‘By the way….how’s your sex life?’ – A descriptive study reporting primary health care registered nurses engagement with youth about sexual health
Rhiannon Martel 1 , Ruth Crawford 2 , Helen Riden 31 Macleans College, Auckland, New Zealand
2 Faculty of Health, Whitireia New Zealand, Porirua, New Zealand
3 Hawkes Bay District Health Board, Omahu Road, Hastings, New Zealand
Correspondence to: Rhiannon Martel, Macleans College, 2 Macleans Road, Bucklands Beach, Auckland 2145, New Zealand. Email: rh@macleans.school.nz
Journal of Primary Health Care 9(1) 22-28 https://doi.org/10.1071/HC17013
Published: 29 March 2017
Journal Compilation © Royal New Zealand College of General Practitioners 2017.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Youth rates of sexually transmitted infections in New Zealand are among the highest in the Organisation for Economic Cooperation and Development. Registered nurses employed in primary healthcare settings (PHC RNs) may lack confidence engaging with youth about their sexual health.
AIM: To identify what facilitates PHC RNs to discuss sexual health with youth.
METHODS: This descriptive study was undertaken in two phases. In phase one, 23 PHC RNs completed an online survey. Phase two followed up the survey with semi-structured interviews with seven PHC RNs.
RESULTS: Most PHC RNs are female, aged between 40 and 60 years old and identify with New Zealand or other European ethnicity. Participants identified specific educational needs relating to youth sexual health that are not being met: legal and ethical issues (65%); cultural issues (65%); youth sexual (44%) and psychological (52%) development; and working with gay, lesbian, bisexual or transsexual youth (48%). Lack of time was cited as a barrier to engaging with youth about sexual health by 30% of the participants. Ongoing support practices such as regular debriefing, reflections of practice and case reviews with colleagues (74%); support from other sexual health providers (87%); and access to educational materials about youth sexual health aimed at health professionals (100%) were perceived to be useful to increase confidence in discussing sexual health with youth.
DISCUSSION: The PHC RNs lacked knowledge and confidence engaging with youth about sexual health. PHC RNs need resourcing to provide culturally safe, effective sexual health care to youth.
KEYWORDS: Youth sexual health; registered nurses in primary health care; educational needs; ethnic stereotyping; professional; legal and ethical responsibility
References
[1] Azariah S, McKernon S, Werder S. Large increase in opportunistic testing for chlamydia during a pilot project in a primary health organisation. J Prim Health Care. 2013; 5 141–5.[2] Psutka R, Connor J, Cousins K, Kypri K. Sexual health, risks, and experiences of New Zealand university students: findings from a national cross-sectional study. N Z Med J. 2012; 125 62–3.
[3] Terry G, Braun V, Farvid P. Structural impediments to sexual health in New Zealand: key informant perspectives. Sex Res Soc Policy. 2012; 9 317–26.
| Structural impediments to sexual health in New Zealand: key informant perspectives.Crossref | GoogleScholarGoogle Scholar |
[4] Clark T, Fleming T, Bullen P, et al. Youth’12 overview: the health and wellbeing of New Zealand secondary school students in 2012. Auckland, New Zealand: The University of Auckland; 2013.
[5] Denny S, Farrant B, Cosgriff J,, et al. Forgone healthcare among secondary school students in New Zealand. J Prim Health Care. 2013; 5 11–8.
[6] Van der Meulen E, Oliver V, Flicker S,, et al. Obstacles to sexual health services for youth: service providers’ perspectives. Can J Hum Sex. 2010; 19 185–90.
[7] Hart C, Parker R, Patterson E,, et al. Potential roles for practice nurses in preventive care for young people - a qualitative study. Aust Fam Physician. 2012; 41 618–21.
[8] Clark JK, Brey RA, Banter AE, Khubchandani J. The delivery of sexuality-related patient education to adolescent patients: a preliminary study of family practice resident physicians. J Family Med Pri Care. 2012; 1 34–8.
[9] Chaplick KC, Allen P. Best practices to identify gay, lesbian, bisexual or questioning youth in primary care. Pediatr Nurs. 2013; 39 99–103.
[10] Ham P, Allen C. Adolescent health screening and counseling. Am Fam Physician. 2012; 86 1109–16.
[11] Walker ZAK, Townsend J. The role of general practice in promoting teenage health: a review of the literature. Fam Pract. 1999; 16 164–72.
| The role of general practice in promoting teenage health: a review of the literature.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1MzgvVOgsw%3D%3D&md5=8f52e479b54372e325fbc9fa8c272f15CAS |
[12] Kang M, Bernard D, Booth M,, et al. Access to primary healthcare for Australian young people: service provider perspectives. Br J Gen Pract 2003; 53 947–52.
[13] Gott M, Galena E, Hinchliff S, Elford H. “Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care. Fam Pract. 2004; 21 528–36.
| “Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care.Crossref | GoogleScholarGoogle Scholar |
[14] Alexander SC, Fortenberry JD, Pollak KI,, et al. Sexuality talk during adolescent health maintenance visits. JAMA Pediatr. 2014; 168 163–9.
[15] Haley N, Maheux B, Rivard M, Gervais A. Sexual healthrisk assessment and counseling in primary care: how involved are general practitioners and obstetrician-gynecologists? Am J Public Health. 1999; 89 899–902.
| Sexual healthrisk assessment and counseling in primary care: how involved are general practitioners and obstetrician-gynecologists?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M3os1Ogtg%3D%3D&md5=075a01700284e47528cb29c860dbb875CAS |
[16] Wimberly Y, Hogben M, Moore-Ruffin J,, et al. Sexual history-taking among primary care physicians. J Natl Med Assoc. 2006; 98 1924–9.
[17] Magnan MA, Norris DM. Nursing students’ perceptions of barriers to addressing patient sexuality concerns. J Nurs Educ 2008; 47 260–8.
| Nursing students’ perceptions of barriers to addressing patient sexuality concerns.Crossref | GoogleScholarGoogle Scholar |
[18] Magnan MA, Reynolds KE, Galvin EA. Barriers to addressing patient sexuality in nursing practice. Medsurg Nurs. 2005; 14 282–9.
[19] Stokes T, Mears J. Sexual health and the practice nurse: a survey of reported practice and attitudes. Br J Fam Plann. 2000; 26 89–92.
| 1:STN:280:DC%2BD3c3jvVamsQ%3D%3D&md5=4833abb1795ef3c6d40b170dd9d47b88CAS |
[20] Tsai L-Y, Huang C-Y, Liao W-C,, et al. Assessing student nurses’ learning needs for addressing patients’ sexual health concerns in Taiwan. Nurse Educ Today. 2013; 33 152–9.
| Assessing student nurses’ learning needs for addressing patients’ sexual health concerns in Taiwan.Crossref | GoogleScholarGoogle Scholar |
[21] Herson L, Hart K, Gordon M, Rintala D. Identifying and overcoming barriers to providing sexuality information in the clinical setting. Rehabil Nurs. 1999; 24 148–51.
| Identifying and overcoming barriers to providing sexuality information in the clinical setting.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c3hslOjtg%3D%3D&md5=ecc35e0981f469d3b3ccc3bb13cc1082CAS |
[22] Kotronoulas G, Papadopoulou C, Patiraki E. Nurses’ knowledge, attitudes and practices regarding provision of sexual health care in patients with cancer: critical review of the evidence. Support Care Cancer. 2009; 17 479–501.
| Nurses’ knowledge, attitudes and practices regarding provision of sexual health care in patients with cancer: critical review of the evidence.Crossref | GoogleScholarGoogle Scholar |
[23] Betony K, Yarwood J. What exposure do student nurses have to primary health care and community nursing during the New Zealand undergraduate Bachelor of Nursing programme? Nurse Educ Today. 2013; 33 1136–42.
| What exposure do student nurses have to primary health care and community nursing during the New Zealand undergraduate Bachelor of Nursing programme?Crossref | GoogleScholarGoogle Scholar |
[24] Nursing Council of New Zealand. Nurses - Code of conduct. 2012a. [cited 2013 September 24]. Available from: http://nursingcouncil.org.nz/Nurses/Code-of-Conduct
[25] Youth Friendly Services Copenhagen, Denmark; WHO 2014. [cited 2014 July 29]. Available from: www.euro.who.int/en/health-topics/Life-stages/child-and-adolescent-health/adolescent-health/youth-friendly-services
[26] New Zealand Nurses Organisation. Code of Ethics. 2010. [cited 2014 June 3]. Available from: www.nzno.org.nz/Portals/0/publications/Code%20of%20Ethics%202010.pdf
[27] WHO. Core competencies in adolescent health and development for primary care providers: including a tool to assess the adolescent. Geneva, Switzerland: WHO Press; 2015.
[28] Kekus M, Dawson D, Gilmer C, et al. National youth health nursing knowledge and skills framework. Auckland: National Youth Health Nurses Reference Group; 2014.
[29] Nursing Council of New Zealand. Competencies for registered nurses- regulating nursing practice to protect public safety. 2012. Available from: www.nursingcouncil.org.nz/Nurses/Scopes-of-practice/Registered-nurse
[30] Nursing Council of New Zealand. The New Zealand nursing workforce - a profile of nurse practitioners, registered and enrolled nurses 2012–2013. Wellington: Nursing Council of New Zealand; 2013.