Department of Psychological Science, Northern Kentucky University, Highland Heights, Kentucky, USA.
Department of Psychology, Radford University, Radford, Virginia, USA.
Clin Gerontol. 2021 May-Jun;44(3):331-344. doi: 10.1080/07317115.2020.1825584. Epub 2020 Oct 16.
Older adults vary in their safe and unsafe sexual behaviors. While researchers are beginning to understand more about the sexual and intimate expression of older adults, only recently are they beginning to understand how older adults make decisions about sexual risk. Bandura's social cognitive theory offers a frame for understanding how self-efficacy, environmental factors, and goal motivation are related to sexual risk behaviors for older adults, including the interplay between these variables.
Using a diverse sample of older adults ( = 720) age 50+ years, social cognitive theory was modeled to determine the relationship between environment variables (age, gender, and sexual health conversations with practitioners), behavioral variables (self-efficacy), and cognitive variables (importance of sexual wellness goals) with the outcome variable of sexual risk behaviors.
Self-efficacy had an indirect effect on sexual risk via sexual wellness goal motivation. Healthcare provider conversations had both direct and indirect effects on older adults' sexual risk through sexual wellness goal motivation. Models were similarly predictive for older men and women.
Sexual risk behaviors among older adults are more influenced by environmental factors in their healthcare settings and their perception and prioritization of sexual wellness goals.
Providers play a key role in initiating and maintaining sexual health discussions with older patients, potentially mitigating sexual risk and bolstering self-efficacy.
老年人的性行为安全和不安全行为存在差异。虽然研究人员开始更多地了解老年人的性和亲密表达，但直到最近，他们才开始了解老年人如何做出关于性风险的决策。班杜拉的社会认知理论为理解自我效能感、环境因素和目标动机如何与老年人的性风险行为相关提供了一个框架，包括这些变量之间的相互作用。
使用一个多元化的 50 岁以上老年人样本（n=720），对社会认知理论进行建模，以确定环境变量（年龄、性别和与医生的性健康对话）、行为变量（自我效能感）和认知变量（性健康目标的重要性）与性风险行为的结果变量之间的关系。
自我效能感通过性健康目标动机对性风险产生间接影响。医疗保健提供者的对话通过性健康目标动机对老年人的性风险产生直接和间接影响。这些模型对男性和女性老年人同样具有预测性。
老年人的性风险行为更多地受到医疗保健环境中的环境因素以及他们对性健康目标的感知和重视的影响。
提供者在与老年患者开始和维持性健康讨论方面发挥着关键作用，这可能会降低性风险并增强自我效能感。
