The 5-As Framework for Including Sexual Concerns in Mental Health Nursing Practice

Abstract

Available evidence informs us that sexual health concerns of consumers are commonly avoided within mental health services. This paper describes the findings of a qualitative exploratory research project. This research was conducted in three stages, all involving in-depth interviews with 14 nurses working in a mental health setting. Stage 1 involved an exploration of participants' views about including sexual concerns in their practice and included an educational intervention designed to encourage sexual inclusivity in practice. Stage 2 involved follow up interviews 4-6 weeks later to discuss the effectiveness of the intervention and whether practice change had resulted. Stage 3 was conducted two years later with the aim of determining the extent to which practice changes had been sustained. The themes emerging throughout the research emphasised five main stages in the nurses' experience: avoidance; awareness; applying; approval; and acknowledgement. Avoidance of the topic was commonly noted in the early stages of the research. The education program led to awareness raising of sexual concerns and approval towards the importance of this area to which lead to applying it to practice. This ultimately resulted in acknowledgement of the need for sexual concerns to become part of mental health nursing practice. These five stages are represented in the Five A's for including sexual concerns in mental health nursing practice, the framework developed by the first author.

An exploratory investigation of sexual health screening in the first 12 weeks of case management in populations with severe mental illness

“…; Quinn & Browne ; Quinn et al . ). This article reports research that investigated sexual health screening in five community mental health clinics within a large regional mental health service in Victoria, Australia.…”

“…), and opportunities should be provided for consumers to discuss any sexual concerns or issues impacting their psychological health and wellbeing (Quinn et al . ).…”

“…; Quinn et al . ). At present there are no clinical practice guidelines that stipulate the frequency and type of sexual health screening that should be undertaken in case‐managed consumers with SMI, however De Hert et al .…”

“…From a quality perspective it follows that holistic mental health nursing care pertaining to sexual health should involve more than just physical health monitoring and assessment of side‐effects and risks; sexual health should incorporate a holistic approach (Quinn et al . ) that is mindful of the psychological wellbeing dimensions of sexuality (Quinn & Browne ; World Health Organization Department of Reproductive Health and Research ). It is not uncommon for physical and/or mental illness and treatment to adversely affect how people experience their physical body, and how their body responds sexually (McCann & Clark ; Williams et al .…”

Experiences and Perceptions of Nursing Staff Working With Long-Stay Patients in a High Secure Psychiatric Hospital Setting

“…Staff in our focus groups, however, were able to normalise the development of such strong attachments. The development of romantic feelings towards staff in secure settings has been described elsewhere (Quinn et al, 2013;Ruane & Hayter, 2008). It was encouraging to see that it appears possible to handle such situations with sensitivity that ensures that the patient does not feel uncom fortable in talking about this aspect of his or her experience.…”