精神病患對性諮商需求與護理人員執行現況之初探

An Exploratory Study of Psychiatric Patients' Needs and Nurses' Current Practices Related to Sexual Counseling

本研究目的是探討精神病患對性諮商需求及護理人員提供性諮商現況，並進行個人屬性差異性的了解。以北部某精神科專科醫院182位精神科住院病患及44位臨床護理人員做為研究對象。結果發現：有高達63.2%的精神病患未曾被提供有關性方面的訊息；在護理人員提供性諮商角色方面，81.9%的病患指出未曾有護理人員與他們討論此議題，35.2%的病患認為「性」是心理問題，屬於隱私性問題，較希望與心理師討論，但也有33.5%病患希望能與護理人員討論。然而，病患討論性問題時最希望以單獨方式進行，在求助對象上較傾向尋求同性別醫療人員的幫助；教育程度較高者對如何表達性需求及精神疾病對性表達的影響等方面，比教育程度較低者呈現出較高的性諮商需求。女性護理人員之性價值觀較男性來得保守；已婚者、年齡較大者、或曾接受性學在職教育者在執行性諮商時呈現較高的自在感；曾有性學臨床經驗或性學在職教育者對護理在性諮商的責任感及專業角色合適性上認同度較高。期望未來能以此資料建立精神科臨床護理人員性諮商相關訓練及提供病患服務之參考。

The purpose of this study was to explore psychiatric patient needs and current nursing practice with regard to sexual counseling and to understand differences in individual patient characteristics. A total of 182 psychiatric patients and 44 psychiatric nurses were purposively selected from a mental hospital in northern Taiwan. Results revealed that 63.2% of subjects had not been given sexuality information and 81.9% had not been approached by nurses to discuss such issues. While 35.2% of study patients treated sexual issues as psychological or private issues that should only be discussed with psychologists, 33.5% expressed a desire to discuss issues related to sexuality with nurses. Even so, most subjects preferred to discuss sexual issues in a private way, and asked for assistance from same-gender professionals. Also, patients with higher education levels placed greater attention on the counseling topics of how to express sexual needs and the impacts of mental illness on sexuality. With regard to nurses participating in the study, female nurses had a generally more conservative attitude toward sexual values than males. Those who were married, older, or had received continuing sexuality education were more comfortable with conducting sexual counseling. Those with clinical experience and continuing sexuality education were able to take more responsibility and a more professional role in sexual counseling. Data collected on the specific subject groups in order to provide effective comparisons can be employed to refine current sexual counseling training programs for nurses in order to improve patient care.