The purpose of this study was to examine the level of comfort of 340 occupational therapy students during clinical interactions that have sexual implications. Participants completed the Comfort Scale Questionnaire to indicate their anticipated level of comfort. More than half of the students anticipated that they would not feel comfortable in dealing with sexual issues. The three items that students indicated as being most uncomfortable with were 'Walking in on a patient/client who is masturbating' (91.7%), 'Dealing with a patient/client who makes an overt sexual remark' (82.1%) and 'Dealing with a patient/client who makes a covert sexual remark' (77.2%). The three items which students felt relatively comfortable with were 'Homosexual male' (26.4%), '14-year-old female seeking contraception' (26.4%) and 'Handicapped individual who is inquiring about sexual options' (33.5%). At least half the senior students believed that their educational programme had not dealt adequately with sexual issues. Further research investigating the nature and origin of discomfort in clinical settings is recommended as well as research examining the effectiveness of sexuality education in increasing comfort in dealing with sexual issues in clinical settings.

SUMMARY This study examined the attitudes of 1132 higher education students enrolled in health profession education degree programs. Students were asked to indicate their anticipated level of comfort in a variety of interactions including working with a lesbian client or a homosexual male, and asking a client about his or her sexual orientation. Students also indicated whether they perceived their degree program had dealt adequately with these issues. High levels of discomfort were identified in our large sample of students. Approximately 30% of the sample indicated they would be uncomfortable working with a lesbian client and 27% of the sample indicated that they would feel uncomfortable if working with a male homosexual client. There were significant differences for these two items depending on the student's gender. Female students indicated significantly higher levels of comfort in dealing with homosexual male clients than did their male counterparts. Male students indicated significantly greater comfort in dealing with lesbian clients. More than half of our sample indicated that they would not be comfortable asking about a client's sexual orientation. Over 75% of senior-year students believed that their degree program had not adequately dealt with these issues. The impact of homophobia and discomfort on the quality of care health professionals provide for lesbian and gay clients and the role of educational strategies to reduce this are discussed.

No abstract