King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, United Kingdom.
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, United Kingdom.
Int J Nurs Stud. 2020 Jul;107:103566. doi: 10.1016/j.ijnurstu.2020.103566. Epub 2020 Mar 10.
Sexual health is an integral part of overall health in older age. Research consistently reports that heterosexual and queer older people tend not to disclose sexual concerns and difficulties which increases the risks for sexually transmitted diseases. Older people are often absent from policies and information programmes and healthcare providers experience difficulties in initiating conversations around sexual health and history.
To identify what are the barriers that stop older people seeking sexual health advice and treatment.
A scoping review methodology was employed. Published and unpublished literature was scoped through development of a research question, identification of potentially relevant studies, selection of relevant studies using an iterative team approach, charting data, collating, summarising and reporting findings, and considering the implications of study findings for further research.
Electronic databases searches were run to identify published and unpublished literature, including Medline, Embase, PsycINFO, CINAHL, ASSIA, Social Sciences, RCN and Cochrane Libraries. Additional studies were located through hand searching.
Twelve studies from: the USA (n = 6); the UK (n = 3); Australia (n = 2); and one shared paper between New Zealand and UK met the inclusion criteria. Four barriers that stop older people seeking sexual health advice and treatment were identified, including (1) Cultural and societal views and beliefs toward sexual health; (2) Stigma, embarrassment and discrimination; (3) Lack of education and training of healthcare professionals; (4) Quality of relationship between patients and health professionals.
Barriers to seeking and receiving advice and treatment for sexual health in later life clearly exist and are both related to cultural and social factors. Overall, the papers reviewed in this scoping review indicate that healthcare providers are reluctant to initiate conversations around sexual health or offer appropriate advice or clinical tests, and that older people tend to be hesitant to seek medical help. Later life age groups independently from their sexual orientation represent a hidden population and are absent from sexual health campaigns and government policies. Efforts need to be made by influential institutions and healthcare providers to recognise sexuality in older age and give older people the opportunity to open up regarding their sexual health and experiences.
性健康是老年时期整体健康的一个组成部分。研究一致表明,异性恋和同性恋老年人往往不会透露性问题和困难,这增加了性传播疾病的风险。老年人在政策和信息计划中经常缺席,医疗保健提供者在围绕性健康和历史展开对话方面也遇到困难。
确定是什么阻碍了老年人寻求性健康咨询和治疗。
采用了范围综述方法。通过制定研究问题、确定潜在相关研究、使用迭代团队方法选择相关研究、绘制数据、整理、总结和报告研究结果以及考虑研究结果对进一步研究的影响,对已发表和未发表的文献进行了范围界定。
通过运行电子数据库搜索,确定了已发表和未发表的文献,包括 Medline、Embase、PsycINFO、CINAHL、ASSIA、社会科学、RCN 和 Cochrane 图书馆。通过手动搜索找到了其他研究。
从美国(n=6);英国(n=3);澳大利亚(n=2);以及新西兰和英国共同发表的一篇论文中,共有 12 项研究符合纳入标准。确定了阻止老年人寻求性健康咨询和治疗的四个障碍,包括(1)对性健康的文化和社会观念和信念;(2)耻辱感、尴尬和歧视;(3)医疗保健专业人员缺乏教育和培训;(4)患者与健康专业人员之间的关系质量。
在晚年寻求和接受性健康咨询和治疗的障碍显然存在,这些障碍与文化和社会因素有关。总的来说,本范围综述中审查的论文表明,医疗保健提供者不愿意围绕性健康展开对话,也不愿意提供适当的建议或临床检查,而老年人往往不愿意寻求医疗帮助。来自不同性取向的晚年年龄组代表了一个隐藏的群体,他们在性健康运动和政府政策中都没有被提及。有必要通过有影响力的机构和医疗保健提供者努力承认老年人的性行为,并为老年人提供机会,让他们能够公开谈论自己的性健康和经历。