[Applying Swanson`s Caring Theory to a Patient With End Renal Stage Disease Experiencing Hopelessness].

This article describes an experience providing nursing care to a patient under hemodialysis with the end-stage renal disease who had developed depression, loathing, and other, negative personal perceptions and gradually gave up on life goals due to hopelessness. The duration of nursing care, from August 23rd through August 29th, 2019, was revisited to identify the patient`s hopelessness in the dimensions of physiology, mental status, society, and spirituality. The author applied Swanson`s Caring Theory to facilitate the process of "knowing" and "being with" while performing direct nursing care and attentive listening to assist the patient to become more open-minded and to express personal perceptions toward the disease with the goal of further engaging the patient to increase self-awareness recognition, sense of loss, and negative perceptions. Through "doing for" and "enabling," the author reinforced infection control and identified the symptoms of fluid-overload, moisture, and salinity to raise the patient`s self-awareness and self-caring techniques and to lower the risk of hospitalization. Meanwhile, by "maintaining the patient`s belief," accompanied by the encouragement and attention from family members and providing linkages to patient-support communities, the patient was guided to identify and aggregate to foster positive thinking and self-worth to increase acceptance of living with the disease. Nursing personnel may apply Swanson`s Caring Theory to better consider the patient`s perspective, provide individual caring schemes, and strengthen the recognition, self-caring techniques and supportive systems of patients, increasing patient perceptions of self-worth, restoring their confidence, promoting their adaption to their disease, and improving attentiveness.

Undergraduate nursing education to address patients' concerns about sexual health: the perceived learning needs of senior traditional four-year and two-year recurrent education (rn-bsn) undergraduate nursing students in taiwan.

The aims of this study were to identify learning needs among traditional four-year and two-year recurrent education (RN-BSN) undergraduate nursing students in Taiwan with regard to patients' concerns about sexual health. A 24-item instrument (Learning Needs for Addressing Patients' Sexual Health Concerns) was used to collect data. Compared to RN-BSN undergraduate nursing students, traditional four-year undergraduate nursing students had more learning needs in the aspects of sexuality in health and illness (2.19 ± 0.66 vs. 1.80 ± 0.89, P = 0.005) and approaches to sexual health care (2.03 ± 0.72 vs. 1.76 ± 0.86, P = 0.033). After adjustment for other variables by the backward selection approach, those with experience in assessing patient's sexual functioning had fewer learning needs in sexuality in health and illness (ß = -0.375, P = 0.001), communication about patient's intimate relationships (ß = -0.242, P = 0.031), and approaches to sexual health care (ß = -0.288, P = 0.013); those who agreed that sexual health care was a nursing role also expressed greater needs to learn about these 3 aspects (all P < 0.01). Content related to sexuality in health and illness and approaches to sexual health care should be strengthened in the traditional undergraduate nursing curriculum in order to support sexual health related competence, build a positive attitude regarding sexual health care as a nursing role, and strengthen the experience of assessing patient's sexual functioning. A different, simplified program may be more suitable for those with clinical experience.

Nursing students' attitudes towards provision of sexual health care in clinical practice.

AIMS AND OBJECTIVES: To investigate nursing students' attitudes towards providing sexual health care in clinical practice and to identify associated factors. BACKGROUND: Sexual health care is an important component of holistic health care. Nurses' personal sexual knowledge and attitudes are shown to influence provision of sexual health care. DESIGN: This is a descriptive, cross-sectional study. METHODS: We selected 146 senior nursing students by convenience sampling from nursing schools in two medical universities in central Taiwan. Data were collected using the Nursing Attitudes on Sexual Health Care scale developed based on the 'Permission/Limited Information/Specific Suggestions/Intensive Therapy' model. Higher scores indicated more positive attitudes. RESULTS: Participants' mean age was 22.15 years. Mean total Nursing Attitudes on Sexual Health Care scores ranged from 45-75 (61.40 ± 10.17). Nursing students' most positive attitudes towards Permission/Limited Information/Specific Suggestions/Intensive Therapy sexual healthcare interventions were at the Permission level, and least positive attitudes were at levels of Specific Suggestion and Intensive Therapy. The top three positive items were as follows: accept patients' expression of sexual concerns, initiate discussions and encourage patients to talk. Male nursing students had negative attitudes towards sexual healthcare interventions, which became more positive as age increased, especially at the Limited Information level. CONCLUSIONS: Nursing students had different attitudes towards different levels of sexual health care in the Permission/Limited Information/Specific Suggestions/Intensive Therapy model. Attitudes were associated with age and gender. The Nursing Attitudes on Sexual Health Care scale is useful and reliable for identifying nurses' attitudes towards providing sexual health care. RELEVANCE TO CLINICAL PRACTICE: The Permission/Limited Information/Specific Suggestions/Intensive Therapy-based Nursing Attitudes on Sexual Health Care scale helps to identify nurses' attitudes. A better understanding of nurses' attitudes towards provisional sexual health care will provide information needed to develop appropriate education programmes to improve delivery of sexual health care.

The effect of design thinking approach in interprofessional education programme of human sexuality course: A quasi-experimental design.

AIMS: To determine the effect of design thinking approach in interprofessional education programme of human sexuality course. DESIGN: A pre-test and post-test of single-group quasi-experimental study. METHODS: The 35 nursing students and seven psychology students in their third year were selected by the computer randomly sampling through the lottery method. The course proceeded between September 2019 and January 2020. The participants had received an 8-week, 16-hr design thinking approach in interprofessional education programme of human sexuality course (one section per week, 2 hr per section). We used the nursing attitude toward sexual healthcare scale, nursing intervention toward sexual healthcare scale to assess students' attitude and behaviour intention toward sexual health care and competence of interprofessional education scale to assess students' competence of cooperation before and after the teaching programme. Data analysis used descriptive statistics and t-tests. A qualitative reflection log was also provided and analysed for themes. The SQUIRE-EDU checklist was followed. RESULTS: The students' attitude and behavioural intention dimension score in the post-test is higher than those in the pre-test and reach statistically significant differences both in total and subscale. Interprofessional core competence score of Observation Experience, Reflective Feedback, Interprofessional Cooperation, Innovative Design, and Applied Technology score in the post-test is higher than those in the pre-test and reach statistically significant differences both in total and subscale. Design thinking in interprofessional education programme of human sexuality course could significantly improve both nursing and psychology students' attitude, behaviour intention of providing sexual health care and competence of interprofessional cooperation.

Nursing interventions on sexual health: validation of the NISH Scale in baccalaureate nursing students in Taiwan.

INTRODUCTION: No widely accepted tool is available to assess nursing interventions on patient's sexual health among nursing students. Consequently, nursing school faculty cannot determine the sexual healthcare-related skills of nursing students. AIM: The aim of this article was to develop and test a scale to assess nursing interventions on sexual health. METHODS: A 19-item instrument Nursing Interventions on Sexual Health (NISH) was developed using 10 semi-structured interviews of senior nursing students, expert review, and comparative analysis of text and field notes. A total of 198 senior nursing students were recruited from two nursing schools in central Taiwan to test the instrument. Exploratory factor analysis (EFA) was used to measure construct validity and Cronbach's alpha to measure internal consistency. MAIN OUTCOME MEASURES: Validity and reliability of the NISH scale based on the Permission, Limited Information, Specific Suggestion, and Intensive Therapy (PLISSIT) model. RESULTS: Three factors (permission, limited information, and specific suggestion) were retained after EFA of the 19 items of NISH. Cronbach's alpha for the subscales increased from 0.71-0.93 to 0.74-0.94 and from 0.93 to 0.95 for the total scale, with 72.42% of the cumulative variance explained by these three factors. Nursing students' age (P=0.019) correlated positively with total score. CONCLUSIONS: NISH is a useful and reliable scale for assessing the frequency of PLISSIT-related behaviors used by nursing students to address patient's sexual health concerns. Nursing faculties can use this scale to assess students' performance and find their omitted behaviors in clinical practice regarding sexual health care.

Gender role moderates correlation between learning needs and behavioural intention of sexual health care in female nurses.

AIM: This study evaluated the correlation between learning needs and behavioural intention of sexual health care in female Registered Nurses and to assess the moderating effect of gender role on this relationship. DESIGN: In this cross-sectional questionnaire-based survey, a convenience sampling of female Registered Nurses was included from Chung Shan Medical University Hospital, Taiwan. METHODS: Three questionnaires were used to obtain self-reported data on learning needs, behavioural intention and gender role. RESULTS: Based on gender role scores, 11.8% of participants were feminine, 10.0% were masculine, 31.0% were androgynous and 47.2% were undifferentiated. Significant positive correlations between learning needs and behaviour intention were observed in the total population as well as in undifferentiated, feminine and androgynous nurses (all p < .05). Learning needs were positively associated with the behavioural intention of sexual health care in female nurses, which was moderated by gender role (F = 2.868, p = .036).

The Relationship Between Gender Role Orientation and Sexual Health Care in Taiwanese Nurses: A Structural Equation Model.

INTRODUCTION: Patients' sexual concerns are private, sensitive issues, and providing sexual health care (SHC) is a legitimate area of concern for the nursing practice. AIMS: This study tests a structural equation model for factors that affect SHC among Taiwanese nurses. METHODS: A cross-sectional study was performed between August 2014 and July 2015. A total of 471 registered nurses from a medical center in Taiwan were enrolled in this study. All nurses participated anonymously and completed 3 questionnaires: Nursing Attitude in Sexual Health Care scale, Nursing Intervention in Sexual Health scale, and Gender Role Orientation scale. The Permission-Limited Information-Specific Suggestions-Intensive Therapy model based on scale was application, and theory of planned behavior was used to examine the relationship of these 3 scales in nurses. MAIN OUTCOME MEASURES: SHC surveys were developed for nurses. These valid and reliable instruments included Nursing Attitude in Sexual Health Care, Nursing Intervention in Sexual Health, and Gender Role Orientation. RESULTS: The fitted structural equation model was valid. The construct reliability of latent variables ranged from 0.730 to 0.942, which met the requirement of 0.70. The attitude about SHC (ß = 0.182, P < .001), subjective norms on SHC (ß = 0.146, P < .001), and confidence about SHC (ß = 0.583, P < .001) had significant effects on the behavioral intention to provide SHC. Subsequently, the behavioral intention to provide SHC had a significant, direct effect on the behavioral frequency of providing SHC (ß = 0.356, P < .001). However, gender role orientation was not significantly associated with behavioral intention and behavioral frequency to provide SHC. CONCLUSIONS: The good fit for the structural equation model suggests that the predictors of behavioral intention and behaviors of providing SHC include attitude, subjective norms, and perceived control. The stronger behavioral intention of providing SHC resulted in a higher frequency of providing SHC. However, the relationship between gender role orientation and SHC had no significant effect. Huang C-Y, Liou C-F, Lee S-H, et al. The Relationship Between Gender Role Orientation and Sexual Health Care in Taiwanese Nurses: A Structural Equation Model. Sex Med 2020;8:565-573.

Correlation Between Needs Satisfaction and Behavioral Intentions of Sexual Health Care.

BACKGROUND: This study aimed to evaluate correlations between female nurses' needs satisfaction and behavioral intentions for providing sexual health care and to assess moderating effects of learning needs on that correlation. METHOD: A total of 300 female RNs were enrolled. Two validated instruments were used to collect information on participants' learning needs, needs satisfaction, and behavioral intentions for providing sexual health care. RESULTS: Adjusted multivariable regression analysis revealed significant moderating effects of medium and low learning needs on correlations between needs satisfaction and behavioral intentions (medium learning needs: ß = 0.282, 95% CI = 0.075, 0.490; p = .008; low learning needs: ß = 0.293, 95% CI = 0.033, 0.553; p = .027), while no moderating effect was observed in those with high learning needs. CONCLUSION: Needs satisfaction was significantly correlated with behavioral intentions of sexual health care in medium and low learning needs groups. [J Contin Educ Nurs. 2020;51(10):457-464.].

Differences in the Sexual Function and Sexual Healthcare Needs of Pregnant Women Who Underwent in Vitro Fertilization and Women Who Conceived Naturally at Each Trimester: A Prospective Cohort Study.

INTRODUCTION: Infertility may negatively impact sexual function. Women with fertility problems usually prioritize treatment for infertility, but their sexual function in each trimester of pregnancy is poorly researched. AIM: To compare the sexual function and sexual healthcare needs of women who underwent successful in vitro fertilization (IVF group) and women who conceived naturally (CN group) during each trimester. METHODS: Longitudinal prospective cohort study was conducted from August 2016 to July 2018. The IVF group (n = 100) was recruited from a leading reproductive treatment center; the CN group (n = 100), at the prenatal clinic of a medical center in central Taiwan. Questionnaires were mailed to women in the 10th-11th gestational week; 70 women in the IVF group and 75 in the CN group completed all 3 questionnaires, during the 10th-11th, 20th-21st, and 30th-31st gestational weeks. MAIN OUTCOME MEASURES: Female Sexual Function Index and Nursing Intervention on Sexual Healthcare needs were compared between groups in each trimester. RESULTS: Most participants reported sexual dysfunction concerns during pregnancy. In the first trimester, the Female Sexual Function Index score was significantly lower in the IVF group than in the CN group (18.13 ± 6.27 vs 20.34 ± 5.87, respectively; P < .05). Sexual healthcare needs at the permission level were significantly lower in the IVF group than in the CN group (10.78 ± 2.41 vs 11.79 ± 2.67, respectively; P < .05). CONCLUSION: The IVF group had lower sexual function in the first trimester than the CN group. Sexual function improved in the second trimester in the IVF group but decreased throughout pregnancy in the CN group. The CN group had a greater need for sexual healthcare nursing intervention at the permission level than the IVF group. Huang C-Y, Liou C-F, Lu Y-C, et al. Differences in the Sexual Function and Sexual Healthcare Needs of Pregnant Women Who Underwent In Vitro Fertilization and Women Who Conceived Naturally at Each Trimester: A Prospective Cohort Study. Sex Med 2020;8:709-717.

[Problems and their frequency, and emotional disturbances and needs among nurses providing sexual health education].

This study investigated the problems encountered by nurses delivering sexual health education, the frequency of occurrence of such problems, the types of emotional disturbances experienced by such nurses, and the needs of such nurses. Ninety urology nurses from six hospitals in northern Taiwan participated in this cross-sectional survey by completing a Problems and Needs in Sexual Health Education (PNSHE) questionnaire. Factor analysis showed that the PNSHE consisted of three dimensions: patient's response, environmental interaction, and nurses' self-preparation. Among 26 items listed as "difficult," nurses faced 23 (89%), at frequencies ranging from "half the time" to "often". They faced "moderate" degrees of emotional disturbance and "moderate" needs for assistance. Over all, Environmental interaction was the dimension which arose most frequently, caused the greatest degree of disturbance and prompted the greatest need for assistance among nurses. Nurses were frequently disturbed by the problem of "evaluating effects of sexual health education," and most needed assistance for "lacking suitable materials." Stepwise multiple regressions demonstrated that ability in providing sexual health education, years of nursing experience, and proactiveness in providing sexual health education were significant variables related to the frequency of the problems, accounting for 21% of the variance. Ability in providing sexual health education was significantly related to the degree of emotional disturbance, accounting for 6% of the variance. Ability in providing sexual health education and years of nursing experience were related to nurses' needs while providing sexual health education, accounting for 6% of the variance. The findings of this study provide information of problems and needs encountered by nurses while delivering sexual health education, and should also assist senior nurses in identifying educational courses and resources to develop competency in providing sexual education.

Assessing student nurses' learning needs for addressing patients' sexual health concerns in Taiwan.

BACKGROUND: Patients' health status may involve sexual issues and nursing education must prepare nurses to address patients' sexual health concerns. In Taiwan, nursing school curricula rarely include programs related to patients' sexuality or sexual health issues, and reflect conservative Asian attitudes toward sexuality. OBJECTIVES: Our aims were to determine Taiwanese student nurses' learning needs relative to addressing patients' sexual health concerns, and to gather information for curriculum development in sexual health education. DESIGN: Descriptive, correlational study. SETTING: Nursing school at a medical university in central Taiwan. PARTICIPANTS: 140 senior student nurses. METHODS: A 24-item instrument entitled "Learning Needs for Addressing Patients' Sexual Health Concerns" (LNAPSHC) was developed through 15 semi-structured interviews of senior nursing students, expert review, and comparative analysis of text and field notes. Content validity and reliability were evaluated using exploratory factor analysis to measure construct validity and Cronbach's alpha to measure internal consistency. Univariate and multivariate linear models were developed. RESULTS: Age, gender, and religion were not significant influences. Expressed learning needs included sexuality in health and illness, communication about patients' intimate relationships, and approaches to sexual health care. "Obtaining a comprehensive sexual health history" was the highest learning need. "Having sexual consultations with patients without embarrassment" was lower. Most participants recognized their role in sexuality-related health care, but their preparation and willingness to address it were limited. CONCLUSIONS: Our results indicated a gap between student nurses' positive perspectives on the role of nursing in sexual health care and their limited intention to provide it. Reported learning needs indicated that student nurses needed an effective curriculum to increase their ability and willingness to address patients' sexual health. Our results may help nursing educators develop curricula and clinical training to increase student nurses' competence in addressing patients' sexual health concerns.