Sexual health and the practice nurse: a survey of reported practice and attitudes.

Background: Practice nurses have an important role in the provision of sexual health services in general practice.

Aim: This study set out to determine practice nurses' reported practice and training in sexual health, attitudes towards sexual health, barriers to discussing sexual health with patients, and training needs.

Method: A confidential self-administered postal questionnaire survey was sent to all 298 practice nurses in one English health district (Leicestershire).

Results: Completed questionnaires were returned by 234 practice nurses (response rate 79%). Most nurses routinely offered well-person checks (90%), cervical smears (89%), travel clinics (83%), saw women with genito-urinary symptoms (77%) and offered family planning advice (54%). Only a minority of nurses (13%) offered specific teenage health clinics. Sexual health issues were always discussed in a majority of consultations when giving family planning advice (65%) and in women with genito-urinary symptoms (58%). Most practice nurses (62%) had undertaken at least one course dealing with sexual health issues in the last 5 years. Uptake of training was, however, significantly lower in certain groups of nurses. An analysis of the attitude statements suggested that nurses were more comfortable discussing sexual health issues with female patients and teenagers than with male patients and those of different sexual orientations. Nurses who had received training reported more positive attitudes towards discussing sexual health issues with patients.

Conclusion: Practice nurses offer a wide range of services in which the need to be able to take a sexual history and offer appropriate advice is important. There is scope to improve the provision of sexual health services by nurses in general practice, particularly in relation to services for teenagers.