Self-reported benefits and risks of open water swimming to health, wellbeing and the environment: Cross-sectional evidence from a survey of Scottish swimmers.

Engaging with natural environments benefits human health by providing opportunities for social interactions, enhancing mental wellbeing and enabling outdoor spaces for physical exercise. Open water swimming has seen a rapid increase in popularity, partly due to the physical health benefits it can provide but also with the growing interest in (re)connecting with nature for environment-health interactions. Using a national-scale online survey of 717 open water swimmers, the aim of this study was to investigate patterns and trends in the perceived benefits and risks of open water swimming to both public health and the environment; and to understand whether these perceived risks and benefits vary across different typologies of swimmers and open water, or 'blue space', environments. Strong associations were found between the most important self-reported benefit associated with open water swimming and both participant age and the categorisation of their typical swim style. All but one of the age-groups surveyed perceived mental wellbeing benefits to be the most important benefit of open water swimming; whilst those aged over 65 identified physical rather than mental wellbeing benefits to be the most important outcome. Participants who preferred lake swimming reported greater concern regarding possible environmental damage caused by the increasing popularity of open water swimming compared to those engaging in river or sea swimming. However, the majority of participants perceived the risks to the environment from open water swimming to be minimal. Our study adds to the growing evidence that open water swimming is perceived by participants as benefitting their mental and physical wellbeing. Improved understanding of the benefits and risks of engaging with blue spaces used for open water swimming can contribute to co-designed policy development to promote safer, healthier and more sustainable outdoor recreation opportunities associated with this increasingly popular outdoor pursuit.

Discussing sexuality in health care: A systematic review.

AIMS AND OBJECTIVES: Using the PRISMA guidelines, a systematic literature review was conducted to explore current and relevant evidence regarding factors that influence nurses' provision of sexual healthcare education to patients. BACKGROUND: The World Health Organization and Healthy People 2020 emphasise the importance of sexual health care. Although the nursing profession has the ability to develop a competent level of sexuality education, sexual health care is often ignored in nursing care and education. Many nurses are failing to engage in meaningful conversations about sexual health with patients, and this could lead to negative health events. However, patients would like reliable and nonjudgmental access to education about sexual health. DESIGN: Electronic databases were searched for articles published between 2012-2017. Studies of nurses providing sexual health education in healthcare settings were included. The Melnyk and Fineout-Overholt (2015, Evidence-based practice in nursing & healthcare, Philadelphia, PA: Walters Kluwer) quality assessment framework was used. The researchers independently reviewed 532 studies and agreed upon ten to include in this review. RESULTS: Findings from this systematic review suggest that nurses' provision of sexual health education to patients is influenced by four factors: (a) a lack of knowledge about sexual health, (b) nurses' attitudes and beliefs that sexual health care is private and not a priority, (c) nurses' comfort discussing sexual health, and (d) perceived barriers related to time, responsibility and organisational support. CONCLUSION: The ten articles reviewed were all Level VI descriptive and qualitative studies, as defined by Melnyk and Fineout-Overholt (2015). It is evident that sexual healthcare information is not being widely addressed. To reduce stigma, the positive aspects of sexual health care must be promoted on multiple levels. RELEVANCE TO CLINICAL PRACTICE: Leaders in professional and community-based organizations should be on the forefront of making recommendations for nurses and practitioners, so they could improve their ability to provide sexual healthcare information to their patients.