriateness of sexual and intimate activity among couples in nursing homes, given certain situational factors (e.g., cognitive impairment, relationship status, assent behaviors).
A randomized experimental vignette design was implemented to determine situational factors that influence future resident preferences for sexual expression in nursing homes. Data were analyzed via multilevel modeling, allowing for multiple vignette ratings to be nested among respondents.
Behavioral indications of assent, level of intimacy between the couple, and age of respondent affected respondents' ratings of appropriateness of sexual and intimate activities. Also, cognition and relationship levels interacted for more nuanced effects on activity appropriateness.
Future resident preferences are often incongruent with attitudes and common practices for approaching sexual expression in nursing home settings. This marks a unique opportunity for person-centered policy development and implementation in the realm of sexual expression.
养老院中的性行为方式往往缺乏以患者为中心的要素，例如患者的选择。对于不同情境下患者对性行为和亲密表达的偏好，我们知之甚少。为了评估未来患者的偏好，本研究评估了美国 389 名中年及以上成年人对养老院中夫妇在某些情境因素（如认知障碍、关系状况、同意行为）下进行性行为和亲密活动的适当性的看法。
本研究采用随机实验情境设计，以确定影响未来患者对养老院中性行为表达偏好的情境因素。通过多层建模分析数据，允许受访者对多个情境案例进行嵌套评分。
同意行为的迹象、夫妻之间的亲密程度以及受访者的年龄会影响受访者对性行为和亲密活动的适当性的评分。此外，认知和关系水平的相互作用对活动适当性产生了更细微的影响。
未来患者的偏好往往与养老院中性行为的态度和常见做法不一致。这为性表达领域的以患者为中心的政策制定和实施提供了独特的机会。
