護理人員提供性諮詢的觀點與現況之探討

An Exploration of the Nurses' Perspectives and their Current Practice on Sex Consultation

本研究目的在調查護理人員提供性諮詢的觀點與現況。研究採調查性研究設計，以立意取樣選取北部某醫院共290 位護理人員為研究對象。研究發現：77.9%護理人員對病人提供性健康護理評估比例為「很少」或「沒有」；與病人討論其性困擾的比例以「很少」(43.1%)最多。護理人員在面對病人討論其性困擾態度上，有74.8%認為當病人提出時再與之討論最好，但只有58.3%實際有被病人提出討論其性困擾的經驗。以單因子變異數分析發現年齡、護理年資較資深、教育程度較高及曾經修習相關性學教育者呈現較高的自在感、責任感與專業角色合適性之認同度，以共變數分析發現不同性價值觀對自在感有顯著差異。本研究建議護理教育應將性議題納入護理基礎與在職教育課程，提供一系列之疾病、性議題與性諮詢概念與技巧課程，並建立跨領域專業合作模式，藉由護理專業連結不同專業領域的人，傳達性的多層面與整體性概念的健康照護，以降低對性諮詢的不自在感與專業角色衝突，提升護理的競爭力與完整性。

The purpose of this study was to investigate the nurses' perspectives and their current practice on sexual consultation. A total of 290 nurses were purposely selected from a medical system hospital in northern Taiwan. The results found that 77.9% of the nurses seldom had or never provided nursing assessment on sexual health, and 43.1% seldom discussed patients' sexual difficulties with them. Regarding the nurses' attitudes discussing sexual difficulties, about 74.8% of nurses would talk with the patients only when the patients proposed to do so but only about 58.3% of nurses experienced patients' requests for discussion of sexual difficulties. By using ANOVA, the result indicated that nurses with older ages, more clinical experiences, higher education, or relevant sexuality courses training showed more comfortableness, higher responsibility, and professional role appropriateness on sex consultation. Moreover, through the use of ANCOVA, the study revealed that nurses' sexual values had significant impacts on their comfortableness. Therefore, nursing education should (1) provide more sexuality curricula on the subjects of diseases, sex issues, and the concepts and skills of sexual consultation, and (2) build the cross-disciplinary collaborations with experts in related fields to convey the holistic concept of multidimensional and integrated health care. This can reduce nurses’ uncomfortable feelings and their professional conflicts on sex consultation practice, and further enhance their competitiveness and integrality.